Sex Addiction: What the Tiger Woods Story Forces Us to Confront

Anna Clark

The term “sex addiction” is used to describe a pattern of frequent, progressive, and often secret sexual behavior, even when the behavior jeopardizes a person’s time, employment, financial stability, relationships, and reputation. While often conflated with adultery, sex addiction does not necessarily mean cheating—or even intercourse. Rather, it can manifest as a dependency on pornography, masturbation, phone or Internet sex, and other related behavior.

From Tiger Woods to Lifetime movies, there has been no small amount of conjecture about the slippery concept known as ‘sex addiction." 
But does such a condition really exist?

Finding out requires sweeping aside the presumption,
dismissiveness, and shame that clouds the subject.

The phenomenon didn’t have a name until 1983 when
psychologist Patrick Carnes published the influential book, Out of the Shadows: Understanding Sexual
Addiction
. Prior to that, the behavior was described as “hyper-sexual
arousal.” In short, the term “sex addiction” is used to describe a pattern of
frequent, progressive, and often secret sexual behavior, even when the behavior
jeopardizes a person’s time, employment, financial stability, relationships,
and reputation. While often conflated with adultery, sex addiction does not
necessarily mean cheating—or even intercourse. Rather, it can manifest as a
dependency on pornography, masturbation, phone or Internet sex, and other
related behavior.

People who struggle with sex addictions are of varying ages,
genders, and sexual orientations. The Society for the Advancement of Sexual
Health estimates that 3 to 5 percent of the American population wrestles with
addictive or compulsive sexual activity.

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Re-framing compulsive sexual behavior has led the
therapeutic community to look at it through the lens of addiction for the last
twenty years, noting how the behavior activates the same pleasure centers of
the brain, releasing the same chemicals as drug use does, and providing the
addict with the same kind of euphoric high, and numbed escapism that addictive
substances cause.

Maureen Canning treats sex addiction both in her private
practice and as a consultant at The Meadows, a recovery center in Arizona.
She said the therapeutic response to sexual addiction parallels that of
chemical addiction. Its diagnosis uses the same assessment tool, gauging, for
example, whether the behavior progresses over time and has negative
consequences on the person’s life.

If an addiction is assessed, Canning said, the treatment she
provides hinges on listening.

“We listen to what they’ve been doing, how they’ve been
doing it,” Canning said. “We listen for the story around their childhood, how
they were influenced sexually, both overtly and covertly. Sometimes they were
abused, or exposed to something traumatic.”

She added that treatment guides people into stabilizing
their lives—they often begin recovery while in chaotic circumstances—and then
helping the individual learn to manage their feelings, set boundaries, and find
healthy coping mechanism. The process can be painful.

“For many sex addicts, they’ve been acting out for most of
their lives and (treatment) is like a death—this was the one thing they could
count on to make them feel good,” Canning said.

She also noted that there is an anorexic cycle to sex
addiction, where an individual compulsively avoids sexuality. Others, she said,
especially women, can become addicted to the process of seduction rather than
the sex per se.

Especially with the advent of the Internet, there have been
more and more diagnoses of sex addiction.

“We called (the internet) the crack cocaine of sex
addiction,” Canning said. “It’s affordable, accessible, and anonymous. People
who have addictions are likely to experience them more intensely, and those who
might not have had them (without the internet) develop them.”

Dean W., who asked that only his first name and last initial
be used in this story, said that he was addicted to pornography and phone sex
for more than ten years; he continues to be actively engaged in therapy. While
he spent 30 to 40 hours a week acting out, he said, sex addiction is “much,
much easier to conceal” than other addictions—which is why very successful
people, such as CEOS, can find themselves struggling with it, and why he
believes the disease is still not well known.

“When I’ve told
people, they think it’s funny, not true, or that I’m a pervert,” Dean said.
“The biggest thing that hurts as a person is that (sex addiction) is so
misunderstood.”

To underscore the reality of his situation, Dean points out
to the addictive patterns that played out in his life—twelve to fourteen hours
of looking at pornography at a time, he said, and extended phone sex binges.
One of his phone sex binges lasted 36 hours, in which Dean neither ate nor
slept, and which cost him $2000. In all, Dean estimates that he spent more than
$150,000 on phone sex over the course of his addiction.

The addictive pattern, Dean said, was a way to escape
feelings of low self worth and loneliness. These deep feelings had roots in
both his parents and his grandfather being alcoholics; his brother has a
gambling problem. Dean said that he was emotionally, physically, and sexually
abused as a child. His steep investment in his therapy—he has been through many
intensive programs and has been in a weekly program for more than two years,
most of which is not covered by his health insurance—is in part an effort to
ensure that his own child is not affected by his addiction.

Elle can attest to the pain that sexual addiction can cause
a family. The Canadian mother, who asked that her real name not be used, never
heard of sex addiction until her husband confessed to her that he was seeking
recovery from it.

“I was floored. (Sex addiction) …  what the hell was that?” Elle said. “I worried that it meant
he was a pervert. The very next morning (after he told me about it), we had a
conference call with his counselor who helps set up treatment programs for sex
addiction. Thankfully he laid out the facts, assured me it was treatable,
explained to me that my husband was doing very well and desperately wanted to
put his past behind him.”

That past involved betrayal that Elle said nearly destroyed
her. What she initially thought was one affair turned out to be a pattern of
secrecy that was difficult for her to accept.

“I had a very hard time with it. Felt very, very lonely.
Felt duped. Ripped off,” Elle said. “My perfect world wasn’t so perfect after
all.”

Elle and her husband didn’t discuss the details of the sex
addiction with their young kids, but Elle said that the process of recovery has
made it possible for her husband to reconnect with his whole family by spending
more time together; his addiction had led him to detach from the family.
Recovery, she said, “involves a lot of soul-searching, a lot of reparations,
total disclosure, total transparency.”

There remains, however, a strong segment of the population
that believes that sex addiction is merely a manufactured phenomenon. John
Wilder is one of them. A retired Baptist minister from Newcastle, Indiana who
serves as a marriage and relationship coach, Wilder contends that sex addiction
is so much “pop psychology.” A true addiction is distinguished by a chemical
dependence, resulting in painful physical withdrawal, he argues. While many
people have obsessive-compulsive patterns of sexuality, often out of a need to
be soothed, Wilder said, it is misleading to call it an addiction.

“There’s simply no physical (withdrawal) component with
so-called sex addiction,” Wilder said.

In the most recent version of the American Psychiatric
Association’s Diagnostic and Statistical
Manual of Mental Disorders
(DSM-IV), published in 2000, “sex addiction” is
not listed as a diagnosis

Nonetheless, Canning said that in the last ten years, public
awareness about sex addiction has developed—though it has a long way to go. In
no small part, this is because American culture itself is sex-addicted, she
said.

“As a sex-addicted culture, we carry a lot of sexual shame,”
Canning said. “We haven’t really been able to accept it, we like to act out, and
we objectify people sexually. This all reinforces the belief that sex is the
most powerful thing.”

It is a point where she and Wilder actually seem to agree.

“This society teaches people, especially girls, that sex is
a nasty, dirty thing,” Wilder said. “Sex is a great gift from God, but you
never see that taught in churches or Sunday school. … Most of us get stuck in
an adolescent mode: ‘Hurry up, get it
over with before someone catches us
.’ … There’s very poor communication
about sex.

Canning added that, “oftentimes as a culture, we confuse
intimacy for intensity.

“We think the goal is to have the most intense kind of
experience—that’s where the high is, the power, the excitement. We need to
shift our paradigm of what healthy sexual experience is. When we make someone
an object, we depersonalize him or her. When we depersonalize them, there can’t
be intimacy.”

Both Dean and Elle were able to relate to the idea of objectification.

“I learned (in therapy), even though its still difficult,
not to objectify women,” Dean said. “Objectification in our culture is just
rampant.”

Elle said that she was particularly surprised about one
woman her husband had an affair with because she was someone he typically would
find unappealing. But as she learned about addictive behavior, she realized
that this woman was ‘safe’ because her husband knew he’d never have an
emotional connection with her.

“Sex addicts usually—not always but usually—seek out
partners they can objectify. That are really nothing more than sexual
partners,” Elle said. “My husband feels a lot of shame that he treated people
that way—that he didn’t even really see them as human beings, but as objects.”

Elle added: “Believe me, there’s nothing sexy or passionate
or exciting about (sex addiction). It’s generally two sick people feeding off
each other.” 

The public reaction to Tiger Woods’ personal struggles has
ignited this sex-addicted culture. The top athlete is reported to have sought
treatment for sex addiction at a recovery center in Arizona.

Canning said that while the publicity of his treatment
provides an opportunity for discussion, which can ultimately normalize struggles
with sex addiction, she’d like to see the conversation about it be more
educated—and less joking.

“I think if we are more educated about it, there’s less
shame for an individual to reach out for resources and help when they need it,”
she said.

In his support communities, where he connects with about forty
people each week who are seeking treatment for sex addiction, Dean said that
there is almost unanimous hope that Woods will speak out about his experience.

“There’s a glimmer of hope (in the therapy groups) and a
sense of understanding,” Dean said. 
“I hope he gets the help he needs.”

Dean said one of the most important things that could happen
for sex addiction would be the emergence of a spokesperson like Tiger Woods, as
well as active support from the National Institute of Health and coverage from health
insurance companies. He added, though, that he knows that recovery takes many
years of reducing shame and guilt—and he suspects that Woods will probably not
go beyond making a public statement indicating, “everything’s taken care of.”

Elle too hopes that the conversation about Woods leads to
more public understanding. While emphasizing that there’s no clear confirmation
that Woods is indeed receiving treatment for sex addiction, she admits that the
signs seem to indicate that it’s so.

“I would hope that (the Woods story) might bring sex
addiction to the public arena and perhaps educate more people, particularly
those who know their sexual behavior is causing them pain, but don’t have a
name or understanding of it,” Elle said. “And I would hope that maybe, just
maybe, we might become more compassionate about it.”

Elle added, “My husband isn’t the least surprised that his
background is similar to Tiger Woods. The domineering father who demanded
perfection, the high pressure career… the false sense of invincibility. … I
ache for (Woods’) wife, who has to be witness to her pain being played out on
the world stage.”

Resources:

  • Sexual Addicts Anonymous, which models the
    Twelve Steps principles of recovery from Alcoholics Anonymous, offers a network
    of in-person meetings around the world—single gender or mixed, open or
    closed—as well as tele-meetings and online meetings.
  • The Society for the Advancement of Sexual Health is
    a membership organization founded in 1987 “dedicated specifically to helping those who suffer from out of control
    sexual behavior.”
  • Dean uses
    Safe Eyes for Internet access. Costing $40-50 a year, Safe Eyes is one among
    several tools that blocks sexually explicit websites. Dean, who struggled
    particularly with pornography, said it has “helped a lot.” He added that he
    looks forward to the day when sex addiction is no longer so taboo that people
    feel like they can’t have it installed on their work computers.

Roundups Sexual Health

This Week in Sex: The Sexually Transmitted Infections Edition

Martha Kempner

A new Zika case suggests the virus can be transmitted from an infected woman to a male partner. And, in other news, HPV-related cancers are on the rise, and an experimental chlamydia vaccine shows signs of promise.

This Week in Sex is a weekly summary of news and research related to sexual behavior, sexuality education, contraception, STIs, and more.

Zika May Have Been Sexually Transmitted From a Woman to Her Male Partner

A new case suggests that males may be infected with the Zika virus through unprotected sex with female partners. Researchers have known for a while that men can infect their partners through penetrative sexual intercourse, but this is the first suspected case of sexual transmission from a woman.

The case involves a New York City woman who is in her early 20s and traveled to a country with high rates of the mosquito-borne virus (her name and the specific country where she traveled have not been released). The woman, who experienced stomach cramps and a headache while waiting for her flight back to New York, reported one act of sexual intercourse without a condom the day she returned from her trip. The following day, her symptoms became worse and included fever, fatigue, a rash, and tingling in her hands and feet. Two days later, she visited her primary-care provider and tests confirmed she had the Zika virus.

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A few days after that (seven days after intercourse), her male partner, also in his 20s, began feeling similar symptoms. He had a rash, a fever, and also conjunctivitis (pink eye). He, too, was diagnosed with Zika. After meeting with him, public health officials in the New York City confirmed that he had not traveled out of the country nor had he been recently bit by a mosquito. This leaves sexual transmission from his partner as the most likely cause of his infection, though further tests are being done.

The Centers for Disease Control and Prevention (CDC)’s recommendations for preventing Zika have been based on the assumption that virus was spread from a male to a receptive partner. Therefore the recommendations had been that pregnant women whose male partners had traveled or lived in a place where Zika virus is spreading use condoms or abstain from sex during the pregnancy. For those couples for whom pregnancy is not an issue, the CDC recommended that men who had traveled to countries with Zika outbreaks and had symptoms of the virus, use condoms or abstain from sex for six months after their trip. It also suggested that men who traveled but don’t have symptoms use condoms for at least eight weeks.

Based on this case—the first to suggest female-to-male transmission—the CDC may extend these recommendations to couples in which a female traveled to a country with an outbreak.

More Signs of Gonorrhea’s Growing Antibiotic Resistance

Last week, the CDC released new data on gonorrhea and warned once again that the bacteria that causes this common sexually transmitted infection (STI) is becoming resistant to the antibiotics used to treat it.

There are about 350,000 cases of gonorrhea reported each year, but it is estimated that 800,000 cases really occur with many going undiagnosed and untreated. Once easily treatable with antibiotics, the bacteria Neisseria gonorrhoeae has steadily gained resistance to whole classes of antibiotics over the decades. By the 1980s, penicillin no longer worked to treat it, and in 2007 the CDC stopped recommending the use of fluoroquinolones. Now, cephalosporins are the only class of drugs that work. The recommended treatment involves a combination of ceftriaxone (an injectable cephalosporin) and azithromycin (an oral antibiotic).

Unfortunately, the data released last week—which comes from analysis of more than 5,000 samples of gonorrhea (called isolates) collected from STI clinics across the country—shows that the bacteria is developing resistance to these drugs as well. In fact, the percentage of gonorrhea isolates with decreased susceptibility to azithromycin increased more than 300 percent between 2013 and 2014 (from 0.6 percent to 2.5 percent).

Though no cases of treatment failure has been reported in the United States, this is a troubling sign of what may be coming. Dr. Gail Bolan, director of CDC’s Division of STD Prevention, said in a press release: “It is unclear how long the combination therapy of azithromycin and ceftriaxone will be effective if the increases in resistance persists. We need to push forward on multiple fronts to ensure we can continue offering successful treatment to those who need it.”

HPV-Related Cancers Up Despite Vaccine 

The CDC also released new data this month showing an increase in HPV-associated cancers between 2008 and 2012 compared with the previous five-year period. HPV or human papillomavirus is an extremely common sexually transmitted infection. In fact, HPV is so common that the CDC believes most sexually active adults will get it at some point in their lives. Many cases of HPV clear spontaneously with no medical intervention, but certain types of the virus cause cancer of the cervix, vulva, penis, anus, mouth, and neck.

The CDC’s new data suggests that an average of 38,793 HPV-associated cancers were diagnosed each year between 2008 and 2012. This is a 17 percent increase from about 33,000 each year between 2004 and 2008. This is a particularly unfortunate trend given that the newest available vaccine—Gardasil 9—can prevent the types of HPV most often linked to cancer. In fact, researchers estimated that the majority of cancers found in the recent data (about 28,000 each year) were caused by types of the virus that could be prevented by the vaccine.

Unfortunately, as Rewire has reported, the vaccine is often mired in controversy and far fewer young people have received it than get most other recommended vaccines. In 2014, only 40 percent of girls and 22 percent of boys ages 13 to 17 had received all three recommended doses of the vaccine. In comparison, nearly 80 percent of young people in this age group had received the vaccine that protects against meningitis.

In response to the newest data, Dr. Electra Paskett, co-director of the Cancer Control Research Program at the Ohio State University Comprehensive Cancer Center, told HealthDay:

In order to increase HPV vaccination rates, we must change the perception of the HPV vaccine from something that prevents a sexually transmitted disease to a vaccine that prevents cancer. Every parent should ask the question: If there was a vaccine I could give my child that would prevent them from developing six different cancers, would I give it to them? The answer would be a resounding yes—and we would have a dramatic decrease in HPV-related cancers across the globe.

Making Inroads Toward a Chlamydia Vaccine

An article published in the journal Vaccine shows that researchers have made progress with a new vaccine to prevent chlamydia. According to lead researcher David Bulir of the M. G. DeGroote Institute for Infectious Disease Research at Canada’s McMaster University, efforts to create a vaccine have been underway for decades, but this is the first formulation to show success.

In 2014, there were 1.4 million reported cases of chlamydia in the United States. While this bacterial infection can be easily treated with antibiotics, it often goes undiagnosed because many people show no symptoms. Untreated chlamydia can lead to pelvic inflammatory disease, which can leave scar tissue in the fallopian tubes or uterus and ultimately result in infertility.

The experimental vaccine was created by Canadian researchers who used pieces of the bacteria that causes chlamydia to form an antigen they called BD584. The hope was that the antigen could prompt the body’s immune system to fight the chlamydia bacteria if exposed to it.

Researchers gave BD584 to mice using a nasal spray, and then exposed them to chlamydia. The results were very promising. The mice who received the spray cleared the infection faster than the mice who did not. Moreover, the mice given the nasal spray were less likely to show symptoms of infection, such as bacterial shedding from the vagina or fluid blockages of the fallopian tubes.

There are many steps to go before this vaccine could become available. The researchers need to test it on other strains of the bacteria and in other animals before testing it in humans. And, of course, experience with the HPV vaccine shows that there’s work to be done to make sure people get vaccines that prevent STIs even after they’re invented. Nonetheless, a vaccine to prevent chlamydia would be a great victory in our ongoing fight against STIs and their health consequences, and we here at This Week in Sex are happy to end on a bit of a positive note.

Culture & Conversation Law and Policy

The Modern Struggle Over Anti-Trans Bathroom Laws Has Its Roots in Decades of Title VII Fights

Jessica Mason Pieklo

Because of Sex: One Law, Ten Cases, and Fifty Years That Changed American Women’s Lives at Work, written by Gillian Thomas, senior staff attorney with the American Civil Liberties Union Women’s Rights Project, goes beyond cases that helped shape workplace anti-discrimination policies. Rather, it focuses on ten key women whose own lives changed the law.

In 1966, Ida Phillips, a single mother working as a waitress, sat down at her kitchen table and wrote a letter to then-President Lyndon B. Johnson. She told him her story: Despite her qualifications, Phillips had been told by a Martin Marietta employee not to apply for an assembly-line position at one of the construction-material company’s manufacturing plant. The job would have paid more than double what she was making as a waitress. It included a pension plan and insurance, benefits unavailable in most female-dominated industries at the time (and which since have only marginally improved.) The reason Phillips was turned away? She was a woman with a preschool child.

That letter, Phillips’ subsequent lawsuit, and her Supreme Court win would help spark a civil rights revolution in the workplace—one with consequences that reverberate today.

So opens Because of Sex: One Law, Ten Cases, and Fifty Years That Changed American Women’s Lives at Workwritten by Gillian Thomas, senior staff attorney with the American Civil Liberties Union (ACLU) Women’s Rights Project. Despite its full title, though, Because of Sex goes beyond cases that helped shape workplace anti-discrimination policies, focusing on ten key women whose own lives changed the law.

Title VII of the Civil Rights Act of 1964 prohibits employment discrimination based on race, color, religion, sex, and national origin. And it was Phillips’ case, and the nine others profiled in the book, that would ultimately shape that law into one that, decades later, is an important tool in advancing gender and sex equality. As Thomas explained to Rewire in an interview, Title VII it is not just a foundational piece of civil rights legislation important for its historical effect on workplace equality. In the face of anti-transgender bathroom bills and statewide “religious liberties” legislation sweeping the country, it is a crucial tool for pushing equality forward.

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Thomas’ book is organized along three key themes in employment discrimination law: pregnancy-related workplace policies, gender stereotypes in the workplace, and sexual harassment. Those themes act as an inroad toward thinking more broadly about how, in Thomas’ words, we achieve “substantive equality” in the workplace. They illustrate how early fights over promotions and workplace policies that kept women out of certain jobs due to concerns of harming their potential fertility foreshadowed the legal showdowns over contraception coverage in employee health-care plans in cases like Burwell v. Hobby Lobby and Zubik v. Burwell.

“The subject matter areas that I saw [as a researcher and employment discrimination litigator] were, number one, women’s capacity for pregnancy, and then their subsequent roles as mothers, which, historically, has played a huge role in their second-class status legally,” Thomas told Rewire. “Women of color have always been seen as workers, irrespective of whether they had children, so that’s not an entirely universal stereotype. But I think it’s pretty safe to say that generally pregnancy and motherhood have proven to be enormous conflicts in terms of what equality looks like when you have these distinct differences” in how race and gender are perceived.

Take, for instance, the case of Peggy Young and the question whether an employer can refuse to make on-the-job accommodations for pregnant employees when it does so for nonpregnant employees. Young, another one of the women featured in Thomas’ book, was a United Parcel Service (UPS) “air driver” who became pregnant. When Young told her employer she was pregnant, UPS told her they couldn’t accommodate the light-lifting recommendation made by Young’s medical providers. Instead, UPS told Young, she would have to take unpaid medical leave for the remainder of her pregnancy.

In March 2015, the U.S. Supreme Court ruled against UPS, vacating the Fourth Circuit Court of Appeals ruling that had supported UPS’ policy. The decision produced a new test for assessing pregnancy discrimination claims and sent Young’s case back to the lower courts for another look. Not long after the Roberts Court’s decision, UPS and Young settled the lawsuit, bringing an end to Young’s case.

The decision was a qualified win for advocates. The Roberts Court had accepted Young’s argument that UPS had no legitimate business reason for failing to accommodate her particular request, but the decision went short of ruling businesses must accommodate any pregnancy request.

But Because of Sex doesn’t stop at unpacking overt discrimination like the kind detailed in Young’s 2015 case or Phillips’ one in 1966. The book also takes a look at what the law has described as more “benevolent” kinds of discrimination. These include employment policies designed to “protect” women from endangering possible future pregnancies, such as prohibiting women employees from working jobs where they may be exposed to hazardous chemicals.

“It really all boils down to two issues that we are talking about in all these things,” Thomas explained, when discussing workplace policies that, employers have argued, were put in place to protect their female employees from potentially endangering a pregnancy. “One is [employers] ignoring hazards that apply to men and making women into baby-making machines. And number two is [employers] treating health effects or health hazards on the job as reasons for diminishing women’s opportunities, instead of arming women with information and assuming that they will make the right choice for themselves.”

This disconnect is most apparent in the case of United Automobile Workers vJohnson Controls, Inc., another case Thomas highlights in her book. In 1982, the car battery manufacturer Johnson Controls sent a memorandum to all its employees that said “[w]omen who are pregnant or who are capable of bearing children will not be placed into jobs involving lead exposure or which would expose them to lead through the exercise of job bidding, bumping, transfer or promotion rights.”

The policy amounted to a demotion for many female employees and a closed door for others.

Title VII actually permits employers, in a limited context, to have employment policies that discriminate on their face, such as policies that permit churches to only hire members of the same faith. Johnson Controls argued its policy of keeping women out of certain positions due to employer concerns of health risks to future pregnancies fit within Title VII’s narrow window for permitting explicit discrimination.

The Supreme Court would eventually rule in 1991 that Johnson Controls’ policy violated Title VII because it forced female employees to have to choose “between having a child and having a job,” thereby rejecting the argument made by Johnson Control’s that a woman’s fertility—or infertility—can in most situations be considered a bona fide occupational qualification.

As Thomas noted in her book, “It was no coincidence that fetal protection politics were most prevalent in well-paid, unionized industries from which women historically had been excluded. Indeed they had been excluded precisely because they had been deemed physically unsuited for the dirty, sometimes strenuous work.”

But “in female-dominated fields, though, fetal protection policies made no business sense; they effectively would gut the workforce. That reality apparently trumped any hypothetical harm to employees’ future pregnancies,” Thomas wrote.

In other words, these policies didn’t exist in female-dominated fields.

Johnson Controls may have helped grant women the agency to determine how and when they earned a paycheck with regard to policies targeting their potential fertility, but it hardly ended the debate around when and how employers attempt to diminish women’s opportunities related to their roles as potential mothers. This has played out in the hundreds of lawsuits over the contraception benefit, for example.

In other words, if Johnson Controls had settled the question of whether a woman’s fertility was an appropriate grounds for discrimination, we would not have Hobby Lobby.

Because of Sex draws another connection between the historical fight over Title VII and the contemporary one: How do employers adjust workplace policies around shifting gender norms, and when is it discriminatory if they don’t?

The law asks, “What are women supposed to want to do?” said Thomas in her interview with Rewire. “What work are they able to do? What work do they want to do? [Given] assumptions and stereotypes that are about their abilities, their preferences, their interests and how [they are] conforming to [those] in terms of stereotypes about what femininity is—what [are] women … supposed to look and act like?”

Gender nonconforming behavior, and the manner in which employees experience discrimination as a result of that behavior, is a key component over the debate around transgender rights. But it would take a “shrill” woman and the birth of the notion of “workplace harassment” to get us and the law there first.

By every measure, Ann Hopkins should have been made a partner in the global accounting firm Price Waterhouse. She was smart. Ambitious. Worked hard and constantly outperformed her peers. But it was those very attributes that her male partners deemed “too aggressive” or as evidence that she needed “charm school,” and ultimately used to deny her a partnership that by every objective measure she had earned.

The Supreme Court would ultimately disagree. In 1989, it ruled Hopkins should have been made a partner and that the comments relating to her demeanor amounted to improper gender stereotyping, a violation of Title VII’s sex discrimination provisions.

If Hopkins was initially shut out of workplace advancement due to her defiance of feminine stereotypes, so too are women subjected to on-the-job harassment, as Thomas draws out in Because of Sex. “Sexual harassment didn’t even have a name in 1974, but was such a prevalent force driving women out of the work force, driving them into different jobs [and] subjugating them just generally in terms of the identity as sexual objects on the job,” Thomas further explained in her interview.

1974 was the year Mechelle Vinson first hired a lawyer to represent her in a case against her boss, who was chronically sexually abusing her on the job. But at the time, courts largely wrote off those kinds of complaints as a kind of chasing-around-the-office, and not sexual harassment, or in Vinson’s case, on-the-job rape. As described by Thomas in her book, “throughout the 1970s, many courts responded to complaints about abusive bosses with a collective shrug that conveyed, ‘You can’t blame a guy for trying.'”

“Sexual harassment was such a prevalent force driving women out of the workforce, driving them into different jobs, and subjugating them just generally in terms of the identity as sexual objects on the job,” Thomas told Rewire.

That “you can’t blame a guy for trying” attitude hasn’t completely gone away as far as the federal courts are concerned. After all, in 2013 the Roberts Court in Vance v. Ball State made it even harder for employees to bring workplace harassment suits, and employees still face losing jobs for “being too cute” or having their sexuality be a perceived threat to their employer’s ability to remain professional in the workplace.

Which is why, in the fight over transgender bathroom access in 2016, Title VII should be a powerful force in defeating these latest attempts to stymie social progress. The idea that “you can’t blame a guy for trying” has morphed into “how the hell can we police gender roles if we don’t know where you pee.” That’s thanks almost entirely to the manner in which the law has wrestled with gender stereotypes under Title VII, Thomas explained.

In 2012, the Equal Employment Opportunity Commission (EEOC), the federal agency charged with enforcing workplace anti-discrimination laws, issued the landmark decision Macy v. Holder, which held that employment discrimination based on transgender status was a form of unlawful sex discrimination under Title VII. Then in 2015, it issued a ruling stating that denying employees access to restrooms consistent with their gender identity is also a violation of Title VII. Meanwhile several federal courts of appeals have ruled that Title VII protects against gender identity discrimination.

But the Roberts Court has yet to weigh in.

“I think sexual orientation in a way is the sort of a final frontier” in Title VII litigation, said Thomas. “The court seems really fixated on this idea of analogizing very precisely from Hopkins. In other words, if you look or act in a way that doesn’t conform to gender stereotypes then, OK, [the courts] can understand that’s sex discrimination,” said Thomas. “But if your identity is not conforming to stereotypes in that you, you know, are romantically attracted to someone of your sex, that is harder for [the courts] to get, even though it’s obviously the most obvious manifestation of stereotype.”

This is, in many ways, a fight that started in the workplace—one that eventually got the backing of the Obama administration before becoming a flashpoint of conservative election-cycle politics. Thomas’ book doesn’t close on a prediction of what the next big Title VII fight will be per se, but it is impossible to finish it and not see the narrative threads of the historical fight for workplace equality woven throughout the the contemporary one. Sex. Gender. How the law understands and navigates the two. All this is what makes Thomas’ Because of Sex the closest thing to an assigned reading I can make.