A comprehensive psychoendocrine theory of sexual behavior in early adolescence would specify the hormones involved, their behaviorally effective blood levels or dose-response curves, hormone-receptor interactions, sensitive periods of development, differential effects of hormones on the various components of sexual behavior, and the interactions of hormones, physical appearance, and social factors. Although the recent advances in endocrinology make this approach feasible, our current data base is obviously much too limited for establishing such a theory and is sufficient only to answer the question of whether hormones play any role at all in psychosexual development during puberty. The correlation between age at first intercourse and pubertal development is far from impressive. The developmental data on masturbation are suggestive, at least for males, but there are no studies of direct assessments of somatic development and hormones. The same is true of the data on romantic love. On the other hand, clinical studies of patients with pubertal failure strongly support the notion that untreated hormonal deficiencies in adolescent development are incompatible with full psychosexual maturity. Thus, puberty seems to be a necessary condition for normal psychosexual development but by no means sufficient by itself. This conclusion is supported by the clinical findings on delayed puberty and pubertal failure which show that the exposure to endogenous or exogenous hormones per se does not bring about normal psychosexual development unless the timing of hormonal exposure is adequate.
An important facet of psychosexual development that is clearly hormone-dependent is attractivity. For coital behavior, hormones seem to have a permissive role which must be partly mediated through their effects on the genital apparatus, but the separation in time of puberty from the initiation of intercourse for most adolescents demonstrates the importance of non-hormonal factors. Pubertal hormones may have a particularly important role for the development of sexual attractions, imagery, and arousability, but supportive data on humans are minimal.
As for the hormones important to psychosexual development, estrogens and androgens play a major role in the development of secondary sex characteristics and the resulting attractivity, as well as in genital development, although many details still have to be clarified. Direct effects of specific pubertal sex hormones or their metabolites on brain systems controlling distinct aspects of sexual behavior are likely, since hypothalamic and limbic systems in man seem to be very similar to those of other mammals, but the demonstrations of such effects require more comprehensive and sophisticated investigations than are available to date.
The theoretical position advocated here is an interactionist one. A deterministic-biologic concept of an “activation” of sexual behavior as a consequence of neuroendocrine processes is a necessary component of a theory of sexual behavior development in lower mammals but even there is not sufficiently comprehensive. A purely sociological theory in which the development of adolescent sexuality is described exclusively in such terms as role theory and social learning, neglects the available clinical evidence on the role of hormones. The interactionist viewpoint, albeit unsatisfactorily vague in its current formulations due to the paucity of the data available, is the only one that can adequately take into account both the somatic-endocrine and the social influences.
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