PATTERNED OFFENDERS: HOMOSEXUAL EXPERIENCE

In all groups except the incest offenders, where the percentages are equal, the patterned offenders have definitely larger percentages of men with homosexual experience, ranging from 50 to 100 per cent. This is in part the result of a carry-over from their more extensive prepubertal homosexual activity.

The greater incidence of homosexual experience among the patterned offenders does not imply a greater quantity (beyond the one time necessary to be counted in incidence) or intensity of experience.

A tabulation of the proportions of men with substantial amounts of homosexual activity shows no consistent differences between the incidental and the patterned offenders. Evidently while the factors having to do with patterned offense behavior have some bearing on whether an offender ever had a homosexual experience, they do not determine whether or not he will go on to more extensive experience.

No significant differences exist in the ages at which the average (median) individuals had their first postpubertal homosexual experience. Neither does the frequency per year differentiate the incidental and patterned offenders in any uniform fashion.

Paralleling the incidence of homosexuality, in five of the six groups the patterned offenders were more neutral or approving in their attitude toward it than the incidental offenders. This is not surprising, since persons who engage in any sort of sexual activity are more apt to approve of it, or be tolerant of it, than those who do not.

*395\161\2*

STATUS OF OFFENDER AT TIME OF OFFENSE: MARITAL STATUS

In examining the degree to which various kinds of sex offenses were committed by offenders of varying marital status it is necessary first to take into consideration the differences in their age levels. Thus, while a high percentage of the peeping offenses (68 per cent) were committed by males who had never been married at the time of their conviction (twenty-three years), this phenomenon is certainly strongly related to their youthfulness. Table 139 presents the marital status of the offender at the time of committing the indicated offense. With the exception of the peepers, the three groups of homosexual offenders had the highest percentages of males who were still single at the time of the offense. The three homosexual-offender groups show no marked differences in their median ages when arrested.

Turning now to the remaining groups of offenses (except for incest), one finds that the percentage committed by men who were still single at time of offense is roughly related to the age-rankings presented earlier: the younger the age at offense the higher the percentage of never-married offenders. It is clear that in the present sample a large number of sex offenses were committed by men who had never been married. This is not unexpected. Many of these are males who had not yet settled down to the typically stabilized sexual patterns for their age and hence were apt to get into trouble. Also, their periods of incarceration often prevented them from getting married.

There is yet another group that lacked the stabilizing factor of marriage at the time of the offense, namely, men who had been previously married but who were currently separated, divorced, or widowed. The proportions of offenses committed by men in this marital status range from 4 to 40 per cent. However, if calculations are based on only the ever married, the proportion of offenses committed by separated, divorced, or widowed men rises from a low of 4 per cent in the incest vs. children offenses to a high of 82 per cent in the homosexual offenses vs. minors.

The incest cases vs. children and minors with fewest offenses by separated, divorced, or widowed men apparently represented offenders with a stable home pattern, although the incest cases vs. adults show that more than a quarter of the offenses occurred after the breakup of the marriage. The marriages of the homosexual offenders were clearly the least durable—in from three fifths to over four fifths of the cases the marriage had been interrupted before the offense. The remaining groups of offenses, comprising the majority, fall between the high-ranking homosexual and low-ranking incest classification.

One other point in connection with marital status is worth examining. It has sometimes been suggested that the temporary absence of a man’s wife from home might serve as a triggering circumstance for the sex offense. We checked the present data on this point, using as a criterion an absence of 24 hours or more, and found it to be a possible contributing factor in a small number of offenses, a total of 50 in all. While the wife’s absence is of minor importance as a possible causative factor from an over-all point of view, if we examine only men whose marriages were intact at the time of the offense, it can play a not inconsiderable role in several types of offense. This can be seen in Figure 25 in which such per cents range up to a high of 23 per cent in the offenses vs. adults.

In summary, for eight of the 14 types of sex offenses, from one fourth to one third of the offenses were committed by males who were married at the time. These eight groups include the heterosexual offenders, heterosexual aggressors, and the peeping and exhibition groups. In contrast to these eight, the three incest-offense groups showed a higher married ratio at the time of the offense, and the homosexual offenses a much lower proportion. All the varieties of offense except incest were preponderantly committed by men who cither were single or whose marriages were not currently intact.

*357\161\2*

EXTRAMARITAL COITUS: FREQUENCY

The median frequencies, calculated only for those with extramarital coitus, are surprisingly uniform up to age forty-five, lying between 4 a year and 20 a year in every age-period. In the late thirties and early forties this uniformity appears to be a case of the ends of the range remaining unchanged, while large gaps develop between groups. The control and prison groups behave differently from each other: the prison group in early life displayed a high frequency of extramarital coitus of nearly 20 per year, but this frequency dwindled to 5 per year by their early forties. The control-group frequencies held constant at 4 to 5 per year from age twenty-one on to forty-five; this is intermediate to low in the rank-orders. Little can be said regarding trends or clusterings: between ages twenty-one and thirty-five the incest offenders tend to concentrate in the lower portions of the rank-orders.

The median frequencies of extramarital coitus with companions are similar, but the positions of the various groups in the rank-orders change because certain groups were more predisposed than others to have extramarital coitus with prostitutes.

Average frequencies of extramarital coitus with prostitutes were almost always low: 3 to 5 per year. In only three instances were higher frequencies reported (the highest being 10 per year) and these were by numerically very small groups. Indeed, many frequency calculations were not made because there were too few males in the age-period with commercial extramarital experience.

*319\161\2*

MASTURBATION FREQUENCY

Studying the masturbation frequencies of the unmarried who masturbated, one finds that the homosexual offenders rank highest from puberty on. The homosexual offenders vs. adults lead, the homosexual offenders vs. minors are usually second, and the homosexual offenders vs. children fluctuate generally from second to fourth rank.” The control group occupies an intermediate position. The above statements apply to both mean and median frequencies. The lower portions of the rank-orders of frequency are monopolized by the incest offenders and the heterosexual offenders vs. adults and minors.

The position of the homosexual offenders is probably the narcissistic result of their being equipped with the genitalia of the sex they desire as sexual partners. In the case of the homosexual offenders vs. adults a second factor is strongly operative: a larger proportion of them are from the better-educated segment of the population, a segment characterized by great dependence upon masturbation as a sexual outlet.

The fairly high rank of the exhibitionists in adult years may be in part attributed to the fact that their exhibition often involved masturbation. On the other hand, their fourth rank from puberty to fifteen, a period usually prior to the emergence of their exhibitionistic pattern, suggests preoccupation with their genitalia in addition to reflecting their somewhat poor heterosexual adjustment at that age.

The groups with low masturbation frequencies might be explained in the following way. The low ranking of the heterosexual offender vs. adults is the consequence of his frequent sociosexual outlet; however, this explanation does not hold true for the incest offenders vs. children and minors. At present, the only explanation that presents itself is this: all incest offenders have low frequencies of total sexual outlet, and this is reflected in the masturbation frequencies.

The availability of coitus radically reduces the frequency of masturbation among married males. The average (median) husband in the control group masturbated about 10 to 15 times a year well into middle age, where our calculations cease because of sample size. His counterpart in the prison group had frequencies half as great. All the sex offenders except for the homosexuals and exhibitionists had frequencies of masturbation within the general limits set by the prison and control groups. The emphasis upon masturbation which typified the unmarried homosexual offender carried over to some degree into marriage where on an average he masturbated between 15 and 50 times per year, depending upon his age and to which homosexual-offender group he belonged. The married exhibitionist also had high masturbatory frequencies^—about 25 to 50 per year—some of this being, as we have said, in connection with his exhibition.

We asked every man we interviewed what was the maximum number of times that he had masturbated, after puberty, in any consecutive seven-day period. This question was an effort to gain some idea of the physiological capacity for repeated orgasm. By and large, we found that more homosexual offenders had high maximum frequencies than other groups (see Figure 5). The peepers also rate rather high; this in part is due to their frenetic outbursts of peeping plus self-masturbation. The groups which rate lowest in this respect are those characterized by extensive heterosexual activity (the offenders vs. adults being the prime example). The incest groups also rank low, not because of frequent heterosexual activity but because of their low sexual drive and/ or restraint, both being suggested by their low frequencies of total outlet prior to marriage.

*281\161\2*

EXHIBITIONISTS: CIRCUMSTANCES OF THE OFFENSE

The average exhibitionist was nearly thirty at the time of his first conviction for exhibition. A large number of exhibitionists were married at the time of the offenses—a total of 31 per cent, including 6 per cent whose wives were temporarily absent. Forty per cent had never married and 29 per cent were separated, divorced, or widowed. Having a sexual partner available apparently does not seriously lessen their exhibition. Like the peeper, the exhibitionist seldom chooses his wife or girl friends as objects of his offense behavior. The statistics are as follows: 92 per cent strangers, 5 per cent acquaintances, 2 per cent friends, and 1 per cent relatives.

They frequently had committed other sex offenses prior to their exhibition. Only 38 per cent of the exhibition convictions were their first sex offenses. Slightly over one quarter were second offenses; 13 per cent, third; 7, fourth; 6, fifth; and 10 per cent were sixth or more. Despite the exotic and symbolic nature of exhibition, only a relatively small proportion (3 per cent) of the exhibitionists had previous histories of mental difficulty. On the other hand, a substantial proportion (nearly one third) of the offenses involved drunkenness, and an additional 8 per cent involved mild to moderate intoxication.5 As usual, drugs were of no consequence. Only three offenses involved drug-users and none of them were using “heavy” drugs.

Like peeping, exhibition is virtually always done by one lone male. In only one offense were other males involved.

While a few (7 per cent) of the exhibition offenses were committed in a state of extreme drunkenness or other mental confusion, the great majority (86 per cent) were clearly premeditated. The remainder were to some degree opportunistic, the individual not having planned to expose himself but acting on sudden impulse.

Exhibition in nearly three fifths of the offenses took place out-of-doors. In almost another fifth the exhibitionist exposed himself from an automobile. In 11 per cent of the offenses the exposure was from a residence, the man generally standing before a window. The remaining places of offense are diverse and numerically unimportant.

Ordinarily data concerning the ages of the females involved are not available. Only when the females are subadult is age likely to be mentioned. We have a record of 30 offenses where the man exposed himself to girls aged eleven or under, and another 19 cases in which the girls were twelve to fifteen. All other cases of the total of 288 offenses may be presumed to involve chiefly adult females. The matter is, of course, complicated by the fact that some exhibitionists are exposing to the world in general or to the female sex in general. These are the men who the psychiatrists might say were attempting to prove their masculinity through genital display or who were expressing their hostility toward people or toward one sex. Even the exhibitionist who is aiming (in some cases literally) at a specific sort of female often must simultaneously expose himself to other nearby individuals or forego the opportunity completely. In this sense he is like the peeper who looks into a room and by definition is peeping upon whoever is in the room regardless of age or sex, although he would much prefer to find himself viewing a female of suitable age and physique. Again, like the peepers, most of the exhibitionists, except those with pedophilic interests, wish to and do expose to females whom society would construe as suitable sexual partners.

These offenders are singularly likely to be caught because they so frequently expose themselves in public and populous places; some even expose themselves from their own residences. We estimate that in slightly over one third of the offenses arrest was probable. In 44 per cent it was possible but not probable, and in 11 per cent arrest was unlikely.

The individual reporting the offense was predominantly the object or one of the objects of the exposure (48 per cent of the cases). In second place are persons to whom exposure was not made but who witnessed it (24 per cent). Friends or relatives of the females reported the offense in 12 per cent of the cases, and in a scattering of instances the police themselves were the original witnesses (7 per cent) or discovered the matter in the course of other investigation (8 per cent).

Our data are not so complete as we would like, but it would seem that the great majority of exhibitionists are in (or achieve) a state of penile erection while exposing their genitalia. A small but still substantial number reach orgasm through self-masturbation while exhibiting.

Almost two thirds of the offenses were fully admitted to the authorities, and nearly three quarters were so admitted to our interviewers. Slightly over 2 per cent of the offenses were allegedly so beclouded by drunkenness or emotional upset that the man could neither affirm nor deny his guilt. Seventeen per cent of the offenses were denied to the authorities and 7 per cent to us. Qualified admissions constituted a uniform 16 to 17 per cent.

The final legal pleas run as usual: 77 per cent guilty, 19 per cent not guilty, and 4 per cent no plea.

*242\161\2*

STD: TESTING FOR MUCOPURULENT CERVICITIS

The symptoms of MPC may be vague, and it may be difficult to diagnose based on history alone. Therefore a pelvic examination is necessary to diagnose MPC. Many women mistakenly believe they are being tested for infections when they have a Pap smear, which is the screen for cervical cancer (see the section on genital warts). A Pap smear may sometimes reveal changes consistent with herpes or trichomonas infection, but the real purpose of a Pap smear is to screen for cervical cancer, and specific tests must be performed to determine the causes of MPC.

The diagnosis of MPC is made based on characteristic observations during the examination and under the microscope. On examination, a discharge may be noticed; it will be examined under the microscope to help determine if it is coming from the cervix or the vagina. The cervix may show some telltale signs of infection, such as easy bleeding when it is swabbed, emission of pus from the opening (the os), and excessive redness. On examination of the cervical discharge under a microscope, numerous white blood cells can be seen. Occasionally, gonorrheal organisms can also be seen under the microscope (as noted, gonorrhea is one cause of MPC). Cultures may be performed for specific bacteria. The health care provider will also determine whether there is infection higher up in the pelvic organs.

*353\213\8*

STD HERPES: THE RANGE OF SYMPTOMS

Herpes symptoms range from no symptoms at all in some people to painful ulcers or blisters (the classic symptoms) in others. More subtle symptoms include red, itchy, or tingling areas; red bumps or pimple-like bumps; and tiny slits or “scratches.” First infections with herpes tend to cause more severe symptoms than recurrences, but as mentioned previously, some people have no symptoms when they become infected, so there are exceptions to this generalization.

Lesions on skin surfaces—such as the face; the penis, pubic area, buttocks, and scrotum for men; and the outer labia, buttocks, or pubic area for women—usually form a scab as they heal. However, lesions that are on mucosal surfaces—such as the anal area, inner labia, vagina, or urethra—do not form a scab as they heal. These lesions usually do not leave a scar. Symptoms usually last for a few days and then clear up.

Other symptoms may accompany the sores, or the sores may be the only symptoms of an outbreak. Lymph nodes in the groin may swell and be painful when a person has a genital herpes recurrence, or those in the neck may enlarge during an oral herpes recurrence. Other possible symptoms are headache, back pain, leg pain, stiff neck, sore throat, heightened sensitivity of the eyes to light, and a feeling of being tired and achy all over, similar to the experience of having the flu.

Some unusual symptoms that can occur in the genital area are numbness or increased sensation in the genital area or lower back, weakness or tingling in the legs, and constipation. These symptoms tend to be more common with the first infection, but they may also occur in future outbreaks. With genital herpes, a woman may experience a vaginal discharge or pain during urination. A man with a herpes infection may feel burning during urination, with or without discharge, and without lesions.

*260\213\8*

STD EPIDIDYMITIS AND PROSTATITIS: WHAT ARE THE SYMPTOMS?

Epididymitis

The symptoms of epididymitis are scrotal pain, redness, and swelling, usually on only one side. The pain can be severe. There may be symptoms or evidence of urethritis, such as burning with urination and discharge. These symptoms may be subtle or not present at all, even if urethral infection is present, and they are more common in men whose epididymitis has a sexually transmitted cause. In older men there may be history of a change in the urinary stream and evidence of a bladder infection, such as pressure in the bladder and burning with urination. The symptoms are usually gradual in onset but can occur suddenly.

Prostatitis

Prostate infections are usually classified as acute or chronic. Acute infections produce severe symptoms of fever, chills, fatigue, difficulty urinating, increased frequency of urination, and sometimes the inability to urinate. Chronic prostatitis produces these same symptoms, but they are more subtle, and there may be no symptoms at all. Most men with chronic prostatitis experience difficulty urinating, “dribbling” after urination, and more frequent urination. Sometimes there is a dull pain between the scrotum and the anal area, in the region known as the perineum. Occasionally there are pain with ejaculation and blood in the semen.

Often the pain of prostatitis is made worse by standing. In addition, depending on the underlying cause of the prostate inflammation, there may be symptoms of either a bladder infection or a urethral infection. Some men have epididymitis and prostatitis at the same time.

*168\213\8*

WHY IT IS SO HARD TO TALK ABOUT SEXUAL HEALTH AND STDS: ALCOHOL AND DRUGS

Alcohol and drugs make it harder to make decisions and often lead to risky behavior—such as driving too fast or spending the night with a relative stranger. The combination of not thinking clearly and being in situation in which sex is involved can make a person very vulnerable. It’s hard, in such a situation, to ask questions or practice safe sex, or even to remember that a person can become infected with an STD from a single unprotected sexual contact. If you have a problem with drugs or alcohol, seek help and counseling.

pare yourself to respond in a way that produces the best outcome for you. If you are in a relationship with someone who contributes to remember that a person can infected with an STD from a single unprotected sexual contact. If you have a problem with drugs or alcohol, seek help and councellings.

*75\213\8*

OTHER RISK FACTORS OF PROSTATE CANCER: LOCALE

Does where you live affect your chances of getting prostate cancer? Actually, yes—suggest the results of a recent study of prostate cancer and geography.

The theory behind the study was that insufficient levels of vitamin D, a hormone known to have anticancer properties, may increase a man’s risk of getting clinical prostate cancer. What’s the biggest source of vitamin D? Everyday exposure to the sun’s ultraviolet rays. The researchers looked at geographic distribution of the sun’s ultraviolet rays and the number of prostate cancer deaths throughout the country. Their results were startling. They showed a striking north-south pattern, with the heaviest areas of prostate cancer death in the north and the lightest areas in the south. (This despite the fact that the

south has a higher concentration of older men than other parts of the country. Data were age-adjusted; using this method, researchers can compare different groups as if the populations had the same underlying age distribution.) But when they looked at sunlight exposure, they found just the opposite—the heaviest exposure in the south, and the least in the north. Areasgetting the least UV radiation had the most prostate cancer, and vice versa. Their conclusion?

Ultraviolet radiation may protect men from getting clinical prostate cancer. And vitamin D, called a tumor inhibitor, somehow slows or prevents incidental prostate cancer from becoming clinical. (If you live in Alaska, or spend most of your time indoors, don’t panic. More work needs to be done to confirm this theory, and as yet, having an inadequate supply of vitamin D has not been established as a definite risk factor for prostate cancer.)

These findings might help explain why prostate cancer death rates are highest in Scandinavian countries, Canada, and the United States, and lowest in Hong Kong and Japan. Also, the Japanese diet is rich in fish that contain vitamin D.

These findings also might help scientists understand why black men in this country are so susceptible to prostate cancer: People with dark skin absorb less sunlight and thus have lower levels of vitamin D. African scientists compared blood levels of vitamin D in black men in Zaire with Zairian black people living in Belgium and found significantly lower levels of vitamin D in those who had left sun-drenched Zaire.

*29\201\8*