The construction and psychometric properties of an instrument measuring support for sexual rights.

The purpose of this paper is to report the findings of an attempt to construct and examine the psychometric properties of an instrument that measure support for the 11 sexual rights formulated by the World Association of Sexology. Since international conferences held in the mid- 1990s, a new approach to sexual issues has been promoted by health professionals, sex educators, and human rights advocates. This approach emphasizes the empowerment of individuals and examines sexual health concerns within a human rights framework. Goals of a sexual rights approach have been to promote awareness and advocacy of sexual issues and especially to facilitate the work toward better sex education and sexual health services. Analysis of reliability and validity data from two university samples (n = 388 and n = 175) indicated that the majority of the sexual rights scales have acceptable psychometric properties. This paper concludes with a discussion of ways to improve the scales for future use and the need to validate the scales using samples that allow generalizability of findings.

At the 1994 International Conference on Population and Development in Cairn and the 1995 Fourth World Conference on Women in Beijing, a new approach to sexual issues was promoted. This approach emphasized the empowerment of individuals and examined sexual health concerns within a human rights framework (Garcia-Moreno & Claro, 1994; Germain, Nowrojee, & Pyne, 1994; Sen, Germain, & Chen, 1994; United Nations, 1996). An important highlight of the Cairo platform was the agreement that sexual health should be considered an important part of a person's physical and psychological well-being. The documents from the Beijing conference gave support for many of the principles of sexual rights. Since these conferences, many international agencies, including the World Health Organization, the International Planned Parenthood Federation, the United Nations Population Fund, the International Women's Health Coalition, and the World Association of Sexology have worked to expand upon and implement the programs endorsed at Cairn and Beijing. In an effort to increase awareness of the new human rights approach to sexual issues, organizations have formulated lists of sexual rights. The goal has been to use these lists to advocate for higher quality and more comprehensive sexual health services and sex education in many areas around the world.

To further advance the link between health and human rights, the "Reproductive Health, Gender, and Human Rights: A Dialogue" meeting took place in 1999 among members of the Women's Rcproductive Health Initiative of the Program for Appropriate Technology in Health (PATH), the Global Health Council, the Center for Health and Gender Equity, the Center for Research on Women, the Human Rights Watch, the Center for Reproductive Law and Policy, and the Public Health Departments of Columbia and George Washington Universities. Those in attendance agreed that an important goal of their organizations was to provide useful information to public health policymakers and implementing agencies on the relevance of a human rights approach to reproductive health and gender inequity. Thus, a substantial proportion of the presentations of this meeting dealt with sexual rights and sexual health (Murphy & Ringheim, 2001).

Because of the importance of sexual rights, internationally acknowledged by health professionals, human rights advocates, sex educators, and feminists, we sought to develop an instrument that could be used to measure support for such rights by citizens. Data obtained from the administration of such an instrument could assist policy-makers and health professionals in better understanding the population's needs with respect to sexual rights.

The concept of sexual rights and its integration into a discourse on sexual health originated in the mid 1990s (Correa, 1997). Although feminist campaigns have a history of using a human rights discourse, only since the Cairo and Beijing conferences, dominated by women's health advocates and those working for gender equality, have human rights been applied to discussions of sexual health concerns. Before the 1990s, Dixon-Mueller (1993) found that for a 12-year period only about 4% of articles, commentaries, and reports from five major publications in the family planning field discussed issues of sexuality and gender-power relations. The new rights approach to population issues and family planning has adopted words commonly used by feminists such as gender equity, gender gap, empowerment, citizenship, sexual freedom, and male responsibility in attempting to promote policies that improve the sexual health of women.

Compared to the term sexual rights, the term reproductive rights has a somewhat older history. It has been used by groups working to establish or improve women's ability to have access to safe contraceptives and abortions. Similarly, the term sexual health has been in use longer than the term sexual rights by those in the health and sex education fields. In attempting to incorporate sexual health concerns such as unwanted pregnancy, sexually transmitted diseases, and sexual violence into family planning services, the word sexual has often been used in the forms of sexual and reproductive health or sexual and reproductive rights. Many believed that the terms sexual health and sexual rights by themselves would be too controversial or associated with less important concerns, and therefore thought that the terms sexual and reproductive health or rights would have a better chance of legitimizing and including health problems linked to sexual behavior.

Nevertheless, some international health professionals have argued for an emphasis on sexual health and rights outside of the context of reproductive health and rights. Ketting (1996), former editor of the journal Choices, Sexual Health and Family Planning in Europe, believes that sexual health and reproductive health services should be separate. According to Ketting (1996), reproductive health problems are "'medical problems related to pregnancy, childbearing and infancy", whereas sexual health has to do with

   ... helping people to gain full control of their sexuality and to
   enable them to accept and enjoy it to its full potential. It is not
   primarily about diagnosis, treatment, or medical care but about lack
   of knowledge, self acceptance, identity, communication with partner,
   and related issues. (p. 1)

Brazilian feminist Correa (1997) argues that the change in semantics from reproductive rights to sexual rights was accompanied by a radical agenda for social change as well as an emphasis on the formulation and application of new concepts such as sexual self-determination and erotic justice.

Lottes (2000) discussed the increasing use of the terms sexual health and sexual rights in elaborating on this new discourse and approach to sexual issues. Indeed, from a global view, this approach seems to be increasing among sex educators, family planning organizations, human rights advocates, feminists, health providers and organizations, and scholars. Two new journals were launched in the last decade to deal with links between either health and sexuality or health and rights: Health, Culture & Sexuality, and Health and Human Rights. Another journal initiated in 1997. Citizenship Studies, has as one of its primary purposes a focus on the globalization of the rights discourse.

Although the dominant view or practice in the U.S. has not been to take a rights approach to health, unlike almost every other developed country and many developing countries, a discourse about sexual rights has begun here. The Sexuality Information and Education Council of the United States (SIECUS, 1998) defines sexual rights as

   ... the rights of individuals to have the information, skills,
   support, and services to make responsible decisions about their
   sexuality consistent with their own values. These include the
   right to bodily integrity, voluntary sexual relationships, a
   full range of voluntary sexual and reproductive health services,
   and the ability to express one's sexual orientation without
   violence or discrimination.

Professionals associated with SIECUS (Daley, Orenstein, & Wong, 2001) have recently authored an article in a new sexuality reader entitled "SIECUS Looks at States" Sexuality Laws and the Sexual Rights of Citizens." In addition, some sexuality professionals from the U.S. such as Eli Coleman, recent past president of the World Association of Sexology, have argued that access to sexual information and access to services necessary for good sexual health are basic human rights (Coleman, 1997). During her presentation at a meeting of the International Academy of Sex Research (IASR), Tiefer (2001) stated that professionals in this organization should consider a rights approach to sexual issues. At the 2002 meeting of IASR, a symposium on human rights and women's sexuality was presented (Ehrhardt, 2002). In addition, anthropologist Carole Vance was awarded a grant by the Rockefeller Foundation in 1998 to support her new program at Columbia University entitled The Study of Sexuality. Gender, Health, and Human Rights. Thus, it seems that a sexual rights discourse has emerged among sexuality professionals and scholars in the U.S. as well as throughout the world.

Although those in Cairo and Beijing responsible for coining the term sexual rights had the concerns of women primarily in mind, others have argued that this term needs to be more inclusive and applied in broader contexts. Basu (1996) emphasized that men's rights and women's responsibilities also need consideration. Further, Basu stressed that improving the sexual well-being of women involves more than simply changing men's attitudes and behaviors. In addition, at least since the last quarter of the 20th century, many have written about the lack of social and sexual rights of other groups of people that include men, especially gays, bisexuals, and transsexuals (Baird, 2001; Donovan, Heaphy, & Weeks, 1999; Richardson, 1998). In a recent publication (Lottes & Kontula, 2000), the sexual rights of children, adolescents, nonheterosexual and transgender people, the disabled, and elderly in Finland are discussed in detail. Lottes (2000) noted that organizations including the International Planned Parenthood Federation and the subgroup Health, Empowerment, Rights, and Accountability of the International Women's Health Coalition have made lists of sexual rights and/or reproductive rights.

Not surprisingly, there is considerable overlap and duplication in the lists of sexual and reproductive rights. In constructing our sexual rights instrument we used a list of rights developed in 1997 in Valencia Spain at the biannual meeting of the World Association of Sexology (WAS) and revised in 1999 at the meeting of WAS in Hong Kong (WAS, 1999). These 11 rights are stated in Appendix A. We chose this list of rights as a guideline because it was also used by the Pan American Health Organization (PAHO) in one of its recent major publications (PAHO, 2000). The Sexuality Information and Education Council of the United States also includes the WAS list of sexual rights on its Web page (SIECUS, 2002). In our estimation, the WAS list of rights seems to be known to a greater number of professionals in more diverse areas compared to other lists. It focuses on sexual health rather than both sexual and reproductive health and applies to both men and women.

The implications of a sexual rights discourse are not simple (Boland, Rao, & Ziedenstein, 1994: Correa & Petchesky, 1994). Attempts to establish such rights for various groups have and will continue to foster political controversy. Many have documented the strongly held yet divergent views on sexual issues relating to sexual rights (e.g., Hunter, 1991; Reiss, 1981, 1990, 1997). Within both the U.S. and the international community, debates about the acceptability of sexual rights and the application of sexual rights to specific populations will surely continue due to diverse political and sexual ideologies. Indeed, Matika-Tyndale (2002) presented compelling examples from Kenya and Thailand that challenge the application of sexual rights to dominant ideologies and widespread practices in those countries. Others (Correa & Petchesky, 1994) believe that sexual rights and more generally human rights should be applied to promote social change in all regions of the world. Correa and Petchesky (1994) attempt to transform the classical liberal rights model to a more inclusive one that would have value for marginalized groups worldwide. These authors provide examples of how boundaries among health, sexuality, and rights issues are dissolving throughout the world.

For those who support a democratic system, a basic assumption is that views of the general public should be considered by those who make decisions thai impact greatly on the sexual lives of the citizens of their country. Although aspects of sexual rights such as attitudes toward abortion, sex education curricula, and homosexuality have been measured on surveys, we could not find a study that systematically examined multiple aspects of sexual rights. This paper reports the results of our attempt to construct and examine the psychometric properties of an instrument assessing the 11 sexual rights formulated by the World Association of Sexology (Appendix A). Although a random sample of the U.S. population or even a random sample of one adult community would have been part of the most ideal research design to validate our new instrument, limited resources prevented us from implementing such a study. The samples for the present study were convenience snowball samples of university students. We reasoned that the knowledge gained from a preliminary investigation using convenience samples would facilitate the design and perhaps even enhance funding possibilities for a future validation study that would allow for generalizability.

METHOD

Participants

Sample 1. Sample 1 included 85 students in a human sexuality sociology class from a public university in a mid-Atlantic state. Other participants were those asked by these students to also complete the survey. All participants responded to the survey on their own time, not in class. Students seemed eager to complete The survey for they expressed interest in learning how their own views compared with others. Also, they were given a small amount of extra credit toward their grade for returning completed surveys. The cover letter for the survey assured all respondents that their decision to complete the questionnaire was entirely voluntary, that they could stop completing the questionnaire at any time, and that all of their responses would remain completely confidential. Each student returned at least one survey. The cover letter with identifying information was torn off from the survey and destroyed after a student's participation was recorded and before data coding. In all, 419 surveys were collected. Of these, 388 were used in the analysis. Excluded surveys were those with excessive missing values or those that failed a reliability test based on comparing responses to three pairs of almost identical questions. The sex and racial distributions were as follows: 40.5% male and 59.5% female; 71% White, 11% Black, 10% Asian, 4% Hispanic, and 4% other. Sexual orientation based on self-reported sexual behavior was 83.6% exclusively heterosexual, 8.3% mainly heterosexual, 3.6% bisexual, 0.8% mainly homosexual, and 3.6% exclusively homosexual. The mean age for Sample 1 was 26.5 years with 80% less than age 31.

Sample 2. Because students in sexuality classes are thought to be more liberal in their attitudes toward sexual issues, Sample 2 included 31 students from a social science research methods class at the same public university as Sample 1. This class is often taken by nonsociology students who do well in math and computer science and need a social science course to meet graduation requirements. We reasoned that including this class would increase the range of responses to views on sexual rights. Again, students recruited other people to complete the questionnaire. As with Sample 1, all students returned at least one survey, and identifying information was destroyed after a student's participation was recorded. After we eliminated surveys with many missing responses and applied the same reliability test for consistency of responses that we used for Sample 1, there were 175 usable surveys out of the 194 collected. The sex and racial distributions of this sample were as follows: 38% male and 62% female; 74% White, 16% Black, 3% Asian, 3% Hispanic, and 4% other. Sexual orientation based on self-reported sexual behavior was 95.9% exclusively heterosexual, 2,9% mainly heterosexual, and 1.2% bisexual. The mean age for Sample 2 was 28.6 years with 70% less than 31.

Measures

Scale construction. Each author prepared lists of items for consideration to assess each of the 11 sexual fights listed in Appendix A. As part of this preparation, the senior author examined ilems of appropriate scales in the Handbook of Sexuality-Relaled Measures (Davis. YarbeK Bauserman, Scheer. & Davis, 1998). We included [9 items from seven different scales in this handbook in at least one of the sexual rights scales. We discussed all items from our lists for both content and wording. The final list of items to measure each scale was sent to three experts in the sexuality field. Two of these experts have published and given presentations at conferences on the topic of sexual rights. Of these three experts, two indicated that they were too busy to examine the items sent to them. The third suggested a substantial shortening of the scales and highlighted in slightly revised versions lwo items that he considered to have the best construct wdidily for measuring each right. Because we wanted to examine the statistical properties of a greater number of items in this first attempl to measure sexual rights and because we wanted to lhcililate reliability using a multi-item approach, we kept most of Ihe items in the longer scales. We reasoned that the lime to conslrucl shorter versions of the scales would be after more information was obtained about the statistical properties of items. As a last step before presenting the questionnaire to students in the two classes, the junior author tested the items for readability, meaning, and wording with four students.

Sexual rights measures. Scales composed of Likert-type items assessed support for each of the 11 sexual rights. All items bad the same 5 point responses: strongly agree. agree, neither agree nor disagree, disagree, and strongly disagree. We used 94 items to form scales measuring sexual rights, and of these we reverse scored 63%. The items were coded from 1 to 5, where a 5 indicated the greatest agreement with the right and a 1 indicated the most disagreement with it. Each right was measured by one scale except for the right to sexual equity, Five scales corresponding to five subpopulations assessed this right. Therefore, 15 scales assessed the 11 sexual rights. The five special subpopulations considered were poor people, gays and lesbians, adolescents, handicapped people, and elderly people. We realize this list excludes some nmrginalized populations, but it does include major groups whose sexual rights have been severely limited in most countries (Coleman. 2002). Due to the space limitations of this papel; only Iwo sample items from each scale are provided in Appendix B. The entire list of scales wilh their items is available upon request from the senior author.

Validation measures. The measures included lot validation assessed (a) religiosity, (b) attitudes toward the women's movement, (c) political orientation. (d) importance of sexual pleasure in the respondent's own life, (e) sex of the respondent, and (f) sex of the respondent's sex partners. We assumed that the sexual rights scales would demonslrate predictive validity if they correlated significantly with a lower level of religiosity, more support for the women's movement, and a more liberal political orientation. We also expected that those who indicated that they valued sexual pleasure for themselves and their partners would be more supportive of sexual rights than those who indicated a lower imporlance of sexual pleasure in their lives, hi addition, because men and heterosexuals historically and cross-culturally have had more sexual rights than have women and nonheterosexuals (Baird, 2001 ; Lottes & Kontula. 2000; Reiss. 1986), we predicted that women and those who reported same-sex partners would be more supportive of sexual rights than would men and those who reported only opposile-sex partners.

Religiosity and political orientation were each assessed by one question similar to questions on the General Social Surveys: "How religious are you?" (four choices from very religious to not religious at all): and "How would you describe your political orientation'?" (six choices from very liberal to very conservative). There were six possible responses (from very negative to very positive) to the attitude toward the women's movement question. "How would you describe your attitude toward the women's movement and their issues (equal work/career opportunities, equal pay, support from falher lbr household and childcare duties, equal standards of social behavior, domestic violence, rape. etc.)?"

We used the following items to form a scale to measure the personal importance of sexual pleasure in a respondent's dent's life: "'I expect that a pleasurable sex will be very important my overall sense of well being": "I hope that my long-term intimate relationships are characlefized by pleasurable sex": "It is or would be important to nle to sat isfy my sex partner": and "I try to be very sensitive to my partner's sexual needs and desires." Cronbaeh alphas for this 4-item scale were .66 and .61 for Samples 1 and 2. respectively. The question to measure the sex of respondents' sex partners was "How would you describe your sexual behavior?" It had five responses from exclusively heterosexual to exchtsively homosexual.

RESULTS

Analysis

To determine the reliabilty of the 15 scales (5 scales assessed the right to sexual equity), we computed Cronbach alphas. To evaluate the predictive validity, we examined the Pearson correlations between measures of religiosity, sup port for women's movement issues, political orientation, and importance of sexual pleasure in respondent's life with measures of support for each of the 11 rights. In addition, we used t tests to determine if there were significant differences in the predicted directions between women and men and between those whose sex partners were exclusively of the opposite sex and those whose sex partners included someone of the respondents' same sex. Because of an insufficient number of participants, we did not run a factor analysis to investigate faclorial validity (Aleamondi, 1976; Kunce, Cook, & Miller, 1975)

Reliability

Table 1 contains the descriptive statistics for the 15 sexual rights scales as well as their Cronbach alphas. Using a standard requiting that the value of alpha be .70 or greater for both samples, 12 of the 15 scales have acceptable alphas. The 3 rights that corresponded to the lowest alphas were, for Sample 1 and Sample 2 respectively, the right to sexual freedom ([Alpha] =.72 and .65), the right to sexual privacy ([Alpha] -.71 and .57), and the right to emotional sexual expression ([Alpha] =.64 and .67). For the righl to sexual freedom scale, one factor conlribufing to the low alpha is the small number of items; only four items made up this scale. Revisions of this scale should include additional items with construct validity. The low alpha for the right to sexual privacy scale for Sample 2 was due to two items that correlated weakly with the other items in the scale (see "Discussion"). The low alphas for the scale assessing the righl to emotional sexual expression may be due to the lack of understanding of precisely what the right implies (see "Discussion"). Nevertheless, no item for either sample stood out as a bad item when we examined the alphas with each item deleted. Thus, it seems that more construct-valid items are needed to improve the reliability of the tight to emotional sexual expression scale as well.

Validity

Table 2 contains the item means by sex for the sexual rights scales and the t values to test the significance of the difference between the scale means for women and men. Our prediction that women would be inore supportive of sexual rights than men was confirmed for 7 of the 15 scales; that is, for those 7 scales there were significant sex differences in the predicted direction at at least the .05 level for both Sample 1 and Sample 2. Thus, compared to men, women gave more support for the rights to (a) sexual autonomy and safety of the sexual body. (b) sexual equity for poor people. (c) sexual equity for gays and lesbians, (d) sexual equity for elderly people. (e) sexually associate freely. (f) make free and responsible reproductive choices. and (g) sexual health care. For Sample 1 women also indicated more support for 5 of the remaining 8 sexual rights (p < .05): (a) the right to sexual privacy, (b) the right to sexual equity for adolescents. (c) the right to sexual equity elderly people. (d) the right to information based on scientific inquiry, and (e) the right to comprehensive sexuality educalion. The gender differences for Sample 2 on these 5 scales were in the predicted direction but did not reach statistical significance at the .(15 level. The smaller size of Sample 2 compared to Sample 1, of course, contributed to the lack of significant gender differences. Nevertheless. it is important to emphasize that some of the significant gender differences for both samples may be due to the chance factor present when a large number of comparisons are made. Only 4 of the 15 differences were significant for both samples at p <.01.

For three scales the differences in the scale means for men and women were not significant at the .05 level for either Sample 1 or Sample 2. These three scales assess the right to sexual freedom. Ihe right to sexual pleasure, and the fighl to emolional sexual expression.

Table 3 contains the scale item means by sex of respondents' sex partners and the t values for Sample 1 to test the significance of the difference of the scale means between those who have only had opposite sex partners and those who have had a sexual partner of their same sex. As the table shows, mean differences were consistent with pre dictions; respondents who have had a same-sex sexual panner reported greater support for all 15 sexual rights (p < .01). There were too few respondents who reported they had had a same-sex partner in Sample 2 to calculate a t value to determine the significance of a mean difference by sex of sex partners.

Table 4 contains tbe Pearson correlations of the 15 sexual right scales with conservative political views, religiosity, support for the feminist issues, and personal importance of sex. The most consislent finding is lhal for both Sample 1 and Sample 2, with only 1 exception out of 30. the correlations between the personal importance of sexual pleasure and support for the 15 sexual rights were all statistically significant (p < .01). The correlations between a conservative political orientation and support for sexual rights were also in the predicted directions, with only 2 of the 30 correlations not significant at at least the .05 level.

Similarly. for Sample 1. as predicted, all of the correlations between support for women's issues and support for sexual rights were significant (p < .01). but only 11 of 15 reached statistical significance at the .05 level for Sample 2. As predicted, the majority (24 of 30) of the correlations of tbe sexual rights scales with religiosity were significant (p < .05) and indicated that, in general, those who reported a lower degree of religiosily were more supportive of sexual rights than were those who reporled higher degrees of religiosity. Thus. overall, the correlalions of the sexual rights scales with the tbur validation measures provided strong support for their validity. Nevertheless, it is important to emphasize that the predictive wdidity is question able for those correlations significant for only one sample.

DISCUSSION

Overall, the 15 scales measuring support for sexual rights demonstrated acceptable reliability, with 12 of the scales having alpha values above .70 for both Sample 1 and Sample 2. The 3 scales that had an alpha less than the level we set assessed (a) the right to sexual freedom. (b) the fighl to sexual privacy, and (c) the right to emotional sexual expression. Only 1 scale, which assessed the right to emotional sexual expression, had alphas less than .70 for both Sample 1 and Sample 2. Because the alphas for both samples for this scale were above .63. adding a few construct-valid items to this scale should increase its reliability. To get ideas for new items for this scale, the senior author asked students in her sexuality class to give two examples of what emotional sexual expression meant to them. Although answers were diverse, three common themes were exchanging long eye contact, giving lender caresses, and having sex with someone they were in love with or closely attached to.

As stated in Appendix A, The World Association of Sexology (1999) gave the following explanation of the right to sexual expression: "Sexual expression is more than erotic pleasure or sexual acts. Individuals have a right to express their sexuality through communications, touch. emolional expression, and love." Despite this explanation by WAS, we believe Ihe meaning of the right to emotional sexual expression is not clear and needs further elaboration. For example, are only positive emotions included here? Does this right only apply to marginaIized groups such as gay men who are harshly criticized for showing affection to their partners in public'? Does this right include sadomasochism and the expression of anger and control within a mutually agreed-upon relationship? The paradoxical and complex emotions ofien felt leading up to and during sexual activity may supercede the boundaries stated by WAS and cause the right to emotional sexual expression to be difficult to assess. It is our intention to continue to try to consult with those in the sexual rights field to gain a better understanding of their view of this right as well as the meanings of other rights. In addition, researchers interested in learning what sexual fights mean to members of the adult population would likely gain ideas for scale items by conducting focus groups whose members come from diverse backgrounds.

The other two scales with alphas below .70 assessed the right to sexual freedom and the right to sexual privacy; however, the alphas were low only fiw Sample 2. The low alpha for the right to sexual freedom may be partially due to its small number of items (four). An examination of the inter-item correlations and the alphas with each item removed tbr this scale for both samples indicated that all items did in tact raise the alpha. Thus, adding a few items with construct validity should improve the reliability of the right to sexual freedom scale.

Unlike the previous two scales with low alphas, the low alpha for Sample 2 for the right to sexual privacy scale was traced to two items that correlated weakly with the other items in the scale. The alpha increased for this scale when the following two items were removcd: "Candidates for public office should be willing to disclose their sexual histories" and "Nursing homes have no obligation to provide privacy for residents who wish to express their sexuality. either alone or with their sex partner." Because these items were acceptable for Sample 1 but not Sample 2. future research needs to determine if these two items should be included in the right to sexual privacy scale.

The sexual rights scales also demonstrated predictive validity. As predicted, more support tbr sexual rights was generally given by those who reported (a) a liberal rather than conservative political orientation. (h) high rather than low support for women's issues, (c) a low rather than high degree of religiosity, and (d) a high rather than low value of sexual pleasure in their personal lives. In addition, those who reported same-sex sexual partenrs gave more support for all sexual rights than those who only reported opposite-sex sexual partners.

Less consistent support was found for our prediction that women compared to men would indicate more support for sexual rights. In particular, for three rights--the right to sexual freedom, the right to sexual pleasure, and the right to emotional sexual expression--there were no significant gender differences for either Sample 1 or Sample 2. Unlike most of the other rights that involve duties of institutions to provide sexual information, education, services, and equity, these three rights seem to apply more personally to the respondent, especially the right to sexual pleasure. It may be the case that with respect to rights relating to personal aspects of sexuality there are few gender differences. Alternately. perhaps men's sexual socialization to actively pursue sex and to seek a variety of sex ual activities influenced men in this study to support the three above rights. This argument, however, applies only to the right to sexual freedom and the right to 'sexual pleasure, not to the right to emotional sexual expression. It is women n]ore than men who have associated sexual expression with emotion (Carroll, Yolk, & Hyde, 1985: Lottes, 1993). The findings of this study suggest that rights involving personal sexual expression constitute a different dimension of sexual rights than do rights involving the responsibilities of institutions to provide sexual health services, information, education, and sexual equity for various groups.

The uniformly and highly significant differences in support for sexual rights between those who have had only opposite-sex sexual partners and those who reported a same-sex partner is an important finding. It seems likely that those having a same-sex sexual partner are very much aware of their lack of sexual rights and strongly support a more accepting culture in which their rights and the rights of others would be guaranteed. It is also important to note that of all 15 scales assessing support for sexual rights. respondents from both samples gave least support to the rights of gays and lesbians.

In conclusion, the Sexual Rights Instrument with its 15 scales showed acceptable reliability and validity properties when administered to university students at one university. The major limitation of this study is its lack of generalizability. Clearly. this instrument needs to be tested with diverse and representative samples. More construct-valid items need to be added to the scales with low reliabilities and few items, and for efficiency purposes, some items could be dropped from the scales with many items and high reliabilities. Another task for future researchers would be to obtain larger samples so the factorial validity of the scales could be investigated. Factor analysis using representative samples would facilitate the construction of shorter versions of the longer scales, and shorter scales would allow the use of the Sexual Rights Instrument in more diverse research settings. Finally, different culturally appropriate versions of the Sexual Rights Instrument could be administered in different countries. It would be valuable to find out if the countries where people give more support for sexual rights are also the ones where the population has more of its sexual rights actually realized. The sexual rights scales presented here represent an important step in promoting future sexual rights research.

APPENDIX A

Sexual Rights Formulated by the World Association of Sexology

The Right,to Sexual Freedom Sexual freedom encompasses the possibility for individuals to express their lull sexual potential However. this excludes all forms of sexual coercion, exploitation and abuse at any time and situations in life.

The Right to Sexual Autonomy, Sexual Integrity; and Safety of the Sexual Body This right involves the ability to make autonomous decisions about one's sexual life within a contest of one's own personal and social ethics, It also encompasses control and enjoyment of our own bodies free from torture, mutilation. and violence of any sort.

The Right to Sexual Privacy This involves decisions and behaviors about intimacy as long as they do not intrude on the sexual rights of others.

The Right to Sexual Equity This refers to freedom from all forms of discrimination regardless of sex. gender, sexual orientation, age. race, social class, religion, or physical and emotional disability.

The Right to Sexual Pleasure Sexual pleasure, including autoeroticism, is a source of physical, psychological, intellectual, and spiritual well-being.

The Right to Emotional Sexual Expression Sexual expression is more than erotic pleasure or sexual acts. Individuals have a right to express their sexuality through communications, touch, emotional expression, and love.

The Right to Sexually Associate Freely This means the possibility to marry or not, to divorce, and to establish other types of responsible sexual associations.

The Right to Make Free and Responsible Reproductive Choices This encompasses the right to decide whether or not to have children, the number and spacing of children, and the right to full access to the means of fertility regulation.

The Right to Sexual Information Based Upon Scientific Inquiry This right implies that sexual information should be generated through the process of unencumbered and yet scientifically ethical inquiry, and disseminated in appropriate ways at all societal levels.

The Right to Comprehensive Sexuality Education "This is a lifelong process from birth throughout the lifecycle and should involve all social institutions.

The Right to Sexual Health Care Sexual health care should be available for prevention and treatment of all sexual concerns, problems, and disorders.

APPENDIX B

Selected Items from the Sexual Rights Instrument

Seminal Freedom

* I approve of state laws which make anal sex illegal.

* It is wrong to investigate the sexual activities of two consenting adults.

Sexual Autonomy, and Safety of the Body

* It is wrong to psychologically pressure someone to engage in sexual activity.

* Public high schools should provide programs to try to eliminate forms of non-consensual sexual activity.

Sexual Privacy

* Health care professionals should have to gel parental consent before treating an adolescent (<18) for a sexually transmitted disease.

* The media should be able to report on the sexuality of any person.

Sexual Equity

Poor people

* Low-income women should be given financial assistance for the purchase of contraception.

* There should be a place where uninsured people with low incomes can get immediate treatment for curable sexually transmitted diseases.

Gays and lesbians

* The federal government has done enough already to eliminate discrimination against gay men.

* Homosexual couples should have the same legal rights as married couples.

Handicapped people

* Institutions for the physically disabled should provide privacy to allow residents to engage in sexual activities.

* Care takers of the disabled should be educated about the sexual needs of their patients.

Adolescents

* Teenagers should be taught ways to reduce their risk of getting a sexual transmitted disease.

* It should be easy for teenagers to get contraceptives.

Elderly people

* Care takers of the aged should be educated about the sexual needs of their patients.

* Nursing homes should restrict the sexual activities of their residents.

Sexual Pleasure

* A pleasurable sex life is very important to the vast majority of women's overall sense of well being.

* A pleasurable sex life is very important to the vast majority of men's overall sense of well being.

Emotional Sexual Expression

* Sexual intimacy provides a way for many people to express their love for their partner.

* For most people, emotional expression is of little value to their long-term sexual relationships.

Sexually Associate Freely

* The union of homosexual couples deserves some form of public recognition.

* It should be socially acceptable fur two people to live together without being married.

Responsible Reproductive Choices

* Teenage girls should be educated in high school about the harmful effects of a mother's sexual transmitted disease or her drug use on her baby.

* Teenagers should be given up to-date information on bow to avoid becoming a parent before they are ready.

Information Based on Scientific Inquiry

* Physicians should be educated on bow illnesses and their treatments affect a patient's sexual response.

* Sexuality instructors should have training in the health, social cultural, and biological aspects of sexuality.

Comprehensive Sexuality Education

* It is the duty of parents and NOT the schools to provide sex education for their children. It is a responsibility of the media, including TV and the Internet, to inform people about scientific research relating to contraception/birth control.

Sexual Healthcare

* The government should provide more financial assistance to hospitals and doctors to help cover the cost of the health care of poor people.

* Health insurance companies should routinely cover the majority of costs to treat the most common and curable sexually transmitted diseases.

Table 1. Descriptive Statistics of Sexual Rights Scales for
Sample 1 (Sample 2)

                 Number of      Scale item     Standard    Cronbach's
Right              items           mean        deviation       alpha

Sexual freedom        4            4.03           2.96          0.72
                                  (3.92)         (2.75)        (0,65)

Sexual autonomy
  and safety         13            4.25           6.06          0.84
                                  (4.15)         (5.61)        (0.79)
Sexual privacy        9            3.89           5.18          0.71
                                  (3.74)         (4.42)        (0.57)
Sexual equity
  Poor people         5            4. 10          3.12          0.77
                                  (4.03)          3.36         (0.81)
  Gays and lesbian   13            3.68          10.30          0.93
                                  (3.53)        (10.09)        (0.92)
  Handicapped
    people            5            3.98           2.82          0.75
                                  (3.91)         (2.82)        (0.75)
  Adolescents        15            4.18           7.44          0.87
                                  (4.04)         (7.02)        (0.83)
  Elderly people      6            3.84           3.44          0.74
                                  (3.74)         (3.24)        (0.72)
Sexual pleasure       9            3.87           5.36          0.83
                                  (3.70)         (5.42         (0.82)
Emotional sexual
  expression          7            4.03           3.32          0.64
                                  (3.91)         (3.32)        (0.67)
Sexually associate
  freely             11            3.69           7.23          0.83
                                  (3.64)         (5.96)        (0.72)
Responsible
  reproductive
  choices            18            4.05          10.42          0.90
                                  (3.98)         (8.83)        (0.85)
Information based
 on scientific
 inquiry             10            4.27           4.65          0.82
                                  (4.22)         (4.32)        (0.79)
Comprehensive
  sexuality
  education          27            4.17          12.01          0.91
                                  (4.08)        (11.56)        (0.90)
Sexual healthcare    11            4.17           5.80          0.86
                                  (4.13)         (5.81)        (0.86)

Note. Rights are from the World Association of Sexology (1999). Item
codes range from 1 to 5 with a higher score indicating greater support
for the sexual right.

Table 2. Sexual Rights Scale Item Means by Sex for
Sample 1 (Sample 2) With t Values for Mean Sex
Difference

                               Item mean for sexual
                                 rights scale

Right                               Men       Women      t value

Sexual freedom                       4.05      4.02       0.35
                                    (3.95)    (3.90)     (0.48)
Sexual autonomy and safety           4.05      4.39      -7.26***
                                    (3.97)    (4.25)    (-4.26)***
Sexual privacy                       3.79      3.96      -2.81**
                                    (3.66)    (3.79)    (-1.74)
Sexual equity
  Poor people                        3.89      4.24      -5.68***
                                    (3.86)    (4.13)    (-2.61)**
  Gays and lesbians                  3.38      3.88      -6.38***
                                    (3.16)    (3.77)    (-5.31)***
  Handicapped people                 3.86      4.06      -3.44***
                                    (3.81)    (3.97)    (-1.84)
  Adolescents                        4.04      4.28      -4.82***
                                    (3.98)    (4.08)    (-1.36)
  Elderly people                     3.71      3.93      -3.74***
                                    (3.64)    (3.81)    (-2.09)*
Sexual pleasure                      3.82      3.90      -1.28
                                    (3.71)    (3.70)     (0.10)
Emotional sexual expression          3.98      4.07      -1.80
                                    (3.85)    (3.94)    (-1.16)
Sexually associate freely            3.57      3.76      -2.76**
                                    (3.52)    (3.72)    (-2.47)*
Responsible reproduction choices     3.88      4.17      -4.91
                                    (3.83)    (4.07)    (-3.18)**
Information based on scientific
  inquiry                            4.12      4.37      -5.43***
                                    (4.17)    (4.25)    (-1.13)
Comprehensive sexuality
  education                          4.03      4.27      -5.27***
                                    (4.03)    (4.12)    (-1.24)
Sexual healthcare                    3.98      4.30      -6.16***
                                    (4.00)    (4.20)    (-2.43)*

Note: The range for all scale item means is from 1 to 5 where a higher
number indicates greater support for the right.

* p<.05.

** p<.01.

*** p<.001.

Table 3. Sexual Rights Scale Item Means by Sex of Sex
Partners With t Values for Scale Mean Differences
for Sample 1

Right                        Opposite        Some
                           sex partners    same-sex
                              only          partners      t value

Sexual freedom                3.97            4.35        -3.74***
Sexual autonomy
  and safety                  4.20            4.51        -4.91***
Sexual privacy                3.84            4.17        -4.27***
Sexual equity
  Poor people                 4.04            4.38        -3.97**
Gays and lesbians             3.54            4.32        -7.65**
Handicapped people            3.92            4.26        -4.51***
Adolescents                   4.13            4.42        -4.33***
Elderly people                3.79            4.11        -4.11**
Sexual pleasure               3.80            4.22        -5.31***
Emotional sexual
  expression                  3.99            4.25        -4.07***
Sexually associate
  freely                      3.59            4.15        -6.56***
Responsible reproductive
  choices                     3.99            4.37        -4.76***
Information based on
  scientific inquiry          4.21            4.54        -5.20***
Comprehensive sexuality
  education                   4.12            4.44        -5.30***
Sexual healthcare             4.11            4.48        -5.15***

** p<.01. *** p<.001.

Table 4. Correlations of Sexual Rights with Validation Measures for
Sample 1 (Sample 2)

Right                           Conservative
                               political views     Religiosity

Sexual freedom                    -.33***             -.32***
                                 (-.30)***           (-.20)**
Sexual autonomy and safety        -.29***             -.11*
                                 (-.23)**            (-.07)
Sexual privacy                    -.40***             -.31***
                                 (-.46)***           (-.26)***
Sexual equity
  Poor people                     -.35***             -.09
                                 (-.14)              (-.09)
Gays and lesbians                 -.43***             -.33***
                                 (-.58)***           (-.27)***
Handicapped people                -.22***             -.08
                                 (-.25)***           (-.21)**
Adolescents                       -.38***             -.19***
                                 (-.19)*             (-.17)*
Elderley people                   -.21***             -.12*
                                 (-.24)**            (-.26)***
Sexual pleasure                   -.34***             -.35***
                                 (-.35)***           (-.35)***

Emotional sexual expression       -.28***             -.24***
                                 (-.37)***           (-.36)***
Sexual associate freely           -.49***             -.43***
                                 (-.52)***           (-.31)***
Responsible reproductive
  choices                         -.49***             -.34***
                                 (-.41)***           (-.36)***
Information based on
  scientific inquiry              -.34***             -.19***
                                 (-.11)               -.17)*
Comprehensive sexuality
  education                       -.37***             -.17***
                                 (-.12)              (-.13)
Sexual healthcare                 -.35***             -.10*
                                 (-.17)*             (-.11)

                                 Support for        Personal
Right                          feminist issues     importance
                                                      of sex

Sexual freedom                    .13**               .25***
                                 (.06)                .26)***
Sexual autonomy and safety        .29***              .40***
                                 (.32)***            (.38)***
Sexual privacy                    .24***              .25***
                                 (.18)*              (.29)***
Sexual equity
  Poor people                     .29***              .35***
                                 (.26)***            (.37)***
Gays and lesbians                 .38***              .25***
                                 (.31)***            (.13)
Handicapped people                .16**               .41***
                                 (.14)               (.33)***
Adolescents                       .27***              .47***
                                 (.29)***            (.44)***
Elderley people                   .16**               .43***
                                 (.09)               (.41)***
Sexual pleasure                   .17***              .60***
                                 (.11)               (.48)***

Emotional sexual expression       .25***              .63***
                                 (.15)*              (.57)***
Sexual associate freely           .29***              .28***
                                 (.30)***            (.22)**
Responsible reproductive
  choices                         .30***              .45***
                                 (.35)***            (.36)***
Information based on
  scientific inquiry              .27***              .48***
                                 (.26)***            (.46)***
Comprehensive sexuality
  education                       .27***              .46***
                                 (.28)***            (.40)***
Sexual healthcare                 .31***              .42***
                                 (.25)***            (.45)***

Note. Sample size varied from 358 to 385 for Sample 1 and from
158 to 174 for Sample 2.

* p<.05.

** p<.01.

*** p<.001.

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Manuscript accepted March 26, 2003

The research for this paper was partially funded through the provost's office of the University of Maryland, Baltimore County, by an undergraduate research grant awarded to Charles W. Adkins.

Address cortespondence to Ilsa L. Lottes, University of Marylands, Raltimore County, Department of Sociology and Anthropology, 1000) Hilltop Circle, Baltimore, MD 21250; e-mail: [e-mail].