control over the frequency or intensity of sexual activity. But numbers reveal little about motives; one cannot infer women's levels of autonomy from high or low levels of premarital sexual activity.
Asian cultures, on the whole, are characterized by discouragement of premarital sexual behavior, and Middle Eastern cultures are generally even more insistent on premarital chastity. There has reportedly been no "sexual revolution," though political and feminist efforts have been made to encourage greater gender equality and female autonomy in spheres of life other than sexuality (Hathout, 1989). Premarital sexual control is not just an ideal in many societies: institutions and cultural practices support enforcement of this norm, although such institutions and practices are under increasing pressure to change. For example, one frequently stated reason for the traditionally early marriage of girls in South Asia and the Middle East has been the need to ensure their virginity at the time of marriage. The literature of South Asia is replete with real and fictional accounts of the methods used to confirm such virginity, as well as the opprobrium heaped on brides who fail to meet the requirement.
Female seclusion is also a common way of preventing unwanted male-female interactions. Seclusion has obvious implications for the ability of women to use clinical services of all types, particularly when it is their own health needs rather than those of their children for which they seek care. Seclusion of women as a way to control their sexuality operates not just through overt seclusion, but also through norms about matters such as the correct occupations for women (see, e.g., the constraints on working class women in Naples described by Goddard, 1987). Norms about seclusion and work can also operate to limit women's ability to serve as health care and family planning providers (see, e.g., the discussion of Bangladesh by Koenig and Simmons, 1992).
More often, adolescent sexual activity in traditional societies is restricted by less drastic means. For example, in South Asia, norms about female seclusion do not necessarily require young girls to be secluded from all males in the household or even in the village. Instead, premarital chastity is promoted by a cultural proscription on intrakin or intravillage marriage so that all men in a girl's village of birth are in principle her brothers and any relationship that develops is by definition incestuous. In many cultures the importance given to virginity may reflect not so much a concern about premarital sexual activity as about premarital pregnancy. Strategies to preserve the virginity of unmarried girls may therefore emphasize the latter. Whiting, Burbank, and Ratner (1986) record several such strategies, ranging from a ban on all sexual activity to relatively unlimited freedom to experiment with sexual activity that stops short of actual intercourse (see also Du-Toit, 1987).
Prohibitions against male sexual activity before marriage are universally