Review By

Lara Hazelton, MD, FRCPC
Halifax, Nova Scotia

Since the end of the 19th century, shifts have occurred in our attitudes tward sex, sexuality, and gender—the result of a complex interplay of factors that include medical advances such as birth control, societal change, and the dissemination and integration of sexual theories into modern thought. As Ethel S Person writes in the introduction to this collection of essays, the 20th century has been “the century of Freud, who taught us that sex has as much to do with the mind as with the genitals.

Ethel Spector Person is a psychiatrist and psychoanalyst currently affiliated with the Columbia University Center for Psychoanalytic Training and Research. The Sexual Century is a collection of papers written between 1972 and 1998, some of them reports of original research, others theoretical. While much of the book is devoted to understanding questions of sex and gender from a psychoanalytic point of view, there is also an effort to incorporate historical and anthropological perspectives. As the author points out, one of the unifying principles of these essays is that human development results from the effects of nature, nurture, and cultural influences and should not be understood in terms of intrapsychic development only.

There are 20 papers or chapters in all, divided into 5 sections. The first section,

entitled “Sex and Gender: General Considerations,” introduces the subject and provides a theoretical framework for these concepts. The first paper, which bears the same title as the book, presents a historical overview of the subject. Person then reviews contributions of various authors, looking at how psychoanalytic thought regarding sexual motivation and gender has changed since Freud.

The second section, “Cross-Gender Disorders,” comprises papers on transsexuality, transvestitism, and homosexual cross-dressing. The papers in this section, written between 1973 and 1985, are the oldest; much of their focus is on defining and classifying these conditions.

“Sex and Fantasy” is the title of the third section, which looks at desire, fantasy, and enactment of fantasy. Along with a paper that attempts to place fantasy within a psychoanalytic framework, this section includes 2 interesting papers reporting results from the Fantasy Project, an early 1980s questionnaire study of university students.

Section 4, entitled “Sex and Gender: Female Sexuality and Femininity and Male Sexuality and Masculinity,” focuses on differences in the experiences and cultural expectations of men and women. It also includes a paper, entitled “Male Sexuality and Power,” that examines the dynamics of control and power issues in sexual relationships.

Section 5, “The Impact of Culture,” consists of a single paper, “Harry Benjamin and the Birth of a Shared Cultural Fantasy.” This paper is primarily biographical, although it incorporates other themes, including the effect of historical or cultural context.

Reading this book, I was struck by the range of topics included in the clinical

and theoretical study of sexuality. Whether critiquing libido theory or investigating the association between sexual experiences and fantasies, Dr Person tackles the subject with an impressive attention to detail and with what appears to be a comprehensive knowledge of psychoanalysis and sexology. This is a fairly academic text, and the papers themselves are replete with quotations, citations, and references to the ideas of other authors.

As a result, despite its rather engaging title, the book is not intended for a general audience. Several papers originally appeared in psychoanalytic journals, including The Journal of the American Academy of Psychoanalysis; clearly, they are intended for the reader who has some familiarity with the principles and terminology of psychoanalysis. Without this background, much of the book may prove quite challenging to read. Although the articles are grouped into related subject areas, they are still quite distinct, often introducing new concepts and terms. In addition, because this is a collection of previously published articles, there is not the opportunity for continuity that would have allowed the author to introduce a concept and subsequently develop it across several chapters. However, the case studies are for the most part very readable and interesting, and the original research articles—including one on extreme boyhood femininity—may prove more accessible for the average psychiatrist than the more theoretical papers.

The book is a convenient size and has no obvious deficiencies in its printing or editing. In my opinion, it is most likely to appeal either to readers with a particular interest in sex or gender issues or to those with a background in psychoanalysis. Nonetheless, even those without training or experience in these areas may appreciate an authoritative discussion of these topics.