Prostitution and Fellatio.

Questionnaires gathered from men arrested while trying to hire female prostitutes in three Western cities indicate that the desire for fellatio is an important reason clients seek female prostitutes. Respondents were more likely to select fellatio than any other practice when asked which sexual practices they (a) had ever experienced with a prostitute (81% in comparison to 55% for vaginal sex; N = 995), (b) usually experienced with a prostitute (51% in comparison to 12% for vaginal sex, the second most common practice; N = 926), and (c) experienced during their most recent sexual encounter with a prostitute (68% in comparison to 43% for vaginal sex; N = 424). Though a majority of respondents (65%)found the practice of fellatio very appealing, an even greater proportion expressed that opinion about vaginal intercourse (76%; N = 55). These findings, when analyzed in the context of other research on sexual practices, suggest that the desire for fellatio may be one reason some men seek prostitutes.

Like prostitution policy, research on prostitution has focused primarily on prostitutes rather than on their clients (Carmen & Moody, 1985). Some argue that the neglect of clients, virtually all of whom are male, reflects a double standard in which women are held responsible for male deviance (Davis, 1993). Others argue that the lack of attention to male clients is due to the assumption that seeking prostitutes is natural behavior in men, hardly worthy of explanation (Prasad, 1999). A more common explanation for the lack of research on male clients is that they are inaccessible. Clients usually seek to keep their activities hidden, and the justice system may assist them to spare embarrassment to them and their families (Faugier & Cranfield, 1995; Special Committee on Prostitution and Pornography, 1985).

Recently, efforts to curtail prostitution have begun to focus on clients. Since 1995, weekend educational programs for arrested clients have developed in San Francisco, Las Vegas, and Portland, Oregon. These "johns schools" provide unprecedented access to this formerly hidden population. San Francisco's First Offenders Prostitution Program (FOPP), the largest and longest-running program of this kind, sees as many as 80 men per month (Monto, 2000). For a description of a similar but now defunct program in Portland, Oregon, see Monto (1998).

The little existing research on clients points to multiple explanations for seeking prostitutes. Indeed, Monto (2000), in a study of arrested clients, argued that most of the popular explanations as to why men seek out prostitutes are supported by existing data. Clients may seek sex with prostitutes because they are attracted to the illicit or risky nature of the encounter (Holzman & Pines, 1982; McKeganey & Bernard, 1996; Monto, 2000), because they want to have greater control over their sexual experiences (Monto, 2000), because they have difficulty becoming involved in conventional relationships (Jordan, 1997; Monto, 2000), because they want to avoid the responsibilities or emotional attachments of a conventional relationship (McKeganey & Bernard, 1996; Monto, 2000), or because they are interested in companionship, intimacy, or love (Holzman & Pines, 1982; Monto, 2000). Additionally, research supports the idea that one of the main reasons clients pursue encounters with prostitutes is that they are interested in sexual practices to which they do not have access, either because they have no regular partners or because their partners are unable or unwilling to accommodate their desires (Jordan 1997; McKeganey & Bernard, 1996; Monto, 2000; Sullivan and Simon, 1998).

If some men seek prostitutes because they desire sexual practices that are not regularly available to them in their conventional relationships, then what are these desired practices? Findings from the nationally representative National Health and Social Life Survey (NHSLS) suggest a substantial discrepancy between men's and women's interest in fellatio. While 45% of men found receiving fellatio very appealing, only 17% of women found performing fellatio very appealing. In contrast, the proportion of men who found performing cunnilingus very appealing (34%) was slightly higher than the proportion of women who found receiving it very appealing (29%). While results showed that there were other practices, such as anal sex and group sex, that men found more appealing than women, fellatio was distinctive in that such a large proportion of men found it appealing and the discrepancy between men's and women's attitudes toward it was substantial (Laumann, Gagnon, Michael, & Michaels, 1994).

Despite the appeal of fellatio to men, only 28% reported that they experienced it during their most recent sexual encounter (Laumann et al., 1994). While this discrepancy in the appeal and experience of fellatio seems to suggest that a significant minority of men in the U.S. may not have their perceived sexual needs met in conventional relationships, one cannot assume that men who find fellatio very appealing necessarily desire it during the majority of their sexual encounters. Additionally, even if some men experience less fellatio than they would prefer, most do not respond to the deficit by seeking prostitutes. In fact, only a small proportion of men completing the NHSLS reported ever having visited a prostitute (16%), and less than 1% reported having visited a prostitute during the previous year (Michael, Gagnon, Laumann, & Kolata, 1994).

Utilizing a large sample of men arrested for trying to hire prostitutes, the present study evaluates the importance of fellatio in prostitution encounters. I hypothesize that respondents will be more likely to select fellatio than any other practice when asked which sexual practices they (a) have ever experienced with a prostitute, (b) usually experience with a prostitute, (c) experienced during their most recent sexual encounter with a prostitute, and (d) find most appealing. I also hypothesize that respondents will generally report that their sexual interests are different than those of their regular partner, and that they want a different kind of sex than their regular partner wants.

METHOD

Participants

Participants were all men arrested for trying to hire prostitutes in three Western cities. Most of the data reported in the present study come from questionnaires administered to 1281 men participating in programs in San Francisco, California (N = 950); Las Vegas, Nevada (N = 254); and Portland, Oregon (N = 77). An additional set of questions concerning the degree to which respondents found various sexual practices appealing was asked of 55 men participating in the Portland program, and one question concerning respondents' practices during their most recent prostitution encounter was asked of 424 men participating in the San Francisco and Las Vegas programs.

Demographic characteristics of the participants included in the primary sample are presented in Table 1. Chi-squared tests revealed no statistically significant differences between the samples from these three cities on all but two variables, ethnicity and education. Mirroring the differences between these communities, the Portland sample was less ethnically diverse than the other two samples, and the San Francisco sample included a higher proportion of Asians. Additionally, the Las Vegas sample had a higher proportion of individuals who had not completed high school, and the San Francisco sample had a higher proportion of individuals with graduate degrees. Because most of the background characteristics were similarly distributed in all three cities, the samples were combined for reporting here.

Table 1. Clients' Background Characteristics

Characteristic                                   Percentage

Ethnicity (N = 1252)
      White                                         60%
      Hispanic, Chicano, or Latino                  17%
      Asian                                         13%
      Black                                          5%
      Other or combination                           5%

Level of education (N = 1270)
      Did not graduate from high school              9%
      High school graduate                          18%
      Some college training                         37%
      Received bachelor's degree                    25%
      Received graduate degree                      11%

Marital status (N = 1267)
      Married                                       42%
      Never married                                 35%
      Divorced                                      15%
      Separated                                      6%
      Widowed                                        2%

Work status (N = 1242)
      Working full time                             81%
      Working part time                              6%
      Retired                                        2%
      Student                                        2%
      Other                                          9%

Age (N = 1204)
      18-21                                          4%
      22-25                                          9%
      26-35                                         33%
      36-45                                         31%
      46-55                                         17%
      56-65                                          4%
      66 or older                                    2%

Sexual orientation (N = 1281)
      Strictly heterosexual                         94%
      Experience with both                           5%
      Strictly homosexual                            1%

Number of sexual partners past year (N = 1261)
      None                                           9%
      1                                             38%
      2                                             16%
      3 or 4                                        17%
      5 to 10                                       13%
      11 or more                                     7%

Overall, 59% of the men who completed surveys reported that they had sexual relations with a prostitute at least once over the last 12 months. Twenty-one percent reported one episode, while 28% reported having had sexual relations with a prostitute more than one time but less than once per month. Eight percent reported having had sexual relations with a prostitute one to three times per month, and 2% reported having had sexual relations with a prostitute once or more per week. Another 21% reported that they had not had sexual relations with a prostitute during the past year. And 20% claimed never to have had sexual relations with a prostitute, indicating that their only experience had been propositioning the police decoy, which led to their arrest.

Procedures

Anonymous questionnaires were administered while men were gathered together immediately prior to their participation in intervention programs designed to discourage reoffense. Because attendance at these programs eliminates the arrest records of those who participate, nearly all men who are arrested for trying to hire prostitutes in these jurisdictions choose to attend. Participants were informed of their right not to participate through an attached letter. A signed consent form was not used because pretests revealed that respondents felt threatened by leaving a signature. All procedures were approved by the Institutional Review Board at the author's host institution, which operates in full compliance with the standards established by the National Institute of Health.

About 80% of men gathered for these programs completed questionnaires. Though refusals probably account for the largest proportion of the remaining 20%, language problems, late arrivals, and misunderstandings also accounted for a substantial proportion.

Measures

Measures were selected from among 87 items developed to provide basic information about the arrested clients of street prostitutes. The original intent of the questionnaire was not primarily to explore sexual behavior but to address motivations, to characterize attitudes, and to generally provide an overview of this heretofore inaccessible population. Items were selected to explore popular and scholarly assumptions about the clients of prostitutes and to provide information that might be of use to those who provide intervention programs for these men. These issues are explored in other articles (Monto, 1999a, 1999b, 2000). An opportunity to conduct qualitative interviews was not available.

Most of the measures reported here rely on single questions developed specifically for this study. The exact wording of the questions and the response frequencies are presented in Table 2. The four questions concerning the degree to which respondents found various sexual practices appealing were borrowed from the National Health and Social Life Survey (Laumann et al., 1994). The wording of these questions is also presented in Table 2.

Table 2. Clients' Sexual Interests and Behaviors with Prostitutes

Item                         N    Sample   Location

How would you rate each
  of these activities?
  Vaginal intercourse               54     Portland
     Very appealing         76%
     Somewhat appealing     17%
     Not very appealing      2%
     Not at all appealing    5%
  A partner performing
    oral sex on you                 55     Portland
     Very appealing         65%
     Somewhat appealing     22%
     Not very appealing      6%
     Not at all appealing    7%
  Performing oral sex on
    a partner                       55     Portland
     Very appealing         58%
     Somewhat appealing     31%
     Not very appealing      2%
     Not at all appealing    9%
  Having anal intercourse
    with a partner                  55     Portland
     Very appealing         18%
     Somewhat appealing     15%
     Not very appealing     20%
     Not at all appealing   47%

What kind of sexual
  activities have you
  ever engaged in with a
  prostitute?                      995     Portland, Las Vegas, and
     Blow job               81%              San Francisco
     Vaginal sex            55%
     Half and half (oral
       and vaginal sex)     36%
     Hand job               35%
     Anal sex               10%
     Performing oral sex
       on her                9%

What sexual activities
  did you engage in
  during your most recent
  encounter with a
  prostitute?                      424     Las Vegas and San Francisco
     Blow job               68%
     Vaginal sex            43%
     Hand job               14%
     Anal sex                4%
     Performed oral sex
       on her                6%

What kind of sexual
  activity do you engage
  in most often with a
  prostitute?                      926     Portland, Las Vegas, and
     Blow job               51%              San Francisco
     Vaginal sex            12%
     Half and half (oral
       and vaginal sex)     10%
     Hand job                6%
     Anal sex                1%
     Performing oral sex
       on her                0%
     Selected 2 or more
       responses            18%
     Other                   2%

I would rather have sex
  with a prostitute than
  have a conventional
  relationship with a
  woman.                           1197    Portland, Las Vegas, and
     Agree strongly          5%              San Francisco
     Agree somewhat         13%
     Disagree strongly      18%
     Disagree somewhat      64%

I want a different kind
  of sex than my regular
  partner.                         1191    Portland, Las Vegas, and
     Agree strongly         12%              San Francisco
     Agree somewhat         29%
     Disagree somewhat      21%
     Disagree strongly      38%

Now, thinking about the
  sexual relationship
  with your wife or
  partner... How similar
  are your sexual
  interests?                       831     Portland, Las Vegas, and
     Very similar           36%              San Francisco
     Somewhat similar       39%
     Somewhat different     17%
     Very different          8%

RESULTS

The sexual interest and behavior items that are the focus of this study are presented in Table 2. Among the small sample of respondents (N = 55) answering questions about the degree to which they found various sexual practices appealing, 66% rated the idea of receiving oral sex as very appealing. This percentage is substantially higher than the 45% endorsing this response among men participating in the nationally representative National Health and Social Life Survey (Laumann et al., 1994). While this comparison would seem to support the central proposition of this study, that some men seek prostitutes because they desire fellatio, one should note that an even greater proportion of the client sample (76%) found vaginal sex very appealing. The hypothesis that respondents would rate fellatio as more appealing than other sexual practices is not supported.

Results are consistent with the hypotheses that respondents would be more likely to select fellatio than any other sexual practice when asked about which practices they had ever experienced with a prostitute, usually experienced with a prostitute, and experienced during their most recent encounter with a prostitute. When 995 respondents from all three cities were asked whether they had ever participated in various sexual practices with a prostitute, 81% reported that they had received oral sex, or a "blow job." The second most frequently reported practice was vaginal sex at 55%. Many of the clients (36%) reported participating in "half and half," which includes both oral and vaginal sex. Being manually masturbated, or receiving a "hand job," was reported by 35% of respondents.

Of 926 men asked to identify the practice in which they participated most often when with a prostitute, 51% selected blow job, followed by 12% who selected vaginal sex, 10% who selected half and half (which includes oral sex), and 6% who selected hand job. Eighteen percent misunderstood instructions and selected two or more responses, and of those, fellatio was the most frequently chosen.

Among a separate sample of 424 respondents from Las Vegas and San Francisco who were asked about their most recent encounter with a prostitute, 68% reported that the encounter included oral sex, while 43% reported that it included vaginal sex, 14% reported being manually masturbated, and 4% reported anal sex.

The results do not support the hypotheses regarding two other attitudinal items. When 1191 arrested men from all three cities were asked to respond to the statement "I want a different kind of sex than my regular partner," 41% agreed somewhat or strongly. The responses of those 41% are consistent with the central proposition of this article. Of the remaining 59%, some may have disagreed because they were among the 20% of the sample who were not married and/or had no regular sexual partner. The remaining men, about 39% of the total sample, did not indicate that they wanted a different kind of sex than their regular partner wanted. Additionally, among 831 men from all three cities who reported having a wife or regular sexual partner, 36% reported that their sexual interests were very similar to those of their wife or regular sexual partner, while 39% answered Somewhat similar. Twenty-five percent reported that their sexual interests were somewhat different or very different than those of their wife or regular sexual partner. While the desire for fellatio may be a major reason some men consort with prostitutes, it would be incorrect to assume that the majority of clients with partners find their sexual interests unreciprocated.

DISCUSSION

These simple descriptive findings indicate that men arrested for trying to hire street prostitutes were more likely to select fellatio than any other sexual practice when asked which practices they had ever experienced with a prostitute, experienced most frequently with a prostitute, and experienced during their most recent sexual encounter with a prostitute. Additionally, respondents were more likely than men in general to find fellatio highly appealing. All of these findings point to the importance of fellatio in the prostitution encounter. This contrasts sharply with nonpaid sexual practice in which vaginal sex is overwhelmingly preferred and practiced (Laumann et al., 1994). These findings tend to support the proposition that the desire for fellatio may be one reason some men seek prostitutes.

However, other findings leave room for alternative explanations. Despite the appeal of fellatio, vaginal sex was still described as very appealing by more of the respondents. Additionally, only a minority of respondents agreed that they wanted a different kind of sex than their regular partner wanted, and only 25% of respondents with partners rated their sexual interests as somewhat or very different than the desires of their partner. In other words, the predominance of fellatio during prostitution encounters cannot be fully explained by its appeal to potential clients or by its lack of availability in conventional relationships.

There are other possible explanations for the frequency of fellatio during prostitution encounters. Clients may believe that there is a lower risk of AIDS from fellatio than from other practices. They may believe that there is less need to wear a condom during fellatio than during vaginal or anal intercourse. They may perceive vaginal sex to be more intimate than oral sex, and hence pursue fellatio when with prostitutes. Alternatively, the prevalence of fellatio during prostitution encounters may reflect the preferences of prostitutes themselves, who may prefer fellatio to less easily accomplished sexual practices.

The results of this study are limited in that the respondents participating were not a representative sample of prostitution clients. Virtually all were arrested while trying to hire street prostitutes rather than while patronizing escort services or indoor establishments. It may be that sexual practices differ in these settings. In a recent study by Lever and Dolnick (2000), street prostitutes were more likely to report performing oral sex (57%) during their most recent encounter with a client than were "call girls" (45%). One of the reasons for higher rates of fellatio in street prostitution encounters may be that such encounters often occur in vehicles, where fellatio may be more easily accomplished that vaginal sex. Additionally, since it is relatively easy to avoid arrest while trying to hire prostitutes, less experienced clients may be overrepresented among the participants in this study. The motivations and sexual practices of less experienced clients could differ from those with greater experience. Nevertheless, the data gathered and the results presented represent an opportunity to move beyond idiosyncratic impressions and anecdotal accounts, and to evaluate current understandings of the prostitution client in light of a large body of data collected from a previously inaccessible population.

It is clear that the desire for fellatio alone is not sufficient to cause men to seek out prostitutes. Though data from the National Health and Social Life Survey indicate that a substantial minority of men in the U.S. desire fellatio and suggest the possibility that some may not receive it as often as they would prefer, the overwhelming majority of men in the U.S. do not visit prostitutes. In fact, fewer than 1% of men participating in the NHSLS reported having engaged in sex with a prostitute over the previous year (Michael et al., 1994). Clearly, there must be additional predictors that discriminate between men who seek to fulfill their sexual desires through prostitution and men who do not. These could include many of the explanations described in the beginning of this paper, such as an attraction to risky sex, shyness, the desire to be in control, the desire to avoid emotional attachments, or an interest in companionship. One promising predictor is the degree to which individuals conceive of sex as a commodity rather than as a mutually fulfilling aspect of an intimate relationship. Monto (1999b) found a strong correlation between this construct and the frequency with which clients visited prostitutes.

Overall, the findings presented here reaffirm the importance of fellatio in the prostitution encounter. While there are multiple explanations for the prevalence of fellatio in prostitution encounters, findings suggest that some clients seek prostitutes because they are interested in fellatio, a sexual practice to which they may not have regular access through socially approved means. Clearly, this explanation does not apply to all clients, many of whom seek other sexual practices with prostitutes or who have partners who share their sexual interests. Additionally, results should not be misconstrued to suggest that women who choose not to perform fellatio lead their partners to seek prostitutes. Fellatio may be appealing for some men partly because it is unavailable. If given greater access to fellatio, some clients might simply move on to other practices that remain unavailable through conventional relationships.

This project was supported by Grant No. 97-IJ-CX-0033 awarded by the National Institute of Justice, Office of Justice Programs, U.S. Department of Justice. Points of view in this document are those of the author and do not necessarily represent the official position or policies of the U.S. Department of Justice. I wish to thank Alexander V. Monto. M.D., Ph.D. for his comments on an earlier draft of the manuscript.

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Manuscript accepted March 22, 2001

Address correspondence to Martin A. Monto, Ph.D., Dept. of Social and Behavioral Sciences, University of Portland, 5000 N. Willamette Blvd., Portland, OR 97203; e-mail: [e-mail].