Sexes: Target: Masters and Johnson

Researchers cast new doubts on their methods and results

The publication in 1970 of Human Sexual Inadequacy, by Dr. William H. Masters and Virginia E. Johnson, was one of those events that transform the clinical landscape. Afterward sex therapy seemed a brave new world, and Masters and Johnson were its gurus. Already known for their significant findings about the physiological processes involved in sex, the pair devoted the book to the therapies they had developed at their St. Louis clinic for such problems as frigidity, impotence and premature ejaculation. Over a period of 16 years, they reported, they treated 790 cases, mostly involving married couples; in each case they conducted intensive sessions for a few weeks, then followed up with consultations for five years. They laid claim to a remarkable success rate: only 20% of their patients, they said, failed to respond.

Last year Masters and Johnson published Homosexuality in Perspective, describing a similar program for homosexuals; this time, they said, only 28% of their patients resisted a conversion to heterosexuality.

The Masters and Johnson record in sex therapy was unparalleled, even unique, and therein lay the catch. Other sex therapists have since been unable to match their success rate and consequently have been growing increasingly skeptical of the reliability of their findings. Now two California psychologists, Bernie Zilbergeld and Michael Evans, in the current issue of Psychology Today, have written the sharpest, most substantial attack yet. "Masters and Johnson's research is so flawed by methodological errors and slipshod reporting that it fails to meet customary standards—and their own—for evaluation research," say Zilbergeld and Evans. "This raises serious questions about the effectiveness of the ten-year-old discipline they created."

The key to evaluating any research —"the only impeccable yardstick," as Masters and Johnson themselves put it —is the ability of other researchers to duplicate the results using the same techniques. But, say Zilbergeld and Evans, it is impossible to tell from Masters and Johnson's own account precisely what they did and how they did it. Among many unanswered questions, according to the two psychologists: How did Masters and Johnson define success and failure in sex therapy? Who decided if treatment had succeeded? By what criteria?

Many of Masters and Johnson's patients tended to be highly motivated and prescreened through referrals by psychiatrists and psychologists; hence they were probably likely to respond to treatment. Zilbergeld and Evans fault Masters and Johnson for not being more candid about the special nature of their sample. Masters and Johnson never divulged how many applicants they considered and how many they rejected, nor how many were accepted and then later quit or were asked to leave. Similarly, in their study of homosexuality, Masters and Johnson used a Kinsey-developed system of seven categories of sexual preference. Of their 67 patients, 82% fell under the heading of bisexuals, or "flawed" heterosexuals. This calls into question their claim to have turned true homosexuals to heterosexuality, say Zilbergeld and Evans.