William Masters and Virginia Johnson were pioneers in the scientiﬁc study of human sexuality, as well as innovators in the therapeutic treatment of sexual dysfunction. Masters, a gynecologist, recognized that although Alfred Kinsey’s work had made human sexuality a legitimate subject for scientiﬁc research, little was actually known about the physiological and psychological nature of the human sexual response. In his quest for an objective, scientiﬁc understanding of sexuality, he enlisted the help of psychologist Virginia Johnson in 1957 as a research assistant. Together, they went on to develop a wide range of clever and innovative tools to measure what happens to the bodies of men and women during sex. Despite the large amount of survey data turned out by Kinsey and others, almost no objective data existed, as no direct observation had actually been undertaken under scientiﬁc conditions.
Some of the devices Masters and Johnson created are quite inventive. For example, to measure various changes in the vagina during sexual arousal, they created a clear artiﬁcial penis containing sensors for temperature and blood ﬂow, and which could also eventually be equipped with a small camera. To measure changes in penis girth during erection, as well as to time it, they invented the strain gauge: a ﬂexible, mercury-ﬁlled rubber ring with wires attached, which could convert changes in size into electrical impulses to be read by a polygraph-like device.
By the time they published their book Human Sexual Response in 1966, they had observed over 700 men and women either having sex or masturbating in the laboratory, and they were able to turn these observations into a scientiﬁc description of the human sexual response cycle. According to Masters and Johnson, the response goes through four phases: excitement, plateau, orgasm, and resolution.
In the excitement phase, heart rate, blood pressure, and muscle tension all increase, and both sexes experience increased blood ﬂow to the genitalia. In males, the penis becomes erect; and in females, the vagina becomes lubricated and the labia swell. In the plateau phase, physiological arousal increases further, along with both sexual pleasure and muscle tension. Orgasm is simply the conclusion of the plateau phase, with the release of sexual tension and rapid rhythmic muscle contractions in both men and women. During resolution, muscles relax, blood pressure and heart rate drop, and males experience a refractory period during which time must pass before orgasm can again be achieved.
The book became a best seller, and Masters and Johnson became household names. In 1970 they turned their attention to impotence, often referred to as erectile dysfunction, in the book Human Sexual Inadequacy. Based on their research, speciﬁcally the observation that many men experiencing impotence were nonetheless experiencing normal erections in their sleep, they argued that as many as 90 percent of the cases of impotence were due to psychological rather than physiological causes, and that the problem could therefore be overcome through psychological means, such as overcoming performance anxiety.
These two books together were largely responsible for the birth in the 1970s of the ﬁeld of sex therapy, the clinical treatment of sexual problems. Masters and Johnson established a sex therapy practice in St. Louis that proceeded to train many sex therapists who then went out to establish their own practices in other parts of the country. For a time in the early 1970s, most of the country’s sex therapists were either trained by Masters and Johnson or by their students.
For the next two decades Masters and Johnson continued their research and their string of successful books. In 1979 they published Homosexuality in Perspective, which described the sexual responses of gay men and women in the same detail as they had previously documented heterosexual behavior. This book devoted substantial space to debunking the notion that homosexuality is a psychological disorder (a position only abandoned by the American Psychiatric Association in 1973), but Masters and Johnson have drawn considerable ﬁre, both from other sex researchers and from the gay community, for their claim to be able to change the sexual preferences of homosexuals who wished to change. In fairness to Masters and Johnson, this claim was still a part of the psychiatric profession’s diagnostic manual at that time, listed as ego-dystonic homosexuality.
Masters and Johnson’s collaboration ended with their divorce in 1993, but they have had an enormous inﬂuence on the way sexuality is viewed. Most widespread practices in sex therapy are based directly on their innovations. While better physiological measurement has shown that many cases of erectile dysfunction are in fact medical rather than psychological (hence the huge success of such drugs as Viagra and Cialis), for example, in the 40 to 50 percent of cases where psychological factors are involved, Masters and Johnson’s treatment techniques are still widely applied.
One lingering concern about their original data should be addressed, however: it remains unclear how generalizable their ﬁndings are to the overall population, given how unrepresentative their research subjects may have been. After all, their data are based entirely on uninhibited people who volunteered to have sex under observation in a lab, attached to a variety of electrical monitoring devices.
- Masters, W., and Johnson, V. Human Sexual Response. New York: Lippincott, Williams & Wilkins, 1966;
- Masters, W., and Johnson, V. Human Sexual Inadequacy. New York: Bantam, 1980 (reissue).