The Wire Act prohibits gambling businesses from knowingly receiving or sending certain types of bets or information that assists in placing bets over interstate and international wires. Thus, if an Internet gaming Web site operating in any country (including the United States) receives a bet transmitted by an individual located in the United States, the operator has violated the Wire Act. For this reason, foreign entities offering gambling to U.S. citizens through the Internet would be subject to the Wire Act. Although some Internet gambling businesses, including foreign entities, have been successfully prosecuted under the Wire Act, courts do not agree on the applicability of certain sections of the statute.

Each of the two major associations in our review is owned by its member financial institutions. Around 21,500 member financial institutions own VISA, and about two-thirds of them are located in the United States. About 20,000 financial institutions participate in MasterCard worldwide. As described in a prior GAO report, MasterCard has a two-tier membership structure composed of principals and affiliates.17 Principal members have a direct membership relationship with the association and serve as sponsors to affiliates. For example, a U.S. or foreign bank can apply to become an affiliate member if a principal member agrees to sponsor the bank and the bank satisfies the association’s membership criteria and clears the approval process.

In their view, these characteristics promoted a high level of anonymity and gave rise to complex jurisdictional issues. Law enforcement officials acknowledged the lack of adjudicated cases involving money laundering through Internet gambling sites but cited what they believed to be contributing factors, including the lack of any industry regulations or oversight. Banking and gaming regulatory officials did not view Internet gambling as being particularly susceptible to money laundering, especially when credit cards, which create a transaction record and are subject to relatively low transaction limits, are used for payment. Likewise, credit card and gaming industry officials did not believe Internet gambling posed any particular risks in terms of money laundering.

Gaming industry officials did not believe that Internet gambling was any more or less susceptible to money laundering than other types of electronic commerce and pointed out that, in their view, the financial industry, which is responsible for the payments system, is better suited to monitoring for suspicious activity in the area than the gaming industry itself.

This report makes no recommendations. We provided copies of this report to the Departments of Justice and the Treasury for their comment. DOJ had no comments on it. Treasury provided technical comments, which we incorporated where appropriate.

The limitations of epidemiological data in providing estimates of the frequency of sexual dysfunction in the general population can be appreciated by a careful analysis of the most comprehensive studies to date, the Global Study of Sexual Attitudes and Behavior [8]. This study collected data from 27,500 men and women in 29 countries. Sampling techniques had to be modified for some countries such that comparisons of rates across countries is somewhat problematic. The question pertaining to low sexual desire was ‘During the last 12 months have you ever experienced for a period of two months or more when you lacked interest in having sex?’ If the answer was affirmative, the subject was then asked to rate its frequency as occasionally, sometimes or frequently. This study has been quoted as finding that approximately 33% of women in Canada and the United States complained of low sexual desire. However, this number represents an aggregate of all women reporting occasional, periodic and frequent problems with low libido.

Data indicating that many sexually responsive women do not report sexual fantasies was cited as well as evidence that some sexually responsive women do not experience desire for sexual activity but respond to sexual stimuli once involved in a sexual situation. It was recommended that lack of responsive desire be substituted for absence of desire for sexual activity. This group also noted evidence that interest in sexual activity appears to lessen both with age and relationship duration for many women. Basson  specifically states that the linear sequencing of desire, arousal, orgasm as outlined in DSM-IV-TR is a model better suited to male than female sexuality. She posits that many women are unaware of desire for sexual activity at the onset of sexual activity and that emotional intimacy may be the most important factor influencing a woman’s initial sexual responsiveness. In this model, responsive desire and sexual arousal clearly overlap.

It should be noted that the DSM-IV-TR criteria and suggested revisions lack precise criteria sets designating severity or duration criteria. Also, the separation of sexual dysfunctions from relationship discord and adjustment disorders is imprecise. Many clinicians would not diagnose a sexual problem as a sexual dysfunction if it is clearly secondary to relationship discord. However, this is not clearly specified in the DSM-IV-TR text. Similarly, the distinction between an adjustment disorder influencing sexual function and a sexual dysfunction is not clearly specified. Precise operational criteria are necessary to define homogenous clinical groups for research and advancement of knowledge in the field.

The first official nomenclature for the sexual disorders was published in the DSM in 1980. In this system, inhibited sexual desire was defined as persistent and pervasive inhibition of sexual desire. The text also indicated that the diagnosis would rarely be made unless the lack of desire was a source of distress to either the individual or partner. In DSM-III-R the term inhibited was deleted as this was felt to imply a psychodynamic etiology and the somewhat awkward term, hypoactive sexual desire was substituted for inhibited sexual desire. The definition was also slightly modified. The new definition was persistently, or recurrently deficient or absent sexual fantasies and desire for sexual activity. In this edition, the following subtype modifiers were introduced: psychogenic only or psychogenic and biogenic, lifelong or acquired, generalized or situational. In DSM-IV, the definition of hypoactive sexual desire remained unchanged except for a new provision that the diagnosis could not be made unless the disturbance caused marked distress or interpersonal difficulty. This definition remained unchanged in DSM-IV-TR.

The goal of this chapter is to review current evidence concerning the diagnosis, epidemiology, etiology and treatment of hypoactive sexual desire disorders. Masters and Johnson and the DSM-IV-TR  regard male and female sexual disorders as symmetrical.

However, there appear to be sex differences in the strength of sexual desire, its covariates, its sequencing in the sexual response cycle, and its response to relationship discord. In this chapter, female disorders of desire will be considered separately from male disorders of desire as they may represent different diagnostic entities.

Males are more likely to gamble for money than females. Over ninety percent of men reported participating in gambling in their lifetime, and almost half of our male respondents reported having gambled in the past month (47.8%). Nearly eighty-five percent of women had gambled in their lifetime and over a third of women had gambled in the past month (36.8%). The largest difference between male and female gamblinparticipation was found when asked if they had gambled in the past year. Nearly fiftepercent more males (74.2%) reported gambling than women (60.3%) in the past year. Men also conveyed that they have tried more types of gambling for money than have women between the ages of 21 and 59.