Masters and Johnson

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Masters and Johnson

The research team of obstetrician and gynecologist William Masters (1915—) and his then-wife, psychologist and sex therapist Virginia Johnson (1925—) pioneered the study of human sexual response. Their research helped to debunk myths concerning male and female sexual performance, to redefine society's definition of "normal" sexual behavior, to change both male and female expectations for sexual performance and sexual satisfaction, to encourage development of the sex therapy profession, and to coin much of the descriptive language used in modern discussions of sex behavior and sexual response. They also pioneered the use of direct observation as a research technique for the study of sexual behavior.

Masters and Johnson's discoveries led to numerous changes in sexual attitudes and sexual behavior. For example, Masters and Johnson's research focused attention on vaginal lubrications as a source of pleasure in intercourse and oral-genital activity, identified the source of that lubrication, and identified its role in reproduction. As couples became more concerned with foreplay activities which produce vaginal lubrications, sex play became more acceptable in marital and sexual relationships. The team's determination that female orgasms resulting from non-intercourse sexual stimulation are more intense than those resulting from intercourse and that female multiple orgasm is common and often associated with non-inter-course sexual stimulation encouraged many females to explore the pleasures of masturbation, oral-genital stimulation, sexual touch, and the use of mechanical and battery powered sexual devices. The team's findings also increased emphasis on touch and tactile exploration of the entire surface of the body as a sexual activity, helped women understand and appreciate their physical sexual capabilities, and helped both men and women understand the sexual response cycle and the control they each and both have over that cycle.

Many of Masters and Johnson's findings contradicted the prevailing myths concerning pregnancy, breast feeding, premature ejaculation, homosexual behavior, and numerous other social and cultural impositions on sexual behavior which are associated with sexual dysfunction. Masters and Johnson's research findings helped trigger the sexual revolution of the 1960s and 1970s and significantly altered the sexual relationship between men and women. The changes in sexual attitude quickly found their way into literature, film, and television, with increased variety and experimentation in sexual behavior, frank discussion of and depiction of sexual dysfunction, and the quest for female sexual satisfaction each becoming significant plot themes. Fictional characters increasingly became interested in, involved in, and preoccupied with, sexual behavior and the quest for sexual satisfaction.

Masters and Johnson's research findings also revolutionized sex therapy techniques. The team's emphasis on touch and tactile exploration led to the use of assigned "homework," or sexual behavior exercises in sex therapy, first concentrating on touching experiences called sensate focus, followed by genital exploration, called the sexological exam. The team's claim that female sexual dysfunction is more the result of social and cultural taboos than physical problems encouraged the breakdown in those taboos. The team's discoveries concerning multiple orgasms and orgasms from non-intercourse stimulation encouraged development of the sexual aids and "sex toy" industry. The team's four-phase response cycle provided focus points for evaluating sexual response, for timing the application of therapeutic efforts, and for couples to evaluate their own sexual responses. Finally, the team's discoveries led to the development of a variety of specific sex therapy techniques to reduce sexual dysfunction, including squeeze techniques to prevent premature ejaculation and digital insertion exercises to reduce vaginismus, or involuntary muscle contractions that make coital penetration difficult and painful.

In their most acclaimed study, Masters and Johnson studied 382 college women and 312 college men in more than 10,000 completed sexual response cycles to produce Human Sexual Response, published in 1966. They recorded responses in a variety of stimulus situations, including masturbation, coitus with a partner, artificial coitus, and breast stimulation. The research team also included 61 women aged 41 to 78 in the study, making this the first study of sexual response in menopausal and postmenopausal women.

Other studies conducted by the team include: a study of sexual response in male and female prostitutes, completed before the 1966 study; a study of the rationale, methods, and success of various treatments for sexual problems, published as Human Sexual Inadequacy in 1970; and a 15 year study of homosexual behavior, both comparing sexual responses between homosexual and heterosexual research subjects and evaluating treatment strategies for improving homosexual sexual performance or reducing homosexual orientation, published as Homosexuality in Perspective in 1979.

Instead of relying on questionnaires, surveys, and interviews used by most sex behavior researchers to gather research data, Masters and Johnson pioneered the use of direct observation in a laboratory setting to produce the research presented in Human Sexual Response. They used direct personal observation to record changes in the primary and secondary sex organs, photographic equipment and physiological response instruments to record muscular and vascular changes throughout the body during sexual arousal and sexual release, and an ingenious phallus-shaped artificial coition machine to photographically record changes in the vagina and lower portions of the uterus during artificial coitus. The team used many of the same research methods in their 1979 study of homosexual behavior and response.

Masters and Johnson's research methods and findings have come under close scrutiny by social scientists. Critics of their 1966 Human Sexual Response study contend research subjects' reaction to the laboratory setting, the researcher's observation of the sexual acts, and the often artificial nature of the sexual activity encouraged the research subjects to exhibit extra-ordinary sexual responses. Critics also claim a demographic bias in the research, noting that most subjects were white, middle class, and of above average intelligence. Masters and Johnson's 1970 study of treatment strategies for sexual dysfunction is criticized for a variety of problems in methodology, inadequate measurable definitions for many of the variables in the study, a low response rate in follow-up studies, and the inability of subsequent research teams to replicate the Masters and Johnson findings. The team's 1979 study of homosexuality is criticized for methodological and definition problems, the choice of research subjects, the laboratory research setting, and differences in interpretation of the findings. Critics claim some of the 1979 subjects were actually bisexual or heterosexuals engaged in homosexual behavior due to temporary sexual dysfunction. The team's 1960s study of prostitutes was discontinued when the team concluded that prostitute's physiosexual responses were not typical of those of the general public.

Masters and Johnson made several breakthrough discoveries, including: identifying the source and describing the process for vaginal lubrication; identifying and describing myotonia, or increased muscle tension and spasms in various parts of the body—from feet to face—occurring during the sexual response cycle; evidence that once the male enters the emission phase of arousal, the orgasmic ejaculation process cannot be interrupted but, in females, orgasm can be constrained, interrupted, delayed, and postponed by various psychosensory stimuli; determination, through experiment, that there is no difference in sexual response or sensitivity between circumcised and uncircumcised males; evidence that female orgasms resulting from non-intercourse sexual stimulation are more locally intense and less diffuse than those resulting from intercourse; evidence that female multiple orgasm is common, especially with non-intercourse stimulation; evidence that female orgasm can result from breast stimulation alone; evidence that females experience increased sexual desire in latter phases of pregnancy and that coital activity during pregnancy is not harmful; evidence that breast feeding speeds the return of sexual desire in new mothers; a determination that postmenopausal women experience the same sexual response cycle as younger women, but experience a decreased intensity and increased time of response; and identification and description of the four-phase model of sexual response that became the model pattern for many sex therapies. The four phases in the sexual response pattern are: excitement (increased muscle tension and tissue engorgement throughout the body); plateau (sustained excitement leading to the orgasmic platform); orgasm (release); and resolution, followed by a refractory period (recovery) in the male cycle. The researchers formed the Reproduction Biology Center and later the Masters and Johnson Institute in St. Louis, Missouri.

—Gordon Neal Diem