Rubin discusses sexual essentialism: the idea of sex as purely biologically without taking into consideration social context, history and culture. She draws from Foucalt to show how this idea has changed over tie. She also talks about sex negativity: The idea that sex bad and people should be feel shameful and guilt about sex. She also talks about how our society categorizes sexual acts into being either good or bad. Religion has played a major role on how certain sex acts are valued. Heterosexual sex between a man and woman who are married for procreation is the only justifiable sex. Other sex acts such as homosexual, masturbation, porn, public sex, group sex are all seen as being deviant from the social norms and what is considered "good sex". The domino effect is described as if one bad act is accepted, society will then continue to allow worse sex acts to be seen as ok.
Wilkerson discusses how the sexual hierarchy includes dividing people among race, class, age, gender expression, and disability. People with disabilities are often seen as not being sexual beings. It is a taboo and doctors often ignore sexual needs of their patients. One doctor told his paraplegic patient who asked for birth control that she couldn't have any because it would make her bloat and instead but the pill between her legs and say no. Wilkerson also stresses the importance of sexual agency with political agency. People who are oppressed because of their sexual choices are often penalized with laws and regulations that try to keep their practices looked down upon.