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Sex Matters for Women, Second Edition: A Complete Guide to Taking Care of Your Sexual Self

Sex Matters for Women, Second Edition: A Complete Guide to Taking Care of Your Sexual Self

by Sallie Foley, Sally A. Kope, Dennis P. Sugrue

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Sex is talked about more openly today than ever before, but if you still struggle with sexual myths, self-doubt, and "embarrassing" questions, you're in good company. Now in a fully updated second edition, this trusted guide has already helped many thousands of women understand how their bodies work and take charge of their sexuality. The authors are


Sex is talked about more openly today than ever before, but if you still struggle with sexual myths, self-doubt, and "embarrassing" questions, you're in good company. Now in a fully updated second edition, this trusted guide has already helped many thousands of women understand how their bodies work and take charge of their sexuality. The authors are experienced therapists who interweave candid reflections from diverse women with current, science-based information, exercises, and advice. You'll find answers to everything from how to have more satisfying sex to questions about body image, anatomy, hormones, relationships, sexual orientation, sexually transmitted infections, and trauma. Sexuality is a lifelong journey—this book gives you a roadmap for self-discovery and growth.

Winner--Society for Sex Therapy and Research (SSTAR) Consumer Book Award

Editorial Reviews

From the Publisher

"The most comprehensive book on women's sexual health I have ever read. The clear, positive information and the suggested exercises cover all aspects of women's sexuality and offer ways for women to take charge of their sexual selves. The second edition features new information and resources, offered in a supportive and affirming manner, which will help readers develop sexual comfort, confidence, and satisfaction. A 'must read' for women of all ages."--Beverly Whipple, PhD, RN, FAAN, coauthor of The G Spot

"The second edition of Sex Matters for Women will allow me to quietly retire my tattered and worn copy of the first edition. I have lent this superb book to dozens of the women I have treated."--Sheryl A. Kingsberg, PhD, Professor of Reproductive Biology and Psychiatry, Case Western Reserve University 

"This second edition takes a classic book on female sexuality to another level. It is comprehensive and grounded in research, yet fun to read alone or with a partner. With a focus on female sexual satisfaction and pleasure, this book is a 'must have' for women of all ages and backgrounds. I can't wait to share it with my daughter!"--Hilda Hutcherson, MD, author of What Your Mother Never Told You About Sex

"This is my favorite book on women's sexuality and sexual health! In the second edition, the authors respond to new research and deliver an up-to-date, even more enlightening book that emphasizes the positive. It's an empowering guide that you can fully rely on for accurate information and useful exercises for sexual growth. I especially love how the book celebrates female sexuality in its many diverse forms."--Pamela H. Stephenson-Connolly, PhD, author of Sex Life

"This is a book you can trust. The authors obviously know and care a great deal about helping women have fulfilling sex lives. The first edition was terrific, and the updated second edition is even better."--Pepper Schwartz, PhD, author of Prime: Adventures and Advice on Sex, Love, and the Sensual Years

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Sex Matters for Women

A Complete Guide to Taking Care of Your Sexual Self

By Sallie Foley, Sally A. Kope, Dennis P. Sugrue

The Guilford Press

Copyright © 2012 The Guilford Press
All rights reserved.
ISBN: 978-1-60918-999-0


Every Story Has a Beginning

Children are sexual beings from birth, and their adult sexuality is influenced by childhood experiences. In this chapter, we explore the common milestones of childhood and adolescence that impact a woman's sexuality. It's not our goal to write the definitive treatise on development and sexuality—entire books have been devoted to that theme (e.g., Zoldbrod, 1998). Instead, we want to provide you with the opportunity to reflect on how an important period in your life—the time between birth and young adulthood—influenced where you are today on your sexual journey so that you can better decide how you want to live your life now and in the future. The knowledge you gain may lead to a greater understanding of how you arrived where you are. It may also lead to your own sexual growth as a woman and greater satisfaction and pleasure in your life.


Annie raced back home after playing with Jack and Sean. She dumped her things in her fort, a place she had constructed of plywood and old junk. She tried not to step on the tiny row of lilac bushes her mother had planted in front of the fort in a futile attempt to disguise her daughter's shack.

Eight years old today, Annie sat down and rested under the pine tree. Her shirt felt sweaty and sticky; she pulled it off and leaned back on the rough bark, scratching a few choice places as she relaxed. Just last summer her mom had made her start wearing a shirt all the time. Jack and Sean didn't have to wear shirts on hot summer days. But Annie's mother had told her that girls were different—they had to cover up their chests once they were in grade school because girls were "developing."

Annie didn't want to "develop." She wanted to move on hot summer days like the boys did. After all, she could run faster and climb higher than Jack and Sean—why wasn't she allowed to be just as free? Annie decided that when she grew up she would live where she could take off her T-shirt whenever she wanted. Annie sighed and looked around her. This pine tree fort was Annie's favorite place in her backyard, and late afternoon was her favorite time of day. Drawing her knees up to her chest, she wrapped her arms around them and rested her head there. She breathed in and smelled the piney smell, then rubbed her face across her forearm. She thought how much she loved her body. She liked how her skin was so taut and smooth across her bones. She examined those tiny hairs that grew on her arms. She rubbed her cheek against them, feeling her skin's smoothness underneath that soft, fuzzy hair. Then she smelled her skin. More than anything, Annie loved these private, special smells of her body. She thought the skin on her forearm smelled the best: a clean, sweet smell that was all hers. She slid her hands along her legs and arms, scratched where a pine needle poked her in the neck, and then stood up and rubbed her hands over her body, making her feel cool and shivery. She looked down at her chest. There, too, her skin was smooth. There were few hairs to see, and her nipples were flat and round and pink and interested her.

Looking down at her body, Annie felt for the bones just under the skin and watched as her breath made her stomach suck in and out. Her ribs disappeared and reappeared. The muscles on her chest seemed to spread all the way out to her arms. She tightened her fist and flexed her arm like a strongman. The muscle bulged. Boy, I'm strong! she thought.

Annie was an 8-year-old girl, an explorer, and at that moment, a person at peace with her body and herself.

When does a woman's sexual story begin? The first time she makes love? The moment she discovers orgasm? Puberty?

A woman's sexual story starts in infancy and continues throughout her life. Early childhood experiences that most people would never consider sexual are, in fact, fundamental to being a sexual person. Young Annie, reveling in the wonders of her body, is learning to become a sexual person because she's learning how to live in her body, how to be at peace with herself, and how to find pleasure from her senses. Each of these discoveries is part of a lifelong sexual journey.


Even during the first years of life, a girl's sexuality is being shaped and scripted. Biology assigns her gender, but it is people around her who quickly assign her the role that is supposed to go with that gender—a role that will influence how she views and values herself and how she will relate to others for years to come. During these earliest years she also will learn whether she can trust other people to love her and to respect her body and her emerging sexuality. The foundation for bonding and trust is established even before a child takes her first steps. Finally, as an infant and toddler, a girl will make important discoveries about her body that will influence her self-acceptance and her capacity to experience pleasure well into her adult years.

It's a Girl!

Sociologists have studied the reactions adults have to newborn babies. By the time babies are 1 minute old, they are treated differently depending on their sex. Think about the observations that people make: "Look at those delicate fingers." "Such big, strong hands!" "Check out the size of those feet!" Actually, most newborns look remarkably alike. But right from the beginning, people viewing a newborn will respond differently depending on the baby's gender. Parents will hold a girl more gently and speak to her more softly than with a baby boy.

This pattern continues as a baby girl grows into a toddler and begins exploring her world. If a little girl takes a tumble while running, she'll be consoled more quickly and allowed to cry about it longer than if she were a little boy. She'll be held more often than a boy toddler. And girl toddlers are often encouraged to be gentler and less aggressive than boys, and to get along and resolve conflicts quickly.

While the seeds of many wonderful attributes—such as sensitivity, nurturing, and an orientation toward cooperation and constructive problem solving—will be implanted by the age of 4 or 5, so will the seeds of characteristics that conform to the dictates of cultural sexism, myths, and double standards—such as the emphasis on being "nice" and "good," pretty and thin, and using clothes, jewelry, or makeup as a way of drawing attention. These characteristics may make it difficult to separate self-worth from personal appearance. They may also make adult relationships more complex because a woman's traditional gender role and identity may conflict with her attempts to gain autonomy, be assertive, and act competently. They may make the natural desire to enjoy sexual passion difficult because "good girls don't do that." Perhaps you can relate to what one woman told us:

"Sometimes when I get really turned on during sex, I want to moan and thrash about because it feels so great. But I don't—I keep hearing my mom's voice saying, 'That's not what classy women do. That's trashy.'"

Peekaboo: Where Trust Begins

An important part of our sexuality is how comfortably we relate to a partner. The abilities to bond, to trust, and to freely touch and be touched are essential for a successful sexual relationship, and the foundation of these abilities is established in infancy. Even before a baby girl can speak, she's spoken to. Even before she can hug, she's hugged. Children's earliest experiences are shaped by their adult caregivers. When the child is hungry or in distress, she cries. If a parent or caretaker responds and tends to the child's needs, a foundation of trust is formed. If parents treat a baby with love, nurturance, and respect, the baby receives important information not only about trusting others but also about self-worth. Because her needs are met, she feels important and valued. And by feeling valued by others, she learns to value herself. Without early nurture and loving touch, a girl may grow up wary of trusting others, uncomfortable with physical contact, or feeling unworthy and unlovable. One woman recalled:

"My parents came from the 'old school' of parenting—let your child cry herself to sleep, don't hold a baby too much, make a child independent as quickly as possible. They never touched or hugged me. It's made it hard for me, as an adult woman, to feel comfortable being in close contact with other people. I cringe when friends hug me, and even though I like sex, I don't like cuddling before or after."

Junior Scientists in Action

Our bodies are the epicenter of our sexuality. It is by means of our bodies that we experience sexual pleasure and connect with other people. This relationship between our bodies, pleasure, and connecting with others begins within minutes of birth. Sucking is the child's first experience of satisfaction. Whether breast-fed or bottle-fed, the child derives pleasure from her mouth, and this pleasure is associated with close physical contact with the parent or caregiver. This association between physical contact with another person and pleasure derived from the body becomes the basis for all future sexual relationships.

Later, a girl makes further discoveries about her body's ability to produce pleasure. During early childhood, children are junior scientists. They love to learn and explore. They are naturally curious about themselves and their world. One woman recalled:

"When I saw a woman nursing her baby, my mom did a great job of explaining breast-feeding to me. But when I came home and tried to get my baby doll to suck my breast, she freaked out."

This curiosity includes their bodies. After all, children spend an enormous amount of time trying to learn how to do things in their bodies, from potty training to tying shoes, from skipping to whistling. It's normal and natural for children, girls and boys alike, to explore their own bodies with all their senses: sight, hearing, touch, taste, and smell. Part of that exploration will include their genitals. They will touch themselves for the pleasure of it. This isn't sexually stimulating in the erotic way that adults might think of it. Rather, it is a normal expression of interest and an experience of pleasure in a part of the body that feels good when touched. Many women remember playing in the bathtub as little girls and touching and looking at their genitals.

"Look What I Found!"

Little girls are at a disadvantage compared with little boys in developing long-term familiarity with their genitals. Little boys have "outies"—their penis is right there for them to explore, stroke, and tug. If a small girl attempts to probe her vagina in an exploratory way, her parent will most likely interrupt her and make it clear that she shouldn't do this. Little girls are far less clear about the source of their pleasure because they have "innies." They probably have no idea that the pleasure they feel when rubbing their vulva comes from their clitoris, a part of their body largely unseen and, in all likelihood, unnamed. They may have been told that they have a vagina, but that's a part of their body they don't have ready access to, and it will be years before it will become fully biologically functional.

She may not know what to call it, but free of parental shaming or restrictions, a little girl will quickly learn that touching and rubbing her vulva can be very pleasurable. It's natural and normal that she will want to reproduce these pleasant feelings, especially for the purpose of self-soothing or pleasant sensation. She may touch herself to settle into sleep or when she is nervous or bored.

"Even now, in my 60s, I can still remember the pleasure I got from masturbating as a little girl. I would go to bed and tuck my hand between my legs and rock back and forth until I fell asleep. Before sex was arousing, it was soothing."

When this natural curiosity and self-pleasuring is allowed to occur without shame or embarrassment, the child has a fairly good start toward developing a healthy sexuality. Unfortunately, a girl can receive a message that her body is shameful and that genital pleasuring is bad at the same time she is discovering that it feels good to touch her vulva. All too often these messages are carried into adulthood and influence many women's sexual experiences.

Where do these messages come from? How does a little girl pick up negative attitudes about her body and genital pleasure?

"Shame on You!"

"I remember I was watching TV and idly rubbing my vulva because it felt good. My mom came into the room, saw me, and screamed. I thought someone had died. What 'died' was my interest in pleasuring myself."

Consider what happens when a little girl is caught rubbing her vulva or exploring her vagina. All too often parents react with anger or embarrassment. Not surprisingly, the girl associates touching her vulva with upsetting people and doing something wrong. All children rely on adults for love, and if faced with the fear of displeasing her parents, a young girl will readily give up the good feelings that come from touching herself so that she can hold on to parental approval. She will deny her own pleasurable experience because she's too young to determine that her parents are wrong; her connection to her parents at this stage of life is stronger than her connection to pleasuring her body.

Sometimes parents' reactions aren't meant to shame but to protect. Children must learn that orifices—ears, noses, vaginas, and anuses—aren't meant to have things put into them. But some parents go overboard by promoting a "hands-off" approach to the genitals. It's normal for a young child to ask questions about sex, to explore her genitals, and to be curious about other children's genitals. Because masturbation is a healthy part of development, forbidding or punishing self-pleasuring makes no more sense than forbidding a child to read books or punishing a child for eating healthy food.

What's in a Name?

Do you remember the names you were given for your genitals? Were they even remotely close to the accurate names for the vulva, clitoris, or vagina? Girls pick up negative attitudes about their bodies and their sexuality in a number of subtle ways. When parents refer to a girl's genitals as her "wee-wee," "tinkle," or "place down there," a girl is left wondering, Why don't people like talking about that part of my body? It's a small leap from this kind of thinking to My body must be shameful or bad because no one mentions it.

It isn't just that adults aren't comfortable teaching children the accurate names of genitals, but that most wouldn't know what to do if the children were to start using them.

"When I was three, my mom told me all the names of my genitals. I was so proud I wanted to tell everybody. I showed my genitals to my friend Evan, pointing and naming. Then he showed me his, and we named them together. I still remember the feel of his penis when I touched it. When Grandma came over later in the day, I enthusiastically asked her if she had a vulva just like mine!"

Even adult women struggle to have open conversations with each other or their healthcare providers regarding questions or comments about their vulvas and vaginas. Recall that Oprah Winfrey playfully created the euphemism "vajayjay" on her daytime talk show and many women enthusiastically embraced the term, relieved to finally have a shared cultural slang term that is neither childlike ("pee pee") nor shadowed with disrespect ("cunt").

"Don't Forget to Wipe!"

Most of us don't remember toilet training, but we do have our "habits" in the bathroom, habits that often got an early start. Little girls are usually toilet trained differently from little boys. They miss out on the thrill of arching their stream at a floating target but instead are expected to sit quietly and to take thorough steps to wipe themselves clean afterward. The strong emphasis on staying clean after voiding can reinforce a notion that there must be something dirty about their genitals. One woman remarked that every time she got aroused, her underpants would get wet with discharge, and she'd feel embarrassed about "messing her panties." Another woman reported feeling like she has to thoroughly wash her genitals before sex with her partner, afraid that her natural smell is "dirty."

Private Property

As children grow, so does their need for privacy. While 3-year-olds want to show off what they did in the toilet, 7-year-olds want to be alone in the bathroom. There is a natural, increasing desire to be private about one's body. Most of the time this is what kids also see modeled in their homes. Mom and Dad request privacy for toileting, bathing, dressing, and other personal times. A child initiates her own need for privacy as she grows. Women recall very different experiences.

"I was a wild, intense little girl, very high-spirited. My parents had to work with me to close bathroom doors. I'd masturbate in the living room 'til my mom helped me finally understand the difference between 'public' and 'private.'"

"I was a painfully shy girl. I'd undress in my closet because I didn't want anyone to see me in my underwear. Annual trips to the doctor's office were agony. I could only get through them if my mom stayed right with me the whole time."

"I live on my own, and because of a physical disability, I have a personal attendant to help me with toileting and bathing. As a girl, my mom did all that. You have a different relationship with your mom when you're arguing about whether you can watch an R-rated movie at the same time she's wiping your butt and changing your menstrual pad."


Excerpted from Sex Matters for Women by Sallie Foley, Sally A. Kope, Dennis P. Sugrue. Copyright © 2012 The Guilford Press. Excerpted by permission of The Guilford Press.
All rights reserved. No part of this excerpt may be reproduced or reprinted without permission in writing from the publisher.
Excerpts are provided by Dial-A-Book Inc. solely for the personal use of visitors to this web site.

Meet the Author

Sallie Foley, MSW, a faculty member at the University of Michigan School of Social Work, is Director of the University of Michigan Sexual Health Certificate Program and founder and former director of the University of Michigan Health System's Center for Sexual Health. She has a private practice in Ann Arbor, Michigan. She and her husband have three grown children. Her website is www.salliefoley.com.

Sally A. Kope, MSW, is in private practice in Ann Arbor, Michigan, and is the former program director of the University of Michigan’s Sexual Health Counseling Services. She and her husband are the parents of four and grandparents of six.   Dennis P. Sugrue, PhD, is on the faculty of the Department of Psychiatry at the University of Michigan Medical School and has a private practice in Bloomfield Hills, Michigan. He is the founder and former codirector of the Henry Ford Center for Human Sexuality and past president of the American Association of Sexuality Educators, Counselors, and Therapists. He and his wife have two grown sons.


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