Long before blow jobs entered the public discourse, a psychotherapy patient of mine in her 20s revealed that she was upset because her boyfriend had “cheated” on her. (Translation: He had sexual intercourse with another woman.) When I pointed out that she had been involved with other men recently, she replied, incredulous, that she had not “gone all the way” — she had “only fooled around.” (Translation: She had performed fellatio.) Obviously, this was less of a transgression than that of her boyfriend because oral sex is not quite sex. The subtlety of this distinction may have eluded me, but it was entirely obvious to her. As I listened to her talk, it occurred to me that I was stuck in a time warp. Like many in the baby boom generation, I tend to regard oral-genital contact as, well, real sex.

Of all the revelations that emerged from the Clinton-Lewinsky scandal, this transformation in sensibility — this sexual generation gap between young women and their mothers — is one of the most interesting. As we slide toward the end of the millennium, various sexual practices are taking on different meanings. What was deviant for middle-agers has become mainstream for their offspring. Phone sex, casual transvestism, computer sex — it’s all OK. And the genders are leaking into each other. Each is playing with each other’s toys, mimicking each other’s icons; this is the age of G.I. Jane and Mr. Mom. With these transformations, the significance of various bodily orifices has changed as well. Contact with one or the other may variably signal intimacy, contempt, hipness, commitment or any combination thereof — or not much of anything at all. Among many young people, fellatio is notably banal. Think of the scene in the film “Chasing Amy” where two of the main characters boast about their fellating techniques, as if oral sex was as neutral an act as shaking hands.

But for boomers, it is not like shaking hands. Oral sex means something — or it used to. My over-40 male patients, for example, take for granted they have “scored” when they get a woman to perform fellatio on them outside of a relationship. (To do so within a relationship means something else, especially when it is in the course of making love.) In these men’s salad days, good girls — the kind of women with whom you had conversations — did not do that sort of thing sans souci.

To male boomers, the practice of oral sex involves the reduction of a woman into a desiring body (or, more accurately, a body part) available for servicing them. The word “score,” of course, speaks volumes. As illustrated in Woody Allen’s recent movie “Celebrity,” in which access to blow jobs was portrayed as one of the perks of being an alpha male, unilateral oral sex is a power trip for middle-aged men. Swallowing is the ultimate victory. Even President Clinton must have understood this, for in an uncharacteristic gesture of gentlemanly concern, he resisted using Monica Lewinsky in this manner. His consideration turned out to be gratuitous, however, for Lewinsky has said that, far from feeling used, she regarded it as a measure of his trust. Therein lies the generation gap.

The view of my middle-aged women patients is consistent with that of their male peers. Veterans of the ’60s sexual revolution, these women might well have engaged in casual sexual intercourse in their youth, but they tended to reserve oral sex for a relationship in which they felt safe. To most of them, fellatio was somehow more serious than intercourse. It was a privilege of intimacy. A loving, enduring relationship would allow these women to find pleasure in a range of activities that might shame them otherwise. In “giving head,” a woman assumes a subordinate position (sometimes literally down on her hands and knees) — it was understood that she was performing this act in service of her passion for a man and that no decent man would exploit her. Moreover, he should be willing to return the favor in kind.

In retrospect, the era of free love was not quite as free as it was billed, at least with regard to one’s oral cavity; the 1972 porno film “Deep Throat” would not have been such a threshold event had it been otherwise. When John Updike included oral sex in his 1960 novel “Rabbit,” it was quite sensational. In an interview last year on National Public Radio’s “Fresh Air,” he explained that it was a way of indicating a special bond between two people in an adulterous relationship. “Fellatio,” he asserted, “is more intimate than intercourse because it involves one’s head.”

Updike’s statement echoes what anthropologists have observed — that the human body is universally employed as a symbol. The upper body represents high culture, reason, power and privilege, while the lower signifies raw, unprocessed, vulgar passion; the former is the province of the elite, the latter relegated to the swinish rabble. According to culture critic Laura Kipnis, our gaseous, fluid emitting nether region is embarrassing — an area continually defying the strictures of social manners and instead governed by one’s gonads and intestinal tract; a region threatening to erupt at any moment. In standard heterosexual intercourse, two dark underbellies meet, more or less democratically, but in fellatio, the smutty lower half of one body is juxtaposed against the higher half of another, thereby sullying an elevated site. Symbolically speaking, this may be seen as corrupting one’s higher-minded self and, by extension, the social order. In other words, blow jobs are transgressive, requiring a sense intimacy — or so the boomers thought.

Their children have a different take. In a study reported earlier this year in the Journal of the American Medical Association, a majority of college students attending a major Midwestern university did not define oral sex as having “had sex” — and, for the most part, these were students who identified themselves as politically moderate to conservative Republicans. The journal’s top-ranking editor, Dr. George D. Lundberg, was demoted for publishing the study just as Clinton’s Senate impeachment trial was getting under way, in a move thought to be motivated by politics. But I suspect his dismissal was also motivated by the conservative medical establishment’s anxiety over its dicey content, which challenges the status quo.

Just why has oral sex become less transgressive to the younger generation? Certainly, it has to do with the AIDS epidemic and the popularization of terms like “bodily fluids.” After short-lived hand-wringing about what to call the substance that stained Lewinsky’s blue Gap dress, the media brought the word “semen” out of the closet and injected it into the daily news. Now the public appearance of semen — once a symbolic violation of society’s taboos about dirt, order and hygiene — has become little more than a cinematic sight gag: hair gel in “There’s Something About Mary” and a doggie treat in “Happiness.” Our recent obsession with exposure and propriety violations, our seemingly relentless “tabloid mentality” cannot help but desensitize us to what was once subversive.

Undoubtedly, a number of young women engage in fellatio rather than intercourse in order to maintain “technical virginity” or in the mistaken belief that they are practicing safe sex. But for them, oral sex may also be emotionally safer sex — it is a way of performing a sexlike act without having to take off one’s clothes and thereby reveal one’s imperfect self. That is far from the whole story, however. Many deliberately embrace “bad girl” sexuality — call it grrrl power — taking pride in their erotic doings and bragging about them to their friends — much as Monica Lewinsky did. And unlike their fathers, the young men I see today do not necessarily disrespect them for it. While virtually all my 40ish patients of either sex think Lewinsky was either a mixed-up or conniving fool, a number of those in their 20s admire her pluck. Indeed, at one point, she became a poster girl for overweight young women. Articles about how to perform oral sex have proliferated in magazines targeted to Gen X females, replete with information about the caloric content of semen, thereby addressing two sources of young adult female anxiety — sexual adequacy and body image — in one fell swoop.

A paradoxical outcome of ’70s feminism is that today’s young women exult in their seductive power even though the seduction is often not reciprocal. Mimicking male bravado, some of my young female patients now regard “giving good head” as an accomplishment, an end in itself, yet they are really boasting about what they “give,” while males have historically bragged about what they “got” — the power differential still holds. In a misguided attempt to appear liberated, I believe many young women are allowing themselves to be exploited this way, participating in sex that is unilateral, usually in service of the male’s orgasm. In effect, they are doing what desperate women have always done — using their sexuality to lure a man into a relationship while deluding themselves into thinking otherwise — that, for example, they are doing it for the thrill. But the thrill of what?

Of course, sexual expression has always been a kind of “Rashomon,” a social and subjective construction. Its meaning is perpetually slippery, varying from person to person, culture to culture, historical period to historic period — not to mention from moment to moment
during the act itself. To be sure, I am not arguing against young people engaging in oral sex, but I wonder if they understand their own and their partners’ motives.

So the Clinton-Lewinsky convergence of bodies was actually a cultural collide, with each side of the generation gap bringing to the act its own set of assumptions. To parents’ horror, the gap may be expanding to a chasm as the behavior of young women and men seems to be trickling down to the preteen set. Recently the Washington Post reported that a growing number of middle-schoolers are engaging in oral sex in an effort to avoid pregnancy and AIDS, to hang on to their virginity and to become popular. Pressed by her parents about the significance of doing so, one girl quoted in the article shrugs, “What’s the big deal? President Clinton did it.”

Working mothers, relax. But don’t get too comfortable.

In the latest skirmish in the ongoing culture war that pits stay-at-home moms against those who work outside the home, working mothers are the winners. A new study, published in the March issue of the journal Developmental Psychology, has exonerated mothers from charges of causing harm to their children by working. Reported by Elizabeth Harvey, a psychologist at the University of Massachusetts, the findings suggest that even children who were babies when their mothers started back to work did not suffer because of their moms’ absence. Harvey evaluated the development and health of more than 6,000 youngsters, using data from the National Longitudinal Survey of Youth.