As a staunch believer in the interaction of both nature and environment in shaping one’s sexual development, I see its parallel in how I ended up teaching and researching sexuality in the State of Hawaii. My path was shaped by a combination of a wide-ranging curiosity, some ability, sheer chance, and luck. The convoluted road here also speaks to the strong influence of certain individuals.

I was born in the Bronx in 1934 in an area then a neighborhood of Eastern European Jewish immigrants who had worked themselves out of the ghetto of the Lower East Side. My father and mother owned a small corner grocery store. While I was still a preschooler, my parents began to change one store for another in seeking better business locations. So, too, did we often move. My father was excellent at taking stores that were failing, building them up, and then reselling them and moving on. It was the classic mode of buying low and selling high, with my parent’s sweat equity (and our—my brother’s, sister’s, and my—added labors) making the difference. Unfortunately, these failing stores waiting to be revitalized were often in neighborhoods where academics or “neighborliness” were not rated highly by all. Some of my earliest recollections of elementary school times were of having rumbles or other “street adventures” not of my making.

My second year of junior high school found us moving to upper Manhattan. Here the majority of my peers belonged to street gangs and thought school a waste of time and gang fights a sanctioned team sport. Fortunately, except for an occasional “zip gun,” firearms were rare. But knives were not and any excuse seemed good enough for someone to pick a fight. Although I had enjoyed school until then, and had skipped a grade in my junior high freshman year while living in the Bronx, I now tried to avoid fights and whatever else I found negative at school and the school yard. I would regularly play hooky. School had become an aversive location. I would usually go to the park and read, walk the streets, or visit a museum. The advice and aspirations of my immigrant parents, “Get a good education. We were denied the opportunities to go to school in Ukraine and in America education will be your vehicle to whatever you want,” didn’t seem to make much sense at the time.

An accidental academic break came when some friends told me they were taking a test to enter a special high school. Since it meant another day off from school I decided to take this legitimate opportunity to be away from class and take the test. I had no idea of what was on offer. From this test followed a major positive turning point in my scholastic life. I was admitted to the Bronx High School of Science. Although it meant travel from Manhattan to the Bronx every day, it was well worth while. School now became enjoyable and a valued adventure in learning. My peers here looked forward to school and camaraderie replaced combativeness. We competed in fun for who knew more trivia while keeping up with the adult world, sports, and other extracurricular activities. While I would return home to the “gang” neighborhood to work in the family store and get in my homework, it was now school that provided relief. My Bronx High School of Science experience convinced me that my future would be in science and teaching would be my preferred occupation.

My choice for a college was uncomplicated. From a poor family, the only possibility I could realistically consider was the subsidized City College of New York (CCNY). I was admitted to the college and enrolled as a physics major. As I hadn’t fully appreciated the high school I was choosing before my experience there, the same was true for CCNY. Nevertheless, I came to relish my college experiences.

My physics major courses were stimulating and engrossing. To this day I fondly recall some of the challenging questions posed and the theoretical discussions. But the university, as most, required taking courses outside one’s major area. This included biology courses and nonphysics electives. As I passed beyond the basic biology courses into more electives such as genetics and comparative anatomy, I found the area fascinatingly stimulating and realized I wanted somehow to integrate biology into my physics interest. I switched my major to biophysics and, as far as I am aware, was the first student to graduate from CCNY with that as an undergraduate major. An undergraduate research project on the lethal effects of heat on living organisms helped earn me a scholarship in marine biology at Woods Hole. But here again was another serendipitous occurrence that shifted my direction.

I entered college in January 1951 when the possibility of being drafted for the Korean War was a reality all male college students faced. Joining the ROTC (Reserve Officers Training Corps) offered a way to stay in school and also get the small stipend it provided to help pay tuition. (I supported myself all through college and looked forward to the promised GI Bill to help finance graduate studies.) While I finished all required courses and was eligible for graduation in January 1955, I was not yet twenty-one, the minimum age to be commissioned. Since the ROTC would pay for any further schooling, I remained in school an additional semester so I would be of age when I was graduated and could receive my second lieutenant’s bars. This was consequential for my academic direction. In this last “extra” semester I took two additional biology electives: endocrinology and animal behavior. The teacher for both courses was William Etkin.

Etkin was one of those fabled teachers who could inspire and weave knowledge, learning, and research into a fascinating fabric. His own area of expertise was evolution and metamorphosis and some of his publications are as valuable today as they were then. His knowledge of both endocrinology and behavior was extensive. I loved the courses and subject matter; our in-class and after-class discussions led to our becoming good friends. Now I thought to myself, “This is the direction I want to go. I want to understand behavior and its underlying mechanisms. “ But before I could pursue this area I had an obligation to Uncle Sam. While this precluded going to Woods Hole, it proved a substitute stroke of fortune.

My assignment in Japan was as a topographic engineering officer involved in the analysis and the production of maps. (Being a biophysics major I had the unique opportunity as an ROTC cadet to choose whether I wanted to be in the infantry or engineers. It was standard that for the third and subsequent years of ROTC training and active military duty, all biology majors were assigned to the infantry and all physics majors were assigned as military engineers. Given a choice, I made a decision that probably took all of about three seconds.)

My outfit was stationed outside Tokyo. My wife and I (we married just prior to coming to Japan) lived off base in a typical Japanese neighborhood and loved our Japanese experiences so much I renewed my two-year military contract for an additional year. I was even, for a while, seriously considering making the topographic service my career. The work was interesting and allowed me the opportunity to travel to many Asian countries. My first professional publications were on cartography and mapping. While in Japan, however, I established relationships with Japanese animal behavior researchers at Tokyo Kyoiku Daigako (Tokyo Teacher’s College) and met with them regularly. These experiences in Japan would later prove quite significant.

While living in Japan I asked Professor Etkin to recommend for me graduate schools in which to pursue the interface of behavior and its hormones. In the old-school manner he recommended not schools, but individuals with whom to study: Frank A. Beach at UC Berkeley, Charles H. Sawyer at UCLA, and William C. Young at the University of Kansas. I applied to all three without any real preference. I only knew these individuals from some of their writings but trusted Etkin completely. I didn’t apply to any other schools. As things were done in those days, graduate school training was to start in the summer or fall and applications and acceptances were to be finalized the preceding April. Chance again intervened. Acceptance from Young arrived by airmail, and came before the cutoff dates. The acceptances from Sawyer and Beach came via sea mail and arrived afterward. I responded to the offer of studying with Young. The joke at home was our life itinerary would read: New York, N.Y., to Tokyo, Japan, to Lawrence, Kansas. The sequence, going from the sophisticated, urban areas of New York and Tokyo to rural Lawrence, seemed ludicrous. The joke was on us. We loved Lawrence for what it had to offer as we had loved New York and Tokyo for other reasons. With Etkin I did one of my first behavior publications. It was a movie describing a colony of Japanese macaques and some of their socially transmitted behaviors (Etkin and Diamond, 1961).

A certain naïveté must be admitted to at this time. Attending only to the individuals with whom I might work, I give little real thought to what academic department I would be in nor how that might influence my future. I had no idea of what it meant to be associated with an anatomy department and that is the department to which I was admitted. Both Young and Sawyer were anatomists. In retrospect, at the time I would have preferred to major in a psychology or a zoology department. However, I guess if Young were in a nutrition department I might have gotten my degree in that field. Similarly, I had no real preference as to which behaviors I might study. My thinking on the issue was quite global. At the time, I didn’t realize that the only behaviors with which Young was interested were those associated with reproduction.¹ Indeed, at that time it was probably the area of reproductive behavior in which underlying mechanisms were better understood than for any other aspect of behavior. And actually all three, Beach, Sawyer, and Young were researching different endocrinological aspects of sexual behavior. It is also well to appreciate that until the 1970s, reproductive behavior was easily understood to incorporate all aspects of sexual behavior.² That part of my graduate training now seemed fixed without any real choice of my own.

A minor area of study was required by the graduate school requirements of the University of Kansas. Against Young’s advice—who preferred I minor in biochemistry—I chose experimental psychology, where I came under the wing of Professor Ed Wike. He too became a friend and mentor. The combination of anatomy, endocrinology, and experimental psychology I found very enjoyable and beneficial.

At the time I was at Kansas (1958-1962), another configuration of fate was to my benefit. Working with Young at the time were Robert (Bob) W. Goy, Charles (Charley) H. Phoenix, and Arnold (Arnie) A. Gerall. I couldn’t imagine a better graduate school research environment in which to cut my teeth. Later fellow graduate students Ken Grady and Harvey Feder joined the mix. It was ideal. Research was in the air and one could go to the old wooden-shack lab at any time of day or night, seven days a week, to find one or more of the group. Everyday discussions typically revolved around one aspect or another of sexual behavior and its associated reproductive and endocrinal mechanisms. Interest in different theories, research attempts, failures and successes was not something affected but part of the intellectual juices and mental challenges that gave us all pleasure. It was a wonderfully cooperative and mutually supportive group. We became more than colleagues; I consider them all friends .and respect them, each in his own way, as having influenced me.

Certainly the hot topic at the lab at the time was trying to understand sexual development. Using guinea pigs and rats as primary models, research focused on prenatal influences on the developing individual. Out of this work came the now classic study that showed how early androgen administration can masculinize the female fetus, the Endocrinology paper of Phoenix, Goy, Gerall, and Young (1959). The significance of the work was apparent to all. And each of us, in his own way, saw this as the springboard to many other lines of research to be pursued. As a graduate student my first thesis attempt in this vein was to see if estrogens could feminize male fetuses as androgens masculinized females. My injections of estrogens into pregnant guinea pigs invariably resulted in fetal death. This was a great disappointment to me since it’s hard to study behavior that way. Had I or others at the lab been thinking along different lines at the time, however, we would have recognized this now-understood phenomenon and touted my findings as a simple and safe abortifacient or “day-after” pill.

While injecting the guinea pigs in the lab in an attempts to induce masculinization of the fetuses, I noticed that the pregnant females into which the testosterone was injected did not themselves masculinize. In contrast, those that aborted did. My final thesis research looked into the mechanism of this maternal protection. It led to one of the early descriptions of the protection offered by pregnancy (Diamond and Young, 1963). Several years later, this line of research with Ulrich Westphal (Diamond, Rust, and Westphal, 1969) brought to light specific testosterone and progesterone binders particularly available during pregnancy. This route became for him and others a major direction of biochemical study. I preferred to focus again on behavior.

It is relevant to recall that in the 1950s and early 1960s funds for graduate research were scarce. Such money came from the university departments themselves and grants were uncommon. Funds for graduate students were also uncommon. Most of us earned our income, if we could get it, as teaching or research assistants. I assisted in teaching neuroanatomy to the medical students and teaching gross anatomy for the university athletes majoring in physical education.³ I also earned money as a research assistant. Injecting and testing guinea pigs for the lab became a seven-day-a-week routine.

Consideration of funding is pertinent since the opportunity appeared to apply for a graduate research stipend from the National Academy of Sciences, National Science Foundation (NSF),Committee for Research in Problems of Sex. It was the first time such NSF funds were available for graduate students. One of the requirements for the award was that a research paper be submitted. For my application I prepared an analysis of how I saw humans fitting into a paradigm of having their adult sexual behavior biased by prenatal events. This analysis and critique of the then-prevalent theory of John Money and his colleagues that humans were independent of such influences (Money, Hampson, and Hampson, 1955a; Money, Hampson, and Hampson, 1955b; Money, Hampson, and Hampson, 1957) helped earn me the award. The critique, eventually published in the Quarterly Review of Biology (Diamond, 1965), basically proposed and defended the then-novel theory of a biased interaction of nature and nurture working together to forge an individual’s sexual behavior. While there were those who continued to do so, no longer could one rationally argue that human psychosexual behaviors, such as those related to sexual orientation and identity, were the exclusive result of nature or nurture. From that period on, while continuing experimental work with animals, I was simultaneously interested in human physical and psychological sexual development. Intersexuality of all sorts and sexual variations of all stripes became grist for the mill.

I received my doctorate in 1962 and went to teach at the University of Louisville. One of the attractions to that university was the agreement that I would be able to simultaneously attend classes to obtain a medical degree. It wasn’t that I wanted to practice medicine but I wanted better access to patients with whom I could more closely study human sexual development and intersexuality. Now, while a member of the faculty, I initiated a seminar on sexual behavior for medical and graduate students. It quickly became clear that the faculty and student interest was more on humans than on other animals. My teaching and research, too, expanded to encompass human subjects as well as animals. During my stay at Louisville, William C. Young died. In his honor I edited a festschrift volume of the Anatomical Record (Diamond, 1967).

As things developed, life at the University of Louisville was, unfortunately, not up to my experiences at Kansas. Nor was it to my wife’s liking. While I was fortunately able to pursue my research and scholastic interests, and able to begin research on intersexed individuals (Diamond, 1968), we began to look for new opportunities. Chance again took center stage. Vincent J. DeFeo and Robert W. Noyes from Vanderbilt University, both well reputed for their works on reproduction and fertility, were heading to Hawaii to help start a new medical school. It was their idea to start a program that would cover all aspects of reproduction throughout the life cycle. In their minds this would include sexual behavior from puberty through fertile years, pregnancies, and so on. They invited me to join them in starting this new type of department: one that would combine teaching and research in both basic and clinical sciences and concentrate on all aspects of reproduction. It was to be called the Department of Anatomy and Reproductive Biology. Bob Noyes, an obstetrician-gynecologist, was to be the department chair and assistant dean. By then I had completed my basic medical science boards and I was also offered the opportunity to complete my medical degree while on the faculty. After considering other possibilities, I agreed to come to Hawaii. My primary responsibility was to teach neuroanatomy and sexuality to the medical students. My research was to be on topics at the interface of reproductive biology and sexual behavior. My wife and I also thought Hawaii would be an ideal place to raise our children. We now had four daughters. The year was 1967.

Here again was a wonderful and fruitful research environment. Along with Noyes and DeFeo was Ryuzo Yanagimachi, world renowned for his work on fertilization. The four of us forged a strong academic and animal research environment. My research focused on endocrine and behavioral parameters of reproduction. Now, some thirty years later, three of us are still together. The medical school welcomed my offering an elective course in human sexuality to the medical and nursing students which I started in 1968. Along with this, in 1968, without any fanfare or objection, I became faculty advisor to a gay student organization. “The Gay Student O‘hana (family),” believed to be perhaps the first college-sanctioned gay organization in the country, is still in existence.

Perhaps more importantly for the nation as a whole, and surely influential for furthering my career in human research, in 1968 the state began to discuss the possibility of legalizing abortion. As related to reproductive biology and sexual behavior, I and colleagues from the departments of sociology and maternal and child health began to simultaneously look into the scientific aspects of the matter and consult for the state legislature. In 1970 Hawaii became the first state in the union to permit legal abortions and, with state and federal funding, we began to do in-depth studies of abortion-related behaviors. These writings were among the first to offer abortion data not only from matched cohorts but also from a total population. Along with these major human studies, basic research on sexual behavior in animals continued apace. But the work on humans began to take a major share of my time. It included defending the biased nature-nurture interaction in transsexualism and intersexuality (Diamond, 1974).

My professional and personal life took another series of major steps in the 1970s. They were each unique and had a significant effect on my research and academic direction. The first event was catastrophic when, in 1970, my wife became seriously ill with a disease that would affect our lives until she died in 1989. Among other things it precluded my being able to finish my medical degree.

A good turn occurred in 1973. In that year, in collaboration with Public Television Station (PBS) KHET-TV and the University of Hawaii educational extension program, I was asked to offer a human sexuality television series. It was the first such television series on sexuality in the country that went beyond the so-called talking heads. Until then people only discussed sexual matters. This series, in contrast, took viewers to the action, whether it was to a transvestite bar, a nudist beach, or a demonstration of a breast or prostate examination. The series, with additional requirements and a final test, was also used as an extension credit course by the University of Hawaii and other colleges around the country. Although it was extremely low budget, it showed and discussed a wide gamut of subjects, controversial and mundane. It covered topics from many angles. The series was quite popular and went on for thirty one-hour programs. It was rebroadcast several times and, surprisingly, received few complaints while dealing with all the politically sensitive issues our field has to offer. In 1973 the series won the National University Extension Association “Creative Programming Award” for Arts and Sciences. Most listeners found it refreshing and informative as welt as entertaining.

The success of the television series led to my being requested to offer an American Association for the Advancement of Science—National Science Foundation Chautauqua series of short courses for college teachers. Four weeks a year, from 1974 to 1977, I traveled around the country teaching hundreds of teachers how to teach: “Human Sexuality: Psychological, Biological and Social Aspects.”

Meanwhile my thesis of a biased interaction of nature and nurture for human psychosexual development as presented in the Quarterly Review of Biology paper seemed to be catching on and I was invited to spend a 1974 sabbatical at Oxford’s Children’s Hospital to work with Christopher Ounsted and David Taylor investigating human psychosexual development. This was a wonderful opportunity to learn firsthand of some of the research going on in Britain and to meet John Bancroft, now director of the Kinsey Institute, and others.

Two additional events added to this exciting period. On my return from England I was invited to join the Human Sexuality Graduate and Psychiatry Residency Training Program headed by Richard Green at the State University of New York at Stony Brook. I readily accepted this opportunity and for three years held, along with my position in Hawaii, a joint appointment at the department of psychiatry at SUNY. Richard and I became close friends and I found it an extraordinary occasion to interact with Joseph LoPicollo, Julia Hymen, Diane Fordney-Settlage, and others. The staff and postdoctoral candidates offered a wonderful, calm intellectual atmosphere. Several joint works resulted from these associations, particularly in the developing area of video education for physicians. The second event was an invitation to offer a workshop for Japanese sex educators of the same type I was offering for Americans. This started a string of invited lectures and workshops both in Hawaii and Japan that continues to this day. Obviously while I still did animal research, my medical school human sexuality teaching as well as my human research activities and publications began to increase in salience.

Many of my ideas and syntheses from the decade of the 1970s and before were introduced in a text and teachers’ manual published in 1980 with Arno Karlen (Diamond and Karlen, 1980a, 1980b). Candidly it must be said that appreciation of my work on human sexuality outside of Hawaii was not mirrored by the feelings of all my medical school colleagues at home. Several new department members and other faculty of the developing medical school were not as broad-minded or visionary as the school’s founders. They thought animal research associated with reproduction appropriate while investigation of human sexuality “a little far out” and perhaps actually inappropriate. Thank goodness for tenure.

The 1980s brought with them additional involvement in teaching sex to professionals. The decade started off with my being contracted by the United States Agency for International Development (US-AID) to do a two-week workshop in Thailand, to be attended by professional population experts and ministers from throughout Asia. The workshop was organized, at their request, to teach family planning workers how to integrate sex education and sexuality concerns into their population control programs. Amusingly, since US-AID didn’t want to use the word “sex” in the workshop in fear it might offend someone, they gave the workshop the longest title they ever used: “The International Workshop on Training of Trainers in Family Life Education Relative to Family Planning.”

This experience was coupled with a mini-sabbatical in Japan and Hong Kong to learn more of cultural components of sexuality and to collaborate with colleagues in those countries. The sabbatical time was also used to complete two chapters for the American Medical Association medical handbook Sexual Problems in Medical Practice (Diamond and Karlen, 1981a, 1981b). The first chapter was on the sexual response cycle. Our second chapter, on sexually transmitted diseases (STDs), was one disease too short. Completed in the late 1970s and reviewed by James W. Curran, who would later come to head the Centers for Disease Control HIV/AIDS investigation program, the chapter contained nothing on this scourge.

HIV/AIDS most prominently began to penetrate into our lives and consciousness in the early 1980s. With the increasing number of cases of this strange infection primarily touching the lives of homosexuals and heroin addicts along with Haitians, hemophiliacs, and harlots (the disease’s victims were then best identified by the mnemonic string of “h”s), it seemed natural for me, both as a sexologist and as a medical school faculty member, to turn attention to the topic. In the early 1980s I saw this disease developing as had the “great pox” of syphilis of the fifteenth century: a mysteriously spreading sexually transmitted disease that had no cure. I started to lecture and speak wherever I could warning about AIDS and the future as I saw it. At first only a minority of individuals, heterosexual or homosexual, academic or lay persons, politicians or businessmen, would listen. Even my dean thought I was making too much of the issue and thereby calling undue attention to the medical school. Indeed, he objected to my identifying my early AIDS work with the medical school.

In a more general mode I also published a synthesis of my accumulating ideas on sex in general with a cross-cultural perspective (Diamond, 1984). This book, SexWatching, following in the mode of Desmond Morris’s ManWatching with many illustrations, was highly popular and reprinted in the United States, the Nether lands, Japan, and elsewhere. Along with these human-related activities, research continued on animal sexual behavior in many species, including hamsters and rabbits. I still loved the intellectual challenge of experimental animal research.

But without doubt my attention was turning to the developing social impact of AIDS. The evolving situation appeared too serious to avoid. In 1985 I co-founded the Hawaii AIDS Task Group (HATG), one of the first community-wide organizations of its kind. Acceptable to both the straight and gay populations, the HATG fostered the start of many city, county, and state. government and nongovernment groups and projects dedicated to all aspects of dealing with HIV/AIDS. Until disbanding in 1995, after having served its purpose, the HATG was the only statewide nongovernmental organization known in the country which was able to amicably bring together diverse political, educational, and administrative factions to work for the common good. While serving as director of the HATG I started to simultaneously do research on HIV/AIDS. Considering the potential pandemic effect of HIV in Asia, I also authored a book AIDS: Love, Sex, Disease (Diamond, Ikegami, and Thorne, 1988). Originally prepared primarily for a Japanese audience, the book has since been reprinted in Chinese in Hong Kong and Taiwan and is now being prepared by the Chinese government for educational distribution throughout the People’s Republic of China.

During the second half of the 1980s, in addition to working with HIV/AIDS, I returned to research sexual orientation and identity (e.g., Diamond, 1989), and turned to new interests in pornography, cross-cultural aspects of sexuality, and the esoteric topic of asphyxiophilia, or erotic self-strangulation. In the latter study I had the good fortune of working with two Swedish students from the department of psychology at Göteborg, Sweden, Sune Innala and Kurt Ernulf, and their professor, Lars Gösta Dahlöf. I also began to establish links with the national AIDS programs of the Netherlands. Some of these European links are still maintained.

The decade of the 1990s has continued to focus my research increasingly on human sexual issues, several occurrences of which I am particularly proud occurred early in this decade. The first was an invitation to Europe, initially to do an “outside” review of the HIV/AIDS prevention, research, and educational program for the Dutch Ministry of Health and Culture and then to deliver the Magnus Hirschfeld memorial lecture held at the Reichstag at the historic Third International Berlin Conference for Sexology. The first and second such Berlin conferences were held before World War II and this meeting, organized by Erwin Haeberle and Rolf Gindorf, also served to honor the rejoining of the previously divided Berlin. I spoke on “Bisexuality: Biological Aspects” (Diamond, 1994). Research on the development of sexual orientation and identity among different populations was again occupying my attention.

Animal research, while still of interest, has taken a back seat to my human interests, which continue to expand. In addition to ongoing research on pornography and sexual aspects of body modification (tattooing, piercing, etc.), future subjects look ever interesting. This is said in full awareness of the censorious nature of the times and the increasingly loud call for measures against sex education, sex research, and sexual pleasures. On the other hand, during my professional lifetime majestic changes have occurred in the sexual world in which we live. These offer reason for optimism. Thirty years ago in the United States it would have been unthinkable to imagine the wide availability of contraceptives, abortion as a legal choice, the availability of a simple abortion “pill,” no-fault divorces, and the relative availability of sexually explicit material. Most dramatically, these last thirty years have seen major steps forward in the rights of and protections for women, the wide acceptance of domestic partnerships,. the abolition of anti-homosexual laws in many states, and even the consideration of same-sex marriages. Certainly there are backlashes and jeremiads against such changes, but I think despite such retrogressive calls and forces, the field of sexology and the accompanying adjustments of society will proceed apace. I trust my research will augment and document some of the future changes. From a school dropout to a perpetual student and from physics to sex—now if those sorts of changes can be bridged there is no telling what is possible.

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