Thursday, April 28, 2011

Do women like adult media and content as much as men?

By, Ian Kerner, a sexuality counselor and New York Times best-selling author.

If you’d asked me this question a couple of years ago, I would have said “no.” But the times they are a-changing: just as female infidelity is on the rise, women are catching up to the guys in other ways, too - including a propensity for porn.

As a sex therapist and founder of the website Good in Bed, here’s what I’m observing:

– More couples are enjoying porn together, with women often taking the lead in choosing the material.

– More women are using porn to get themselves in the mood for sex or to enjoy their sexuality on their own.

– More women are using porn to learn new sexual techniques or to explore sexually adventurous situations.

– More women are using porn to satisfy a general curiosity about sex overall, and

– More women are comfortable and confident in asserting their opinions on the subject.

In short, women are increasingly using porn for pretty much the same reasons (and pleasures) as men. Meanwhile, guys are increasingly surprised to discover that their female partners are interested in porn - and tend to be even more surprised to discover what they’re watching (I’ll get to that in a moment).

So what’s going on? Why the apparent change? To be honest, I’d always been of the mind that men and women are somewhat different when it comes to porn, for both biological and sociological reasons:

On the biological side, I’ve often said female sexual desire is more complex than male desire, and that porn rather clearly illustrates that difference: In men, visual stimulation leads quickly to sexual arousal, and with that chain of arousal often comes a desire to be stimulated to orgasm. In that sense, arousal and desire are very closely related, and it’s one of the reasons that Viagra has been so successful with men: Give a guy an erection and he basically wants to use it. In men, porn initiates the “sexual-circuit” very quickly.

That’s not to say that women don’t respond to visual stimulation either, or that that stimulation doesn’t lead to genital arousal, but that arousal doesn’t always trigger desire in women the way that it does with men.

When I talk to guys about their porn use, many describe a lack of pre-meditation. For example, a guy could be hanging out on his computer, checking out his favorite sports site, when up pops an ad with a sexy woman in a bikini and, bang, next thing he knows he’s trawling porn sites in search of sexual release.

With women, however, the use of porn or the desire/decision to have an orgasm is often less opportunistic. A woman may see something super-sexy, and recognize it as sexy, and even arousing, but that doesn’t mean she’s necessarily going to stop what she’s doing to stimulate herself to orgasm. (By the way, if you don’t agree with any of this, please chime in below in the comments - sexual desire is by no means a one size fits all model: everyone is different and topic of women and porn is a highly debated one.)

On a more sociological level, generations of women have been told that porn is evil: that it exploits, objectifies, and degrades women, and that a woman who enjoys porn is a betrayer of Women. Some may still feel this is true, (and there are plenty of women who feel uncomfortable with porn), but there are also plenty of women who would beg to disagree and look at porn as a fairly innocuous form of erotic escapism that’s a personal choice and not a big deal.

Additionally, many women have contended that porn, until fairly recently, was never really created with female customers in mind; that porn was designed to appeal to men and lacked elements that were more organic to female sexuality, such as foreplay, intimacy and erotic storylines.

Well, today there are many porn sites geared toward women. In fact, there’s even a regular Feminist Porn Awards that recognizes erotic entertainment that is smart, sexy, and appreciates women as viewers.

Combine a recognition of a female audience with the rapid proliferation of easily accessible Internet porn, and it only makes sense that more women are enjoying porn. (By the way, if you’re a woman and you’re interested in dipping a toe - or perhaps nose-diving - into the world of porn, I suggest checking out the work of Violet Blue and her book, "The Smart Girl's Guide to Porn." Or if porn isn’t your thing, but you’re interested in some hot erotic literature, take a look at the anthologies that are edited by Rachel Kramer Bussell.)

As it turns our women may be able to enjoy porn with less guilt, or at least with less grief from their male partners. In my experience, women tend to worry a lot more about their man’s porn habits and what it means to their relationship, whereas many of the men I’ve spoken with tend to be intrigued by the idea of women and porn - especially since women are much more likely to enjoy porn that does not directly reflect their sexual orientation.

One study at Northwestern University, for example, examined the effects of porn on genital arousal and concluded that men responded more intensely to porn that correlated to their particular sexual orientation, whereas women tended to be genitally aroused by a much broader spectrum of erotic material. Who knows –- perhaps the enormous variety of material offered by the Internet will end up playing more to the spectrum of female desire than male desire in the long run?

For the moment, it would seem that women are not watching porn nearly as much as men. Recently, a researcher from the University of Montreal set out to study whether pornography had an impact on guys’ sex lives. He searched for men in their 20s who'd never consumed porn, and guess what? He couldn't find a single one. I can still show you plenty of women who have never looked at porn - but perhaps not for long.

So do women like porn as much as men? You tell me.

Friday, April 15, 2011

Understanding what bipolar disorder is and how to diagnose if you have it.










Bipolar disorder involves periods of elevated or irritable mood (mania), alternating with periods of depression. The "mood swings" between mania and depression can be very abrupt.
Causes, incidence, and risk factors

Bipolar disorder affects men and women equally. It usually appears between ages 15 - 25. The exact cause is unknown, but it occurs more often in relatives of people with bipolar disorder.

Types of bipolar disorder:

People with bipolar disorder type I have had at least one fully manic episode with periods of major depression. In the past, bipolar disorder type I was called manic depression.

People with bipolar disorder type II have never experienced full-fledged mania. Instead they experience periods of hypomania (elevated levels of energy and impulsiveness that are not as extreme as the symptoms of mania). These hypomanic periods alternate with episodes of depression.

A mild form of bipolar disorder called cyclothymia involves less severe mood swings with alternating periods of hypomania and mild depression. People with bipolar disorder type II or cyclothymia may be misdiagnosed as having depression alone.

In most people with bipolar disorder, there is no clear cause for the manic or depressive episodes. The following may trigger a manic episode in people who are vulnerable to the illness:

Life changes such as childbirth

Medications such as antidepressants or steroids

Periods of sleeplessness

Recreational drug use

Symptoms

The manic phase may last from days to months and can include the following symptoms:

Agitation or irritation

Inflated self-esteem (delusions of grandeur, false beliefs in special abilities)

Little need for sleep

Noticeably elevated mood

Hyperactivity

Increased energy

Lack of self-control

Racing thoughts

Over-involvement in activities

Poor temper control

Reckless behavior

Binge eating, drinking, and/or drug use

Impaired judgment

Sexual promiscuity

Spending sprees

Tendency to be easily distracted

These symptoms of mania are seen with bipolar disorder I. In people with bipolar disorder II, hypomanic episodes involve similar symptoms that are less intense.

The depressed phase of both types of bipolar disorder includes the following symptoms:

Daily low mood

Difficulty concentrating, remembering, or making decisions

Eating disturbances

Loss of appetite and weight loss

Overeating and weight gain

Fatigue or listlessness

Feelings of worthlessness, hopelessness and/or guilt

Loss of self-esteem

Persistent sadness

Persistent thoughts of death

Sleep disturbances

Excessive sleepiness

Inability to sleep

Suicidal thoughts

Withdrawal from activities that were once enjoyed

Withdrawal from friends

There is a high risk of suicide with bipolar disorder. While in either phase, patients may abuse alcohol or other substances, which can make the symptoms worse.

Sometimes there is an overlap between the two phases. Manic and depressive symptoms may occur together or quickly one after the other in what is called a mixed state.
Signs and tests

A diagnosis of bipolar disorder involves consideration of many factors. The health care provider may do some or all of the following:

Ask about your family medical history, particularly whether anyone has or had bipolar disorder

Ask about your recent mood swings and for how long you've experienced them

Observe your behavior and mood

Perform a thorough examination to identify or rule out physical causes for the symptoms

Request laboratory tests to check for thyroid problems or drug levels

Speak with your family members to discuss their observations about your behavior

Take a medical history, including any medical problems you have and any medications you take

Note: Use of recreational drugs may be responsible for some symptoms, though this does not rule out bipolar affective disorder. Drug abuse may itself be a symptom of bipolar disorder.
Treatment

Spells of depression or mania return in most patients, in spite of treatment. The major goals of treatment are to:

Avoid cycling from one phase to another

Avoid the need for a hospital stay

Help the patient function as best as possible between episodes

Prevent self-destructive behavior, including suicide

Reduce the severity and frequency of episodes

The doctor will first try to determine what may have triggered the mood episode, and identify any medical or emotional problems that might interfere with or complicate treatment.

Drugs called mood stabilizers are considered to be the first-line treatment. The following are commonly used mood stabilizers:

Carbamazepine

Lamotrigine

Lithium

Valproate (valproic acid)

Other antiseizure drugs may also be tried.

Other drugs used to treat bipolar disorder include:

Antipsychotic drugs and anti-anxiety drugs (benzodiazepines), which can be used to stabilize mood

Antidepressant medications can be added to mood-stabilizing drugs to treat depression. People with bipolar disorder are more likely to have manic or hypomanic episodes if they are put on antidepressants. Because of this, an antidepressant is only used in people who are also taking a mood stabilizer.

Electroconvulsive therapy (ECT) may be used to treat the manic or depressive phase of bipolar disorder that does not respond to medication.

ECT is a psychiatric treatment that uses an electrical current to cause a brief seizure of the central nervous system while the patient is under anesthesia.

ECT is the most effective treatment for depression that is not relieved with medications.

Transcranial magnetic stimulation (TMS) uses high frequency magnetic pulses that target affected areas of the brain. It is most often used as a second-line treatment after ECT.

Patients who are in the middle of manic or depressive episodes may need to stay in a hospital until their mood is stabilized and their behaviors are under control.

Doctors are still trying to decide the best way to treat bipolar disorder in children and adolescents. Parents should consider the potential risks and benefits of treatment for their children.

SUPPORT PROGRAMS AND THERAPIES

Family treatments that combine support and education about bipolar disorder (psychoeducation) appear to help families cope and reduce the odds of symptoms returning. Programs that emphasize outreach and community support services can help people who lack family and social support.

Important skills include:

Coping with symptoms that are present even while taking medications

Learning a healthy lifestyle, including getting enough sleep and staying away from recreational drugs

Learning to take medications correctly and how to manage side effects

Learning to watch for early signs of a relapse, and knowing how to react when they occur

Family members and caregivers are very important in the treatment of bipolar disorder. They can help patients seek out proper support services, and help make sure the patient follows medication therapy.

Getting enough sleep is extremely important in bipolar disorder, because a lack of sleep can trigger a manic episode. Psychotherapy may be a useful option during the depressive phase. Joining a support group may be particularly helpful for bipolar disorder patients and their loved ones.

A patient with bipolar disorder cannot always reliably tell the doctor about the state of the illness. Patients often have difficulty recognizing their own manic symptoms.

Mood variations in bipolar disorder are not predictable, so it is sometimes difficult to tell whether a patient is responding to treatment or naturally emerging from a bipolar phase.

Treatment strategies for children and the elderly have not been well-studied, and have not been clearly defined.

Expectations (prognosis)

Mood-stabilizing medication can help control the symptoms of bipolar disorder. However, patients often need help and support to take medicine properly and to ensure that any episodes of mania and depression are treated as early as possible.

Some people stop taking the medication as soon as they feel better or because they want to experience the productivity and creativity associated with mania. Although these early manic states may feel good, discontinuing medication may have very negative consequences.

Suicide is a very real risk during both mania and depression. Suicidal thoughts, ideas, and gestures in people with bipolar affective disorder require immediate emergency attention.
Complications

Stopping or improperly taking medication can cause your symptoms to come back, and lead to the following complications:

Alcohol and/or drug abuse as a strategy to "self-medicate"

Personal relationships, work, and finances suffer

Suicidal thoughts and behaviors

This illness is challenging to treat. Patients and their friends and family must be aware of the risks of neglecting to treat bipolar disorder.
Calling your health care provider

Call your health provider or an emergency number right way if:

You are having thoughts of death or suicide

You are experiencing severe symptoms of depression or mania

You have been diagnosed with bipolar disorder and your symptoms have returned or you are having any new symptoms

References

Moore DP, Jefferson JW. Bipolar disorder. In: Moore DP, Jefferson JW, eds. Handbook of Medical Psychiatry. 2nd ed. Philadelphia, Pa: Mosby Elsevier;2004:chap 80.
Schiffer RB. Psychiatric disorders in medical practice. In: Goldman L, Ausiello D, eds. Cecil Medicine. 23rd ed. Philadelphia, Pa:Saunders Elsevier;2007:chap 420.
Benazzi F. Bipolar disorder -- focus on bipolar II disorder and mixed depression. Lancet. 2007;369:935-945. [PubMed]
Morriss RK, Faizal MA, Jones AP, Williamson PR, Bolton C, McCarthy JP. Interventions for helping people recognise early signs of recurrence in bipolar disorder. Cochrane Database Syst Rev. 2007;24;(1):CD004854. [PubMed]
Sachs GS, Nierenberg AA, Calabrese JR, et al. Effectiveness of adjunctive antidepressant treatment for bipolar depression. N Engl J Med. 2007;356:1711-1722. [PubMed]

Wednesday, April 13, 2011

7 tips for moving past a rotten childhood

Author Tracy McMillan knows a thing or two about getting over a bad childhood. Her father was a drug-dealing pimp and convicted felon who spent most of his daughter's life behind bars. Her prostitute mother gave her away.

Here's what she wants you to know about getting over your past.

1. Get a new story

There are two ways for me to look at my childhood story. In one, I'm a person who is so unloved and unwanted, my own mother gave me away.

In the other, I was born, took a look around at my prostitute mother and criminal father, and said to myself, "I can totally do better than this. Get your stuff, we're leaving." In one I'm a victim, in the other, I'm in power.

2. Realize blame = same

Blame is awesome. It feels good, right? It feels righteous. It feels powerful. It feels like someone's going to pay for what they did to you.

The only problem is -- as long as you're blaming -- nothing can ever change. Why? Because in order for your life to change, you have to want things to be different.

And if it feels good to blame, you have to admit that you like it. And if you like it, you have to admit that you don't really want it to change. Which is why blame just gets you more of the same.

3. Pretend you work at a retail store

Sometimes, I look at my bad childhood like it's an unruly customer and I'm working customer service the day after Christmas. It'll be acting up, moaning and complaining about how hard everything is, and how unfair it all is.

I just have to say to it, "Yes, I see you, ma'am. I know you have a problem. But right now I'm busy, so please have a seat. I''ll be with you just as soon as I can."

Then I do something productive that will actually change my situation, like go to work.

4. Accept the fact that some don't really want you to succeed

This sounds harsh, and it is. But it's true.

Some of your family and friends "support" you by cosigning all your b.s. about how hard you have it, because if you succeed, two things will happen:
1) You will leave. And 2) They will be left behind.

This doesn't mean you have to get rid of your friends and family, you just have to remember that they love you so much, they're perfectly happy for you to stay exactly where you are right now.

5. Decide to KSA (Kick some ass)

When my 13-year-old said he hated science class, I told him that getting a 95 on the test was the equivalent of getting in the face of his least favorite teacher and saying, "Have some!"

In other words, kicking ass on the test is just like playing a video game. Needless to say, he's getting As now. Channeling your anger will get you a long, long way in life.

6. Hoard your money

The number one way to end your bad childhood is to save money. I have a very simple rule about money: If I never spend everything I make, I will always have money. And money is power.

All those commercials you see are a big, rich company's attempt to get you to give them your power. Don't do it! Think of every dollar you save as one step away from the people and places that have kept you down.

7. Get a paper route

In fifth grade, I wanted a 10-speed bike like all the other kids had. So I started delivering papers when I was 11. In Minnesota. In the winter.

Compared to that, every job I've had since has been easy. While there may not be papers to deliver in the snow, the point is to do the thing you don't want to do.

Get a hard/crappy job and do it until the voices in your head stop telling you that you can't take it another minute. Everything after that will be cake, and your bad childhood will be over. I promise.

Monday, April 11, 2011

Sexual side effects: A silent epidemic?

By, Ian Kerner

Are meds zapping your mojo? Is a prescription inhibiting your passion? If so, you’re far from alone. More than 27 million Americans take antidepressant drugs and research suggests that 37 percent of those people experience sexual side effects. And that’s just in the category of antidepressants! When you consider that millions of drugs are prescribed for common medical conditions, such as high blood pressure, and that many of those drugs can lead to sexual dysfunction of some sort, it’s no wonder that nearly 40 million Americans describe themselves as being stuck in sexless marriages. Many of us may be grappling with a sexual problem and not even realize that a drug or drug combination could be the underlying cause. In this sense, sexual side effects could be a silent epidemic.

But for many people going off their medications simply isn’t an option. In the case of antidepressants, most people who take them are actually happier than they were before they went on the drugs, and while they may be dealing with sexual side effects such as erectile disorder or loss of desire, they weren’t necessarily interested in sex before the medication either. “After addressing your depression, anxiety, or other mental health concern, you're interested in sex again—enough to worry about how the medication is affecting your sex life,” explains my Good in Bed colleague, psychiatrist Dr. Ed Ratush. “You may be bothered by what you think is a lower sex drive, but consider how you felt before. In a way, your libido has actually increased!”

Sexual side effects don’t have to destroy your sex life, but they may mean that you have to change your approach to sex. In the case of low desire (a very common sexual side effect), you may have to put your body through the motions in order to get your mind to follow. Or you may have to spend a lot more time on foreplay and getting yourself physiologically aroused. Ratush suggests trying a sexual warm-up, a technique that helps generate arousal but intentionally does not lead to climax or ejaculation. “The idea is that the process of getting aroused will increase the person's ability to generate more of the sex hormone testosterone later in the day or later in the week,” he says.

And remember that mental stimulation plays a big role in sexual arousal, so you may have to try some new things and develop some new routines.

What are some other things you can do?

  • Talk to your doctor. Sounds simple enough, but many people are uncomfortable talking about sex with their doctors and, believe it or not, many doctors are uncomfortable as well. Not all doctors are adequately trained in human sexuality, and many don’t take the time to discuss all of a patient’s needs. It can be challenging to start a conversation about sex, but it’s worth it: Your doctor may be able to switch you to a similar medication with fewer side effects. Some people find that switching from Celexa to Lexapro, for example, helps treat their depression without affecting their sex life.
  • Reduce your dose. It’s possible that you can still achieve benefits of medication, but at a lower dose that may not induce sexual side effects.
  • Have sex at a different time. Sexual dysfunction may be significantly higher two hours after a dose of medication and may be less problematic two hours before the next scheduled dose, so time your rendezvous accordingly. Or have morning sex: Testosterone levels are generally highest in the morning and decline throughout the day.
  • Add a sexual enhancer. Some medications can improve excitement by increasing either desire or blood flow. In the case of erectile disorder, for example, a physician may prescribe a medication such as Viagra, or in the case of low desire he or she may recommend a drug like Wellbutrin. It may sound a little strange to deal with the sexual side effects of one drug by adding another, but under the supervision of a physician who is familiar with your medical history, drugs can be combined in creative ways.
  • Focus on diet and exercise. Your lifestyle and overall fitness plays a big role in your sexual health. For example, many people end up gaining weight once they go on an SSRI antidepressant, which also contributes to low libido and erectile disorder.

Dealing with sexual side effects can be tricky and frustrating, but the point is to not just give up. Go on the web and do some research. Be proactive in communicating with your doctor and your partner. Try new things in the bedroom. When you have to say “yes” to drugs, don’t say “no” to sex.

Tuesday, April 5, 2011

Too Old To Hold

Slate Magazine
Science

The mystery of gerontophilia.
By Jesse Bering
April 5, 2011

Perhaps it's just an artifact of having close, affectionate relationships with both of my grandmothers—one of whom was gnarled by debilitating rheumatoid arthritis but was as sage as a Nirvana-bound monk, the other of whom led a flapper-esque alcoholic lifestyle and was clever, mischievous, and wickedly funny—but I've always found elderly women rather endearing. Just as chubby, doe-eyed infants and the smell of baby powder bring out the maternal part of my androgynous personality, the Loris-like gait of an aged spinster redolent with ancient perfume elicits in me a similar strain of docility. On more than one occasion I have been tempted to reach out and hug a lonely old widow making her way slowly down the grocery-store aisle. Yet it is safe to say that, while I am not immune to other curious sexual rumblings from time to time, I have never been titillated by an octogenarian. (Since I'm a gay man, I should add that this applies to the penis-bearing elderly, too. I never really knew my grandfathers, though, so the inbound anecdote wasn't quite as fitting.)

There certainly are individuals for whom the elderly are equated, quite strongly, with the erotic, and it's these fascinating, little-known souls—referred to in the clinical scientific literature as gerontophiles—to whom we shall now turn. Austrian psychiatrist Richard von Krafft-Ebing, in his classic 1886 book on sexual deviancy, Psycopathia Sexualis, first described this particular "erotic age orientation." His definition was brief and nonspecific, describing gerontophilia simply as "the love of persons of advanced age." Krafft-Ebing offers the case study of a 29-year-old man who reportedly found sex with "old women" pleasurable after being seduced by one when he was a teenager.

In nosological terms, precise definitions are exceedingly important, however, since younger persons' perceptions of "old" may vary; it's unclear in such cases if we're talking about, say, Sex and the City-old or Golden Girls-old. In a 2005 review of gerontophilia, British psychiatrist Hadrian Ball shows how the definition has sharpened, if only a tad, since Krafft-Ebing's days. For example, in 1981, the American sexologist John Money defined gerontophilia as:

The condition in which a young adult is dependent on the actuality or fantasy of erotosexual activity with a much older partner in order to initiate and maintain arousal and facilitate or achieve orgasm.

Ball laments this continued obtuseness in defining how old is old, exactly, when it comes to certifiable gerontophilia. So he clarifies that by "elderly," the clinical insinuation should be an erotic target aged 60 or more years. This is helpful, indeed, because it emphasizes that the particular sexual orientation is not so much in line with our fetish du jour of a cougar subculture—which, in everyday parlance, implies a libidinous middle-aged woman soliciting the attention of a much younger man. Rather, in sheer chronological terms, gerontophiles are perhaps better thought of as being closer to necrophiles than cougar-hunters. The same applies for women (or men) who prefer old men as partners: While a conventional "silver fox" in his 40s or 50s may be a bit long in the tooth, true gerontophiles are more likely to find themselves with someone who has no teeth.

It would be a major understatement to say that scientific research on gerontophilia is scant compared to the study of other paraphilias, but scattered references do exist. In 1929, a psychiatrist by the name of "A. Kutzinski" published a brief case study in Psychiatry and Neurology. The author writes about his gerontophile patient:

At the age of 24 he married, and he had six children; he served in the army during the war. Following complete sexual abstinence for over a year, he encountered, while bathing, an elderly woman with whom he had sexual relations. He lost all love for his wife, showing instead outspoken erotic impulses toward elderly women, which were so compulsive that they rendered work impossible.

In terms of the actual prevalence of gerontophiles, there is no known figure, or even an ongoing attempt to find one (at least so far as I can gather). Unlike pedophilia (peak attraction to prepubescent children), hebephilia (peak attraction to early pubescent-aged children) ephebophilia (peak attraction to adolescents) and teleiophilia (peak attraction to reproductive-aged adults), gerontophilia has not been explored systematically using sexological laboratory techniques—penile plethysmographs, clitoral stimulation measurements, and so forth—that are capable of assessing precise strength of genital arousal to images, sounds, and stories depicting differently-aged characters.

Ball points out that there is absolutely no mention of gerontophilia in either of Alfred Kinsey and his colleagues' most famous works (Sexuality in the Human Male, 1948, and Sexuality in the Human Female, 1951). Kinsey certainly wasn't shy about discussing other stigmatized sexual proclivities, such as bestiality and pedophilia, so this is an interesting omission in his works. Neither is there any specific mention of gerontophilia in the clinician's diagnostic bible, the DSM-IV—odd, since, within psychiatric circles, it is at least implicitly conceptualized as a distinct type of sexual deviancy, especially when it involves elder abuse. "The lack of any specific recording of gerontophilia within classification systems is probably significant," writes Ball:

Other sexual states are independently mentioned; examples include exhibitionism, voyeurism, pedophilia and sadomasochism. It can be deduced that the absence of the term gerontophilia is an indication that the condition does not typically present itself to mental health clinicians as a major clinical problem demanding a solution.

In other words, the population-level occurrence of gerontophilia appears to be miniscule by comparison with that of the other erotic age orientations. There are multiple ways to interpret this ostensible infrequency of the phenomenon. First, it is possible that gerontophilia is more common than we realize; unlike pedophiles, individuals who find themselves aroused principally by the elderly may be viewed as unusual, and certainly confusing, but they are not seen as criminals. Thus, cases of gerontophilia simply may not come to light as often as other erotic age orientations. From a lawyer's perspective, for example, Harold's relationship with Maude was perfectly legal—grist for the gossip mill, but that's about it. Humbert's relationship with Lolita, by contrast, was a criminal affair. Another way to interpret the dearth of gerontophiles, however, and one that makes more theoretical sense, is that it runs against the evolutionary grain. It's not terribly difficult to understand why the average person would become more intensely aroused by a bland coed than a hoary siren. There's the obvious problem with reproduction and menopause, which contradicts our evolved (if unconscious) interest in passing along our genes. The same logic suggests there wouldn't be many "true" pedophiles around, either. Indeed, recent findings suggest that pedophilia, for its part, is much less common than hebephilia or ephebophila.

Yet as unusual and counterintuitive as gerontophilia may be, the pornography industry reminds us—as it so often does—that there is a niche following for just about any form of love. Whether it's genuine gerontophiles who gravitate to these fetish websites or, perhaps more likely, puerile peeping toms with a fleeting carnival curiosity, is impossible to say. But there are at least two fairly "popular" dating websites catering to connoisseurs of the aged, one for straight men (www.nannydate.co.uk) and one—definitely NSFW—for gay men (www.silverdaddies.com). Even these specialized dating websites, however, do not appear to include many admirers of the most senior of senior citizens, but instead are laden with a common vernacular ("mature," "experienced") to connote a primary interest in late middle-age. From a clinical perspective, those with a sexual dependency on cougars, nannies, MILFs, DILFs, silver daddies, and so on would be lumped together under the normative category of teleiophiles, but it is interesting to note that this umbrella group could, in principle, be subdivided further still into even more discrete erotic age orientations through the same physiological measurements discussed earlier.

Literary erotica featuring elderly characters is mostly nonexistent as well; when they do appear in fiction, they're more likely, as Ball points out, to occur in the horror genre. In the short story Awake, Sleeping Tigress (1972), by Norman Kaufman, the narrator is a nauseated 23-year-old fugitive who's been blackmailed by his lecherous 100-year-old landlady into having sex with her:

I looked at her as a sick loathing constricted my throat: I looked at the thin white hair and the sunken cheeks and the toothless mouth; at the flat chest and obscene swollen belly and the fleshless flanks. I moved towards her, found myself touching the mottled body, felt the stink of the dirt in my nostrils, felt the bile in my mouth as the veined arms encircled me …

One man's worst nightmare is another's wet dream, however, and, rare though they may be, we've established that gerontophiles do indeed exist, even toward the extreme end of the age spectrum. Let's take at face value this Reddit thread, for example, in which the fit 32-year-old poster outs himself as a "gay gerontophile" and invites honest questions from the curious. He claims that he is financially secure and that there are no monetary incentives to his taste for heavyset men 60 and above, that he became aware of his predilections for this abundant demographic—one respondent remarks cheekily to the gerontophile that "the world is your oyster!"—at the age of 15, and that the oldest partner he'd ever happily copulated with was a 77-year-old man. The sparse scientific literature focuses exclusively on male gerontophiles like him; that could be because female gerontophiles don't actually exist. Yet maybe, just maybe, we've all been a bit hasty in judging women like Anna Nichole Smith (who at 26 married wheelchair-bound, 89-year-old oil tycoon J. Howard Marshall) and Crystal Harris (24-year-old fiancĂ©e of a still-peppy, 84-year-old Hugh Hefner). Nah.

The whole subject, of course, is bound to unleash a torrent of crude jokes, but there are some sobering considerations regarding the safety and well-being of vulnerable adults. In a 2007 report in Aggression and Violent Behavior, Ann Burgess and her colleagues report several case studies involving sexual abuse of the elderly. Although many such cases are opportunistic (occurring, for example, without premeditation in the context of a robbery) or symptomatic of the perpetrator's more generalized sexual sadism, a slim minority do appear to involve individuals who specifically target their victims because of their advanced age. The authors describe the case of a 33-year-old nursing-home assistant who'd been quietly molesting and raping his female charges for several years. Some of this man's victims were rounding the epochal century mark and were suffering from dementia, thus his defense was that they were "not aware of what was happening."

The abuse might have continued in silence, had not the shrewd daughter of a 98-year-old woman deduced foul play by noticing that her mom became uncharacteristically frightened whenever the elder-molesting aide came into the room. Ball also reviews forensic data revealing that, in the U.K., somewhere between 2 and 7 percent of all rape victims are over the age of 60.

Elder sexual abuse is reprehensible, of course; but from a bloodless moral philosophical perspective, it does raise intriguing questions about issues related to consent, trauma, and the impact of sex crimes on victims with different psychological and physical stakes. Is the rape of a 98-year-old Alzheimer's patient—who, whether we like it or not, has only a limited awareness of what is happening, just as the perpetrator says—comparable to, say, the rape of a lucid, vulnerable child who would have to deal with the emotional scars of such sexual violence for the rest of his or her long life, or a teenager who might be impregnated?

It should be stressed that there is no link between violence and gerontophilia, and in fact at least some gerontophiles appear especially concerned with the well-being and safety of their erotic targets. A self-confessed "straight gerontophile" on another Reddit thread writes this, for example, in response to queries about the physical logistics of making love to an elderly woman:

So far as worrying about injuring them, I do worry. Very much so. For that reason I usually let her lead the way, I figure she knows her limitations better than I do. But obviously I don't toss any woman I'm with around like a rag doll. As fun as that might be if she's into it, a broken hip would put a downer on things.

The etiology, or psychosexual origins, of developing such a taste for aged flesh is presently unknown. Not surprisingly, earlier theories tended to highlight Oedipal influences, with gerontophiliac males said to be expressing some form of repressed carnal desire for their own mothers (or grandmothers). John Money, however, pushed aside the Freudian psychoanalysis and instead postulated a hazy, unrefined model of sexual imprinting, in which sexual experiences with significantly older adults stamp on the individual's brain an erotic fixation on this type of age disparity.

In a 1992 issue of the Journal of Forensic Psychiatry & Psychology, Ball describes a case that touches on both theoretical perspectives. A 17-year-old male who'd been sentenced to youth custody after trailing elderly women into elevators and assaulting them, reported that at the age of 12, his mother "displayed herself to him and played with his penis." By 16, he realized he could not maintain an erection by fantasizing about girls his own age, but only by masturbating to imaginary (much) older women. His ideal partner, he said, would possess the following characteristics: "face would be old, hair going grey, normal or fat."

Perhaps the oddest theory regarding gerontophilia was the one put forth—without any supporting data—by British psychiatrist T. C. Gibbens in 1982. This inventive author thought that gerontophiles are likely to have underlying pedophiliac tendencies as well, both paraphilias stemming from a phobia of pubic hair. Brushing off the pubic-hair issue, an article from earlier this year in The Lancet does describe the case of three individuals who, on pre-admission to a nursing home, "appeared as frail, nice elderly men." It wasn't long before these men began taking egregious sexual liberties with their co-residents, "massaging the breasts or buttocks of the most frail women," "committing sodomy," and "making rude gestures." Intriguingly, in their earlier lives, two of these men had served jail time for child molestation and, though he wasn't prosecuted, the third man was thought to have molested his nephews. Whether such individuals are pedophiles, gerontophiles, or simply those that would take sexual advantage of vulnerable people, is unclear. It's important to recall that gerontophiles are dependent on having an elderly sexual partner to achieve orgasm, not simply that they are willing to make love to a senior citizen.

Alas, from the perspective of psychiatry, gerontophilia is the youngest of all the paraphilias, and remains a great enigma.
Jesse Bering is an evolutionary psychologist and director of the Institute of Cognition and Culture at the Queen's University, Belfast. His new book, The Belief Instinct, will be published in February (available as The God Instinct in the United Kingdom). He also writes the column "Bering in Mind" for Scientific American and is currently working on a book about human sexuality. His Web site is www.jessebering.com.

Article URL: http://www.slate.com/id/2290515/