SexualitySexuality

Thanks to the complementary expertise of its authors, Human Sexuality, second edition, by Simon LeVay and Sharon Valente, is an exceptional book that addresses nearly every aspect of sexuality from multiple theoretical, historical, and cultural perspectives. Valente holds a doctorate in counseling psychology and has taught human sexuality at the undergraduate level since the 1990s, while LeVay is an acclaimed neuroscientist who now devotes most of his time to writing about sexuality. Although their book is intended for an undergraduate course in sexuality, it is also eminently suitable for use in medical school and residency. Not only does it provide a strong foundation in the physiological and psychosocial aspects of sexuality, it does so in such a compelling manner that I feel confident that even my students in the throes of the demanding first year of medical school will put aside their gross anatomy and biochemistry texts long enough to read the assigned chapters.

This book stands out because it goes beyond the standard material and presentation in several ways. The first chapter normalizes sexuality in the academic curriculum and demonstrates that many aspects of human sexuality are amenable to rational inquiry and critical analysis. This chapter lays down a model for thinking critically about the complex issues raised in the study of human sexuality. Biological issues are addressed next (eg, evolution, development, anatomy, and physiology), before moving on to biopsychosocial issues (eg, gender, attraction and arousal, relationships, sexuality across the lifespan). The origins of sexual orientations are explored in the chapter on sexual attraction and arousal, allowing a separate chapter, “Sexual Minorities,” to focus not on what causes people to become gay, lesbian, bisexual, or transgendered but rather on the personal and social significance of belonging to such a group. The discussion of intersexuality, which also appears in this chapter, concisely and poignantly frames the social and ethical issues that come into play in the current debate regarding medical management of disorders of sexual differentiation.

The emphasis of the chapter “Atypical Sexuality,” which includes the paraphilias, differs a bit in this edition from that in the first. The revised chapter pays more attention to what defines pathological sexuality and reflects more of the authors' view that the majority of atypical sexualities are not indicative of psychopathology. The next series of chapters addresses sexual problems, including disorders of desire and performance, sexually transmitted diseases and sexual assault, harassment, and partner violence. There is greater discussion than in the first edition of the social and relationship issues within which sexual dysfunctions are embedded. The final chapter, “Sex as a Commodity,” deals frankly with pornography, prostitution, and sex in the mass media.

As in the first edition, the engaging illustrations draw the reader into the text. Well-organized and colorful figures and tables appear on almost every page, and dispersed throughout the text is a multitude of photographs, often of familiar faces from history, entertainment, or news media. These photographs put a human face on areas of sexuality often perceived as esoteric and bring them into the realm of everyday experience. In addition to integrating a surprising number of recent scientific updates, the second edition has been revised in a number of ways that make it even more effective and user friendly than the first edition. The margins now contain a running glossary of terms as they appear in the text, which allows a quick review of the concepts covered in each chapter. There has been slight reorganization of the material, and some of the more detailed technical information has been shifted from the book to its Web site. The Web site presentation facilitates learning of this technical material by requiring the reader to systematically go through it frame by frame. In addition to the media supplements for students, a variety of aids are also available for instructors, including two ready-to-use PowerPoint presentations for each chapter.

The study of human sexuality, like application of the biopsychosocial model in the practice of medicine, benefits from a broad perspective and an open mind. While this book does not deal explicitly with physician insensitivity and other barriers to health care faced by sexual minorities and individuals with sexual problems, it provides a solid foundation for understanding sexuality and offers a perspective that will serve medical students and health care professionals well in sensitively addressing the sexual concerns of their patients.