Would You Say You “Had Masturbated” If … ?: The

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Jan 23, 2017 - Would You Say You “Had Masturbated” If … ?: The. Influence of Situational and Individual Factors on. Labeling a Behavior as Masturbation.
The Journal of Sex Research

ISSN: 0022-4499 (Print) 1559-8519 (Online) Journal homepage: http://www.tandfonline.com/loi/hjsr20

Would You Say You “Had Masturbated” If … ?: The Influence of Situational and Individual Factors on Labeling a Behavior as Masturbation Allison L. Kirschbaum & Zoë D. Peterson To cite this article: Allison L. Kirschbaum & Zoë D. Peterson (2018) Would You Say You “Had Masturbated” If … ?: The Influence of Situational and Individual Factors on Labeling a Behavior as Masturbation, The Journal of Sex Research, 55:2, 263-272, DOI: 10.1080/00224499.2016.1269307 To link to this article: https://doi.org/10.1080/00224499.2016.1269307

Published online: 23 Jan 2017.

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THE JOURNAL OF SEX RESEARCH, 55(2), 263–272, 2018 Copyright: © The Society for the Scientific Study of Sexuality ISSN: 0022-4499 print/1559-8519 online DOI: 10.1080/00224499.2016.1269307

Would You Say You “Had Masturbated” If … ?: The Influence of Situational and Individual Factors on Labeling a Behavior as Masturbation Allison L. Kirschbaum Department of Psychological Sciences, University of Missouri–St. Louis

Zoë D. Peterson Department of Psychological Sciences, Center for Trauma Recovery, University of Missouri–St. Louis The term masturbation is often not clearly defined despite its prevalent use in sex education, sex research, and clinical settings. The purpose of this study was to understand what behaviors are typically considered to be masturbation as well as the situational and individual variables that may affect the labeling of a behavior as such. An online study of 564 individuals demonstrated that a wide variety of behaviors were considered to be masturbation by a majority of participants. No difference was found between men and women in the total number of behaviors labeled as masturbation. Both men and women were more likely to label a behavior as masturbation (1) if there was no sexual partner present than if there was and (2) if an orgasm occurred than if it did not. In addition, women were more likely than men to label a behavior as masturbation if they were alone and if no orgasm occurred. Younger age was associated with labeling more behaviors as masturbation, but sexual identity, self-pleasuring experience, partnered sexual experience, and attitudes toward masturbation were not related to the number of behaviors labeled as masturbation. Results speak to the importance of behavioral specificity when discussing masturbation with students, clients, and in sex research. Masturbation is an important topic for many sexual health professionals. Sex researchers investigate the masturbation behaviors and attitudes of participants, sex educators discuss masturbation with their students, and mental and physical health practitioners discuss masturbation as a function of sexual health with patients. However, in these situations, masturbation often is not defined in behaviorally specific ways. If research subjects, students, and patients differ from sexual health professionals in regard to which behaviors they label as masturbation, then their communication with sexual health professionals about the concept may be unclear. To our knowledge, no published study to date has investigated what behaviors people typically consider to be masturbation; however, prior research has suggested that individuals vary in their application of other sexual labels. For example, in one study investigating what behaviors U.S. college students Correspondence should be addressed to Allison L. Kirschbaum, University of Missouri–St. Louis, Psychological Sciences, 325 Stadler Hall, One University Blvd., St. Louis, MO 63121-4499. E-mail: [email protected] Color versions of one or more of the figures in the article can be found online at www.tandfonline.com/HJSR.

regard as having “had sex,” considerable variation was apparent in students’ use of the label (Sanders & Reinisch, 1999). Almost everyone in the study (99.5%) agreed that penilevaginal intercourse counted as sex, and very few individuals (2%) thought that deep kissing counted as sex. However, there was substantial disagreement about other behaviors, with 40% identifying oral sex as sex and 81% identifying anal sex as sex. These findings have been replicated in the United Kingdom (Pitts & Rahman, 2001), Canada (Randall & Byers, 2003), and Australia (Richters & Song, 1999). A comparable lack of agreement also has been found in gay men’s labeling of behaviors as sex (Hill, Rahman, Bright, & Sanders, 2010). Similar variability in labeling has emerged in studies investigating the terms sexual partner (Cecil, Bogart, Wagstaff, Pinkerton, & Abramson, 2002; Randall & Byers, 2003; Trotter & Alderson, 2007), virginity loss (Carpenter, 2001; Trotter & Alderson, 2007), unfaithful sexual behavior (Randall & Byers, 2003), abstinence (Goodson, Suther, Pruitt, & Wilson, 2003), unprotected sex (Wynn, Foster, & Trussell, 2010), and rape (Peterson & Muehlenhard, 2004). The variability in individuals’ labeling of sexual behaviors raises concern about the validity of sexual self-report measurement; for example, if a clinical or research

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questionnaire asks about the number of “sexual partners” an individual has had without explicitly defining that term, then some individuals may include only vaginal intercourse partners, whereas other individuals may include any partner with whom there was genital contact. Of course, this problem could arise with nonsexual self-report measurement as well; however, it may be a particular concern for sexual selfreports. As Foucault (1978) noted, sex is frequently— almost obsessively—discussed within society but usually in indirect, medicalized, and regulated ways; in other words, the language of sex has been controlled by scientists and physicians. If sexual language is allowable only in clinical discourses and not in common social discourses (where it is often taboo), then there may be limited opportunity for lay individuals to create shared meanings of sexual terminology. Thus, if sexual terms are not clearly defined, survey participants may use their own idiosyncratic definitions when responding, and researchers may over- or underestimate the sexual experiences of their respondents. Masturbation research may be one area of sexual science that is impacted by this problem because masturbation is often not behaviorally defined in the literature. When measuring self-pleasuring behavior, researchers typically ask participants simply “How often do you masturbate?” (Bacak & Stulhofer, 2011; Dosch, Rochat, Ghisletta, Favez, & Van Der Linden, 2016; O’Connor et al., 2008) or “When, if ever, was the last time you masturbated?” (Carvalheira & Leal, 2013). Such questions assume that all participants define masturbation the same way, an assumption that may lead to inaccurate conclusions. To make things even more confusing, some researchers and laypeople use the term masturbation to describe partnered manual-genital sex (“masturbating a partner”; e.g., Galletly, DiFranceisco, & Pinkerton, 2009; Heilborn & Cabral, 2013; Reysen, Shaw, & Brooks, 2015); in this use of the term, masturbation does not even refer to self-pleasuring behavior and instead addresses sexual stimulation of a partner. Historically, masturbation has been medicalized and pathologized by health professionals who have associated masturbation with guilt, shame, anxiety, sin, disease, moral corruption, impotency, blindness, insanity, and even death (Laqueur, 2003). Bennett and Rosario (1995) postulated that masturbation’s recent social status is one of contradiction: It is both a frequently occurring topic within popular culture as well as a taboo subject for everyday conversation. This is consistent with Foucault’s (1978) idea that sexual language is shaped and controlled by those with cultural power and unavailable to those with less power. Perhaps because of these cultural contradictions, Gagnon and Simon (1973) observed that masturbation in adolescence is often experienced as “powerful” and “novel”; yet, there are no shared instructions, discourses, or “places for performance” for masturbation (p. 39). In other words, there is no commonly shared social script for the act of masturbation. Given the lack of shared social script for masturbation, it is likely that individuals will differ substantially in terms of which behaviors they label as masturbation. Also, because 264

there is no single definition of the term masturbation, how an individual applies the term may be determined by individual variables (such as demographics and past experiences), attitudes toward masturbation, and situational factors (such as whether an orgasm occurs and whether the person is alone).

Individual Factors Potentially Associated With Labeling Behaviors As Masturbation Different behaviors may be labeled as masturbation depending on individual characteristics. For example, gender has been associated with the labeling of other sexual behaviors. Although one study found that women label more behaviors as sex than men (Trotter & Alderson, 2007), the bulk of research has found that men label a larger number of sexual behaviors as sex than women do (Bogart, Cecil, Wagstaff, Pinkerton, & Abramson, 2000; Gute, Eshbaugh, & Wiersma, 2008; Pitts & Rahman, 2001; Richters & Song, 1999; Sanders & Reinisch, 1999). If such a pattern extends to the term masturbation, then we would expect that men would label more behaviors as masturbation than women. Further, the shared cultural understanding of masturbation as a typical (albeit secret and guilt-laden) behavior for adolescent boys but a discouraged behavior for girls constructs the act as gendered, arguably leading to lower frequencies of the behavior being observed in women (Gagnon & Simon, 1973). Thus, we might expect that men would be more inclusive in terms of the behaviors that they label as masturbation as compared to women, who perhaps have had more limited exposure to different types of self-pleasuring. Age also has been shown to be associated with the application of sexuality-related terms, with older participants typically applying sexual labels to more behaviors than younger participants (Randall & Byers, 2003; Richters & Song, 1999). However, studies that found an association between older age and more behaviors labeled as sex have typically relied on college student samples, meaning that the age ranges of the samples are quite truncated. In one study that included participants ages 18 to 96 years, for men, those in the youngest (ages 18 to 29) and the oldest age groups (ages 65 and over) labeled the fewest behaviors as sex; there were no differences as a function of age for women (Sanders et al., 2010). In prior research, sexual minority (i.e., gay-, lesbian-, and bisexual-identified) participants have tended to label a wider range of sexual behaviors as sex compared to heterosexualidentified participants, although the differences are typically fairly small (Horowitz & Spicer, 2013; Richters & Song, 1999). This finding is rather unsurprising, because if sex is defined very narrowly as only penile-vaginal intercourse, then sex between same-sex partners becomes impossible. It also may be the case that, because individuals who do not identify as heterosexual are already sexual outsiders by nature of their sexual minority status, on average, sexual

WOULD YOU SAY YOU “MASTURBATED” IF … ?

minority individuals may tend to view sexual concepts in a more flexible, open-minded way than heterosexual individuals; if that is the case, then we might expect that sexual minority individuals would label more behaviors as masturbation than sexual majority (i.e., heterosexual) individuals. In addition, level of sexual experience has been shown to be related to participants’ application of sexual terms. For example, Bogart et al. (2000) found that individuals who had engaged in oral sex were less likely than individuals who had never engaged in oral sex to indicate that a hypothetical actor would label oral sex as sex. Randall and Byers (2003) similarly reported that participants with more sexual experience labeled fewer behaviors as sex than those with less sexual experience. Participants’ experience with self-pleasuring may influence labeling of behaviors as masturbation in a similar way, such that more partnered and solo sexual experience may lead to labeling fewer behaviors as masturbation.

Attitudinal Factors Potentially Associated With Labeling Behaviors As Masturbation Sexual values and attitudes also have been shown to influence participants’ application of sexual terms. For example, Byers, Henderson, and Hobson (2009) found that, compared to male participants with more liberal sexual values, male participants with more conservative sexual values tended to hold a narrower definition of the term abstinence (meaning that, inversely, an individual could engage in a larger number of behaviors while still maintaining abstinence). The authors speculated that subscribing to narrow definitions of abstinence likely allowed the sexually conservative men to maintain their “technical virginity” while still engaging in some sexual exploration (p. 670). This is consistent with other research showing that labeling behaviors as sex is often determined by individuals’ motivations as well as their definitions of the term (Peterson & Muehlenhard, 2007). Using this logic, we might expect that individuals with more conservative sexual attitudes and values—and thus more negative attitudes about masturbation—might hold narrower definitions of the term masturbation (meaning that they would label fewer behaviors as masturbation); a narrower definition might permit more selfpleasuring options while still allowing the sexually conservative individual to avoid engaging in a behavior that he or she would label—and thus condemn—as masturbation.

Situational Factors Potentially Related To Labeling Behaviors As Masturbation Whether a behavior is labeled as masturbation also may depend on situational characteristics, such as whether orgasm occurs. Multiple studies have found that participants are more likely to label a behavior as sex if one or more partners experiences orgasm than if neither experiences orgasm (Pitts & Rahman, 2001; Randall & Byers, 2003; Richters & Song,

1999; Trotter & Alderson, 2007). More specifically, Sanders et al. (2010) found that participants were less likely to label penile-vaginal intercourse as sex if the item specified that the man did not have an orgasm (a) than if the item specified that the woman did not have an orgasm, or (b) than if there was no information about orgasms provided in the item. Male orgasm and ejaculation are often considered defining features of heterosexual sex (e.g., McPhillips, Braun, & Gavey, 2001); in fact, male orgasm is often thought to serve as a marker of the end of sex (Jackson & Scott, 2002). Because male ejaculation offers a visible marker of orgasm and because gendered stereotypes promote the idea that men are more sexually desirous and agentic than women, male orgasm may have greater cultural significance in definitions of sex than female orgasm (Jackson & Scott, 2002). Given the importance of orgasm in labeling behaviors as sex, orgasm also may be an important influence on whether a behavior is labeled as masturbation. Indeed, there is a strong history of tying masturbation to orgasm in research and clinical literature. Beginning with Kinsey and colleagues (Kinsey, Pomeroy, & Martin, 1948; Kinsey, Pomeroy, Martin, & Gebhard, 1953), many researchers interested in prevalence and correlates of masturbation have assessed masturbation experiences by asking participants if they have “masturbated to orgasm,” implying that self-pleasuring without orgasm does not meet their research definition of masturbation. Clinically, masturbation has long been prescribed as a treatment for orgasmic dysfunction (Heiman & LoPiccolo, 1987; LoPiccolo & Lobitz, 1972). Given that many sexual health professionals seem to view orgasm as inseparably intertwined with masturbation, it might be expected that the presence of orgasm would be a central component of lay definitions of masturbation as well. Self-pleasuring behavior also can occur alone or in the presence of a sexual partner (e.g., in the case of mutual masturbation). Whether there is someone else present during self-pleasuring may influence whether individuals think of the behavior as masturbation. Interestingly, Randall and Byers (2003) found that only 3.7% of respondents labeled “mutual masturbation” as sex, but Trotter and Alderson (2007) found that 20% of men and 17% of women labeled “masturbating in each other’s presence” as sex (p. 17). Although self-stimulation in the presence of a partner apparently does not fit most individuals’ definition of sex, the question remains as to whether it fits most individuals’ definition of masturbation.

The Current Study To provide more clarity within research, education, and health care settings, it is important to understand what behaviors people generally consider to be masturbation. Based on research demonstrating individual differences in applications of other sexual terms, we expected that respondents would hold diverse ideas about which behaviors qualify as masturbation. We also expected that labeling of 265

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behaviors as masturbation would be influenced by individual factors, attitudinal factors, and situational factors. More specifically, we predicted the following: H1: Individual factors such as participant gender, age, sexual identity, and level of sexual and masturbatory experience will be related to the number of behaviors participants label as masturbation such that (a) men will label more behaviors as masturbation than women; (b) age will be positively correlated with the number of behaviors labeled as masturbation; (c) sexual minority participants will label a larger number of behaviors as masturbation than heterosexual (sexual majority) participants; and (d) amount of self-pleasuring and partnered sexual experience will be negatively correlated to the number of behaviors labeled as masturbation. H2: The number of behaviors participants label as masturbation will be related to attitudes about masturbation, such that more negative attitudes toward masturbation will be associated with fewer behaviors labeled as such. H3: The number of behaviors individuals label as masturbation will depend on situational factors such that (a) participants will label more behaviors as masturbation when an orgasm is experienced than when it is not; and (b) participants will label more behaviors as masturbation when the self-pleasuring occurs alone than when it occurs in the presence of another person.

Method Participants Male and female participants were recruited through Amazon’s Mechanical Turk (MTurk) website and were paid $1 to complete the survey. The project was described as a study of “sexual attitudes and behaviors.” Due to the subject matter included in the survey, the survey had to be labeled as containing adult content. Participants were directed to the online survey, where they first read and agreed to an informed consent statement. Next, participants completed demographic questions, after which they were directed to complete all study measures. Participants were required to be at least 18 years of age and to reside within the United States in order to access or complete the survey. Participants (N = 568) were 309 men, 254 women, 2 transgender women, 2 transgender men, and 1 “other” gender. Participants ranged in age from 18 to 74, with a mean age of 33.7 years (SD = 10.9). In all, 20% of participants reported being currently enrolled in college. The mean number of years of education was 14.9 (SD = 2.43). The majority (52.2%) of participants identified with no religion. Participants were asked to check all racial categories with which they identified: the majority of participants (80.6%) identified as White/European American, with 9.5% identifying as Black/African American, 6.9% as Asian/Asian American, and 6.0% as Hispanic/Latino/ 266

Latina. Regarding work, 53% of participants reported being currently employed in full-time jobs. The most frequently reported category for relationship status was single and never married (40.8%), and most participants identified as straight/ heterosexual (87.9%). Measures Measures for the study were completed in the order presented here. Demographics. Participants completed a questionnaire assessing gender, age, race/ethnicity, relationship status, sexual identity, education, and income. Masturbation Labeling Scale. We developed this measure based on previous research and attempted to highlight masturbatory behaviors measured in other studies (Carvalheira & Leal, 2013) and described in clinical literature (Heiman & LoPiccolo, 1987). The scale measured which behaviors participants label as masturbation. Similar to the wording in Sanders and Reinisch (1999), the scale began with the question, “Would you say you ‘had masturbated’ if the only behavior you engaged in was … ?” and was followed by statements such as “You touched or stroked your genitals with your hand for pleasure when a partner was present and gave yourself an orgasm” and “You used the shower jet water on your genitals for pleasure when no one else was around and did not have an orgasm.” Nine behaviors were each presented four times with the two situational factors of interest—presence or absence of an orgasm and presence or absence of a partner—varied in each presentation (resulting in 36 different items). Because some individuals use the term masturbation to refer to performing manualgenital sex on a partner, two additional items asked about whether individuals would label that behavior as masturbation if their partner had an orgasm and if their partner did not have an orgasm. Participants responded with Yes, I would call it masturbation or No, I would not call it masturbation. The 38 items (see Table 1) on the measure were presented in a random order and were all gender-neutral to allow for presentation to participants of any gender. Scores could range from 0 to 38, with higher scores indicating more behaviors labeled as masturbation. Masturbation Experiences Scale. This scale repeated the behaviors described in the Masturbation Labeling Scale, but, instead of querying participants about which behaviors they label as masturbation, it asked participants if they had engaged in each of the specific behaviors. Scores could range from 0 to 38, with higher scores indicating more masturbatory experience. A Measure of Sexual Behaviors. This scale was originally used by McCallum and Peterson (2015). The measure began by asking “In your lifetime, have you ever engaged in the following sexual activities?” and followed with

WOULD YOU SAY YOU “MASTURBATED” IF … ?

Table 1. Masturbation Labeling Scale Item Endorsement: Percentages of Participants Labeling Each Behavior as “Masturbation” Orgasm Behavior

With Partner

No Orgasm

No Partner

With Partner

No Partner

Touched/stroked genitals with hand for pleasure

Men = 79.3% Men = 96.1% Men = 65.0% Men = 80.9% * Women = 76.8% Women = 98.0% Women = 63.0% Women = 89.4% Total = 78.2% Total = 97.0% Total = 63.9% Total = 84.7%

Used a vibrator on genitals for pleasure

Men = 76.4% Men = 96.4% Men = 62.1% Men = 84.5% ** Women = 77.2% Women = 96.5% Women = 68.1% Women = 91.3% Total = 76.6% Total = 96.5% Total = 64.6% Total = 87.7%

Put pressure on genitals for pleasure

Men = 68.9% Men = 95.1% Men = 46.9% * Men = 66.7% *** Women = 66.9% Women = 94.1% Women = 56.3% Women = 79.5% Total = 68.0% Total = 94.7% Total = 51.1% Total = 72.4%

Used the shower jet water on genitals for pleasure

Men = 70.6% Men = 95.1% Men = 57.0% Men = 73.8% *** Women = 72.8% Women = 94.9% Women = 61.0% Women = 85.0% Total = 71.7% Total = 95.1% Total = 58.8% Total = 78.9%

Rubbed genitals against an object or surface for pleasure

Men = 69.9% Men = 94.8% Men = 56.0% Men = 75.7% ** Women = 70.1% Women = 95.3% Women = 57.1% Women = 83.9% Total = 69.7% Total = 95.1% Total = 56.0% Total = 79.4%

Stimulated your anus for pleasure

Men = 67.3% Men = 88.0% * Men = 52.8% Men = 69.3% ** Women = 70.1% Women = 93.7% Women = 57.5% Women = 81.1% Total = 68.5% Total = 90.7% Total = 54.6% Total = 74.6%

Inserted a vibrator or some other object into your vagina or anus for pleasure

Men = 71.5% Men = 93.5% ** Men = 60.2% * Men = 81.9% *** Women = 76.4% Women = 98.0% Women = 68.9% Women = 90.9% Total = 73.6% Total = 95.6% Total = 63.9% Total = 86.1%

Touched/stimulated/stroked your breasts or chest for pleasure

Men = 52.1% Men = 72.2% Men = 33.3% Men = 43.0% Women = 49.6% Women = 71.3% Women = 33.5% Women = 48.0% Total = 50.9% Total = 72.0% Total = 33.1% Total = 45.2%

Had a sexual fantasy (without touching yourself) for pleasure

Men = 27.5% Men = 42.1% Men = 13.3% Men = 16.2% Women = 27.2% Women = 34.6% Women = 12.6% Women = 15.0% Total = 27.3% Total = 38.6% Total = 12.9% Total = 15.5%

Touched/stimulated partner’s genitals with your hand to give him or her pleasure Men = 48.9% ** Women = 38.2% Total = 43.7%

Men = 43.0% * Women = 33.5% Total = 38.4%

Significant gender differences based on a chi-square test: *p < .05; **p < .01; ***p < .001.

items such as “Having someone of the other sex stimulate your genitals with his/her mouth (receiving oral sex).” Items assessed a range of behaviors from very common (e.g., kissing) to less common (e.g., group sex) and assessed experience of each behavior with both same- and other-sex partners. Participants responded Yes or No to each behavior. Sexual experience was calculated as the total number of sexual behaviors endorsed. Scores could range from 0 to 29, with higher scores indicating more diverse sexual experience.

guilty about masturbating, or if I don’t masturbate, I would feel guilty if I did.” The response scale presented to participants in this study was slightly different than in the original and ranged from 1 (Strongly disagree) to 6 (Strongly agree). Scores on the scale could range from 30 to 180, with higher scores indicating a more negative attitude toward masturbation. Cronbach’s α in the current sample was .95.

Negative Attitudes Toward Masturbation Scale. The Negative Attitudes Toward Masturbation Scale (Abramson & Mosher, 1975) included items such as “Masturbation is an escape mechanism which prevents a person from developing a mature sexual outlook.” Three of the items were modified for the present study to accommodate nonmasturbating participants. For example, “I feel guilty about masturbating” was changed to “I feel

Results Data Preparation and Descriptive Statistics A total of 730 participants began the questionnaire. Based on IP addresses, a number of respondents appeared to have completed the survey two or more times. Because participants were explicitly instructed to complete the 267

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survey only once, we opted to remove all participants who completed more than one survey, totaling 85 responses. Next, 67 participants who had completed less than 85% of items on the Masturbation Labeling Scale were eliminated. In addition, participants who answered at least two of the three interspersed checker questions (e.g., “If you are reading this item, please select ‘strongly agree’”) incorrectly were removed, which eliminated an additional 10 participants. The final sample consisted of 568 participants. Any remaining missing data on the Masturbation Labeling Scale were treated as nonendorsements (i.e., as though the participant had responded with No, I would not call it masturbation). Most participants (n = 77) with missing data were missing responses on only one item; 19 were missing responses on two items, and 10 participants were missing responses on three, four, or five items. Some participants who completed other measures failed to complete the Negative Attitudes Toward Masturbation Scale. Participants who had completed less than 85% of the items on the scale were eliminated for the test of hypothesis 2; other missing values on the scale were replaced using mean imputation. No problems with skewness or kurtosis were found for any of the measures used for hypothesis testing, and a review of distributions revealed that the data were roughly normally distributed for each scale. An open-ended question was included to inquire whether participants had ever engaged in other self-pleasuring techniques not included on the Masturbation Labeling Scale to assess whether the scale included a complete range of selfpleasuring behaviors that might be labeled as masturbation. A total of 290 participants provided a response to the openended question. The general consensus (n = 268) was that the list of behaviors was sufficient (e.g., responses to the open-ended question such as “I think the list was very thorough” and “I think you covered it” or responses that repeated scale item content using slightly different words; e.g., “I have touched my genitals” and “I have jerked off my penis”). A few participants (n = 6) listed partnered rather than self-pleasuring sexual behaviors in response to the open-ended question (e.g., “My wife fingers my anus sometimes”). Of the 16 participants that did list additional selfpleasuring behaviors, a few described employing BDSM or pain methods (n = 4), a few mentioned male-specific masturbation aids sold specifically for sexual purposes (e.g., the “Fleshlight”; n = 4), and a few mentioned other specific objects or devices used (e.g., “a raw boneless chicken breast,” “rubber bands,” and “an electric toothbrush”; n = 5). Notably, with the possible exception of the pain methods (assuming that those occurred in the absence of genital, breast, or anal stimulation), these responses are simply more specific versions of behaviors described by items on the scale. There were three distinct behaviors not captured by our scale, each mentioned by only one participant: watching pornography (although it was not clear whether this was considered a form of masturbation even if it occurred in the absence of any other sexual stimulation), autofellatio, and “hypnosis.” Thus, the qualitative data 268

seemed to suggest that our measure covered the majority of self-pleasuring behaviors typically used by most people. See Table 1 for the percentages of participants who labeled each behavior as masturbation. Most behaviors on the Masturbation Labeling Scale were labeled as masturbation by the majority of participants. However, there was variability in individuals’ labeling. Hypothesis 1: Individual Factors. Hypothesis 1a predicted that men would label a larger number of behaviors as masturbation than women. Contrary to that prediction, there was no significant difference between men (M = 23.95; SD = 7.54) and women (M = 25.06; SD = 7.12) in the total number of behaviors labeled as masturbation, F (1, 561) = 3.12, p = .08, ηp2 = .01. However, in a few cases, men and women did differ in whether they labeled specific behaviors as masturbation (see Table 1). Hypothesis 1b predicted that older age would be associated with labeling more behaviors as masturbation. A Pearson’s correlation was calculated to determine if age was correlated with the number of items endorsed on the Masturbation Labeling Scale. Age was significantly correlated with the number of behaviors labeled as masturbation, but in the opposite direction from what was predicted, such that younger age was associated with labeling more behaviors as masturbation, r = −.147, p = .002. This relationship was significant for both women, r = −.140, p = .04, and men, r = −.164, p = .01, with similar effect sizes. An analysis of variance (ANOVA) also was conducted to determine if there was a cohort effect in relation to labeling behaviors. Using the same categories as Sanders et al. (2010), participants were grouped into four age cohorts: ages 18 to 29 (n = 200), ages 30 to 44 (n = 181), ages 45 to 64 (n = 78), and ages 65 and up (n = 2); however, because there were only two individuals in the oldest group, those individuals were combined with the 45- to 64-year-old group. Gender and age cohort were entered as independent variables in the model. As described, there was no significant main effect for gender. There was a significant main effect for age cohort, F (2, 451) = 5.21, p = .006, ηp2 = .02. The pattern was consistent with the linear correlation reported; that is, participants in the youngest age cohort labeled the most behaviors as masturbation (M = 26.07, SD = 7.59), participants aged 30 to 44 were intermediate (M = 25.44, SD = 7.48), and participants aged 45 and up labeled the fewest behaviors as masturbation (M = 22.88, SD = 8.63). Specifically, based on follow-up tests, the oldest group labeled significantly fewer behaviors than either the youngest or middle group. The youngest and middle group did not differ significantly from each other. There was no significant interaction between age cohort and gender, F (2, 451) = 1.128, p = .33 ηp2 = .01, suggesting that the pattern was similar for male and female participants. Hypothesis 1c predicted that sexual minority participants would label a larger number of behaviors as masturbation than heterosexual participants. A one-way ANOVA was conducted to compare heterosexual participants (i.e., sexual majority participants) to participants who identified as

WOULD YOU SAY YOU “MASTURBATED” IF … ?

homosexual/gay/lesbian, bisexual, uncertain, queer, or “other” (i.e., sexual minority participants). Sexual majority/minority status was not related to number of behaviors endorsed, F (1, 461) = 1.34, p = .247, ηp2 < .01. A chi-square analysis was conducted to compare the rates of labeling each individual behavior as a function of sexual minority/majority status. There was only one significant difference: Sexual minority participants were significantly more likely than sexual majority participants to label “used the shower jet water on your genitals for pleasure when a partner was present and did not have an orgasm” as masturbation (labeled as masturbation by 72.5% of sexual minority participants and 57.3% of sexual majority participants), X2 (1, N = 565) = 5.80, p = .02. Given the large number of comparisons, though, one statistically significant result at the p < .05 level should be interpreted with caution. Because only five individuals in our sample identified as gender minorities (i.e., identified as transgender or “other”), we could not statistically compare responses as a function of gender minority versus majority status. However, the five gender minorities in our sample labeled a fairly comparable number of behaviors as masturbation (M = 21.80; SD = 5.67) when compared to the gender majority (maleand female-identified) participants (M = 25.27; SD = 7.79). Hypothesis 1d predicted that self-pleasuring and partnered sexual experience would be inversely related to the number of behaviors labeled as masturbation. Two Pearson’s correlations were used to determine if scores on the Measure of Sexual Behaviors (M = 15.44, SD = 5.79) and Masturbation Experiences Scale (M = 18.15; SD = 9.40) were correlated with number of behaviors endorsed on the Masturbation Labeling Scale. However, neither masturbatory (r = −.01, p = .83) nor partnered sexual experience (r = .01, p = .83) was significantly correlated with the number of behaviors labeled as masturbation. Hypothesis 2: Attitudinal Factors. Hypothesis 2 predicted that more negative attitudes about masturbation would be associated with labeling fewer behaviors as

masturbation. However, participants’ scores on the Negative Attitudes Toward Masturbation Scale (M = 66.69; SD = 23.58) were not significantly correlated with the number of items labeled as masturbation, r = −.01, p = .92. Hypothesis 3: Situational Factors. Hypothesis 3a predicted that participants would be more likely to label a behavior as masturbation if an orgasm was experienced than if it was not. Hypothesis 3b predicted that participants would be more likely to label a behavior as masturbation if the individual was alone rather than if a sexual partner was present. To test these predictions, a mixed ANOVA was conducted with the number of behaviors endorsed as masturbation as the dependent variable. The independent variables were participant gender (a between-subjects variable), presence or absence of orgasm (a within-subjects variable), and presence or absence of partner (a withinsubjects variable). As described, no main effect for gender was present. Consistent with the prediction of hypothesis 3a, a large and significant main effect of orgasm was present, suggesting that individuals labeled more behaviors as masturbation when an orgasm occurred (M = 13.60; SD = 3.56) than when it did not (M = 10.85; SD = 4.89), F (1, 561) = 217.18, p < .001, ηp2 = .28. A significant main effect for partner was also present, suggesting that, consistent with hypothesis 3b, individuals labeled more behaviors as masturbation when no sexual partner was present (M = 13.99; SD = 3.17) than when a partner was present (M = 10.46; SD = 5.81), F (1, 561) = 210.96, p < .001, ηp2 = .27. There also were significant two-way orgasm by gender, partner by gender, and orgasm by partner interactions, but all of these must be interpreted in light of a significant three-way orgasm by partner by gender interaction, F (1, 561) = 6.98, p = .008, ηp2 = .01. Women labeled more behaviors as masturbation than men only in situations in which an orgasm did not occur and no partner was present. See Figure 1.

Mean Number of Behaviors Labeled as "Masturbation"

Orgasm x Partner x Gender Interaction 9 7.76 7.73

8 7 6

6.64 5.92

5.87 5.84 4.78

5

4.47

4 Women

3

Men

2 1 0 No Partner*** Partner No Orgasm

No Partner Partner Orgasm

Figure 1. Mixed ANOVA Interaction. ***p < .001.

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DISCUSSION Overall, participants labeled a wide variety of behaviors as masturbation. However, applications of the label varied. For example, although 96.4% of men and 96.5% of women agreed that using a vibrator on their genitals when they are alone and experience an orgasm would be considered masturbation, only 42.1% of men and 34.6% of women agreed that having a sexual fantasy without touching themselves when they are alone and experience orgasm would be considered masturbation. Of the 38 items on the Masturbation Labeling Scale, all but three were endorsed as masturbation by at least 30% of participants, and all but seven were endorsed by at least 50% of participants, suggesting that regardless of the specific behavior and the situational context, most people include a wide variety of selfpleasuring acts in their conceptualization of masturbation. Interestingly, 48.9% of men and 38.2% of women reported that they would say they had masturbated if they touched or stimulated their partner’s genitals with their hand for pleasure and gave their partner an orgasm (a behavior involving no selfpleasuring at all), while 43.0% of men and 33.5% of women would say they had masturbated if they performed the same behavior but did not give their partner an orgasm. This is important because when sex researchers ask about masturbation, they are most often attempting to assess self-pleasuring sexual behavior; yet these results suggest that almost half of men might interpret a question about masturbation as including instances of partner-pleasuring via manual-genital contact. These results clearly show that the term masturbation does not have one universal definition but rather encompasses many different behaviors for different individuals. Although the term masturbation may not have a single agreed-upon definition, the presence of an orgasm and the absence of a sexual partner were found to be significant and robust correlates of labeling a behavior as masturbation for participants in this study. Partnered sexual behaviors are depicted and discussed more frequently than masturbation— and by nature of being partnered, they are shared by more than one person—resulting in shared social scripts for different partnered sexual acts. The script for masturbation may not be as well articulated specifically because masturbation is taboo and often occurs in private. Nevertheless, although the social script for masturbation may not address the specific types of self-pleasuring acts that typically occur, orgasm and the absence of a sexual partner do seem to be important components of a shared sexual script for masturbation. Bennett and Rosario (1995) noted the contradictory status of masturbation in social discourses; that is, masturbation is frequently referenced in popular culture but taboo in direct social interactions. References to masturbation in popular culture may have resulted in a shared—but vague—script for masturbation, which dictates that masturbation typically happens alone and ends in orgasm but which fails to articulate what behaviors actually occur during masturbation. Although it was hypothesized that men would label more behaviors as masturbation than women, there was, in fact, no significant difference in the total number of behaviors men and 270

women labeled. This is not consistent with research on other sexual labels, which has shown that men tend to have broader definitions of sexual terms than women (e.g., Bogart et al., 2000; Gute et al., 2008; Pitts & Rahman, 2001; Richters & Song, 1999; Sanders & Reinisch, 1999). The lack of gender difference in the number of behaviors labeled as masturbation could be due to the fact that, for both men and women, the absence of a sexual partner and the presence of an orgasm are more important determinants of whether a behavior is considered masturbation than the specific self-pleasuring act itself. Further, the lack of gender difference in the number of behaviors labeled as masturbation is likely due to the fact that both genders tended to include a wide variety of behaviors in their definition of masturbation even if they did not always include the same specific behaviors as being a part of that definition (as illustrated by the gender differences in labeling of specific behaviors as masturbation). Although there was no significant gender difference in total number of behaviors labeled as masturbation, women did label more behaviors as masturbation than men specifically in situations in which no partner was present and an orgasm did not occur. This is consistent with observations by other authors who have noted that male orgasm is often seen as more important and more central to the definition of sex than female orgasm (see e.g., Frith, 2013). Specifically, based on the findings of this study, having an orgasm is less important for women than it is for men when labeling a selfpleasuring behavior that they engage in alone as masturbation. In part, this gender difference in the importance of orgasm for masturbation may relate to cultural expectations that men’s orgasm is “‘natural’ and inevitable” whereas women’s orgasm “requires work and, in keeping with the idea of female sexual passivity and male sexual expertise, women’s bodies need to be worked on by the male virtuoso in order to produce orgasm” (Jackson & Scott, 2002, p. 107; italics in original). From this perspective, orgasm would be seen as an inevitable outcome of men’s self-pleasuring but, especially in the absence of a male “virtuoso,” orgasm would be seen as a less likely outcome of women’s selfpleasuring. Prior research also has demonstrated gender differences in the reason for masturbation, which may reflect this expectation that orgasm is natural and inevitable for men but not women: Women often engage in self-pleasuring behaviors with a goal in mind other than reaching orgasm, including to have sexual pleasure, to cope with stress, and to fall asleep (Carvalheira & Leal, 2013). In contrast, men are significantly more likely than women to report masturbating because their current partner did not want sex, suggesting that sexual release is likely a primary goal of masturbation for many men (Laumann, Gagnon, Michael, & Michaels, 1994). In the current study, younger participants were found to label more behaviors as masturbation than older participants; most prior research has shown that older individuals hold broader definitions of sexual terms than younger individuals (Randall & Byers, 2003; Richters & Song, 1999). This surprising finding may be due to cohort effects, with younger participants potentially recognizing a wider repertoire of

WOULD YOU SAY YOU “MASTURBATED” IF … ?

masturbatory behaviors, perhaps due to more explicit discussion of masturbation in popular culture in recent years as compared to the past. Interestingly, Sanders et al. (2010) found that, for men, the youngest and oldest (over age 65) participants in their sample labeled the fewest behaviors as sex. Although we attempted to examine labeling of masturbation as a function of categorical age cohort, we did not have enough participants in the oldest category (over age 65) to allow for analyses. It would be interesting to examine the labeling of behaviors as masturbation in an older cohort. O’Connor et al. (2008) found that, in aging men, masturbatory behavior was distinct from other markers of overall sexual functioning, suggesting that masturbation may be an important and unique aspect of sexuality as individuals age. The authors suggested that more research is needed on age-related changes in masturbation behaviors. Similarly, more research is need on how conceptualizations of masturbation change with age. We also hypothesized that sexual minority participants would label more behaviors as masturbation than sexual majority participants, but this prediction was not supported by findings. Past research has suggested that sexual minorities tend to hold broader definitions of sex than heterosexual individuals (Horowitz & Spicer, 2013; Richters & Song, 1999); however, that difference may been due to the fact that many heterosexuals define sex narrowly as penilevaginal intercourse. Such a narrow definition of sex would exclude any same-sex behavior. Given that, it is logical that sexual minority individuals would label behaviors other than penile-vaginal intercourse as sex. In contrast, sexual identity has no influence on the types of self-pleasuring behaviors that are available to an individual. For that reason, sexual identity may be a stronger predictor of the number of behaviors labeled as sex than of the number of behaviors labeled as masturbation. Interestingly, we also found that participants’ levels of both sexual and masturbatory experience were unrelated to the number of behaviors labeled as masturbation. Their attitudes about masturbation also did not predict their labeling of behaviors as masturbation. Again, the impact of the situational factors of being alone and reaching orgasm seemed to be the primary determinants in whether a behavior was labeled as masturbation. Personal experiences and attitudes were less important. Nevertheless, even looking exclusively at items that described acts completed alone and resulting in orgasms, participants did not fully agree on whether any given behavior qualified as masturbation; thus, there are likely some other individual factors that contribute to labeling or not labeling behaviors as masturbation and that were, apparently, not captured in this study. This study is not without limitations. A majority of the sample was White and identified as heterosexual. Perhaps more importantly, there was likely a self-selection bias in the sample of participants who opted to complete this study. Due to Amazon MTurk’s policy of labeling tasks with sexual material as “containing adult content,” MTurk workers with less permissive sexual attitudes may have been less

likely to participate in this study (indeed, the average score on the Negative Attitudes About Masturbation Scale was fairly low). However, it should be noted that both the Masturbation Experiences Scale and the Measure of Sexual Behaviors showed a wide diversity of masturbatory and sexual experiences among participants, suggesting that not all participants were highly sexually experienced. Another limitation to consider is the imperfection of some of our measures. For example, partnered sexual experience was measured using a scale that relied on a simple binary response (Yes or No to each sexual act on the scale) and that measured diversity of sexual experience rather than amount of experience or number of partners. The scale also assumed that all sexual behaviors (e.g., kissing, oral sex, group sex) are equally weighted. Similarly, the Masturbation Experiences Scale measured the number of different self-pleasuring behaviors engaged in rather than the overall frequency of self-pleasuring. It is possible that amount of partnered or solo sexual experience is related to labeling of behaviors as masturbation even though diversity of experience was not related. Finally, in this study we provided a list of behaviors and asked participants to identify which behaviors they would label as masturbation. It would be interesting in future studies to ask participants to define masturbation using an open-ended, context-free question. Such a method may demonstrate further variability in the behaviors that are commonly considered to be masturbation. The findings of this study highlight the importance of sexual educators, mental and physical health clinicians, and sex researchers using behaviorally specific language when discussing masturbation with students and patients and within sexual research questionnaires. If the term masturbation is used without providing context or definition, communication may be unclear. This is particularly evident in the findings that the stimulation of a partner’s genitals was labeled as masturbation by many participants. Understanding which specific behaviors a student or patient is referring to when he or she uses the word masturbation is crucial for clear discussion of sexual health and wellness. Further, this study points to the necessity of new research measures to study the topic of masturbation, as the standard methods of investigation (e.g., simply asking about the frequency of “masturbation”) may result in imprecise results. By striving to communicate more clearly and precisely about typically taboo topics such as masturbation, sexual health professionals can model good sexual communication and promote better sexual literacy among their patients, students, and research participants.

ORCID http://orcid.org/0000-0002-1887Allison L. Kirschbaum 3825 Zoë D. Peterson http://orcid.org/0000-0003-2975-1062 271

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