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Byline: P. Behere, T. Sathyanarayana Rao, Akshata. Mulmule Introduction Manu Smruti described about women values in ancient time - " Yatr naaryastu pujayante ramante tatr devtaa ," that is Gods abound where women are honored, this was the ancestral enchanting in the land of Bharatvarsha (India) where gory heinous crimes against women and specially children are on rise these days. [sup][1] It is said that sexual abuse is the most common and threatening behavior calculated to induce fear in all women, it means men have chosen to maintain control over women. Rape is the fastest growing crime in the country. [sup][2] Rape occurs in India every twenty minutes. [sup][3] Ministry of Women and Child Development concluded that 53.22% of children reported having faced sexual abuse of which 21.90% faced severe form. [sup][4] Sexual abuse in children refers to sexual behavior between a child and an adult or between two children when one of them is significantly older or uses coercion. More than 70% of abusers are immediate family members and close acquaintance. [sup][5] There is hence a need to focus the enquiry on children. The perpetrator and the victim may be same sex or opposite sex. The sexual behaviors include touching breast, buttocks and genitals, whether the victim is dressed or undressed; exhibitionism; fellatio; cunnilingus and penetration of the vagina or anus with sexual organs or object. Sexual abuse may involve behavior over an extended time or a single incident. In addition to the form, inappropriate sexual touching, sexual abuse also refers to sexual exploitation of children for instance, conduct or activities related to pornography depicting minors promoting or trafficking in prostitution of minors. [sup][6] It is not just a phenomenon by itself but also has very serious and long lasting impact as psychological disturbances. Thus, ranges from anxiety to sexual dysfunction or post-traumatic stress disorder that follow sexual abuse. Research so far has concentrated on sexual crimes against women in the reproductive age. There is increasing incidences of sexual abuse in children today. This area is very sensitive. We should be receptive for early identifications and prevention of such incidences in girls in the community. How Big is the Problem? Child abuse in one or another form has existed in almost all societies throughout the history however, recognition of child abuse as a social problem is of recent origin. The research on child sexual abuse (CSA) in India has not received much attention this due to low reporting of victims . Nearly, 53% of children faced some amount of sexual abuse; among them 52.94% were boys and 47.06% girls. The significant finding was that contrary to the general perception, the overall percentage of boys was much higher than that of girls. Across the country, every second child is being subjected to one or other forms of sexual abuse and every fifth child is facing severe forms of sexual abuse. [sup][4] A total of 33,098 cases of sexual crime against children were reported in country in 2011 as compared to 26,694 in 2010 it means increase by 24%. Number of cases under procuration of minor girls increased from 679 (2010) to 862 in 2011, i.e., increase by 27%. A total of 7,112 cases of child rape were reported in country during 2011 as compared to 5,484 in 2010, increase by 29.7%. Sexual abuse is highest in Madhya Pradesh (1,262) followed by Uttar Pradesh (1,088) and Maharashtra (818). [sup][7] In 2011, more than 24 thousand cases were reported - about 70 a day. New figures released by the Delhi Police reveals that a woman is raped every 18 h or molested every 14 h. [sup][8] There are 80,000 pending rape cases in India and nearly 1,000 rape cases are pending in Delhi courts. [sup][9] Off late, we have seen some cases of CSA in Wardha district which is again a very traumatic event. The cases are yet to start in court. …

BACKGROUND: In light of the social and public health consequences of at-risk sexual behavior for adolescents, a great need exists to understand adolescent sexual and reproductive decision-making. Further information can guide medical professionals in the intervention and counseling of this at-risk population. The main objective of this preliminary study is to survey female adolescent gynecological patients about their sexual experiences via questionnaire. Our forty-three question survey focuses on concerns regarding adolescent sexuality: 1) Is there a correlation between features of the first episode of sexual intercourse and future at-risk sexual behavior and decision-making? 2) Is any decision-making involved before adolescents decide to become sexually active? 3) If adolescents decide to postpone sexual intercourse, are they engaging in other at-risk sexual activities? METHODS: Seventy-two (72) female patients aged 12 to 20 years who presented for routine pediatric/adolescent gynecological care and met inclusion criteria were recruited from St. Louis Children's Hospital Pediatric Subspecialty Clinic. Parental consent for minors and patient consent for participants 18-20 years was obtained prior to completion of the anonymous, self-administered surveys in accordance with the Human Studies Committee at Washington University. The data was analyzed with SPSS Windows. RESULTS: The mean age of the participants was 16.01 years (standard deviation 1.72). Demographically, 20.3% were African-American and 75% were Caucasian. Although 44.4% (32/72) had engaged in sexual intercourse, many surveyed adolescents were engaging in other sexual activities before sexual intercourse: 57.5% of “virgins” described breast stimulation; 45% described vaginal stimulation; 22.5% described engaging in cunnilingus; 27.5% described penile stimulation; and 17.5% described engaging in fellatio. There appeared to be racial differences in oral sex participation. African American girls surveyed were significantly less likely to engage in oral sex before sexual intercourse (p = .026). Only 22.2% of surveyed adolescents denied participation in any sexual experiences. Of all participants who had engaged in sexual intercourse, there appeared to be little decision-making. 46.9% indicated that “it just happened” and 28.1% indicated that they decided to have sex during intimacy. The majority of participants did not discuss birth control (68.8%) or STD's (56.3%) with their partner. This lack of discussion was correlated with failure to use an effective birth control method (p = .034) and risk for later contraction of an STD (p = .022) CONCLUSIONS: In this preliminary study, 78.8% of adolescent girls are participating in sexual activities whether or not they have engaged in intercourse. This study supports the hypothesis that clinicians need to be aware that adolescent patients, who deny being “sexually active”, may be engaging in higher-risk sexual activities including oral sex. More directed questions need to be asked to determine the level of sexual activity. Furthermore, 75.0% of the participants reported no discussion or advanced planning prior to their first coital episode. Inadequate decision-making coupled with inadequate communication about birth control and STD's was associated with poor outcomes including pregnancy and STD's.

Human sexual intercourse, or coitus, is one of the most common sexual outlets among adults. Sexual intercourse generally refers to penile penetration of the vagina, the most common sexual expression between opposite-sexed partners practiced in the United States. In a large national survey study of more than 3,000 participants, Laumann, Gagnon, Michael, and Michaels (1994) found that 95% of men and 97% of women report that they have experienced vaginal intercourse. Other sexual techniques with opposite-sex partners include mutual masturbation, anal intercourse, and oral sex (both cunnilingus, i.e., male mouth on female genitalia, and fellatio, i.e., female mouth on male genitalia). Although less common than vaginal intercourse both in terms of life incidence and most recent experience, these sexual expressions are more openly discussed in the media and more frequently practiced than in the past, especially among adolescents (Weiss & Bullough, 2004). Keywords: coitus; intimacy; sexual standards

Dental dams are distributed and promoted in some safer sex campaigns for use in oral sex. However, whether and how often dams are used for sex between Australian women remains unknown. We investigated the use of dental dams for sex by lesbians and other women who have sex with women, and the relationship between dam use and sexual risk for this group. In 2004, a self-completion questionnaire was distributed to women attending the Sydney Gay and Lesbian Mardi Gras Fair Day and lesbian community venues and health services in Sydney (n = 543). Among the 330 women who had had oral sex with a woman in the previous 6 months, 9.7% had used a dental dam and 2.1% had used one ‘often’. There was little evidence of dam use for prevention of sexually transmissible infections. Although women who practised rimming (oral–anal contact) or had fetish sex involving blood were more likely to have used a dam, dam use was not significantly more common among women who had more partners, or had casual or group sex. Some women avoided oral sex during menstruation or had oral sex with a tampon in place. Latex gloves and condoms were used by more women and more often than dams.

The authors report a case of a 24-year-old nulligravida woman who presented to the hospital with complaints of severe abdominal pain and radiographic evidence of pneumoperitoneum. She had two prior nondiagnostic laparotomies for similar complaints and radiographic findings. After a careful sexual history was taken the patient revealed that she had sexual intercourse preceding every similar episode including this one, during which her partner forcefully blew air into her vagina. Pneumoperitoneum associated with vaginal insufflation has been previously reported in two multigravida patients with and without anatomic abnormalities. When pneumoperitoneum is present in the absence of gastrointestinal symptoms or trauma, a meticulous sexual history should be made to avoid unnecessary laparotomies.

Objectives Assessing and exploring reasons for hard recurrent vaginal mycoses in couples of certain patients’ clientele. Detection of seminal / genital mycoses in male partners, as a mycoses “reservoir”. Methods Within 6 years - until June 2007 - 228 cases (males) whose wives/partners suffered from rec. hard vaginal mycoses had been examined by seven gynaecologists and three urologists. Considering 101 pathogen cases (44%) in 100 of them candidiasis was found and aspergillosis in one case. The fungus cultures had been exclusively made for spermresp. prostate specimen. Profile of symptoms: a slight baroreception in the lower abdomen in just 17 cases, diffuse body complaints in 4 cases or ejaculatory burning to a medium-light extent. Conclusion In abt. 50% of rec. vaginal mycoses the blame attaches to men. It's easy for mycoses to establish and grow in the male genitalia. Assisted by provisory infections or immunodefficiency mycoses could be carried retroactively and may later infect the partner by means of the seminal fluid. Sexual habits like cunnilingus/fellatio and anal intercourse may help the spreading of this. Last but not least: with each spermiogram a fungus culture should be made as the mycosis is the reason for the phenomenon of “lazy sperm”, too

Purpose: Genital pain and vaginal discharge are commonly reported gynecological symptoms, but frequency, duration, and association with sexual practices is unknown. The objective of this research was to describe the prevalence of genital pain, pelvic cramps, and vaginal discharge and to evaluate their relationship of symptom duration to event-level sexual behaviors. Methods: Data were daily diaries collected from young women (N 387), ages 14 17 yrs at enrollment. Symptom variables were genital pain (no/yes), vaginal discharge (no/yes) and cramps (no/yes). Symptom duration for genital pain, vaginal discharge or cramps was calculated as the number of consecutive days on which symptoms were noted as well as for the number of days on which 2 or more symptoms were observed. Event level sexual behaviors included coitus (no/yes), condom use during coitus (no/yes), fellatio (no/yes), cunnilingus (no/yes), anal sex (no/ yes), touching a partner’s genitals (no/yes) and having one’s genitals touched (no/yes). Results: Subjects reported 87,311 diary days; 2% were associated with genital pain (1,654/87,311), 6.5% were associated with vaginal discharge (5,680/87,311) and 6% were associated with cramps (5,139/87,311). Most days (87%; 76,135/87,311) had no symptoms; subjects reported one symptom on 10% of days (8,731/87,311) and 2 or more symptoms on 3% of days (2,445/87,311). On average, genital pain duration was 8.79 days (SD 16.31), vaginal discharge duration was 7.38 days (SD 13.37) and cramps duration was 9.48 days (SD 13.39); duration of two or more symptoms was 11.5 days (SD 17.03). Controlling for vaginal bleeding, mood, partner effects, substance use and usual behaviors, longer duration of genital pain increased the likelihood of cunnilingus (OR 1.09), but decreased the likelihood of coitus (OR 0.93), fellatio (OR 0.93), touching a partner’s genital (OR 0.92) and having one’s genitals touched (OR 0.94). A longer duration of cramps was associated with decreased likelihood of coitus (OR 0.87). Longer duration of vaginal discharge was associated with increased likelihood of fellatio (OR 1.04), but decreased likelihood of cunnilingus (OR 0.88), anal sex (OR 0.63), and coitus with a condom (OR 0.8). A longer duration of two or more symptoms decreased the likelihood of all sexual behaviors (OR 0.86 0.96), but was not associated with condom use. Conclusions: Genital pain, cramps, and vaginal discharge appear to have complex relationships with sexual behavior, even in the absence of vaginal bleeding. These findings provide useful insights into the ways young women organize their sexual behaviors, and suggest ways, in which young women may be taught to recognize, interpret and respond to genital and pelvic symptoms. Sources of Support: HRSA T71 MC00008; NIH-NICHD-R01 HD044387; T32AI07637.

Childhood sexual abuse has been defined as any sexual experience between a child (usually defined as under age 16) and an adult or person at least 5 years older than the child (Finkelhor, 1979). The definition includes a wide range of acts, including exhibitionism, fondling, intercourse, and pornography. “Recent epidemiological findings from adults” retrospective reports indicate that as many as 19% to 28% of women and 8.6% to 16% of men report at least one sexual victimization experience during childhood (Finkelhor, 1979; Russell, 1983; Timnick, 1985). The majority of sexually abusive experiences involve “serious” to “very serious” forms of abuse that have the potential for psychological trauma and short- and long-term sequelae. Finkelhor’s (1979) survey of college students revealed that 20% of his sexually abused sample had experienced exhibitionism, 40% reported genital fondling, and 40% reported either oral-genital contact or vaginal or anal intercourse. Similar statistics were reported by Russell (1983) for a sample of women who were sexually abused as children. Twenty-three percent reported “very serious” sexual contact (penile penetration of the vagina or anus, fellatio, cunnilingus, analingus) and41% reported “serious” sexual contact (digital vaginal penetration, unclothed fondling of breasts or genitals, and simulated or attempted intercourse).

Editor,—We are puzzled by the surprisingly little, if any, serious work done to explain the epidemiological enigma of high prevalence of bacterial vaginosis (BV) in lesbians,1 and the oft observed, but as yet unconfirmed association between BV and receptive cunnilingus in women in general. In a detailed study of 17 consecutive lesbians attending the department of genitourinary medicine at the Royal Sussex County Hospital in Brighton, bacterial vaginosis was found in six women (35%). Of …

The Department of Forensic Medicine (forensic pathology and clinical forensic medicine), Aarhus, Jutland, Denmark, performs examinations of children suspected to have been sexually abused when reported to and requested by the police in Jutland, Denmark. Jutland covers an area of 210,000 km2 with about 300,000 inhabitants in Aarhus. A colposcope initially equipped with an Olympus camera, but now with a video camera attached has been used since 1994. Since 1994 the department has performed more than 100 examinations of children suspected of having been sexually abused. A preliminary study was taken to evaluate all cases from 1995 including the legal outcome. Results: The material included 34 cases with three boys, mean age 11 years, and 31 girls, mean age 8 years, at the time of the examination. The sexual abuse events were fondling, including penetration of the vagina, vaginal (14), anal (7), and oral (5) intercourse as well as cunnilingus and nontouching abuses. The medical examination was most often performed more than a week after the abuse. The examination revealed normal findings in 23 cases, nonspecific findings including erythema in 13 cases, and in only one child was a traumatic lesion with rupture of the hymen seen. The perpetrators were above 25 years of age and were family members or someone known to the child. Nine perpetrators were convicted at court, of whom three admitted having abused the child. Conclusion: A medical examination in cases of sexual child abuse seldom provides a legal proof of sexual abuse. The most important is the story told by the child. Therefore, the examination is a supplement which may support or remain neutral to the story told by the child.

Background Two cases of genital ulceration caused by Epstein-Ban virus(EBV) have p-evicudy been reported, one in a sexually active 23 year-old and another in a 14 year-old practicing cunnilingus. Case A 13 year-old premenarcheal Caucasian female developed vulvar ptin and edema several days after symptoms of mild pharyngitis and fatigue. She was seen first by a local gynecologist who diagnosed her with herpes and treated her with topical and parenteral Zovirax. Bilateral necrotizing ulcerations of her labia minora developed within five days of this treatment and preceded oral lesions by nine days. Cultures for gonorrhea, chlamydia, HSV and aerobic bacteria were negative. She was admitted to the hospital for ten days and treated with intravenous Cefoxitin, sharp detridements and aggressive local care. Given mild. malaise. an alkaline phosphatase elevated to 248(with a normal GGT) and 5% atypical lymphocytes, a monospot was ordered and returned positive. Viral capsid antigen specific antibodies drawn 6 days after lesions appeared were IGM 1:217 and IGG 1:889. Repeat liters 10 days later were 1:35 and 1:1051 respectively. Antibody titers to early antigen (EA) were 1:20 and to nuclear antigen (EBNA) were 1:277. Vulvar pathology was noospecific. Tissue from the ulcer base was insufficient to perform PCR of EBV or to evaluate the presence of the virus in the epithelium. The patient was discharged on oral Augmentin, Nystatin suspension, analgesics ar local care. After 25 days, her vulvar ulcerations were less than 1 mm. deep and preroarin cream was initiated to minimize labial agglutination. This was continued for two weeks at which time, healing was complete. She never developed cervical adenopathy, fever or hepatosplenomegaly. She adamantly denied sexual activity but admitted to “french(oral)kissing.”. Conclusion Genital ulcerations can be the initial manifestation of EBV in adolescents neither sexually active nor immuno compromised. EBV was not likely inoculated onto our patient's genitalia. We postulate that she was exposed to EBV via saliva and that the virus hematologically spread to the vulva. There the virus replicated inside of either infected B-lymphocytes and/or epithelial cells and caused cytotysis evidenced as labial ulcerations.

Analysis of interviews obtained from a random sample of 930 adult women in San Francisco revealed that 17% or one out of approximately every six women who had a stepfather as a principal figure in her childhood years, was sexually abused by him. The comparable figures for biological fathers were 2% or one out of approximately 40 women. In addition, when a distinction was made between Very Serious Sexual Abuse (including experiences ranging from forced penile-vaginal penetration to non-forceful attempted fellatio, cunnilingus , and anal intercourse) and other less serious forms, 47% of the cases of sexual abuse by stepfathers were at the Very Serious level of violation compared with 26% by biological fathers. Possible explanations for these starting discrepancies are discussed, and some of the implications for remarriage are considered.

In our consideration of rapists we will use the term “rapist” to describe men who have sexually assaulted nonconsenting adult females. This will include, therefore, not just those men who have forced women to have vaginal intercourse, but also men who have forced fellatio, cunnilingus, or anal intercourse on their adult female victims. Most researchers and clinicians do not distinguish amongst these acts (e.g. Gebhard, Gagnon, Pomeroy & Christenson, 1965), although some writers attempt to distinguish amongst the offenders usually on the basis of inferred motives (e.g. Groth, 1979). Some of these crimes go unreported; indeed a large percentage of sexual assaults are not reported (Amir, 197 1; Offir, 1975). Even when an offence is reported only a small percentage of those confirmed, lead to a conviction (F.B.I., Uniform Crime Reports, 1982). However, researchers are only able to evaluate those men who are convicted, although it is important to note that many of these convicted rapists have committed numerous additional offenses for which they have never been charged. This, of course, means that any analysis of rape is necessarily restricted in meaning to those men who have been convicted of sexual aggression. Unfortunately this will exclude some rapists, although we do not know how many. It is often inferred from the estimated rates of sexual aggression, and actual conviction rates, that the algebraic difference between these rates represents the number of offenders who go free. Given, however, that rapists who come to the attention of treatment agencies report having raped, on average, nine women (Abel 1981), it is clear that convicted rapists account for many of the unreported or unresolved sexual attacks. In any case, convicted felons are the only ones available for study at the moment. It might be valuable to distinguish different types of sexual assault in terms of the circumstances under which the offense occurs, since, for our later elaboration of a social learning theory of rape, these circumstantial factors are important. Similarly the circumstances influence whether or not the offense is reported and, to some extent, whether or not a conviction is pursued and secured. Rapes committed by friends or relatives are far less likely to be reported and this is particularly so for rapes that occur in the context of a

The present study reports on the forced sexual, excretory, and sadistic acts that occur during rape. The main sample consisted of 115 adult, adolescent, and child rape victims that were admitted during a 1-year period to the emergency wards of a large municipal hospital. Forced vaginal intercourse was the most frequent act reported, but many other acts also occurred, ranging from fellatio and cunnilingus to urinating on the victim. It is argued that various social-psychological meanings are attached to forced sexual acts, most notably power, anger, and male camaraderie. Pair/group rape differs from single-assailant rape in the emphasis placed on watching and taking turns. Analyzing the social meanings attached to forced sex makes a contribution to our knowledge about the use of sex to express nonsexual issues.

Because of changes in sexual mores, the oral cavity is increasingly becoming the site of primary infection for sexually transmitted diseases. A 28-year-old man who had severe tonsillitis needed hospitalization for parenteral fluid therapy. The tonsils were red and edematous without lacunar exudates. There was a shallow ulcerative lesion on the right posterior pillar. He had engaged in orogenital sex (cunnilingus) two weeks previously. Culturing swab from the ulcerative lesion and immunofluorescent technique showed herpes simplex virus type 2. The initial leukocyte count was 6400/mm3 with 56% neutrophils, 23% lymphocytes and 21% monocytes. Interestingly, the serum anti-EB virus titer was elevated during the acute phase (VCA γ-G 1 : 80 initially and1 : 20 in the convalescent phase). It seemed likely that endogenous reactivation of latent EB virus occurred in the tonsillar B-lymphocytes in a heterogenous response to HSV-2. One month later culturing swab from the tonsil was negative and the serum titer of anti-HSV type 2 was 1 : 4.

The incidence of oral sex in an adolescent population is discussed. More girls have either given or received oral-genital stimulation than have had intercourse. More boys have had intercourse than have either given or received oral-genital stimulation. Oral sex is more common than intercourse for females because they are more likely to have received oral-genital stimulation than to have either had intercourse or given oral-genital stimulation. For both sexes, fellatio is less common than is either intercourse or cunnilingus. For both sexes, oral sex is considerably more frequently reported than was the case in the Kinsey surveys.Using data from 2 surveys conducted in a US Southern city in 1980 and in 1982, this study concludes that the incidence of oral-genital contact among teenagers is increasing. This contact is seen as a way to give and receive sexual stimulation without the necessity of birth control or the risk of pregnancy. For both white sexes, contrary to Kinsey findings, cunnilingus is more frequently reported than is fellatio. Of the nonvirgins surveyed, 69% of each sex have both given and received oral-genital stimulation; of the nonvirgins, 80% have participated in either fellatio or cunnilingus. Slightly more teenagers have given or received oral sex than have had intercourse. Using a Goodman log-linear technique, no difference between the order in which boys and girls engage in giving and receiving oral sex is found, and, for girls, cunnilingus occurs no more often than does sexual intercourse. However, boys are more likely to have had intercourse than to have given or received oral-genital stimulation, probably due to the cited minority of boys who reported that they liked giving oral-genital stimulation, and the minority of girls who reported that they enjoyed receiving it.

Sociology could profit considerably from new research attention to oral sexuality. Data from current large‐scale postal surveys suggests a substantial increase in the number of Americans who include fellatio and cunnilingus in their sexual experience. Small‐scale intensive interview research, however, raises serious doubts about whether usage is always accompanied by satisfaction gains: long‐standing ambivalence and social taboos undermine attitudinal reforms. The mass media focuses unprecedented attention on the subject, but considerable contradictory opinions persist about it. Research possibilities are suggested, as is a case for sustained, systematic research.

As registrar at the First Australian Field Hospital, the author investigated the sexual behavior of Australian troops in Vietnam by questionnaire studies of 488 consecutive venereal disease clinic attenders and 230 soldiers of similar rank randomly selected from the troop population. Masturbation was the most frequent practice for 27% of soldiers, intercourse for 68%, and fellatio for 3.5%; whereas cunnilingus, anal intercourse and homosexual behavior were practiced less commonly. Single and married soldiers had distinctly different patterns of sexual experience, but in all groups those having frequent intercourse made a disproportionate contribution to those infected with V.D. Soldiers having intercourse on the roadside were younger, came from larger families, had less education and were more neurotic than other soldiers. Masturbation had low peer acceptability and was related to age and neuroticism and inversely related to frequent intercourse. Sociologically, fellatio in Vietnam was a differen...

Marital success and failure may be related to sexual satisfaction, including orgasmic capability. Pregnancy represents a life crisis to the pregnant woman and her husband. Complex psychosocial and physiological demands may produce insecurities, anxieties, and somatic complaints. The expectant mother may seek to fulfill increasing nurturant needs through increased physical contact such as cuddling or being held. A pregnant woman's interest in sexual activity may be affected by her changing physical appearance and the hormonal milieu of pregnancy. Although there are marked individual variations and methodological biases and differences among empirical studies, pregnancy appears to be usually accompanied by a decrease in sexual desire, coital frequency, and orgasm. Sexual behavior in pregnancy has been traditionally restricted and is currently poorly defined. Sexual proscriptions may precipitate sexual frustration and marital estrangement. Abortion is only rarely caused by coitus. The relationship of coitus and orgasm to prematurity and distress of the fetus and newborn has not been clearly established. Coitus can indirectly result in maternal, fetal, and neonatal morbidity and mortality through the spread of sexually transmitted diseases. Deaths from air embolism in pregnancy associated with cunnilingus and vaginal insufflation have been reported.

This is the expanded text of a paper presented at the joint meeting of the Forensic Science Society and the British Association of Forensic Odontologists [1] at Bristol on 8–9 April 1988.

When we hear that someone has been raped, the commonsense understanding of that expression is that a person, usually a woman, has been forced to have intercourse. But what is the legal definition of rape? Are there different degrees of rape? What about sodomy, fellatio, cunnilingus? If a woman is forced to commit these acts, is that “rape” as well? What is indecent assault and battery? Does the age of the victim or the rapist make any difference? At law, can males be raped as well? In order to answer these questions, it is necessary to explain briefly the evolutionary process of Anglo-American law.

At a clinic for treatment of sexually transmitted diseases, 1,453 patients were examined for pharyngeal colonization with Neisseria gonorrhoeae. A history of oral sex was reported by 895 (61.2%) of the patients. N. gonorrhoeae was isolated from the pharynges of 42 (2.9%) of the 1,453 patients. Twenty-seven of the 42 patients with N. gonorrhoeae-positive cultures gave histories of oral sex, and all 42 patients reported orogenital contact when questioned again at a follow-up visit. Seven patients with positive cultures had pharyngeal symptoms; all seven practiced fellatio. Eleven of the infected men were asymptomatic heterosexuals whose only orogenital contact was cunnilingus.

One measure of the important changes that have evolved in the ways in which human sexuality may be expressed is the change, since the 1950s, in attitudes toward such practices as fellatio and cunnilingus. Although some older people, and those who are more puritanical, conservative, or less educated, still view these forms of sexual expression as “perverted,” “dirty,” or abnormal, many Americans today consider them perfectly normal, good, and even quite pleasurable. However, compared to other forms of sexual behavior, fellatio or cunnilingus is not as widely accepted, even by college students (Croake and James, 1973, pp. 91–96). Since there is still no majority public acceptance of oral-genital contacts, a woman’s practice of these techniques and her emotional acceptance of them as valid tend to reveal a great deal about her sexual self.

A 24-year-old man developed condyloma acuminatum on his penis and on the upper lip of his mouth approximately three months after his girl friend was diagnosed and treated for vaginal warts. Cunnilingus was the postulated method of spread to the lip. Condyloma acuminatum should be considered among the many sexually transmitted infections that affect both anogenital and oral areas.

The present report is of a serendipitous finding from another study of childhood heterosexual molestation of men who were incarcerated as adults for rape. Subjects were 83 men in a medium security penitentiary who had been convicted of raping women at least 17 years of age. At the time of data collection, they ranged in age from 20 to 54 yr., with a mean of 28.85 yr. and a standard deviation of 6.19 yr. At the time of rhe offenses, their ages ranged from 18 to 47 yr., with a mean of 25.48 yr. and a standard deviation of 5.47 yr. Their education, also at the time of offenses, ranged from 6 to 14 yr., with a mean of 10 86 yr. and a standard deviation of 1.64 yr. Their IQs ranged from 73 to 120 ( M of 98 01, S D of 10.58). Thirty-one subjects were black (37%), 35 were Caucasian (42 9; ) , and 17 were Mexican-American (21 % ) . Forty-nine (59%) of the rapists had been heterosexually molested. Of these, 12 had been so molested by two or more females for a total of 73 "cases" of heterosexual molestation. Jn 56 (77%) of these cases, the molesting person did so on more than one occasion. The ages at the time of molestation ranged from 4 to 16 yr. ( M of 10.81, S D of 4.55); the ages of the older persons ranged from 16 to 54 yr. ( M of 27.39, S D nf O RR > , .-, . In 60 of the 83 cases intercourse was involved, 34 cases also involving fellatio and cunnilingus, 3 cases also fellatio, 1 case also cunnilingus, and 22 cases without oral sex. There were 5 cases of cunnilingus, 4 of the females masturbating the boy, 2 fellatio and cunnilingus, 1 fellatio, and 1 mutual masturbation. The older female was a neighbor in 23 cases, a friend of the family in 22, a baby sitter in 7, an aunt in 5, a teacher in 4, a stranger in 4, a mother in 2, a grandmother in 2, a sister in 1, a foster mother in 1, a probation officer in 1, and a co-worker in 1 case. The heterosexual molestation findings are surprising not only because incidence is high but because of the nature of the acts and the relationships between child and older female. Sixty (82%) of the cases involved sexual intercourse. This contrasts with the preponderance of more "innocuous" acts such as fondling and looking in most reports of male child molesters. For example, Groth ( 2 ) reported that only 31% of his offenders engaged in any sort of penetration-vaginal, oral, or anal. With molestation committed by males, an appreciable percentage of the offenders are strangers or members of the immediate family. Groth (2 ) reported 29% and 14%, respectively. In contrast, only 5% of our female molesters were strangers and 4 % immediate family members. However, perhaps women have less fear of societal retribution for such acts and do not need to turn to children less likely to both identity and report them, namely, children who don't know them and those in their own family. Note that in 15 (21%) of the cases the women who molested had a special mission to nutture, counsel or protect. The incidence of boys being heterosexually molested is higher among our rapists than the 2.9% heterosexual molestation rate before puberty reported for college students ( 1 ) . Although Fritz, et al. ( 1 ) did not specify their criterion of before puberty, even by setting a conservatively low one of below 12 yr. of age, 20 (24%) of our men had been heterosexually molested. It is not certain whether the greatly higher percentage in the present study indicated heterosexual molestation predisposes to becoming a rapist or whether rhe difference is a function of being a sex offender in general, criminality in general, or other variables such as low socioeconomic status.

Studies of adult VD clinics, world-wide, report that the prevalence of pharyngeal gonorrhea (GC) varies from 1.3% to 5.7%, but the incidence among adolescents has not been delineated. A retrospective chart review was conducted to assess the usefulness of pharyngeal cultures in GC screening with urban adolescents. The study population was teenagers who visited the Adolescent Clinic and were cultured for GC; they were routinely cultured at all 3 sites (cervix or urethra, rectum and pharynx) regardless of their history of sexual practice. From Dec. 1979 to Oct. 1930, documented cultures at 3 sites were recorded for 546 patients (no record of sexual practice was available). This population was predominantly urban, black (95%) and female (90%); the age range was 11 to 22 years. Positive cultures were confirmed by fluorescent antibody reaction followed by sugar fermentation (for doubtful reactions). The overall occurrence of GC was 14.7%. Pharyngeal GC was detected in 2.7% of the study population, representing 12 females and 3 males (mean age 15.1, range 12-19). Of the 80/546 patients with GC, 15% had only pharyngeal GC. History was available for 11 of these 12 patients: none had pharyngeal symptoms. Five were detected at a routine family-planning visit and six had genital-tract symptoms.Particularly in the context of routine screening in a general adolescent clinic, the occurrence of pharyngeal GC is sufficiently high to merit study of indications for pharyngeal culture of teenage patients. A positive history of fellatio/cunnilingus may be an adequate indicator, as reported for adults. Alternatively, it may prove appropriate to culture adolescents routinely for pharyngeal GC, regardless of stated sexual practice.