This is part two of the Playboy Interview with Masters and Johnson from the the November 1979 issue of playboy magazine. Click here to read the first part.
Why did you choose to combine them?
MASTERS: We had always intended to study the physiology of homosexual behavior. At first we thought we would report on what we found, just as we had in Human Sexual Response. But we discovered that from a physiological point of view, there was no difference between homosexual response and heterosexual response. Once that was established, there certainly was no indication for a major report.
By that time, we had also learned that we had made a mistake in withholding psychological data in the earlier books. After publishing Human Sexual Response, we were accused of being nothing but “mechanics.” One of the outstanding critics of the work pointed out that the word love isn’t even mentioned in the book—which is true. What that critic very carefully didn’t say is that the word love probably had never been mentioned in any other physiology textbook, either.
JOHNSON: When the world learned that we were working with people in the laboratory, they immediately developed this image of mad scientists, or technicians. I desperately do not want either of us to come through as making sex mechanical, in or out of the laboratory. The people for whom sex works very well are not mechanical people.
How did you recruit subjects?
MASTERS: Fundamentally, by word of mouth. There were a few homosexual couples from St. Louis who worked with us first. When they were genuinely convinced that ours was an objective approach, they helped us contact other people in different parts of the country and encouraged them to participate.
Did you get any help from national gay organizations?
MASTERS: When we started the homosexual-physiology work, in 1964, the national organizations were just fledgling—or were keeping a low profile. We also avoided the gay-bar society, because at that time it did not provide stable relationships. We needed committed couples, not singles.
MASTERS: We wanted to compare homosexual physiology with heterosexual physiology, and most of the subjects in our original heterosexual research were married couples. We needed “committed homosexual couples” in order to have a basis for comparison; but in the Sixties, most such couples were in the closet. However, we also studied a small group of singles, who met assigned partners in the lab.
Would you describe the subjects you found? Were they exhibitionists or just curious?
JOHNSON: Most of the research subjects had an extraordinary interest in learning about their own sexuality. They tended to trust the protected conditions of a research environment. Frequently, they mentioned that someone for whom they cared had had a distressful sexual experience. They felt that this distress had been related to lack of knowledge, lack of concern, lack of compassion. They often expressed what appeared to be a genuine hope that our research would help mankind. Some, as you suggest, were just plain curious.
Other than willingness to help, did the subjects have to have any particular characteristics?
MASTERS: All of the subjects had to be able to respond to self-stimulation, mutual stimulation and either fellatio or cunnilingus. In addition, the heterosexual subjects had to be able to respond effectively during intercourse. We would discuss this by telephone as part of the preliminary screening technique, before we took their histories or introduced them to the lab environment.
Did you measure ability to respond by their capacity for orgasm?
MASTERS: Yes, although we certainly acknowledge that sexual proficiency is not synonymous with orgasmic responsiveness. Sexual gratification, sexual maturity and sexual interest are phenomena that must be considered somewhat apart from orgasmic attainment—or orgasmic failure—alone. But our ability to document orgasm as a precise, definable physiological event made it a useful form of measurement.
How did your subjects perform during intercourse?
MASTERS: Couples failed to achieve orgasm only three percent of the time. And that small failure rate was still four times greater than the failure rate for masturbation, fellatio/cunnilingus or partner manipulation.
But isn’t that an astonishingly successful rate? It has been suggested that your study is biased in favor of sexual superstars, as if you were writing a book on running after interviewing the top five finishers in the Boston Marathon.
MASTERS: I think that’s very fair criticism, but if you want to know what happens, you generally will have to work with those it happens to. We have been studying people who were selected for functional ability in a laboratory setting. We haven’t the vaguest idea of what happens at night, in the dark, under the covers, in the privacy of people’s homes. JOHNSON: There is another reason for studying functional people. To ask an individual who has any history of sexual problems to perform in a lab would be unthinkable. The pressure and potential for trauma could be enormous.
Even the superstars, however, did not do as well during intercourse as they did when experiencing the other forms of stimulation—masturbation, manipulation or oral sex. Does that suggest that intercourse is vastly overrated as a form of pleasure?
MASTERS: If you think about it, the three types of stimulation you just mentioned occur in a my-turn/your-turn situation, whether practiced by homosexuals or by heterosexuals. In masturbation, one is setting one’s own pace, and one is obviously acutely aware of one’s own needs and levels of response. Preferred techniques of stimulation are used as desired. When one is being manipulated by a partner, it’s still a my-turn/your-turn situation, which, with good communication, can work very well. The same thing is true for fellatio/cunnilingus. One partner can focus his or her entire attention on the other and get some sense of what works—through good communication, same-sex empathy or because of familiarity with your response pattern. But in intercourse, we have two people trying to function simultaneously. Inevitably, that is more difficult. There is more opportunity for failure when two people are involved in routine sexual interaction than when responding on a my-turn/your-turn basis. The catch is that the culture says that intercourse is the be-all and end-all of sexual expression.
Aren’t those forms of stimulation subject to the charge of “servicing” one’s partner rather than finding sex mutually pleasurable?
MASTERS: Well, the answer to that is yes. But intercourse can be mere service, too. It is still true in this country, let alone in the rest of the world. Intercourse is a service. There are infinitely more times that the female is used for service than the female and male are together as full partners in intercourse. That is true wherever you have a double-standard society. And that’s most of the world.
Did you intend in Homosexuality in Perspective to make those other forms of stimulation more attractive?
MASTERS: The book is not in any sense designed to be a cookbook or marriage manual. What it does is report what actually happens, as we perceive or measure it in the lab.
JOHNSON: We think it does indicate the many dimensions of erotic stimulation that are available, and we believe that people also have a right to be informed. But right now it seems that many people are terribly vulnerable because of the proselytizing that goes on in the name of ultimate sex.
Meaning intercourse. In spite of the drawbacks you list, many of us prefer intercourse. Why should we change approaches?
MASTERS: I think if we limit ourselves—in any area of interest—to one specific focus, we tend to become restless, unsatisfied and bored over X amount of time. When there is only one right way to do anything, originality is neutralized. Variations can only be so much. Americans rely too much on intercourse.
Perhaps I could compare lovemaking to tennis. It’s like trying to build a game around just a forehand. If someone serves to your backhand, you’re in desperate trouble. You can run around it only so far. If it’s a good serve, you can’t run around it. I’m not saying that the forehand isn’t of value. What I’m suggesting is that if there is only one official way to get pleasure, and you don’t vary it, then you have people trying to cope with boredom by varying partners. If they vary partners lots of times, they’re still doing the same thing. One, two, three, kick. The variances come in the fact that the grass seems a little greener in the neighbor’s back yard. And it’s a little greener until you’ve been there two or three times, and then you have to go somewhere else. We suggest that in order to keep the grass green in one’s own back yard, there’s great advantage in varying the way the lawn is fed.
Perhaps the one notion that most heterosexuals have about gays centers on anal sex. It is generally assumed that it is the gay equivalent to intercourse. Did you observe that behavior in the lab?
MASTERS: For the homosexual men we were working with, it wasn’t the primary means of sexual release, although anal sex was frequently experienced.
But you studied it, didn’t you?
MASTERS: With a few subjects: five homosexual and seven heterosexual couples.
What did you find?
MASTERS: We asked each of the homosexual and heterosexual couples to engage in anal intercourse on two occasions. We noticed an interesting physiological response. Upon initial penetration, there was discomfort, for some partners approximately half the time, but then the sphincter would relax. After full penetration was obtained, there was no further evidence of discomfort. Once thrusting began, the sphincter would reverse its relaxation pattern and constrict tightly around the shaft of the penis.
Did the partners find anal intercourse pleasurable?
MASTERS: The female recipients reached orgasmic levels of sexual excitation on 11 of 14 occasions; there were three instances of multiorgasmic experience. The male recipients did not respond in a similar fashion. In ten episodes, there were only two instances of male orgasm, and in both of those instances, the men were masturbating while they were mounted rectally.
That finding runs against the common myth—it reverses the stereotype that anal sex is the sole right of gays. Women enjoy it, too?
JOHNSON: Some women enjoy it.
Perhaps that finding will permit heterosexuals to experiment a bit more, just as the Kinsey Report effectively gave people permission to try other forms of sexual behavior.
MASTERS: The answer is, who knows? Our role is not to give people permission. It is to present reasonably reliable sex information to the best of our ability, first to the health-care professions and second to the general public. What people do with that information is obviously up to them; many will reject it completely.
JOHNSON: Because that is the response that may be appropriate either to the requirements of their anatomy or to the lifestyle and values with which they are effective and secure.
What do you think of such books as The Joy of Sex? Do they provide useful information?
JOHNSON: The need for that type of book obviously is real, but I think it is one more reflection of people’s lack of confidence in their own ability to explore and share sexual feelings spontaneously with someone in a similar frame of mind. Most of all, the popularity of such books reflects the failure of a society and the parents in that society to prepare their children for the joy of sex.
We’ve noticed that although you’ve said that gays tended to spend more time on certain forms of lovemaking, you never specified the actual times involved. Why?
MASTERS: Because the minute that we say “the average time is such and such,” people are going to start measuring themselves against a presumed standard, and then sex becomes more mechanical and less spontaneous. For example, when we published Human Sexual Response, we purposefully did not include information about the average size of the penis. To some degree, we hoped that by not doing so, we would neutralize the concept that penis size is crucial to sexual response.
If you helped defuse the myth that penis size counted, you did so not because you failed to include measurements but because you pointed out that the female physiology generally can accommodate to the difference. Would you reprise that information?
MASTERS: Well, it has to do with the female’s facility to respond vaginally. The vagina acts in a very interesting way from the time the woman is mounted—presuming there is enough time. Once the female is fully penetrated, the vagina tends to overexpand—regardless of the size of the penis. Then, in a minute and a half to three minutes, with a continuing thrusting action and presuming the male hasn’t already ejaculated, then the vagina begins to contract. It eventually will fit snugly around the penis, regardless of its size. Now, there are certain exceptions to this—the micropenis that is pathologically small or the occasional huge penis that causes a great deal of pain. But these are rare. In routine coitus, the vagina adjusts itself to the penis regardless of size and constricts itself around it, presuming the woman is given time to do this.
But if she doesn’t have time, then size might count.
Masters: Right. But the difference, of course, depends on whether or not the woman believes there is a difference. The adjustment is involuntary. The woman doesn’t know she is doing it, so it may well be that it is like anything else: If I believe white is white, it is going to be white the rest of my life, no matter what.
JOHNSON: It is the same reason women buy one soap over another soap product. For ages, they have been conditioned to believe that the well-endowed man has it all over the less-endowed man. If she believes it, then it can matter, of course.
All right. You’ve given the explanation. Shouldn’t that suffice? Why not release the figures? You say your intention is to provide information. Why not release the penis-size figures and let the chips fall where they may?
MASTERS: I agree with you. But if we had published the size, the rest of the information wouldn’t have made any difference. Everybody would have been using a measuring stick. That way lies impotence.
We suspect that everyone who would already has. Certainly, you could have given the extremes. Say, the male penis is between a quarter of an inch and four yards long.
JOHNSON: [Laughs] I like that range. Masters: Sure we could, but we decided not to measure it at all. No, that isn’t true. Measurements were done, but we decided not to publicize them at all. Some damn fools have publicized measurements somewhere.
But you’ve argued that fact is the only way to fight biases, prejudices and the like. Yet, in this instance, you are not scientists.
JOHNSON: It’s just Bill’s stance and I understand it. But I think the point is perfectly well made as you’ve just stated it. It isn’t scientific. We have more of a commitment to prevention than to the pure science of information. I genuinely love information. I like to know anything and everything I can possibly know about something. I’m not particularly emotional about that information, but once you see the incredible susceptibility of people to being told what they should do and what will happen if they don't—then you cannot help but develop a sense of protectiveness.
To go back to the earlier analogy of running, people who jog are not intimidated by the racers who run four minute miles. Why are you so sure that in the sexual arena people will feel threatened by information?
MASTERS: There’s a hell of a difference between what you do when you’re running and what you do with your penis—or don’t do with it. And you can be just as objective as you want about being unable to run the four-minute mile, but if someone says to you you should routinely complete intercourse in ten or fifteen minutes, then millions of people are going to try. JOHNSON: This is a very vulnerable area. If we are going to be allowed to create a science of human sexuality, then I think we have an obligation to make people understand that there are tremendous variables within the natural range. It’s a new field. You cannot open it up and presume immediate total comprehension.
There can be back-of-the-neck orgasms, bottom-of-the-hand orgasms….
Let’s take this opportunity to review the basics. You stated that during intercourse, the clitoris receives indirect stimulation. There are many women who say that may be true for others but not for them. What do you say?
JOHNSON: The clitoris does not require direct stimulation or contact. The total body is a potentially erotic “organ.” It is very possible to choose a completely asexual part of the anatomy and develop it as the source of sexual stimulation to orgasm. There can be back-of-the-neck orgasms, bottom-of-the-foot orgasms and palm-of-the-hand orgasms.
Our readers may be acquainted with that last kind.
JOHNSON: I grew up in the country, where little kids learn that it’s very sexy to play with the palm of a hand. It has to do with nerve endings, in terms of the sensuous susceptibility of certain parts of the anatomy over others. Similarly, the clitoris is a unique organ, insofar as we know it has no other purpose than receiving or transmitting sexual pleasure. It is certainly very responsive to stimulation, and it is possible for a woman to develop that response to a level of dependency, because she knows it works and she doesn’t know that anything else works. Those women who have not responded in intercourse after having developed real orgasmic effectiveness by stimulation of the clitoris, either by self or by partner—but who expected direct transposition of this successful response pattern to intercourse—can be very disappointed or disillusioned about their presumed “inadequacy.”
Let’s get this straight. First, there was the debate about clitoral versus vaginal orgasms. Your notion is that all orgasms are clitoral orgasms, or rather, all orgasms are total-body orgasms. All this can get a little confusing.
JOHNSON: Freud postulated that if a woman could not be stimulated to orgasm by intercourse, she was sexually immature. He carried it rather far. This is not to indict Freudian concepts in general. His incredible genius was getting answers from women at a time when it was highly inappropriate for women to express themselves sexually. Freud also was a man whose interpretations must have had a lot to do with his personal life. To make matters more difficult, his perceptions and his theories have often been taken out of context by those who treasure a single concept and defend it as the only way—the Word.
We just read an abstract from the Third International Congress of Medical Sexology in which a sexologist claims there are clitoral, vaginal and uterine orgasms.
JOHNSON: Oh, Saint Christopher! The amount of garbage in this field, and the number of people without credibility! Of course, the uterus responds with orgasm—if the woman responding has a uterus. Every other part of her system responds in some fashion as well. The variables are in degree of involvement and intensity and in subjective perception. There aren’t a dozen people in this field who know what they are talking about in terms of the nature of human sexual response. No. Make that 24.
MASTERS: You’re stretching it.
JOHNSON: There are many people out there in the world who have made their own sexual self-discoveries who have infinitely better sexual insights than so many people who presumably are researching the subject.
We’ve heard of doctors who claim that they can cure an inorgasmic woman by surgically realigning the clitoris. Is there any basis to that claim?
JOHNSON: Don’t ask me!
We’re asking you.
JOHNSON: I have such a violent response to that that I don’t even want to publicize it. For God’s sake, this is where I become a radical feminist in every sense of the word. By the way, I’m aware of the strategy of ignoring something inconsequential until it dies a natural death, but I find it difficult to invoke with this issue. That a man determines what is wrong with female anatomical design and a few silly women say “It’s so wonderful” sets us back 50 years. My husband will not criticize other doctors, but as a woman, I cannot sit still and give you a benign smile when you ask me that question. If someone, as an individual, wants surgical modification of anatomy that is neither malformed nor diseased, fine. But for someone to promote a male-oriented, male-originated concept of what women can or cannot do without this surgical intervention—it’s taking gross advantage of the lay person’s vulnerability.
In Human Sexual Response, you suggest that women are potentially multiorgasmic. Yet according to The Hite Report, as many as 70 percent of the women in America are unable to reach orgasm during intercourse. How do you respond to such findings?
JOHNSON: Such reports are very mixed blessings. There are a lot of simple truths that can be distorted by poor interpretation of such reports. They do not reveal the capacity or potential for woman’s sexual response. They only reveal the prevailing condition of generations of women taught to deny their sexual feelings and needs or to pretend they didn’t exist. That is the disservice of such reports. On a more positive side, they do let a woman know she is not alone in her inability to reach orgasm with intercourse. Unfortunately, they strike a note of discouragement at the same time by failing to indicate the realistic expectations she can have for reconditioning a pattern of inorgasmia with intercourse. I’m especially concerned for the woman who might ultimately have discovered this for herself had she not accepted the discouraging interpretations as fact.
There are some women who experience something that they aren’t certain is an orgasm. How do you treat that situation in therapy?
JOHNSON: It’s possible that a woman is orgasmic and doesn’t know it, but I don’t think you can make this judgment for or against such an occurrence unless you have a good definitive history from her about what she thinks orgasm is. One way to further evaluate what she thinks it is is to find out how she came to think about it. Did she read about orgasm? Did somebody tell her? From where did she draw her conclusions? I usually move away from direct questioning at that point and suggest that we talk about her sexual feelings and how they began. We start with the early memory of genital feelings, physical feelings. Then we move in general terms to the circumstances under which they occurred, and then I try to establish her sense of intensity of feelings. Then I try to place these things in an update of her present relationship or present opportunities to respond to some kind of sexual stimulation. Then I want to find out in that whole course of history-taking the kinds of things that she considers stimulating and exciting, romanticized or technical or mechanical or whatever. I want to know where she’s at, what her own base lines are to the extent that she can be disarmed into discovering them for herself. Then with that matrix of knowing how she thinks of herself—sensually in other settings at other times—we go into the circumstance she’s describing: “I don’t know whether I’m orgasmic or not.” Finally, we can kind of measure one against the other.
Isn’t that something new lovers should be doing with each other, anyway?
JOHNSON: I think it’s a part of the excitement of sharing, but most people are so far away from looking at it that way. They think it’s an admission of inadequacy or an admission of previous activity that’s going to engender jealousy. Couples just don’t get into that kind of talking. They personalize. They put clothes and faces and times and places on these activities. I don’t think that is necessary and I think in the present state of the art of forming social or sexual relationships, there is always the factor of jealousy—the emotional tugs and pulls of knowing somebody else has shared something with the person of their choice.
What are the essential ingredients of an orgasm?
JOHNSON: It is a blend—almost always an unequal blend—of three things. An orgasm represents the body’s physical drive to express itself sexually, its system responding sexually. We have to presume a drive. I think it’s rather well established that such a drive exists. Second, there are psychological and emotional requirements that we learn to develop and fulfill. And, third, there are the influences of the social environment. There are dozens of other ways to label those three general areas of sources of response, but all of them have to be present to some degree. It is possible to pre-empt the requirements of two of them by overemphasizing one. The physical, the component that is the entree into the physical drive, is the actual tactile friction that one can apply. The perfect example of this is the woman who is fully satisfied, satiated sexually, who is disinterested in the time and the place and the circumstance, who couldn’t care less at that moment whether she is orgasmic or not—who, as an exercise in achievement or because she has nothing else to do, will pick up a vibrator and will in the face of no interest, no drive, no nothing, produce orgasm. Women all over the world are proving this in the privacy of their own rooms, all the time.
Would you give an example of one of the other sources?
JOHNSON: Let’s take a woman of poor physical well-being, who has a low sex drive for physical reasons or psychological reasons—other demands that are more important—whatever. Give that person an extraordinary evening with a person of choice in a remarkable set of circumstances and you will find that the requirements that are being poorly met by drive or by physical friction are preempted by what you would have to say are the psychosocial components.
You sound like you’re describing the ideal fantasy evening.
JOHNSON: In the past 20 years, we’ve observed several women who were able to reach orgasm through fantasy alone—utilizing none of the other components.
One of the more controversial chapters of Homosexuality in Perspective was your research on fantasy. Dr. John Money, for example, charges that “You can’t understand the sexuality of anyone on earth if you don’t understand their erotic imagination. Masters and Johnson do not appear to be attuned to that part of people’s lives. They measure what can be measured with instruments. You have to build up an extraordinary amount of trust before you can get people to unlock their secret, dangerous images. The content of erotic imagery in homosexuals is different from that in heterosexuals.” How did you get the fantasy material?
MASTERS: To me, the most important thing in the chapter on fantasy is how we gathered the information. We certainly agree with Money that it takes trust, understanding and more than one interview to collect fantasy material that is sufficiently reliable for interpretation. It has been our experience that people tend to tell the interviewer or therapist first what they want you to know. Second, they tell you what they think you want to know. It’s rarely before the third level of interviewing that they tell you how it really is. During the period the fantasy material was being collected—1957 to 1970—three types of interviews were conducted with each subject from the homosexual, heterosexual and ambisexual study groups. First, each subject was interviewed by the research team and then interviewed separately, in depth, by each member of the team on a one-to-one basis. The interviews were open-ended and continued over a two-to-three month time interval until their completion.
Why is that important?
MASTERS: Until very recently, most of the available information we have had on fantasies has come from the published clinical findings of psychologists or psychiatrists. Consequently, most of our beliefs about fantasy tend to be based on the fantasies of persons undergoing treatment for sexual and other problems. It seems to me that if one is going to make use of fantasy material in psychotherapy—as a factor in diagnosis, in the study of process or as a means of evaluating progress—it should be done on a conceptual basis that includes a study of fantasies of men and women who do not have need for health care. If the researcher or clinician questions a sexually dysfunctional male about his fantasies, for instance, what is the basis for determining the significance of his answer? There is a great advantage in having information on the fantasy patterns of sexually functional people, especially when one is trying to arrive at an effective diagnosis for treatment of those men and women who are sexually dysfunctional.
The fantasy that was most frequently reported by all of our groups was that of forced sex.
For years, psychiatrists have used fantasies to diagnose latent homosexuality. If a man dreams about having sex with another man, he’s automatically labeled deviate and subject to therapy. Are you challenging that?
MASTERS: We recorded the five most frequent fantasies for homosexual men, homosexual women, heterosexual men and heterosexual women. The fantasy that was most frequently reported by all of our groups was that of forced sex—the imposition of will, either physical or psychological. The only other fantasy that was common to all four groups was that of cross preference. Homosexual men frequently reported fantasizing about having sex with women, and lesbians similarly reported fantasies about sex with men. Heterosexual women also described fantasies of making love with other women on numerous occasions, and heterosexual men frequently had fantasies about sex with other men.
What does all this mean?
MASTERS: There are innumerable possible interpretations of this data that will be reported later. Suffice it to say that at present, this information should make us take a long look at a very popular diagnosis—"latent homosexuality.“ We have been asked to believe that if a male patient describes regularly recurrent fantasies about sex with other men, he can be labeled a latent homosexual. But consider this: When a homosexual man reports recurrent fantasies of sex with a woman, he has not been labeled a latent heterosexual. What it really means is the diagnosis of latent homosexuality may not have as secure a connotation as we had previously been led to believe.
You mentioned that forced sexual encounters were fantasized by all four groups. Were there any differences between, let’s say, how a homosexual male and a heterosexual male fantasized about forced sex?
MASTERS: In all but one instance, the homosexual man was the rapist. The victims—who were restrained and forced into sexual service via whippings or beatings—were just as likely to be women as men. In contrast, the heterosexual men commonly imagined that they were the ones being forced to have sex—usually by a group of unidentified women rather than by a single woman. However, when they imagined that they were the rapist, the victim was usually identified as a specific woman.
How did the fantasies of lesbians differ from those of heterosexuals?
MASTERS: The forced-sex fantasy was the most frequently reported fantasy for lesbians. Their fantasies might cast them as either victim or rapist. Indeed, they often switched roles back and forth in the same fantasy. Usually, the rape did not involve physical abuse, but rather, some form of psychosocial pressure. Heterosexual women usually imagined they were being "taken” while an unidentified male or males rendered them helpless. But there was little specific sadism or masochism in their fantasies.
What was the most popular fantasy for heterosexuals?
MASTERS: The replacement of one’s committed or current sexual partner. For a man, it could be someone he knew or a public personality. In his fantasy, she was always willing.
That makes sense. Why waste a fantasy on someone who is unwilling?
MASTERS: Even more often, a heterosexual woman imagined engaging in intercourse with a specific man—a Robert Redford. Others, like heterosexual men, perceived someone they actually knew. Like the heterosexual males, homosexual men seldom fantasized their committed or current sexual partners. Their most popular fantasy consisted of images of anatomy—penis, buttocks, shoulders, facial characteristics. Their fourth and fifth favorite fantasies consisted of idyllic encounters with unknown men or groupsex experiences. Only the lesbian women regularly reported fantasies about their established sexual partners.
How do you account for this pattern? Is it natural for us to lust in our hearts over strangers?
JOHNSON: I have no scientific basis for answering your question—only personal opinion. I think sexual fantasy involving a stranger says one of two things: either that so little has been put into the real relationship—when there is a real one—or the partner is so unappealing that “newness” of a fantasized stranger is used simply to provide erotic stimulation. Or it may be saying something about inability to trust intimacy. Holding back from real closeness, not really getting involved out of fear of embarrassment—feelings that can’t be handled. Does the stranger represent less risk of being misunderstood and rejected? Or less responsibility? Whatever, fantasy ultimately provides a substitute for those needs that are never communicated and therefore remain unfulfilled by the partner. Lesbians in our research group more often were more open in allowing their needs to be recognized by their partners. They evidently built their sexual relationships on a realistic basis that more nearly represented what they wanted and needed. Therefore, they fantasized about their partners. Of course, recognizing the eroticism of reality is not just a lesbian’s prerogative. Anyone can discover it if he tries.
Are you saying that most of us are not able to recognize our own desires?
JOHNSON: I’m saying that the difference between romantic desires and erotic necessities of sexual responsivity is something that very few people comprehend. We’ve had 30 therapists at our institute for training and it has been something less than easy to get them to conceptualize and clinically identify each patient’s sexual needs as unique. Of course, most of us initially must work through walls of mythical, cultural givens before we finally understand something of the nature of sexual response. Put simplistically, the concept is this: There are people who live sex and people who perform sex. Those who live it function effectively because their actions reflect their emotional and psychological needs. Those who perform sex are trying to cope with any number of things that keep them from expressing themselves authentically. They are contending with barriers that prevent them from plugging into their set of unique needs and preferences to which their natural response is keyed. Effective treatment of sexual dysfunction often depends upon whether or not such a person can be helped to identify that source of desire and response within and communicate it to his partner in shared activity. It isn’t enough just to say “I want” or “I need.” That assumes the partner is going to make it happen. It’s only fair to add that another crucial factor in treatment is getting partners to understand and accept the other’s primary needs.
OK, given these ingredients, how would you suggest that a couple deal personally with the problem of the nonorgasmic female?
MASTERS: Seek professional help if trying together has reached an apparent stalemate. Your best friend or your partner may be your worst therapist. In the past few years, we’ve been getting a lot of cases of sexual aversion. This is a reaction to sexual activity, or more often to the anticipation of sexual activity of phobic proportion. It may manifest itself as an incredible level of anxiety, dread or revulsion—even as vomiting, diarrhea, palpitation or even momentary loss of consciousness.
What are the causes of such violent aversion?
JOHNSON: Many things. With some frequency, we are encountering women who develop sexual aversion when their partner decides to teach them how to have an orgasm during intercourse. Mind you, I am talking of a woman who has had no background of sexual disinterest or dysfunction but who enters a relationship where she and her partner become interested in her orgasmic response. She has not been consistently orgasmic or with the desired frequency, and her partner feels that she could—or should—be doing better. They start working on this and sooner or later their efforts become just that—work. Not infrequently, the male partner considers her response to be the measure of his own sexual effectiveness. The removal of the pleasure aspect eventually leaves her simply afraid, to the point at which she has become nauseated or otherwise aversive at the mere thought of sex.
No doubt her lover ends each session with the question “Did you come?”
MASTERS: If you want to improve sex, that is not the right time to start such a discussion.
If you want to improve sex, choose a time when you’re not in bed together and sex, ‘What do you enjoy? What do you feel? Because I care.
When should you start it?
JOHNSON: You choose a time when you’re not in bed together and you ask, “What do you enjoy? What is your experience like? What do you feel? Because I care. Because I really want to know. For all the right reasons, curiosity or just wanting to be a part of your experience. I want to enjoy it, to appreciate it.” Also, if you want someone to tell you what has happened to him or her—at the moment it has happened—learn to ask in advance. Say that it means something to you. Not “Did you?” For heaven’s sake, if she didn’t, think where that leaves her: She has to admit inadequacy or know the possible letdown she may bring a partner who depends on sexual achievement.
Should a woman announce her orgasm?
JOHNSON: Like any experience that you acknowledge to another human being, it gains another dimension. If you smell some marvelous fragrance, it certainly reinforces that experience if someone else shares it.
Obviously, if a woman thinks that lovemaking is going to be followed by a quiz—with no chance for a make-up exam—she’s going to get nervous. You mention sexual fakery in your new book. Would you explain the term?
MASTERS: Sexual fakery is an escape hatch, a pattern of behavior that offers the illusion of self-protection. The heterosexual woman who fakes an orgasm would be an instance of sexual fakery. Another example is the homosexual man who is impotent, and therefore always plays the role of the stimulator and insists that he has no interest in receiving pleasure. Usually, this sexual fakery is identified. In the long range, it is rarely anything but deleterious to the individual who practices it.
How does a homosexual woman practice sexual fakery?
MASTERS: In the same way the heterosexual woman does, pretending orgasm. We gave an example in the text of a woman who had engaged in homosexual behavior for ten or twelve years without achieving orgasmic release. Her partners began to complain that it took such a long time for her to respond, so finally she started faking an orgasm.
Does that make it more difficult for her to reach a genuine climax?
MASTERS: It can. A woman who pretends an orgasm generally tends to do so to remove herself as quickly as possible from the sexual interaction because she presumes there’s nothing in it for her. From then on, her chances of ultimately achieving orgasm are significantly diminished, for lack of opportunity and perhaps because she ceases to become involved sensually.
Have you read the foreward to Kurt Vonnegut, Jr.’s Mother Night, in which he warns: “We are what we pretend to be, so we must be careful about what we pretend to be”?
MASTERS: That’s a good understanding of the problem. People who are sexual fakers begin to identify with the image they project. It makes it quite difficult to get to the root of the problem. Once they admit the fakery not only to the therapist but to their committed partner, if one exists, the therapist is well along the road toward helping them. But not until then.
In Homosexuality in Perspective, you also say that you try to get patients to confront their fears of performance. Short of therapy, what can the individual do about performance fear?
MASTERS: Well, it helps a little bit to understand it. And it helps even more if the partner understands as well. Beyond that, there’s not much anybody can do without turning to professional help. Fear of performance is a devastating thing, and effective therapy usually is needed to neutralize it.
Would you summarize your therapeutic approach?
MASTERS: Yes, but we don’t want to appear to be cookbooking it. First of all, we find that facing your fear of performance helps in a therapeutic contest. We explain to patients that having once experienced such fear, they are going to have to live with the possibility of its emerging at any time for the rest of their lives. You must not tell someone that things are going to work splendidly at all times in the future, because after working effectively for two or three years, the fear may return and the man or woman is devastated. It’s much better to be psychologically prepared for realities of sexual response and learn to deal with them.
Our guess is that at least half of the couples in America have sexual problems.
You make it sound as if there’s a sexually troubled person hiding behind every bush. How many people, by your estimate, have sexual problems?
MASTERS: Our guess is that at least half of the’ couples in America have sexual problems. That estimate is based on impressions from our clinical work and an examination of legal literature—divorce cases and the like.
Did any of your subjects try to fake an orgasm in the lab?
MASTERS: On occasion, but it was very easy to tell. The polygraph needle always gave them away.
What are the kinds of problems you handle in therapy?
MASTERS: As I said earlier, in the past few years we’ve been seeing more in the way of sexual aversion. We’re also seeing more cases of male impotence and various female anorgasmic states.
When you wrote Human Sexual Inadequacy, you said that you had an effective-cure rate of around 80 percent. Are you still doing as well?
MASTERS: Our failure rate is running about the same. In some areas, there’s improvement; in a couple of areas, the results are worse than they were. In the past five years, we’ve been less effective in working with the female and more effective in working with the male. It averages about the same. To us these figures represent an improvement, because we’re dealing with more difficult cases.
In what way?
MASTERS: In the first 12 to 15 years of our therapy programs, about 45 percent of our cases were referred to us after there had been failure in prior psychotherapeutic attempts to reverse the sexual dysfunction for which the man, woman or couple had sought professional support. In the past five years, about 85 percent of those who come to us have experienced prior psychotherapeutic failures.
You devoted a whole chapter of Human Sexual Inadequacy to premature ejaculation. At the time, you were quoted as saying that within ten years the condition would not be a problem. Obviously, your prediction hasn’t come true. Can you say why?
MASTERS: Surprisingly, rarely do we see a case of premature ejaculation in the clinic now. Since it’s relatively easy to reverse, our guess is that the first-line health-care professionals are taking care of the problem. It’s screened for us, but it certainly hasn’t disappeared as a sexual dysfunction.
JOHNSON: When we first treated cases of premature ejaculation, we noticed an almost stereotypical case history. Usually, the person’s first experience had been under circumstances in which it was necessary to rush through intercourse under a great deal of pressure. For instance, the back seat of a car. There was no sense that you should linger and appreciate the act; there was just the fun of doing it. I think that conditions have changed—I hope.
With the gas shortage, we doubt that anybody is doing it in back seats anymore. Are there any other reasons for the change?
JOHNSON: I think that premature ejaculation—like a lot of other areas of distress—has come to be accepted as a minor problem. It’s not immediately threatening to the male image. Men know it’s treatable, that there’s something they can do about it. I think there’s a growing feeling about all sexual problems that they are not, as previously thought, a matter of “The Lord giveth and the Lord taketh away.” Which takes them out of that “My life is ruined” or “All is lost” perspective.
MASTERS: Times have changed. One of the last cases of premature ejaculation we treated was that of a 63-year-old man. He had gone to a doctor 25 years previously to seek treatment because he thought he was denying his wife pleasure. The “expert” told him that it didn’t make any difference to the woman, so there was no point in changing. After 25 years, the couple decided to do something about it.
According to Time magazine, you’ve trained over 7000 therapists. How does someone find a therapist?
MASTERS: We have trained 30 therapists. The figure of 7000 represented an approximation of the number of health-care professionals who have attended two-day seminars or five-day workshops sponsored by the institute. When Time called to check the figure, we told them that the designation was incorrect, but they ran the figure of 7000 anyway.
If someone wanted to consult a Masters and Johnson-certified therapist, would he or she contact the institute in St. Louis?
MASTERS: We don’t certify therapists. No one who trains has the right to certify.
JOHNSON: We’d be happy to tell people who the 30 people we’ve trained are. We don’t know to what extent they continue to use our methodology, though. Our main problem occurs whenever some thoughtless or witless writer puts the address of the institute at the end of a newspaper article and we get thousands of letters asking for referral. It absolutely destroys the ability of our office staff to function effectively. We have to stop everything to answer the mail. Bill long ago declared that we would not fail to respond to anyone in trouble who clearly printed his name and address.
How can someone tell if he or she is in the hands of a charlatan?
JOHNSON: You have to rely on others in the community in whom you have already developed trust. If you have a doctor to whom you’re going to entrust your life, then go to him for suggestions of who to consult about your sex life. There’s no perfect system. You cannot define skills practiced by someone behind closed doors. There is a continuing need for review and revision of supervisory procedures. We’re about 50 years behind other fields of medicine when it comes to being responsible for our profession. We have no peer review boards.
In the past few years, several lawsuits have been brought against therapists who initiated sex with patients. Do you have a position on doctor-patient relationships?
JOHNSON: The nature of the patient-doctor relationship is very well defined. Until 1948, the Hippocratic oath contained the line: “I will abstain from… the seduction of females or males or freemen or slaves.” MASTERS: Two years ago, in an appearance before a plenary session of the American Psychiatric Association, we took the position that any health-care professional who takes advantage of a client should not be sued for malpractice. He or she should be arrested for statutory rape.
Isn’t that a bit harsh?
MASTERS: Not really. The client simply isn’t able to give objective permission, or informed consent to the act—because of the very nature of the doctor-patient relationship. If more people were willing to press this type of charge, there would be less of a problem.
Do you find that you have to deal with a great deal of public apathy to your work? Do you ever feel yourselves becoming paranoiac?
MASTERS: To work in this field—I don’t care whether you are publishing playboy or Homosexuality in Perspective—one must expect to contend with significant levels of public opprobrium. When you live for years in this atmosphere, it is inevitable that a significant level of paranoia intrudes on your objectivity.
Are you ever concerned for your security?
MASTERS: Let me put it this way: We certainly don’t have a total sense of security. And we certainly didn’t have a sense of it when we published Homosexuality in Perspective. Anybody as identified in this field of sex research and sex therapy as we are today has to live with the possibility of some manner of social threat.
What kind of threat? Have you received hate mail, for instance?
MASTERS: Hate mail for Human Sexual Response was heavy. Dozens of what we call “drop dead” letters. And there was a significant bundle of similar mail when we published Human Sexual Inadequacy. Inevitably, the hate mail comes in before the “hooray for you” mail. The hate mail comes in the first three or four months, almost immediately following the publication of a book. About 80 percent of it is actually scatological, some of it obviously pathological. Much of it isn’t signed. No return address, so you can’t even respond. But since we published Homosexuality in Perspective, we have received only six drop-dead letters. To me, this is an absolutely amazing change. I anticipated hundreds, even thousands of such letters. They should be here by now. They should be arriving in sacks.
Earlier, you mentioned that a critic had said that love was never mentioned in Human Sexual Response. Neither, perhaps more surprisingly, was oral sex. Why?
MASTERS: We didn’t study oral sex in the original research project because we didn’t have the courage. We were running scared in terms of opportunity to finish the work. We had gambled our professional careers undertaking the investigation of human sexual physiology. Had we been stopped by the university authorities before we had something significant to talk about—where would we have gone from there?
Reduced to a life of private practice?
MASTERS: At best; I might well have been thrown off the listing of a specialist society, even taken off the A.M.A. rolls or brought up for censure before the licensing board for moral misconduct. Those things could have happened.
Have you ever wondered what prompted you to go into sex research at the same time Hefner was beginning playboy 25 years ago? Was it something in the water supply?
MASTERS: I wish I could answer that. Hef and I have talked about it several times. The only thing that I can say is that aside from man’s curiosity about sex, I looked at the total area of human sexual function and realized that nobody knew very much about the subject. Or, rather, that nobody was sure about his information. Everybody knew something about the subject. I suppose it was a combination of an embarrassing lack of knowledge by the health-care professionals and the challenge of working in an area where nobody ever worked before. Such a situation inevitably is a challenge to anybody who’s research oriented—to do things that had never been done before. Of course, Kinsey opened the door for us. Kinsey was the first person to get permission from a major university to conduct sex research. I can find it in my heart to doubt whether Washington University would have given us permission to work in this field if Indiana University hadn’t taken a bath in the cold water first.
Did you ever meet Kinsey?
MASTERS: I met him once in a receiving line. I did not know him. He definitely set the early pace for what we were interested in doing. We received flak primarily because we were not asking people questions about sexual behavior, we were asking people to demonstrate this behavior in an experimental laboratory. It’s a different ball game.
What do you see as the future of sex research?
MASTERS: I would like to see it legitimized to the point where it could be funded in parallel with other legitimate areas of research in human physiology and behavior.
JOHNSON: So that young, well-trained, competent people will be attracted to it, and take these rather primitive early studies and apply the sophistication that is now available. So they might study the perceptions that are enhanced now by the openness in the field, the openness to the idea of human sexuality. Young people could bring incredible insight. Not just a point of view but another stage of the science of human sexuality. But it does take funding and supportive environments, and so far, they are not particularly forthcoming. People are doing what they can. They are certainly working in the psychological and sociological aspects of sexuality, but unless those two areas are supported by basic science and preclinical work, it’s going to fall right back into the old traps of speculative hypotheses. And then we’ll be locked in at another level, as we were after Freudian insights first opened doors to thinking about and looking at the importance of and the role of the sexual dimension of human existence, in terms of daily function—of one’s total existence.
After 25 years of sex research, what remains a mystery to you?
MASTERS: Sex. We don’t even know what we don’t know. There is so little secure information in this field. We don’t even know the questions to ask.
Just how important do you think sex is?
JOHNSON: For most people, sex is of paramount importance in their life. Others have different priorities. Things they value more. However, we are all sexual beings, male or female. The personal option is how we express our sexuality. Although sexuality will remain a dimension of one’s personality regardless of choice, the personal option may be either an active life or a commitment to the choice or circumstance of celibacy. Occasionally, both within one lifetime. One thing you can be sure of: The more one knows about sex, the better chance there is of dealing with it effectively when something is not satisfactory. I believe that is a reasonable principle of education. That is the principle, at least, by which we are committed to sex research. That, plus the fact that we continue to believe that “sex is a natural function.” We’ve proclaimed that for so long now, people surely are tired of hearing it. Maybe in another ten years beyond that, our society will allow us to live it.