Sexuality of Women Survey

1. Abstract

The Sexuality of Women Survey (SWS), designed by clinical psychologist Carol Rinkleib Ellison in collaboration with Bernie Zilbergeld, represents one of the most comprehensive qualitative and quantitative investigative instruments developed to assess the phenomenological, relational, and contextual dimensions of adult female sexual experience. Conceptualized to move beyond the narrow physiological models of the mid-to-late twentieth century, the SWS captures the multi-faceted realities of women’s sexual functioning, desires, cognitive appraisals, and emotional outcomes across the lifespan. The instrument comprises a comprehensive 16-page inventory organized across 19 discrete modules (Sections A through S), spanning demographic parameters, familial socialization, developmental milestones, masturbatory practices, orgasmic functioning, subjective emotional states during sexual activity, relational satisfaction, assertive communication, physical embodiment, and perceived sexual concerns. Administrations employ a multi-modal response format featuring seven-point Likert-type agreement scales (anchored from 1 = Strongly Disagree to 7 = Strongly Agree, alongside a distinct ‘Not Applicable’ category), quantitative numerical estimations, frequency indices, and open-ended commentary fields that preserve ecological validity. Initial standardization and exploratory investigations were conducted with a cross-generational sample of 2,632 women born between 1905 and 1977. From an evaluative psychometrics standpoint, the SWS operates primarily as a multidimensional descriptive assessment and clinical profiling inventory rather than a monolithic unidimensional scale. Its content and construct validity are deeply rooted in feminist sexology, phenomenological psychology, and contextual clinical models, providing an empirical foundation for seminal texts in female sexual self-acceptance and alternative taxonomies of women’s sexual distress.

2. Keywords

Sexuality of Women Survey, female sexuality, orgasmic responsiveness, sexual satisfaction, sexual communication, feminist sexology, Carol Rinkleib Ellison, Bernie Zilbergeld, psychosexual assessment, sexual concerns

3. Authors

The Sexuality of Women Survey was conceptualized and authored by:

• Carol Rinkleib Ellison, Ph.D.: Clinical Psychologist in private practice, Loomis, California. Dr. Ellison has served as an influential clinician, researcher, and author in the field of female sexual wellness, authoring foundational clinical works on orgasmic responsiveness, sexual self-acceptance, and the multidimensional nature of women’s sexual concerns (Contact: [email protected]).
• Bernie Zilbergeld, Ph.D. (Deceased): Clinical Psychologist, Oakland, California. Renowned sex therapist and author of groundbreaking works on human sexuality, psychosexual therapy, and behavioral treatment of sexual dysfunction.
• Statistical Consultant: Doug Wallace, Ph.D. (Contact: [email protected]), who oversaw survey tabulation, comparative sample statistics, and quantitative analyses.

4. Purpose

The primary impetus behind the formulation of the Sexuality of Women Survey was to overcome the historical limitations and gender-biased frameworks that characterized mid-twentieth-century sexology. For decades, scientific models of human sexual response—predominantly grounded in the linear physiological paradigms advanced by William Masters, Virginia Johnson, and Helen Singer Kaplan—presumed that female sexual experiences mirrored male sexual anatomy and chronology. Such conceptualizations reduced female sexual health to linear cycles of desire, vasocongestive arousal, genital friction, and orgasmic release, frequently pathologizing women whose experiences diverged from coitus-dependent orgasmic endpoints.

To dismantle these normative constraints, Ellison and Zilbergeld structured the SWS to capture the subjective richness, developmental nuance, and ecological complexity of how diverse cohorts of women experience, express, and negotiate their sexual lives. Rather than evaluating women against an external clinical ideal, the survey operates from a descriptive and clinical-discovery rationale. It was designed to gather systematic data for Ellison’s clinical research and subsequent book, Women’s Sexualities: Generations of Women Share Intimate Secrets of Sexual Self-Acceptance (2000), as well as clinical contributions addressing the etiology and treatment of female sexual distress (Ellison, 2001, 2003, 2007).

Clinically, the instrument provides sex therapists, clinical psychologists, and couples counselors with a structured mechanism to explore personal histories, uncouple orgasmic capability from intercourse, investigate guilt or trauma, and examine communicative competence. In empirical research, the SWS bridges the divide between epidemiological surveys and idiographic qualitative accounts, offering high heuristic utility for examining generational shifts in sexual socialization, the psychosocial determinants of sexual satisfaction, and the diverse cognitive strategies women employ to achieve sexual pleasure.

5. Psychological Construct

The overarching construct evaluated by the Sexuality of Women Survey is multidimensional female sexual well-being, framed not as the mere absence of diagnostic pathology, but as an integrated constellation of cognitive, emotional, behavioral, relational, and physiological dimensions. The instrument divides this overarching construct into 19 structural domains:

• Sociodemographic and Identity Context (Section A): Assesses chronological age, birth cohort, ethnic self-identification, educational attainment, vocational background, religious observance (both during childhood and adulthood), family composition, income, and sexual identity (heterosexual, lesbian, bisexual).
• Relational Context and History (Section B): Examines contemporary partnership structures, living arrangements, cohabitation history, marriage, divorce, and bereavement.
• Family of Origin and Socialization (Section C): Measures the developmental climate within the respondent’s family of origin, including parental displays of physical affection, appropriate versus inappropriate touching, freedom of personal expression, and overt familial attitudes toward sexuality.
• Early Psychosexual Milestones (Section D): Evaluates early sexual interactions, peer dynamics, consensual versus non-consensual sexual experiences, partner characteristics during initial sexual episodes, and comparative adolescent dating and sexual activity.
• Partner Characteristics and Relationship Dynamics (Section E): Evaluates partner gender, duration of relationships, lifetime sexual partner count, experiences with casual encounters, perceptions of partner suitability, and relational intimacy.
• Solitary Sexual Activity and Masturbation (Section F): Focuses on autoerotic development, age at masturbatory onset, current monthly frequencies, cognitive fantasy engagement, and specific functional motivations (e.g., tension relief, pleasure, physiological urge, coping with loneliness, sleep induction, or post-coital completion).
• Phenomenology of Orgasm (Section G): Assesses solitary versus partnered orgasmic capability, age at first orgasm, emotional reactions to first orgasm (surprise, fear, spontaneity), contextual discrepancies between partner sex and self-stimulation, satisfaction with orgasmic frequency and quality, emotional release (laughter, weeping), orgasmic pretense (faking orgasm), and cognitive-behavioral augmentation strategies.
• Affective States Accompanying Sexual Experience (Section H): Inventories 57 distinct affective and emotional states experienced during and immediately following solitary self-stimulation and partnered sex (e.g., empowered, loving, connected, alienated, anxious, coerced, guilty, joyful).
• Determinants of Relational Sexual Fulfillment (Section I): Identifies contextual antecedents (intimacy, safety, lack of time pressure, absence of disease/conception anxieties), partner behavioral cues (attunement, lack of performance demand), tactile stimulation parameters (manual, oral, vibratory, intercourse), and interpersonal outcomes that facilitate optimal sexual satisfaction.
• Assertive Communication and Sexual Initiation (Section J): Assesses behavioral comfort in initiating intimacy, setting sexual boundaries, providing real-time feedback, and expressing preferences.
• Sexual Concerns and Discrepancies (Section K): Documents subjective problems, including desire discrepancies, arousal difficulties, dyspareunia, vaginismus, lubrication challenges, orgasmic delay, and help-seeking trajectories.
• Embodiment, Physicality, and Health Parameters (Sections L through S): Encompasses body image appraisals, tactile preferences, menstrual cycle interactions, pregnancy, contraception, sexually transmitted infections, extramarital involvements, and longitudinal trajectories of sexual interest over the life course.

6. Theoretical Framework

The theoretical architecture of the Sexuality of Women Survey is grounded in feminist psychology, social constructionism, and humanistic-phenomenological sexology. It was conceptualized largely in dialogue with and critique of traditional biomedical models of sexual medicine.

A foundational theoretical pillar is the New View of Women’s Sexual Problems, formulated by Leonore Tiefer and colleagues (Kaschak & Tiefer, 2001), to which Ellison directly contributed. The New View posits that female sexual difficulties cannot be divorced from political, cultural, relational, and emotional contexts. Unlike the diagnostic criteria in the American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorders (DSM), which categorized sexual dysfunctions through an exclusively genital and physiological lens, the theoretical framework underpinning the SWS holds that women’s sexual pleasure is contingent upon subjective safety, freedom from performance pressure, relational attunement, and socio-cultural liberation.

Furthermore, the survey integrates social learning theory and developmental psychodynamics by tracing current sexual beliefs back to childhood messages, familial displays of affection, and early adolescent consent or trauma. By assessing cognitive strategies during intimacy—such as cognitive focus, self-attunement, fantasy, and pelvic muscle manipulation—the SWS aligns with cognitive-behavioral sex therapy principles, emphasizing that sexual responsiveness is a dynamic skill cultivated within supportive contexts rather than an involuntary biological reflex.

7. Validity

Because the Sexuality of Women Survey was conceived primarily as a comprehensive descriptive survey and exploratory field inventory, its empirical validation differs from traditional standardized psychometric tests:

• Content Validity: The content validity of the SWS is exceptionally robust. The survey items were generated through an inductive qualitative process incorporating extensive clinical observations and approximately 100 in-depth qualitative interviews with women from diverse socioeconomic and age cohorts. This exploratory phase ensured that the item stems, affective checklists, and behavioral descriptions resonated directly with the lived experiences of women.
• Ecological and Face Validity: The high level of face validity is evident in the qualitative feedback received during data collection. The inclusion of open margins and qualitative prompt lines allowed respondents to validate or qualify items, leading to high participant engagement across the extensive 16-page questionnaire.
• Construct and Convergent Validity: Construct validity is demonstrated through empirical patterns published in subsequent clinical literature (Ellison, 2000, 2001, 2007). Findings demonstrated clear developmental divergence: autoerotic mastery and orgasmic consistency increased with age and self-knowledge, whereas coitus-specific orgasmic frequency did not correlate directly with overall sexual satisfaction. Furthermore, the divergence between solitary orgasmic capacity and partnered orgasmic responsiveness supported theoretical models of performance anxiety and partner-related communication deficits.
• Discriminant Validity: The SWS successfully differentiated between benign, normative fluctuations in desire (appraised as ‘the way life is’) and clinically distressing dysfunctions (appraised as distinct ‘problems’ requiring professional intervention), validating Tiefer’s assertion that physiological variations do not automatically equate to subjective distress.

8. Reliability

As documented in the psychometric literature accompanying the survey’s publication (e.g., Davis et al., Handbook of Sexuality-Related Measures), formal classical test theory coefficients—such as internal consistency reliabilities (Cronbach’s alpha) and test-retest coefficients—were not systematically computed for the overall inventory. This psychometric characteristic stems directly from the survey’s intended design:

The SWS was engineered as a broad epidemiological, biographical, and descriptive inventory comprising distinct, heterogeneous modules rather than a set of homogeneous, unidimensional psychometric subscales. In measurement theory, computing Cronbach’s alpha across heterogeneous categorical and biographical inventories (such as demographic indicators, lifetime milestones, and specific medical histories) yields conceptually uninterpretable values, as the items do not represent parallel indicators of a single underlying latent trait.

However, within specific coherent thematic blocks that utilize standardized seven-point Likert scales—such as Section C (Family of Origin Socialization), Section J (Sexual Communication Comfort), and the satisfaction evaluative items in Section G—the items exhibit strong face consistency and internal conceptual coherence. The descriptive stability observed across cross-generational age bands (spanning women born between 1905 and 1977) further attests to the stability and qualitative robustness of the items when administered across adult developmental epochs.

9. Factor Analysis

No formal exploratory factor analysis (EFA) or confirmatory factor analysis (CFA) structural equation modeling was published in the foundational studies introducing the full 16-page questionnaire. The structural organization of the instrument was established rationally and conceptually, following thematic domains recognized in clinical sexology and developmental psychology.

Subsequent researchers and clinicians examining the domain structures of the SWS have identified clear latent groupings that lend themselves to modern psychometric reduction:

• Sexual Communication and Assertiveness (derived from Section J): Characterized by strong inter-item correlations among comfort in initiating sexual activity, articulating preferences, setting boundaries, and receiving partner feedback.
• Affective Valence Post-Sexuality (derived from Section H): Segregates reliably into positive-intimate affect (e.g., loving, sensual, joyful, relaxed, empowered) versus negative-alienating affect (e.g., resentful, guilty, detached, coerced, anxious).
• Relational Contextual Facilitators (derived from Section I): Reflects latent dimensions of relational security/safety, non-demand partner attitudes, extended tactile foreplay, and freedom from performance constraints.

Researchers intending to use sub-modules of the SWS for inferential psychometric modeling are advised to subject the specific Likert item blocks to contemporary structural equation modeling, testing for measurement invariance across age, sexual orientation, and relationship status.

10. Instrument / Measurement Tool

The Sexuality of Women Survey is a structured self-report questionnaire. Its structural and administrative properties include:

• Administration Format: Paper-and-pencil self-administered questionnaire or digitized web-based survey.
• Length: 16 printed pages comprising 19 distinct modules (Sections A through S).
• Completion Time: Approximately 30 to 45 minutes for full completion, depending on individual relational history and skip-pattern trajectories.
• Response Modalities:
  • Seven-Point Agreement Likert Scales: Employed extensively across Sections C, E, G, I, and J, scored as: 1 = Strongly Disagree, 2 = Disagree, 3 = Slightly Disagree, 4 = Equally Agree and Disagree, 5 = Slightly Agree, 6 = Agree, 7 = Strongly Agree, alongside 0 = Not Applicable to My Experience (NA).
  • Frequency and Severity Scales: Used in Section K (Sexual Concerns), structured as: Rarely (RAR), Sometimes (ST), Often (OFT), and All the time (ALL).
  • Categorical Checklists: Comprehensive multi-selection inventories (e.g., the 57-item affective checklist in Section H, motivations for self-stimulation in Section F, orgasm enhancement techniques in Section G).
  • Numerical and Percentage Estimations: Ratio-level reporting of partner counts, age milestones, estimated percentages of orgasmic attainment, and orgasmic pretense frequencies.
  • Open-Ended Qualitative Commentaries: Provided at the conclusion of sections to capture idiosyncratic experiences outside structured options.
• Scoring and Interpretation Procedures: The instrument does not generate a single composite total score. Instead, researchers and clinicians tabulate frequency distributions, examine discrete domain scores, or interpret individual item responses qualitatively to construct comprehensive psychosexual profiles.

11. Permissions & Fee and Test Year

The Sexuality of Women Survey was developed and primarily administered during 1993–1994. The instrument was formally introduced to the broader scientific community in Dr. Carol Rinkleib Ellison’s monograph in 2000 and through subsequent compendia of sexuality-related measures.

Copyright and Usage Terms: Dr. Carol Rinkleib Ellison maintains the copyright in her name. However, the author explicitly granted permission for the questionnaire to be published and utilized for educational, scientific, and research purposes. In clinical research contexts, practitioners and investigators may access and utilize the survey framework without licensing fees, provided proper academic citation and attribution are given to the author. For specific scoring advice, specialized adaptations, or clinical inquiries, correspondence should be directed to Dr. Carol Rinkleib Ellison ([email protected]) or Doug Wallace, Ph.D. ([email protected]).

12. References

• Davis, C. M., Yarber, W. L., Bauserman, R., Schreer, G., & Davis, S. L. (Eds.). (1998). Handbook of sexuality-related measures. Sage Publications.
• Ellison, C. R. (2000). Women’s sexualities: Generations of women share intimate secrets of sexual self-acceptance. New Harbinger Publications.
• Ellison, C. R. (2001). A research inquiry into some American women’s sexual concerns and problems. In E. Kaschak & L. Tiefer (Eds.), A new view of women’s sexual problems (pp. 147–159). The Haworth Press. https://doi.org/10.1300/J056v12n03_11
• Ellison, C. R. (2003). Facilitating orgasmic responsiveness. In S. B. Levine, C. A. Risen, & S. E. Althof (Eds.), Handbook of clinical sexuality for mental health professionals (pp. 167–185). Brunner-Routledge.
• Ellison, C. R. (2007). Women’s sexual problems and concerns. In A. F. Owens & M. S. Tepper (Eds.), Sexual health: Vol. 4. State-of-the-art treatments and research (pp. 87–106). Praeger Publishers.
• Kaschak, E., & Tiefer, L. (Eds.). (2001). A new view of women’s sexual problems. The Haworth Press.
• Masters, W. H., & Johnson, V. E. (1966). Human sexual response. Little, Brown and Company.
• Tiefer, L. (2004). Sex is not a natural act and other essays (2nd ed.). Westview Press.
• Zilbergeld, B. (1999). The new male sexuality (Rev. ed.). Bantam Books.

13. Items of the Scale