Archives of Sexual Behavior

, Volume 37, Issue 2, pp 252–265 | Cite as

Factors that Influence Sexual Arousal in Men: A Focus Group Study

  • Erick Janssen
  • Kimberly R. McBride
  • William Yarber
  • Brandon J. Hill
  • Scott M. Butler
Original Paper


The goal of this study was to improve our understanding of men’s sexual response and its components as well as the factors or types of situations that men describe as facilitating or interfering with sexual arousal. Six focus groups, involving 50 mostly white, heterosexual men (M age = 35.2 years; range, 18–70), were conducted. As it was previously found in women (Graham, Sanders, Milhausen, & McBride, Archives of Sexual Behavior, 33, 527–538, 2004), men described a wide range of physical (genital as well as nongenital) and cognitive/affective cues for sexual arousal. Also, men described the relationship between sexual desire and arousal as being variable and complex, presented a wide range of factors that increased or decreased sexual arousal, and showed substantial variability in both the importance and direction of their effects. The findings may help further development of models of sexual response and inform discussions about gender differences in sexual desire and arousal.


Sexual arousal Sexual desire Sexual response models Gender Men 


Most of what is currently known about the determinants and mechanisms of sexual arousal is based on research using quantitative, and in particular psychophysiological, methods. Masters and Johnson (1966) were among the first to decrease researchers’ reliance on self-report methods and animal models by providing them with innovative and increasingly non-obtrusive procedures and instruments to observe and measure the physiology of male and female sexual response. In their milestone book HumanSexualResponse, Masters and Johnson (1966) reported on the findings of the direct observation of sexual responses in hundreds of men and women and presented a model of human sexual response that, while descriptive in nature, has had a major and lasting impact on both the laboratory study of sexual response and approaches to the diagnosis and treatment of sexual problems.

Whereas Masters and Johnson made a significant contribution to our understanding of the physiology of sexual response, they devoted less attention to the processes responsible for the activation of such responses. In their model, sexual responses occur when there is “adequate sexual stimulation.” However, they did not define what constituted effective stimulation (Janssen & Everaerd, 1993). With the introduction of instruments to quantify penile tumescence and vaginal blood flow (e.g., Barlow, Becker, Leitenberg, & Agras, 1970; Freund, 1963; Sintchak & Geer, 1975), which allowed for more experimental control and privacy for subjects, research on sexual arousal began to incorporate experimental manipulations and to focus more on factors that might facilitate or interfere with the activation of sexual response. As a result, over the past three decades there has been a significant increase in experimental and psychophysiological studies that assess the role of processes relevant to cognition (e.g., memory, attention), affect (e.g., anxiety, mood), hormones, drugs (e.g., alcohol), and characteristics of the stimulus (e.g., whether they are “male” or “female” centered, romantic vs. explicit, category specific or nonspecific) and the effect they have on the likelihood that a sexual response will occur. This development has culminated in a number of sexual response models that originated from findings of experimental and psychophysiological research (e.g., Bancroft & Janssen, 2000; Barlow, 1986; Janssen, Everaerd, Spiering, & Janssen, 2000; Palace, 1995). Interestingly, although these models all incorporate findings from research using samples of men and women with sexual dysfunction, and although they all could have implications for the diagnosis and treatment of sexual problems, as yet little to no research has been conducted to evaluate their clinical application. Thus, while a rich empirical database and conceptual framework exists for rethinking the psychophysiology of sexual dysfunction, both the clinical literature and clinical practice have been and still are strongly influenced by the work of Masters and Johnson and others who built on it (e.g., Kaplan, 1977, 1979; Lief, 1977).

Recent developments in the diagnosis and treatment of sexual dysfunction, however, have led scholars to revisit and critically appraise models of sexual response such as Masters and Johnson’s and the diagnostic classification systems derived from them (e.g., Tiefer, 1991), and in the process have inspired the reintroduction of qualitative research methods in the study of sexual arousal and related processes (e.g., Graham, Sanders, Milhausen, & McBride, 2004; Nicolson & Burr, 2003). While initially involving concerns about the introduction of and growing reliance on medical treatments (e.g., prostheses, intracavernosal injections) for male erectile dysfunction (e.g., Bancroft, 1990; Tiefer, 1986), the advent of oral drugs, such as Viagra, shifted the discussion towards sexual problems in women and moved it away from a mere criticism of biomedical approaches (or the “medicalization” of sex) to a discourse on gender differences and how to best conceptualize sexual response in women. Thus, in recent years we have seen a growing number of publications questioning whether models such as Masters and Johnson’s are appropriate and relevant to our understanding of women’s sexual desire and arousal (e.g., Basson, 2002a, b; Tiefer, 2001), while its validity as a model for men has remained largely unchallenged. Yet, as Masters and Johnson’s model was based on findings in both men and women, a discussion on its validity ideally would include questions relevant to both genders. For example, while the model has been critiqued for being “linear” and for not doing justice to the complexities involved in the relationship between sexual desire and arousal, a compelling empirical basis for the conclusion that this would not also apply to men is lacking.

Psychophysiological research lends itself well for certain types of questions and allows for a level of control that many other methods lack. When it comes to comparing men and women, however, psychophysiological methods come with some unique challenges. Although experimental procedures can be standardized and made identical for men and women, researchers commonly rely on the use of different instruments for the assessment of genital responses in men and women, complicating their comparison. Also, although the same stimuli can be used, the selection of stimuli can influence the findings in various and largely undetermined ways (cf. Janssen, Carpenter, & Graham, 2003). Recently, researchers have started to use qualitative—in particular, interview and focus group—methodologies to complement experimental and psychophysiological approaches and to provide additional sources of information about factors and processes that are relevant to sexual arousal (e.g., Graham et al., 2004; Nicolson & Burr, 2003, but see also Bancroft et al., 2003, and Bancroft, Janssen, Strong, & Vukadinovic, 2003).

While qualitative methodologies can be used, and arguably more easily than psychophysiological ones, to directly compare men and women, research in this area seems to mirror the tendency observable in psychophysiological research, in that most studies focus on either men or women, but not both. For example, Bancroft et al. (2003), explored, using in-depth interviews, the question of how negative affect (in particular, feelings of anxiety and depression) influences men’s sexual response and sexual decision-making. Although this question can be considered of equal importance to our understanding of women’s sexuality (cf. Lykins, Janssen, & Graham, 2006), only men were included in this research. Examples of the opposite, where topics equally relevant to men have been studied in women only, exist as well. For example, Nicolson and Burr (2003) interviewed women about desire and their perceptions of what constitutes “normal” sexual satisfaction, and explored how this related to the experience of orgasm through sexual intercourse. And Graham et al. (2004) used focus groups to collect information on possible factors and situations that promote or interfere with sexual interest and arousal in women. More specifically, they explored cues for sexual arousal, the distinction between sexual desire and arousal, and factors that are related to the activation and suppression of sexual response.

Graham et al.’s (2004) study was presented as a first step in the development of a new questionnaire to assess women’s propensity for sexual excitation and inhibition (Graham, Sanders, & Milhausen, 2006). The starting point for this project was the dual control model of sexual response (Bancroft, 1999; Bancroft & Janssen, 2000), which postulates that separate and relatively independent excitatory and inhibitory sexual systems exist within the central nervous system, and that it is the balance between these two systems that determines whether a sexual response occurs in any particular situation. Although a questionnaire to evaluate the propensity for sexual excitation and inhibition already existed (SIS/SES; Janssen, Vorst, Finn, & Bancroft, 2002a, b), it was originally developed for use with men. Graham et al. (2004) were concerned that the SIS/SES questionnaire might not adequately assess factors relevant to women. Graham et al. indeed found that women reported a number of themes (e.g., the role of concerns about one’s reputation) that are not represented in the original SIS/SES questionnaire. They suggested that many of the themes “reflected factors that may be of particular relevance to women” (p. 526) and concluded that their findings supported the ideas put forward by The Working Group for a New View of Women’s Sexual Problems (2001) in that inhibition in women seems to arise from relational and sociocultural factors as well as physical and psychological ones. However, as the development of the SIS/SES questionnaire did not include a qualitative phase, the possibility remains that men would report similar themes.

The current study was designed with the goal to improve our understanding of men’s sexual arousal and its components as well as the factors or types of situations that men describe as promoting or interfering with their sexual interest and arousal. In order to allow for a comparison with the findings on women reported by Graham et al. (2004), we used similar procedures and asked similar questions. Like Graham et al. (2004), we covered three topics: (1) sexual arousal and its components (e.g., how do men know when they are sexually aroused?); (2) sexual desire and its relationship to sexual arousal (e.g., does sexual interest always occur before arousal?); and (3) factors that enhance or inhibit sexual arousal (e.g., what stimuli or situations enhance or increase and what stimuli or situations prevent or interrupt sexual arousal?). Whereas Graham et al.’s study included separately recruited African American and lesbian/bisexual groups, the current study did not include individual race or sexual orientation groups, and the majority of subjects were white, heterosexual men.



All participants were English-speaking men age 18 years or older recruited from a medium-sized university town located in the midwestern United States. To ensure diversity in the sample, recruitment strategies included the use of advertisements in local newspapers as well as flyers distributed through community organizations, churches, and campus centers. Men interested in participating were screened by telephone and, if eligible, were mailed a copy of the informed consent form and a demographic questionnaire. Following Graham et al. (2004), the decision was made to conduct groups that were homogeneous in terms of age (18–24 years, 25–45 years, and 46 years and older), while mixed with regard to demographic characteristics such as occupational status, educational background, socioeconomic status, and ethnic background. Participants were 50 men (M age = 35.2 years; SD = 13.9; range, 18–70). The majority (90%) of men self-identified as heterosexual, three self-identified as bisexual, one as homosexual, and one participant was uncertain about his orientation. The vast majority had attended college, technical school, or university (88%). Also, the majority of men were white (84%); three men were African-American/black, three Hispanic, one Asian, and one self-described his racial/ethnic background as “other.” About 50% of the men were single/never married, 26% was married, 20% separated/divorced, and 4% widowed. About 10% of the men were Catholic, 22% Protestant, 4% Jewish, 42% indicated “other” for religion, and 22% indicated to have no religious affiliation. Most men (60%) were in exclusive/monogamous relationships, although 36% indicated not currently being in a sexual relationship, and 4% indicated being in a non-monogamous relationship. Six groups were conducted in total: two aged 18–24 years (N = 20; M age = 20.2 years; SD = 1.9), two aged 25–45 (N = 15; M age = 33.4 years; SD = 6.5), and two aged 46 and older (N = 15; M age = 52.5 years; SD = 6.8).


As recommended by Morgan (1997), moderators who matched group members’ sex and age conducted each of the focus groups. Two male moderators facilitated each focus group session. For each session, at least one senior researcher moderated (EJ, WY), either with the other senior researcher or an upper level graduate student (SB). Each of the sessions was audiotaped and transcribed for analysis. Further, moderators took notes during each session. In order to ensure the anonymity of participants, no individual identifiers were collected.

Focus group sessions were conducted in a private room in a local public library. Consent forms and background questionnaires were collected from participants upon arrival. Sessions began with introductions by the moderators and participants. While name cards were provided for each participant, men were told that they could choose not to use their actual names and could use a pseudonym. Refreshments were provided during the sessions. At the end of the 2 h session, men were thanked for their participation and received a $15 payment. Study approval was obtained from the university’s Human Subjects Committee.

Focus Group Discussion Guide

Moderators followed a discussion guide (cf. Graham et al., 2004), which included the following components:
  1. 1.

    Description of the purpose of the study and the procedural rules of the focus group.

Men were informed that the purpose of the focus group was:

To share ideas to help us develop a better understanding of men’s sexual arousal and its components as well as the factors or types of situations that promote or interfere with men’s sexual interest and arousal.

Men were told that they could share information from their own experience, things they have observed, or experiences described to them by other men (i.e., acting as participant-observers for their peers), and it was made clear they were not expected to reach consensus on any of the themes discussed. Further, participants were asked to respect the privacy of the other participants and not to share contents of the group discussion with individuals outside of the group.
  1. 2.
    The three topics and questions preceding them:
    1. (a)

      Sexual arousal and its components. “How do men know when they are sexually aroused? What cues are there? Can you have erections without feeling sexually aroused or interested?”

    2. (b)

      Sexual interest/desire. “How would you describe sexual interest? How is it related to sexual arousal? Is there a clear demarcation between the two in terms of sequence? Does sexual interest always occur before arousal?”

    3. (c)

      Factors that enhance or inhibit sexual arousal. (i) “What stimuli or situations enhance or increase sexual arousal? (ii) “What stimuli or situations prevent you from being sexually aroused or end/interrupt arousal?”


The facilitators clarified the questions when needed and the discussion guide also contained a list of possible situations/variables that could be used as prompts; however, as much as possible, moderators allowed the group members to generate ideas and to have participants react to the ideas and statements of other group members. As in the study by Graham et al. (2004), the sequence of discussion topics was not rigidly fixed.

Data Analysis

The methods of analysis were drawn from Graham et al. (2004) and Morgan (1997). Conceptual categories derived from the literature on sexuality and gender that represented factors thought to be relevant to sexual arousal and desire (e.g., internal psychological factors such as mood state and self-esteem) was built prior to the initial analysis. Transcripts from each of the six sessions were then independently analyzed and coded by two researchers (KM, BH), independent of the moderators, to confirm that each conceptual category was represented in the transcripts. In instances where a category was not represented in a particular group, the researchers noted its absence. The researchers then identified recurrent themes within the categories and specific quotes within each theme. Following this, the two researchers compared the categories and themes across investigators and groups. In the case of discrepancies related to categorization or themes, the researchers discussed discrepancies until consensus was reached. Once the themes were organized into broad categories, refinements were made to both the coding scheme and labeling of themes. The final coding scheme consisted of six broad conceptual categories. In the final stage of analyses, the coding framework was applied to all of the data by annotating each transcript with the codes that indexed the categories. Consistency between researchers on all categories exceeded 95%.


The results are presented in three sections, corresponding to the three discussion topics explored during each group session: (1) cues for sexual arousal; (2) the relationship between sexual arousal and interest/desire; (3) factors that enhance or inhibit sexual arousal. Following the approach used by Graham et al. (2004), moderators are indicated by the letter “M.” participants by the letter “P,” and comments made by different participants within a discussion segment (delineated by separate paragraphs) are indicated by numbers (e.g., P1, P2). The same letters and numbers do not necessarily represent the same participants for different discussion segments (e.g., P can represent any participant and P1 or P2 can represent different participants for different discussion segments).

Cues for Sexual Arousal

Findings from Graham et al. (2004) indicated that women experienced a wide range of cues for sexual arousal. Similar to their findings, within and among groups, men described a diverse range of cues that indicated sexual arousal, including physiological (genital and nongenital responses) and cognitive/emotional (e.g., interest, fantasies, heightened sense of awareness) indicators. Physiological genital responses were described as erection, and sensations of tingling and warmth, while nongenital responses included increased heart rate, increase rapid breathing, increased tactile sensitivity, changes in body temperature, and flushing of the face.

Though erection was described as one cue of sexual arousal, the majority of men responded to the question, “Can you have erections without feeling sexually aroused or interested?” by indicating that they could, indeed, experience erection without feeling sexually aroused.
  • M: Can you have erections without feeling sexually aroused? Does that happen to you? Often? Every now and then?

  • P1: Something that happens every night (18–24 group).

  • P2: It just has a mind of its own (18–24 group).

  • P: No, I don’t think it always does because sometimes you just wake up with one and it might be that just more blood is in the penis than that you’re horny (46 and over group).

  • P: I can sit at the PC and be working and just my body position, I can get one and not be thinking about it (25–45 group).

  • P: Riding in a bus, sometimes I will get an erection. Or in a bumpy car. Or just waking up in the morning (18–24 group).

  • P: It was the last part of Vietnam, stateside. I had guys coming back and telling me stories. One guy was a gunner on one of the apache helicopter. When they would go into a hot zone he would get a real hard erection. Now he wasn’t sexually aroused but the stimuli of going into a live fire flight, where you are the object of a thing everybody is going to be firing at (46 and above group).

Just as women in the focus group study by Graham et al. (2004) indicated that they could feel sexually aroused without experiencing vaginal lubrication, men reported that they could feel sexually aroused without having an erection, as illustrated by the following (but see also the next section, about differences between sexual desire and arousal):
  • P: Well, I have gone to the strip bar several times and watched the girls, get sexually aroused but not get a hard on (25–45 group).

  • P: I think one of the things that I have noted about getting older is the fact that I can be aroused without getting an erection (46 and above group).

These findings suggest that, at least as subjectively experienced, erection is neither an adequate nor a sufficient criterion for sexual arousal in men.

Sexual Arousal and Sexual Interest/Desire

Prior research suggests that the relationship between sexual arousal and desire is complex, and that individuals often have difficulty distinguishing between the two (Graham et al., 2004). Consistent with that research, we found that many men did not clearly differentiate between sexual arousal and sexual interest/desire. However, the relationship between sexual arousal and sexual desire appeared to be different for solo sexual activities versus sexual activities with a partner.

Partnered Sex

  • P: You can be aroused by someone and not really be interested in doing anything with it. I mean, you can go to the movies and see beautiful women all over the place and you don’t want, necessarily, to have sex with them, but it really catches your eye (18–24 group).

  • M: Can you become aroused and then interested or does it usually begin with interest and then arousal?

  • P1: I think it depends on the situation. As a student out here, I see several out here that I would see as potentials, but didn’t really pursue after (25–45 group).

  • M: So that may have been interest but no arousal?

  • P1: Correct (25–45 group).

  • P2: Then the other could occur. Say your partner comes up and starts to have foreplay. You don’t have the interest there yet but they are providing the arousal first (25–45 group).

  • P: When I become aroused I am not necessarily hard at all. It is the potential to become so, given the opportunity to actually participate in intercourse or some other form of sexual activity (25–45 group).

  • P: Yeah, you can be interested in someone and not be aroused by them. I mean, you can be aroused by people you are not interested in (18–24 group).

  • P1: You know, like you said earlier, I just, for no reason, get an erection. I may not have been thinking about sex or anything else and it just happens. And my next thought is, “okay now you’ve got it, what are you going to do with it” (46 and above group).

  • P2: It’s called automatic penis syndrome (46 and above group).


Views on masturbation differed among participants. While some participants indicated that masturbation was a major part of their sexual expression/repertoire, others indicated that they infrequently engaged in masturbation. In comparison to partnered sexual behaviors, the distinction between desire and arousal seemed less intricate, and the association between desire/arousal and behavior stronger for masturbation.
  • P: I mean, like, you are home alone and you just wake up and then you might masturbate. If your partner is there, you might engage your partner (25–45 group).

  • P: I think masturbation is all about, just like, when I am in a funk it’s a great way to get out of it. If I am just sitting there and everything sucks and I am just like tired. I mean even when I was in a serious relationship it was just like the option was there but like, it is so much work ya know? It’s like masturbation is just, like, give me 5–10 min and we’re done. There is no build-up (18–25 group).

  • P: I think masturbation is more of a release than it is sexual (above 46 group).

  • P: I think if you are with a partner, you’re there. You are feeling sexually aroused because of that woman. But if you just want to masturbate, I mean you are thinking of something that will give you an erection. You know you want to do it and that is all there is to it (above 46 group).

  • P: I feel like masturbation is a mechanical thing. It is something you do when something just feels off and you need to fix that. I don’t know, sex seems to be more something that is real (18–24 group).

Thus, many of the men did not seem to consider masturbation as really being ‘sexual,’ or to integrate it into their views of themselves as sexual beings, in contrast to their experiences of sexual interactions with a partner.


A number of age-related themes emerged during the sessions. One of the most obvious differences between the older and younger groups related to the ability to obtain and maintain erection. Older men reported experiencing changes in the quality of their erections and that such changes had a direct effect on their sexual encounters, including for some a stronger focus on the partner and her sexual enjoyment.
  • P: ...but several years ago I started to realize that I am not getting an erection like I used to and yet I am still having sexual or sensual fantasies. Now, more often, there is a cognitive aspect to it, with either focusing on somebody specifically or wishful thinking. But more and more, I am not really experiencing erection anymore. I just accept it as a fact of aging (46 and above group).

  • P: I think my desire is the same as when I was 18. I find that sex is better. I enjoy it more now. Sometimes the performance, physical erection part, isn’t as great as it used to be (46 and above group).

  • M: What about something like erectile difficulties that you are having?

  • P1: No (18–24 group).

  • P2: No, not yet. I would break down and cry (18–24 group).

  • P3: Oh no, I would have to get help (18–24 group).

In addition to changes in erection, older men also consistently mentioned that they became more careful and particular in choosing a sexual partner.
  • P: That you have a girlfriend type of relationship, that you are in love with. And it makes the sex much better. I have lost years in the kind of casual one-night stand type of thing, years ago. It always seems so shallow, so superficial nowadays (46 and above group).

  • P: I think it is all age-related, too, because when I was younger I didn’t care as long as I was having sex with somebody (25–45 group).

  • P: ...there was a time in my life when any girl—I wasn’t very discriminate because if I was aroused, that was it. I was going to sleep with this girl. I have been this way for a couple of years now, to where I am much more discriminate. Just because I am aroused, I am not going to do it (25–45).

Factors that Enhance or Inhibit Arousal

Factors that enhanced or reduced sexual arousal (see Question 3) were classified into six broad categories, each containing several subcategories. Much like the findings reported by Graham et al. (2004), factors that were reported to be “inhibitors” by some men were described as “enhancers” by others, and even as both by the same men, depending on the specific situation described. For example, negative mood states, such as depression, were reported by some men as inhibiting their ability to become aroused and by others as enhancing it. Likewise, the possibility of being heard or seen while having sex was described as arousing by some men and inhibiting by others. Although individual differences appeared to play a role, men also reported that the context of the interaction was important, particularly whether they were with a new or causal partner versus a long-term or committed partner and the quality of that relationship.

A variety of themes emerged across the different age groups. However, men did consistently raise specific themes in all groups, including feelings about one’s self, feeling desired by the sexual partner, importance of partner attributes, self and partner’s mood state, and feeling emotionally connected to their sexual partner.

Feelings About One’s Self

In terms of facilitating sexual arousal, men frequently cited feeling good, attractive, or positive about one’s self (e.g., one’s accomplishments or appearance) as an enhancing factor:
  • P: When you feel confident in yourself in one way, you can feel sexually confident and more likely to approach women (25–45 group).

  • P: Like I am a musician, so after a concert, if I have done really well, it is a good time (18–24 group).

  • P: I feel like whenever I have accomplished something, and especially when I have accomplished something significant to me, I have a swell of endorphins or something and I want to have sex (25–45 group).

  • P: If you have one of those days where everything is just going your way, it is like, hmmm, I wonder what else I can do (18–24 group).

Or conversely:
  • P: If I am in a situation where I am just not feeling attractive, like maybe if I haven’t bathed for a couple of days, went out hiking, or something like that. Or, I am just feeling scruffy or something like that. I am just definitely not interested in having sex (25–45 group).

Partner’s Sexual Desire

Regardless of age, a number of men reported that their partner’s sexual desire, and feeling desired by their partner, affected their own desire and arousal. Specifically, being with a sexual partner that made one feel desired was considered to be an enhancer while being with a partner who did not make their desire explicit was considered inhibiting.
  • P: I like my wife to initiate, rather than me initiating for the sex act. That means more to me. It really turns me on when my wife gets horny (46 and above group).

  • P: I think another factor is inhibition. When a woman becomes uninhibited and really lets loose, to me that is an incredible turn on (25–45 group).

  • P: The biggest turn off for me is when my partner loses interest, in the middle... (46 and above group).

  • P: A lack of communication can kill my arousal. I think whether it is verbal or internal dialogue that you are sharing with someone. If it’s not there, I guess I feel I need to be told that it is pleasurable (25–45 group).

  • P: I would have to say the number one thing is feedback. I mean, if you show any sign of interest and you get a sign of interest back that is a good thing (18–24 group).

Partner Attributes

For most men, the physical and psychological characteristics of a woman were reportedly very important in terms of enhancing or inhibiting sexual arousal. While individual differences in specific preferences were vast, some of the most commonly reported attributes involved physical appearance, intelligence, scent, and sexual experience (i.e., number of previous partners).

Physical Characteristics Men reported a broad range of preferences in terms of the physical characteristics of a potential sexual partner.
  • P: I usually go about 50% on looks and 50% on body because there has got to be something worth getting underneath the clothes for (18–24 group).

  • P: A good-looking face. I look at that. I think the eyes—when I look into someone’s face. They have to have pretty eyes. I think just that look, you know, let’s do it (18–24 group).

  • P: Just getting back to turn off, I think bad hygiene, for me, is an absolute killer. I like a woman to have good breath, to taste good, and to smell good. But then it is a combination of factors (29–45 group).

  • M: What about things you consider visually stimulating? What do you consider visually stimulating?

  • P1: The back (25–45 group).

  • P2: Lower back (25–45 group).

  • P3: Buttocks (25–45 group).

  • P4: Legs (25–45 group).

Intelligence A large proportion of men reported that they found intelligent women to be a turn on, particularly in, but not limited to, the context of a relationship.
  • P1: Intelligence is a real plus (46 and above group).

  • M: Intelligence is a turn on?

  • P2: A big turn on (46 and above group).

  • P: Being with intelligence. I feel like something that leads up to sexual arousal or interest is conversation. If we can have a conversation and we can see eye to eye, I won’t have much trouble taking the next step (25–45 group).

  • M: Do you all think that intelligence is an important trait or not? Or some who is not intelligent?

  • P1: In a long term, I would say yes (18–24 group).

  • P2: If you are just looking for sex, then no. But if you are looking for a long term, definitely (18–24 group).

  • P3: I find it even important in the short term. Like I just find it really attractive. Like it would mesh with the physical qualities and would be hard to distinguish (18–24 group).

Others indicated that intelligence was not important as an enhancer to sexual arousal, although it was often preferred even when it was not considered essential.
  • P: Smart, wise, I don’t really care if the person is smart at all. That’s not the number one thing I look for (18–24).

  • P: I don’t find dumb women to be a turn off, but I am definitely attracted to women who are intelligent (25–45 age group).

Scent Across groups, men indicated that scent played an important role as either an enhancer or inhibitor of sexual arousal, depending on whether the scent was considered to be pleasant or unpleasant. Furthermore, scent served as a memory trigger, for some men, recalling positive or negative previous sexual experiences contributing to their sexual arousal.
  • P: Yeah, for me scent is one of the big things. I don’t like women who smell like Ivory. I like women who smell like women (46 and above group).

  • P: My last years’ relationship, she wore the same basic perfume. It was great. It was identifying, you know? It became a turn on, you know, because it was something I related to, like, the physical aspect (18–24 group).

  • P: It’s the hormonal response to a stimuli, you know, I don’t know whether it’s getting a whiff of wet pussy or the pheromones, and all of that, but for me it is the same turn on (46 and above group).

  • P: A woman’s scent is definitely one of the things that I find very arousing. A friend and I were talking about this. I asked him why it didn’t work out and he said she didn’t smell right. It is so core (25–45 group).

Number of Sex Partners One theme that consistently emerged from the groups related to the number of previous sex partners that a woman has had. Graham et al. (2004) found that women, particularly those in the younger age groups, were concerned about their reputation and that such concerns had a negative impact on their sexual arousal. Similarly, several younger men indicated that the number of previous sexual partners a woman had been with could influence their sexual desire and arousal. Interestingly, this seemed to be related to fears about “not measuring up” rather than concerns about reputation, sexually transmitted infections, or other factors. Women with more sexual experience were often considered more threatening because they had more varied experience and/or more partners to compare the participants to. However, the opposite was also reported, where a more experienced partner was considered more arousing, and for older men, the number of previous sexual partners seemed to be less important.
  • P: I find that the number of partners that your partner has had will often times be a kind of downer on you (18–24 group).

  • P: Because if you are with a girl and she has never done anything with anyone before it is kind of like a clean slate, you know. You are not being compared (18–24 group).

  • P1: ...I am always concerned that I might not measure up (18–24 group).

  • P2: I would agree (18–24 group).

  • P1: It’s just that if there were numerous people, where do I fall in? (18–24 group).

  • M: How about some of the rest of you? If it is a partner that is experienced, does that enhance arousal or inhibit it?

  • P: That enhances for me. I prefer more experienced partners... (18–24 group).

  • P: The idea that she was smart and a slut. That was a turn on...that was a turn on in and of itself because I knew she has been with 50 guys but was sleeping with me for 6 months, so I’m, like, it was a turn on and made me feel good (25–45 group).

Mood State

Self The majority of men indicated that their mood played an important role in their sexual arousal, as well as interest or desire to engage in sexual activity. While many men reported that a positive mood state was an enhancer and a negative mood state was an inhibitor, some men indicated that negative mood states, such as stress or anger, could also facilitate, or at least not interfere with, their sexual arousal.
  • P: Relaxation always contributes to arousal, as opposed to a tense state or a worried state. Sometimes you can be in a tense state and that can contribute to a sexual thing, often masturbation, because in a tense state you might not want to be with someone. But a certain tension, say a sexual release, can be very good (46 and above group).

  • P: I noticed when I am in a good space and just like flowing; I just get a lot more attraction from women...just subtle stuff (25–45 group).

  • P: Yeah, I see. It is all about my partner. I can be angry, sad, depressed, or mad. If she is interested, I can get over it really quick (46 and above group).

  • P: But if I am down, and generally, if I am alone, no. If I am with somebody, then yes. Because they can take that pain away, at least momentarily (25–45 group).

  • P: I have had experiences where I have been down and depressed and my partner says, hey, let’s have sex and you will feel a lot better. We will have sex and I feel great when we are having sex, and then we are not having sex, I am back down again, literally, and physically (25–45 group).

  • P: Most of my moods don’t usually make a difference (18–24 group).

Partner Not only did men indicate that their own mood state could act as an enhancing or inhibiting factor, but also that the mood state of their partner was also an important factor:
  • P1: If your partner is in a great mood and feeling wonderful and is going to do whatever, then that is great. So that puts you in a good mood. I mean, it is contagious. It is a lot like laughing (18–24 group).

  • P2: If they are having a bad day, you are having a bad day, in most cases (18–24 group).

  • M: So the mood of the partner is an important factor?

  • P1: Oh yeah, most definitely (46 and above group).

  • P2: That is probably, for me, most important (46 and above group).

  • P: But when they get angry sometimes that turns me on as well. So if they are in any kind of emotional state already I am like all ready. Sometimes when they are angry that is the best sex I have ever had (25–45 group).

Relevant to mood was the idea that a woman’s self-esteem, or feelings about herself or her body, could impact a man’s sexual arousal. This finding is particularly interesting given the findings of Graham et al. (2004) who reported that women indicated that they felt less sexually aroused when they were feeling uncomfortable or negative about themselves or their appearance.
  • P: I would say a woman being proud of her body. I mean, because if you were with a girl that just hates her body and just doesn’t want you to see it, and everything, that is a total turn off (18–24 group).

  • P: When a woman feels good about herself, I feel much more drawn to her. To me it has to do with whether it is chronic or not. Everybody can have an off day but when a woman is dealing with chronic self-esteem problems it is impossible, I have found, to be with them sexually... (25–45 group).

  • P: When she is down on herself. When she is really sad about herself and, like, she is not good enough. That inhibits me (18–24 group).

Feeling Emotionally Connected

The majority of men in this study indicated that an emotional connection with their sexual partner contributed to, and sometimes was central to, their sexual arousal. Specifically, men reported that having a strong emotional connection enhanced their sexual arousal and having little or no emotional connection inhibited their sexual arousal. This theme was particularly dominant among the older men; however, many of the younger men also spoke of the importance of emotional connection.
  • P: As I have gotten older, the ability to connect with my partner in other ways has becomes more important (46 and above group).

  • P: For me, it is always, like, I like to be alone with the person and I have to have some kind of connection with them (18–24 group).

  • P: I think when I am in love with a woman that is when I am at my highest level of arousal (25–45 group).

  • P: I have never really hooked up with anyone, I guess. It is for me, it is like, there have been opportunities but it is just like once I have had the emotional connection and experienced it, like just the physical side without the emotional connection it is like impersonal (18–24 group).

  • P: Now it is more emotional that I am looking for, instead of just jumping in bed and get out. It has got to have that something more to it now (46 and above group).

Further, men noted that the context of the relationship, either established or casual, had a direct effect on the actual likelihood of engaging in a sexual behaviors with a specific woman.
  • P: Finding a mate and finding somebody for sex are two different things (age 25–45 group).

  • P: You look at people that you are attracted to in different ways. You are looking at them as potential sex partner or as a potential mate, life mate. If you have already got a mate you are not necessarily looking for another mate, unless they have really turned your head. Mostly just looking for somebody who arouses you (25–45 group).

  • P: It wouldn’t, probably, matter how smart they were. If I wasn’t in a relationship, it would be pure physical attraction (18–24 group).


We found great variation within and between age groups in the role (and effects) of erotica in sexual desire and arousal. While some men reported that they enjoyed viewing erotic materials, and that it enhanced their sexual arousal, others reported the opposite.
  • P1: My wife and I still like to see, together, a porno flick. That’s why you said video. I guess I don’t agree with you (46 and above group).

  • P2: Bores me to death (46 and above group).

  • P1: Really? We find that turns both of us on (46 and above group).

  • P1: I am not big on it (18–24 group).

  • P1: It doesn’t do it for me at all (18–24 group).

  • P2: I think it degrades the real thing. I have never been like one to be like, get a porn, ya know? Ya, know, almost like the sanctity of it. I am not like religious, ya know, but it is like when you watch porn all the time it is commonplace. It is like sex is just sex rather than like the connection (18–24 group).

  • P3: I am a fan. A big fan of pornography. I love it (18–24 group).

  • P: I have to say there are some things I see in pornos that really turn me off, and turns my wife off. S&M is just really offensive to us and that could even turn off our desires, so it is what is happening (46 and above group).

Contextual Variables

In all three age groups, a number of men reported that contextual variables, such as setting, season, and alcohol consumption, could influence their sexual arousal. As with other factors, the same variables could be enhancing or inhibiting. For example, some men reported that the possibility of being heard during sex was a strong inhibitor while others found it to enhance their arousal.

Setting In terms of setting, an overwhelming majority of men reported that engaging in outdoor activities enhanced their sexual desire and arousal.
  • P1: I find outdoors, on a beautiful day... (46 and above group)

  • P2: Yeah, just being outdoors, walking in the woods, going on a picnic in the woods, and spending hours back there. That is a perfect setting (46 and above group).

  • P3: Going on a camping trip, you know, for a few days (46 and above group).

  • P: Camping is a good time. Something about the tent. Something about the sleeping bag. You can’t fight it. If there is a small amount of, you know, attraction there, the tent will seal it (18–24 group).

  • P1: Yeah, nature is a turn on for me (25–45 age group).

  • P2: Sex outdoors is great, especially if under an open sky (25–45 age group).

More variable in terms of acting as an enhancing or inhibiting factor was the proximity of others and/or the possibility of being seen or heard during sex.
  • P: I have children. If the children aren’t in the house, it is a better situation. My wife doesn’t share the sympathy with me and she doesn’t mind. She likes to make noise. It inhibits me (25–45 group).

  • P: In fact, I have decided that there is something to be said for having sex in places that you can be discovered having sex at (25–45 group).

  • P: You know, when I was in the dorms the neighbor, we could hear everything, at all times. That made me never, ever, ever want to have sex in the dorms (18–24 group).

  • P: I don’t like people who keep animals in the room. Period. It is kind of creepy when the family dog is standing there watching. (25–45 group).

Season Another contextual variable that was mentioned in all of the groups, with the exception of the 46 and above groups, as influencing sexual arousal was the season; however, there was great variation in preference.
  • M: How about things related to time of day or certain seasons or something like that that enhances arousal?

  • P1: Fall (18–24 group).

  • P2: Winter (18–24 group).

  • P3: Spring (18–24 group).

  • P4: I would say fall probably more than spring (18–24 group).

  • P1: My hormones seem to peak around January and August (25–45 group).

  • P2: Definitely fall and winter (25–45 group).

  • P3: For me, winter because you are spending more time at home, more time in bed (25–45 group).

  • P4: Working around a university, the first couple of warm days of spring when they go back to bearing it all, you know. Those are definitely peak times (25–45 group).

Alcohol The role of alcohol was mentioned frequently. While the majority of men considered consuming a “few” drinks to enhance their sexual arousal, they indicated that being very intoxicated would be an inhibiting factor or could interfere with the ability to become aroused. Alcohol was attributed to the inability to achieve and maintain an erection; however, sexual interest/desire only decreased concurrently or following the inability of obtaining or maintaining an erection.
  • P: I find that having some drinks turns me on, although, how did Shakespeare put it...heightens the desire but lessens the performance...too many drinks, and I have had that occasion where I have had too much to drink (46 and above group).

  • P1: I am a little bit opposite there. My wife doesn’t drink but when I was with other women and we would go out drinking all night long. This was just a must by the time we were completely plastered (25–45 group).

  • P2: It is like you said, a few drinks will release your inhibitions, but completely trashed, I mean, I had an almost immediate erection from that (25–45 group).

  • P3: I think too much can be a turn-off (25–45 group).

  • P: Alcohol is fine. Good times (18–24 group).

  • M: Can they also be too skinny or...

  • P1: Yeah, too tall and skinny (46 and above group).

  • P2: Wasn’t curvy enough, I like curves (46 and above group).

  • P1: Now, don’t get me wrong. When I’m drinking’ all that stuff could change (46 and above group).


Three topics related to men’s sexual arousal were explored in this study: (1) sexual arousal and its components; (2) sexual interest/desire; and (3) factors that enhance or inhibit sexual arousal. The findings were, to a large degree, consistent with those reported by Graham et al. (2004) on sexual arousal in women, and challenge a number of relatively common assumptions about men’s sexual response. A first conclusion this study appears to justify is simple and straightforward: Men differ. For example, men differ in the importance they attribute to penises, partner characteristics, and to the need for intimacy or interpersonal connection during interactions with a partner. Whereas both scientific and popular discussions of sexual arousal in men tend to emphasize erections, the findings from our study suggest that men experience a wide range of physical (genital as well as nongenital), psychological, and behavioral indicators that characterize sexual arousal. According to the men who participated in this study, erection was only one of the physiological changes that can be experienced, indicating it is often present but not a necessary condition for the experience of sexual arousal.

Also compatible with Graham et al.’s (2004) findings in women, our study found that men did not consistently, or easily, separate sexual interest from sexual arousal. In fact, questions about the two constructs often led to some degree of confusion. When erections were part of the discussion, the distinction between arousal and desire seemed easier to make (with either one regularly experienced in the absence of the other). However, after dismissing a central role for the penis, which many men did, differentiating between the experience of sexual arousal and the experience of sexual interest seemed a challenge for many. Also, men tended to describe the relationship between sexual interest and arousal differently for solo activities (e.g., masturbation) than for sex with a partner. Regardless of age, several participants reported that masturbation tended to be a perfunctory act that served to eliminate sexual tension, while interest and arousal for partnered sex was generally described as more complex with numerous influencing factors.

The existing research literature on sexual desire and arousal seems to endorse, if not reinforce, the belief that men and women differ in their experiences of those states and includes many references, some more explicit than others, to the idea that women are more sexually complex than men, with more variables influencing their desire and arousal. The results from this study challenge this view and suggest that men’s sexual arousal is also complex and multifaceted, and that men and women share a number of commonalities. For example, men reported that contextual variables, such as ones related to setting or timing, played an important role in their sexual arousal. Further, individual factors, such as the effect of mood on sexual arousal, were reported to have vastly different effects on arousal among our participants. These findings, however tentative, suggest that it might be both appropriate and conducive to progress in this area of research to reconceptualize some of our notions about sexual response, putting less emphasis on—while not ignoring—differences between men and women and giving more attention to differences among men and women. This conclusion is consistent with findings from research on the dual control model of sexual response (Carpenter, Janssen, Graham, Vorst, & Wichters, 2007; Graham et al., 2006; Janssen & Bancroft, 2007), which show that whereas women, on average, score lower on sexual excitation and higher on sexual inhibition compared to men, larger variability can be found within than between groups of men and women (Carpenter et al., 2007). Future research is needed, however, to establish the validity and stability of our findings in more representative and ethnically diverse samples. For example, the racial homogeneity of the current study is a limitation, and work with other populations, preferably involving direct comparisons of men and women, is needed to ascertain the generalizability of our findings.

While there were a number of within group differences among all age groups, distinct differences between the younger and older groups were also identified. While men in the younger age groups tended to rely more on erection as an indicator of sexual interest/arousal, men in the older age groups reported focusing more attention on psychological and emotional indicators, as their erections became less reliable. For example, older men reported that as they aged the physical characteristics of their female partner became a less important factor in their sexual arousal and the emotional connection with a partner became more important.

Another age-related difference that warrants discussion relates to the “sexual double standard,” the notion that men are allowed by, and often socially rewarded for having many sexual partners, while women are socially chastised for the same behavior. In this study, a number of men in the younger age groups reported being concerned about the number of previous sexual partners that a woman has had, and considered a woman who has had a “high number” of past sexual partners to be a “turn off.” In comparison, men in the older age groups often reported that number of previous partners was either irrelevant or that a woman with more sexual experience was considered a “turn on.” This finding is interesting from a developmental perspective, as men in the older groups often reported that the sexual experience of a partner was more important when they were younger, and seems consistent with Graham et al.’s (2004) study, in which it was found that younger women were more likely to report feeling the need to “put on the brakes” or stop themselves from becoming sexually aroused out of fear of gaining a bad reputation. To some extent, this finding may be explained by the fact that the younger men also reported fearing comparison to previous sexual partners and “not measuring up,” which may, in part, explain their preference for women with less sexual experience. Conversely, older men tended to report that “measuring up” was less of a concern for them, expressing more confidence in their own sexuality and their ability to please their partner.

One finding worthy of discussion relates to a theme identified in Graham et al.’s (2004) study. Women in Graham et al.’s study consistently reported that their feelings about themselves had a great influence on their sexual arousal and desire for sex. Likewise, several men in the current study reported that how a woman felt about herself had a significant influence on their sexual arousal and desire for sex with her. For example, some men reported that when a woman experienced low self-esteem they were less likely to become aroused by that woman, regardless of other characteristics, such as physical attractiveness. In contrast, when a woman was feeling good about herself, men reported that they were more likely to become sexual aroused and to desire sex with her. The same, however, seemed true for men’s feelings about themselves. For example, several men reported that when they did not feel attractive or were having an “off” day, they were less likely to become sexually aroused, while at times when things were going “right” served to enhance their sexual arousal.

A number of other findings are worthy of discussion, including the role of factors such as scent, intelligence, feedback from the partner, pornography, and the influence of alcohol on desire and arousal. However, for all these topics, too, the most salient finding seems to be the large variation in the importance the men attributed to them. Remarkably absent, however, were discussions of contraception (including condoms) and specific sexual behaviors. In fact, specific sexual behaviors as either an enhancing or inhibiting factor were not discussed in a single group. This topic was not explicitly raised by the moderators, but as participants seemed, in general, relatively comfortable with bringing up topics (e.g., intelligence, intimacy) that were not always introduced by the moderators, the complete absence of comments on sexual positions and specific sexual activities (e.g., oral or anal sex), as well as of those on penis size, female orgasm, or contraception, is intriguing and may be due to, or associated with, a number of factors, including a more general lack of interest in or discomfort with such topics or certain (not established) characteristics of the sample of men who participated in this study.

Although the study was not designed to specifically explore gender- or masculinity-related notions—our questions were aimed at the assessment of factors that men report facilitate or suppress their sexual arousal—our findings nevertheless point toward complex interactions between gender, masculinity, and men’s narratives about desire and arousal (cf. Dworkin & O’Sullivan, 2005; Seal & Ehrhardt, 2003; Tolman et al., 2004). For example, our findings resonate with the work and views of Brod (1988) and Connell (1995), who have long challenged more traditional and one-dimensional views of men’s sexuality and who have contributed to a more complex understanding of the interplay between masculinity (or masculinities; Connell, 1995) and men’s sexuality. On the one hand our findings point at shared themes and communalities among men, and possibly their sexual scripts (e.g., Dworkin & O’Sullivan, 2005). Indeed, several of the men’s narratives seem to reflect more traditional, perhaps even hegemonic (Connell, 1995), notions of masculinity (e.g., desiring sex when performing well, wanting to know how one measures up with other men).1 On the other hand, our findings show large differences among men in how important they consider the influence of various factors, and the role that context, situation, and relational cues play in their experience of sexual desire and arousal. Although our small and demographically homogeneous sample sets limits to generalization and to the discussion of gender differences and similarities, our findings transcend notions of indiscriminate and unfaltering male desire and arousal, and point at more complex and diverse patterns in men, some compatible with more traditional notions of masculinity, some consistent with ideas more commonly associated with women’s experience of desire and arousal (e.g., Basson, 2002a; Graham et al., 2004).

The findings from this study add additional support for the use of focus group methodology to gather information on topics that are sensitive in nature (Seal, Bogart, & Ehrhardt, 1998; Wilkinson, 1999). Yet, a number of limitations should be acknowledged and warrant discussion. For example, as was alluded to above, the sample was self-selected and consisted of men who, overall, were comfortable discussing topics related to sexuality. Also, men may, in varying degrees, have felt pressured to conform to stereotypical notions or gender ideals of what ‘real’ men are supposed to be turned on or off by (cf. Anderson & Sorenson, 1996; West & Zimmerman, 1987). Yet, despite such potential biases we found substantial variation in how men describe the variables and processes involved in sexual desire and arousal. In addition, we found support for the idea that men exist for whom the mechanisms of sexual arousal, at least in their own subjective experience, appear to be more compatible with more recent conceptualizations of sexual desire and arousal in women (e.g., Basson, 2002a, b) than with more traditional models of sexual response (e.g., Masters & Johnson, 1966). Although the current sample may not be representative of men in the general population, the same applies to research and insights based on clinical samples. Where the current study may possibly suffer from an overrepresentation of men who feel comfortable talking about their sexuality, the men and women on whom the clinical observations and research findings are based that informed and inspired the recent introduction of models that propose that the determinants of women’s sexual desire and arousal are different from men’s (e.g., Basson, 2002a, b), may have included disproportionate numbers of women whose partners might not only be different from the men who volunteered for the current study, but who also do not represent men in the general population.

Another limitation, and possible threat to the validity of our findings, involves the reliance on subjects’ self-knowledge and report. The men may have felt comfortable discussing the factors that influence their sexual arousal and desire, but this does not mean their responses were accurate, complete, and based on actual experiences. For instance, participants at various times appeared to talk about the factors that increased or decreased their willingness to engage in certain behaviors rather than their sexual desire or arousal. Thus, some of the responses may have reflected the conditions that need to be met for a participant to take initiative or (continue to) engage in sexual behavior more than actual sexual arousal patterns. In addition, the attributions and interpretations the participants expressed may have been based on real-life experiences, but they may also have guided their real-life decisions and behavior and thus precluded certain experiences. For example, although most participants indicated that certain characteristics of a potential partner could be a “turn-off” (e.g., high numbers of previous partners, low intelligence, absence of an emotional connection), such characteristics may have a stronger effect at the level of partner selection than that they might predict the actual ability to become (physically and/or subjectively) aroused in a sexual situation with that person. This is not to say that we believe all experiences reported by the men in this study should be considered to be unreliable or invalid. The increasing popularity of qualitative research methods appears to coincide with a revival of introspection in the social and biological sciences, which has, for example, even been recommended to be used as additional source of information to help interpret findings from studies using behavioral and brain imaging techniques (e.g., Jack & Roepstorff, 2002). Yet, the reliance on people’s self-report and self-knowledge in the study of complex mental, emotional, and social processes has long been recognized as being potentially problematic (Nisbett & Wilson, 1977; Wilson & Dunn, 2004). This seems especially the case when the questions involve feelings, behaviors, or situations that require retrospective analysis and that may not be commonly or frequently experienced (e.g., Robinson, Johnson, & Shields, 1998).

While acknowledging the limitations of focus group methodologies in general, and of the current study in particular, we believe our findings are informative and valuable, and may help inform discussions about the adequacy of existing sexual response models (e.g., Masters & Johnson, 1966) in explaining both men and women’s sexual desire and arousal. Our findings support the idea that concerns that have been raised about the appropriateness of such models to our understanding of women’s sexuality (e.g., Basson, 2002a, b; Tiefer, 2001)—in that they are too focused on the genitals, make distinctions between interest and arousal that do not reflect the experiences of many women, and minimize the numerous factors that can affect arousal—also apply to men. In addition, we believe that studies like the current one, and also Graham et al.’s (2004), provide various insights that could inspire hypotheses for future studies, both qualitative and quantitative.


  1. 1.

    While this implies a role for social and cultural factors (e.g., socialization), these findings can also be considered consistent with parental investment and evolutionary theory (e.g., Buss, 1994).



This study was supported by the Office of the Associate Dean for Research of the School of Health, Physical Education and Recreation, Indiana University.


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Copyright information

© Springer Science+Business Media, LLC 2007

Authors and Affiliations

  • Erick Janssen
    • 1
  • Kimberly R. McBride
    • 2
  • William Yarber
    • 3
  • Brandon J. Hill
    • 4
  • Scott M. Butler
    • 5
  1. 1.The Kinsey Institute for Research in Sex, Gender, and ReproductionIndiana UniversityBloomingtonUSA
  2. 2.Department of Pediatrics, Section of Adolescent MedicineIndiana University School of MedicineIndianapolisUSA
  3. 3.Department of Applied Health ScienceIndiana UniversityBloomingtonUSA
  4. 4.Department of Gender StudiesIndiana UniversityBloomingtonUSA
  5. 5.Department of KinesiologyGeorgia College and State UniversityMilledgevilleUSA

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