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http://dx.doi.org/10.1037/14193-018
APA Handbook of Sexuality and : Vol. 1. Person-Based Approaches, D. L. Tolman and L. M. Diamond (Editors-in-Chief)
Copyright © 2014 by the American Psychological Association. All rights reserved.

C h a p t e r 1 8

Theories and eTiologies
of sexual orienTaTion

Margaret Rosario and Eric W. Schrimshaw

The purpose of this chapter is to understand what is
meant by “sexual orientation” and to consider what
might explain sexual orientation. In the process of
such examination, we come to understand not only
same-sex sexuality but also other-sex sexuality. In
essence, there is no better way to understand any
phenomenon than by means of contrast.

DEFINITIONS OF TERMS RELATED TO
SEXUAL ORIENTATION

Sexual orientation is related or occasionally con-
flated with other terms. Consequently, it is impor-
tant to define those terms. Although not necessarily
identical, the definitions we provide are comparable
to those offered by others (Shively & De Cecco,
1977; Zucker, 2008).

Sex
The sex of the individual refers to the individual’s
biological sex as male or female, which is based on
the appearance of the external genitalia during utero
or at birth. Agreement is presumed between the
external markers of sex (genitalia, secondary sexual
characteristics that begin appearing around puberty)
and internal markers of sex (sex organs, chromo-
somal sex, relative concentrations of sex hormones).
Although relatively infrequent, evidence emerges
indicating discrepancies between and among inter-
nal and external biological markers of sex (e.g., Becker
et al., 2008). Even when there is no discrepancy and
one has no difficulty invoking the terms boy/man or
girl/woman to describe one’s sex, there may be a

discrepancy between one’s sex and one’s gender
identity (see Chapters 2, 19, 20, and 24, this volume).

Gender Identity
Gender identity refers to the individual’s inchoate
sense of self as girl/woman or boy/man. Correspon-
dence usually exists between one’s gender identity
and one’s assigned sex at birth. This correspondence
is not perfect, however, even when there is no doubt
of the external genitalia or any alternative biological
explanation for the discrepancy. In such a case, one is
a transgendered individual who may choose to chem-
ically or surgically transition as much as possible (or
desired) to the other sex (i.e., the sex that matches
the gender identity; see Chapter 24, this volume).

Gender
Masculine or feminine gender refers to the behaviors,
attitudes, or traits that are associated in a particular
culture and time with the roles or characteristics
assigned or considered more typical of men or women
(see Chapter 2, this volume). Although the linkage
does not imply an underlying biological basis or corre-
spondence, such a link often is made across cultures.
A particular behavior or characteristic is judged nor-
mative or even intrinsic to one but not the other sex.
Such behaviors and characteristics are considered ste-
reotypically “masculine” or “feminine,” and one may
speak of “gender conformity” or “gender nonconfor-
mity” (Bell, Weinberg, & Hammersmith, 1981). Nev-
ertheless, not all behaviors or characteristics may be
categorized as masculine or feminine by the culture;
some may be androgenous (S. L. Bem, 1974).

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Rosario and Schrimshaw

556

Sexual Identity Development
Sexual identity development as lesbian, gay, bisex-
ual, or heterosexual is a long-term process that
probably begins early in life and undoubtedly has
unconscious elements. Subsumed into two pro-
cesses, sexual identity development involves identity
formation and its integration with other aspects of
the self (Rosario, Schrimshaw, & Hunter, 2011). For
purposes of this chapter, sexual identity (i.e., self-
identification as, for example, lesbian or gay) and
sexual identity development are not the same.
Indeed, what the individual calls him- or herself
may not match his or her sexual identity develop-
ment (see Chapters 19 and 20, this volume).

Definition of Sexual Orientation
Sexual orientation usually is considered a multi-
dimensional construct. The aspects of sexual orienta-
tion, however, are not necessarily concordant. The
dimensions of sexual orientation may differ on the
basis of the specific theoretical or practical concerns of
an investigation (see Chapters 19 and 20, this volume).

Sexual Attraction
At its most basic level, sexual orientation refers to the
sex to which one is physically attracted; thus, it piv-
ots on the sex of the object relative to the sex of the
subject. The attractions are toward the same sex, the
other sex, or both sexes. In addition, there may be
no attractions toward either sex.

Sexual attraction refers to the extent to which
sexual fantasies, erotic arousal, and sexual desires
(the latter is also known in the literature as “sexual
attractions”) focus on either, both, or neither sex.
The various dimensions of sexual attraction are con-
cordant. Indicators of the sexes that individuals find
desirable, are aroused by when viewing erotica, or
focus on in their sexual fantasies are highly corre-
lated and load strongly on a single factor (Rosario,
Schrimshaw, Hunter, & Braun, 2006).

Sexual attraction encompasses the internal com-
ponent of sexual orientation. As such, sexual attrac-
tion is independent of whatever pressure may be
applied by any external force (e.g., family, religion,

culture) for one to be attracted to one or the other
sex. Sexual attraction also is independent of what-
ever efforts may be exerted by the individual to
divert attraction to the other sex. Sexual attraction is
not under the control of the individual. It is a reality
that the individual learns about (and, in many cases,
begins to accept and work through) during her or his
sexual identity development. The only control an indi-
vidual may exert over his or her attractions is deciding
whether to accept the attractions and act on them.

Data from the 2006–2008 National Survey of
Family Growth (NSFG), a household-based proba-
bility sample of the U.S. population, indicate that
among those ages 18–44 years, approximately 1% of
men and women are attracted only to the same sex
(Chandra, Mosher, Copen, & Sionean, 2011). The
survey found, however, that more women than men
are attracted to both sexes (2.8% vs. 0.5%) and, con-
sequently, fewer women than men are attracted only
to the other sex (83% vs. 94%).1

Sexual Behavior
Sexual involvement with the object of one’s sexual
attractions is expected, although it is not guaran-
teed. Many factors determine sexual behavior
besides sexual attraction. They include societal or
religious injunctions and sanctions that reduce the
settings offering opportunities to meet potential
partners as well as penalize any such behavior. Even
without such restrictions, the availability of poten-
tial sex partners is a factor. If few partners are avail-
able, sexual behavior is likely to be attenuated. If
none are available for an extended time, sex with a
partner at odds with one’s attraction may occur,
as happens for heterosexual individuals in sex-
segregated settings, such as single-sex boarding
schools (Johnson, Wadsworth, Wellings, & Field,
1994). The factors disrupting the link between sexual
attraction and behavior (and subsequent relation-
ship formation) may include self-negation, meaning
refusal to have sexual relations with the object of
one’s attraction. This situation may occur for same-
sex behavior for some individuals, given internaliza-
tion by the individual of society’s stigmatization of

1The percentages do not sum to 100% because we exclude for ease of presentation the following categories: mostly same sex, mostly other sex, and
unsure.

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Theories and Etiologies of Sexual Orientation

557

homosexuality (Bauermeister et al., 2010; J. Brown
& Trevethan, 2010). Nevertheless, as compared
with factors that may attenuate sexual behavior,
other factors may facilitate it. Sexual experimentation
is likely to be elevated during adolescence because
adolescence is a developmental period characterized
by identity exploration both cognitively and behav-
iorally and in many domains, including the sexual
domain (Erikson, 1968; see Chapter 15, this volume).

Given the potential contextual contingencies
affecting sexual behavior, some scholars exclude
it from the definition of sexual orientation (Sell,
1996). Others, however, do include it along with
sexual attraction (Gonsiorek, Sell, & Weinrich,
1995; Laumann, Gagnon, Michael, & Michaels,
1994; Shively & De Cecco, 1977). The components
of sexual attraction and behavior often are measured
independently. One notable exception is Kinsey,
Pomeroy, and Martin’s (1948) work, as they used
both sources of information from their intensive
interviews to rate their participants along the
famous Kinsey scale ranging from exclusively het-
erosexual (0) to exclusively homosexual (6).

Population data from the full sample of 2006–
2008 NSFG, ages 15–44 years, indicate that more
women than men report a history of same-sex
behavior (12.5% vs. 5.2%), although a history of
other-sex behavior is 89% among both sexes (Chan-
dra et al., 2011). The disparity in same-sex behavior
is even greater among young people ages 15–24
years (13.4% for women vs. 4.0% for men). The
overall prevalence findings for the United States
(9.2% for same-sex behavior) are not necessarily
comparable with those of other locations. For com-
parison, 5.1% of a national household probability
sample of New Zealanders age 16 and older reported
a history of same-sex behavior (Wells, McGee, &
Beautrais, 2011). Comparable figures were reported
in a household probability sample of Britons (Hayes
et al., 2012).

Sexual Identity
Sexual identity refers to self-identification as straight,
lesbian, gay, bisexual, asexual or any variant or syn-
onym (e.g., queer). Sexual identity sometimes is
considered distinct from sexual orientation. How
one self-identifies is a complex function of how one

perceives, situates, and evaluates one’s internal and
external experiences in the time, culture, and set-
tings in which one finds oneself. Many factors exter-
nal to one’s sexual attraction may bear directly and
strongly on self-identification and may have little to
do with the individual’s sexual attraction. Thus, it
may take some time for an individual to explore and
determine his or her sexual identity; in fact, there
may even be a time, especially during adolescence,
when the individual is unsure of his or her sexual
identity (Hatzenbuehler, Wieringa, & Keyes, 2011;
Ott, Corliss, Wypij, Rosario, & Austin, 2011; Wells
et al., 2011; see Chapter 16, this volume). Regardless,
as with sexual behavior, many investigators include
self-identification in their definition of sexual orien-
tation (e.g., Laumann et al., 1994), but others do not
(e.g., Gonsiorek et al., 1995; Kinsey et al., 1948).

Prevalence data from the 2006–2008 NSFG (Chan-
dra et al., 2011) indicate that, of respondents ages
18–44 years, fewer women than men self-identified as
homosexual, lesbian, or gay (1.1% vs. 1.7%) or as het-
erosexual (93.7% vs. 95.7%), but more women than
men identified as bisexual (3.5% vs. 1.1%). In the
New Zealand household survey, 1.4% of the popula-
tion age 16 and older self-identified as homosexual or
bisexual (Wells et al., 2011). As far as we know, one
report is available on asexuality, indicating that 1.1%
of a national probability sample of Britons identified
as asexual (Bogaert, 2004). Of the asexual individuals
(n  195), 138 (70.8%) were women.

Romantic Relationship
More recently, some have begun to consider
involvement in romantic relationships as a marker
of sexual orientation (Wells et al., 2011; Worthing-
ton & Reynolds, 2009), in which the ability to form
an intimate relationship with a representative of the
sex to which one is attracted proves decisive. Many
factors unrelated to one’s sexual attraction, however,
may affect romantic relationships. The stability and
duration of such a relationship undoubtedly varies
with development (i.e., the ages of the partners
involved), the partners’ reciprocity of affection, and
the extent to which both partners have worked
through unresolved issues pertaining to their sexu-
ality. The level of mental health and functioning of
each partner affects the stability and duration of an

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Rosario and Schrimshaw

558

intimate relationship (Kernberg, 1995), as might
other resources brought by the partners to the
relationship (e.g., socioeconomic means). Further-
more, the degree of tolerance for the relationship
expressed by others, ranging from friends and family
to societal policies, also may bear on the relation-
ship. Given the multiple and nonpsychosexual
exigencies affecting romantic relationships, the like-
lihood that such relationships will serve as a preva-
lent marker of sexual orientation seems relatively
low. Nevertheless, the establishment of a stable,
mutually satisfying sexual and romantic relationship
could be considered the ultimate indication of
commitment to and integration of one’s sexual
orientation for all individuals, but especially for
homosexual and bisexual individuals in same-sex
relationships, given the obstacles such couples must
overcome. More generally, given the acknowledged
psychological benefits of having a romantic relation-
ship, it would be anticipated that same-sex individu-
als in romantic relationships would demonstrate a
variety of health advantages (Bauermeister
et al., 2010; J. Brown & Trevethan, 2010; Frost &
Meyer, 2009; see Chapter 10, this volume).

Given that relatively little research has employed
romantic relationships as an indicator of sexual
orientation, we will say no more about romantic
relationships as a possible constituent of sexual ori-
entation. Instead, we will concentrate on the other
potential markers of sexual orientation, specifically
sexual attraction, behavior, and identity.

Multiple Dimensions of Sexual
Orientation
Differences in the definition of sexual orientation
are both theoretical and practical in origin. A
researcher interested in internal dynamics and their
consequences naturally would be drawn to sexual
attraction. A researcher whose interests concern
how social forces shape and constrain the individual
or group might gravitate to self-identification. These
two theoretical foci track to the paradigms of essen-
tialism and social constructionism, respectively (for
details, see DeLamater & Hyde, 1998; Laumann
et al., 1994; see Chapter 1, this volume). Diversity
also exists in the definition of sexual orientation for
practical reasons having to do with some dimen-

sions proving more consequential for a subject mat-
ter than others. For example, sexual behavior is
critical for researchers who study the acquisition of
sexually transmitted infections, whereas other
dimensions are less relevant (see Chapter 23, this
volume). For another example, sexual attraction is
important for those who study substance use or
overweight-related health concerns among sexual-
minority women, as will be discussed later in this
chapter (see also Chapter 21, this volume).

Given the multiple dimensions of sexual orienta-
tion and the fact that theoretical or practical con-
cerns determine the dimensions selected by any
investigator, we have chosen to focus on the dimen-
sion of sexual attraction to either, both, or neither
sex. Unlike sexual activity and self-identification,
sexual attraction is unaffected by external condi-
tions and individual control. We underscore that
our definition does not exclude sexual behavior.
We also understand that others may want to include
self-identification in their definition or investiga-
tions; in fact, we have done so in our own work
(Rosario et al., 2006). All that we affirm is that cer-
tain precepts should be considered when deciding
on the scope of sexual orientation for one’s investi-
gation. The indicator(s) of sexual orientation theo-
retically should be guided or determined by the
outcome under investigation (e.g., sexual behavior
for sexual transmitted infections). The addition of
more components must be weighed against what is
gained at the expense of parsimony. The addition of
more than one component also raises practical mat-
ters, such as how, if at all, the components are to be
combined and what is to be done with inconsisten-
cies among the components. Discordance exists
among the components of sexual orientation, which
is unsurprising given our earlier discussion.

Laumann et al. (1994) conducted a careful exam-
ination of concordance among same-sex sexual
attraction (i.e., what they called “desire” and which
consisted of being attracted to the same sex or find-
ing the idea of sex with the same sex appealing),
behavior, and identity in their national probability
sample of the U.S. population, ages 18–59 years. Of
the women who reported any adult same-sex sexual-
ity (8.6% of the female sample), concordance among
desire, behavior, and identity was only 15%. For the

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Theories and Etiologies of Sexual Orientation

559

10.1% of the men who reported any adult same-sex
sexuality, comparable concordance was only 24%.
With respect to discordance, 59% of the women and
44% of the men reported just same-sex desire (i.e.,
desire but no behavior or identity), the aspect of
sexual orientation with the highest frequency (see
Laumann et al., 1994, pp. 299 and 301, for more
details). Discordance also has been found in more
recent population surveys, such as the 2006–2008
NSFG (Chandra et al., 2011, p. 31, Tables 14 and
15). In this survey, 9.0% of the women and 3.2%
of the men, ages 18–44 years, who identified as
heterosexual had a history of sexual behavior with
the same sex (see Chapter 20, this volume).2

Conceptual Implications
of Sexual Orientation
Our conception of sexual orientation draws on the
work of Shively and De Cecco (1977). They pro-
posed that sexual orientation varies along two
dimensions, one being heterosexuality and the other
homosexuality. For each aspect of sexual orientation
(e.g., sexual attraction), one focuses on the degree of
heterosexuality for one dimension and on the degree
of homosexuality for the other dimension, with each
dimension varying from not at all heterosexual (or
homosexual) to being very heterosexual (or homo-
sexual). Unfortunately, the relations between the
two dimensions were not made clear. In addition,
conflation of sexual orientation and self-identification
is possible given that the response scales focus either
on “heterosexuality” or “homosexuality.”

Storms (1980) proposed two orthogonal dimen-
sions, in which one focuses on same-sex sexual fan-
tasies and the other on other-sex sexual fantasies,
which we represent pictorially (Figure 18.1). The
four resulting quadrants capture the four possible

outcomes of orientation as homosexual, heterosex-
ual, bisexual, and asexual; the latter refers to no
sexual fantasies. Storms found, as hypothesized, that
self-identified lesbians and gay men reported high levels
of homoerotism and low levels of heteroerotism, hetero-
sexual men and women reported the opposite pattern,
and bisexual individuals reported high levels of both
homo- and heteroerotism. There were no self-identified
asexual individuals perhaps because the asexual identity
was not made available to the sample (n  185).

Bisexuality. The uniqueness of the perspectives
proposed by Storms (1980) primarily concerns
bisexuality and asexuality. Bisexuality is regarded
as a distinct orientation, with high levels of both
homoerotism and heteroerotism in terms of sexual
attraction. This perspective differs from that of
Kinsey et al. (1948), in which bisexuality contains
an amalgam of both, but not, for example, high
amounts of both. Kinsey et al. (1948) conceptualized
sexual orientation along a single dimension from

2The concordance data provoke a number of questions or comments. First, concordance among dimensions of sexual orientation is more common
among men than women. Why? Responding that women are more fluid than men merely reframes the empirical observation. A potential explanation
has been offered (Diamond, 2006) that concerns woman’s arousal to non-specific rather than sex-specific sexual stimuli and for which there is some
empirical support (Chivers, Seto, & Blanchard, 2007; Peterson, Janssen, & Laan, 2010), although not unanimously (Chivers et al., 2007; Peterson
et al., 2010; Rullo, Strassberg, & Isreal, 2010). Second, discordance is elevated in men and women particularly among those who report only same-
sex attractions. What does this mean and how does an individual who is attracted to the same sex go about a presumably heterosexual life? What
is psychically going on with this person? Third, the approximately 9% of women and 3% of men who identify as heterosexual but have a history of
same-sex behavior possibly suggests a floor for experimentation, which differs from what the literature uses. The literature tends to classify any same-
sex behavior as a marker of homosexual or bisexual behavior, but should it? What if an individual had one same-sex experience as a young person or
even a brief same-sex relationship while in college, but nothing since; moreover, his or her attractions are toward the other sex and identity is hetero-
sexual. Experimentation also should not be considered a marker of heterosexual or bisexual orientation. It may be that some lesbian and gay individu-
als at one point had penile-vaginal sex and even brief heterosexual relationships as ways of confirming whether they actually were lesbian or gay. Now
that population data are available, more finely calibrated algorithms may be generated to account for sexual activity beyond just experimentation.

High on Same-Sex Dimension

High
Other-Sex
Dimension

No
Other-Sex
Dimension

No Same-Sex Dimension

HOMOSEXUALITY BISEXUALITY

ASEXUALITY HETEROSEXUALITY

FIGURE 18.1. The two-dimensional model of sexual
orientation. From “Theories of Sexual Orientation,” by
M. D. Storms, 1980, Journal of Personality and Social
, 38, p. 784. Copyright 1980 by the American
Psychological Association.

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Rosario and Schrimshaw

560

exclusive homosexuality to exclusive heterosexuality.
Bisexuality is in the middle of the scale—that is, less
than either extreme, a compromise or average
of the two extremes.

The high levels of homoerotism and heteroero-
tism in sexual attraction expected for bisexual indi-
viduals say nothing about the individuals’ sexual
behavior with respect to the number of partners or
the relative number of same- to other-sex partners.
In addition, having a bisexual orientation does not
mean that one is involved concurrently with both
a male and female partner. The extent to which
bisexual individuals may have concurrent partners
remains to be determined and compared with con-
current partnerships among lesbian and gay individ-
uals as well as heterosexual individuals.
Nevertheless, bisexual individuals, as a group, have
more sexual partners over some extended time than
their same-sex heterosexual or homosexual peers,
as evidence on men indicates (Hightow et al., 2006;
Jeffries, 2011; Mercer, Hart, Johnson, & Cassell,
2009). This would be expected, provided bisexuals
had relatively equal desire for both sexes as well as
competing desire for the sex with which they were
not involved. Greater variability in the number of
partners, however, is observed among bisexual indi-
viduals (Hightow et al., 2006; Jeffries, 2011; Mercer
et al., 2009), perhaps because their emotional com-
mitment and sexual satisfaction with their partners
should vary, as they do for heterosexual and homo-
sexual individuals. Bisexual individuals raise inter-
esting questions for which further research is greatly
needed among both female and male bisexuals.

Asexuality. Storms (1980) posited asexuality
as a possible sexual orientation, in which little, if
any, sexual attraction is felt toward either men or
women. This orientation is now receiving serious
consideration, although its possible existence has
been known for some time. Kinsey et al. (1948) had
proposed a category for such individuals, although
it was not included in the Kinsey scale. Clinicians
(Kernberg, 1995) also have been aware of asexual
individuals (see Volume 2, Chapter 4, this handbook).

Bogaert (2006b) has maintained that asexuality
means absence of sexual attraction. An asexual per-
son, however, may be involved in an intimate relation-

ship (Bogaert, 2004; Brotto, Knudson, Inskip, Rhodes,
& Erskine, 2010) and may engage in sexual behavior,
even if minimal (Prause & Graham, 2007).

Equally important is the very definition of “sex-
ual attraction” with respect to asexuality, especially
in light of our definition of sexual attractions as
including sexual fantasies, erotic arousal, and sexual
desire. According to Bogaert (2004), “sexual attrac-
tion” refers to being attracted to one, both, or nei-
ther sex (i.e., what, among the constituents of sexual
attraction, we refer to as sexual desire). Prause and
Graham (2007) used self-identification as asexual
and subjective reports of desire and arousal. The
asexual women and men reported less desire and
lower arousal than nonasexual men and women.
Brotto and Yule (2011) examined self-reports and
physiological arousal to viewing an erotic film, using
a vaginal probe to assess genital congestion. Erotic
arousal to the film was apparent among the asexuals
both by self-report and vaginal photoplethysmogra-
phy. Nevertheless, and as one would expect, the
asexual women reported less sexual desire than the
heterosexual, bisexual, and homosexual women.

Currently, it seems as if the defining characteris-
tic of asexuality is little, if any, sexual desire because
arousal does exist, as does some attenuated level of
sexual activity at least for some individuals. The
existence, characteristics, and effects of sexual fanta-
sies in asexual individuals remain to be assessed. In
general, more detailed examination concerning the
psychosexuality of asexual individuals is needed.

Even with such research, a more basic question
must be addressed: Is asexuality an orientation or a
marker or consequence of psychopathology? It is
always difficult to raise such issues, but they must
be confronted. The fact that some individuals may
identify as something akin to asexual or have experi-
ences that closely relate to notions of asexuality does
not make asexuality an orientation. The possibility
of asexuality, as proposed by Storms (1980), is ulti-
mately a logical deduction that may be divorced
from any biological or psychological grounding.
Certainly, clinical work with individuals who might
identify or be classified by others as asexual suggests
confounding with psychopathology (Kernberg,
1995). In addition, research with community sam-
ples of asexual individuals confirms overlap with

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Theories and Etiologies of Sexual Orientation

561

psychopathology for some (Brotto et al., 2010).
Nevertheless, we are keenly aware that the issue of
psychopathology is a delicate one, given it was once
raised about both homosexual and bisexual individ-
uals. Unfolding theoretical and empirical research
brought an end to the question. Whether asexuality
will enjoy the same outcome remains to be deter-
mined. Regardless, this determination can be made
only by forthrightly and dispassionately examining
the possible confounding of psychopathology and
asexuality. More thought and research are required
about asexuality.

All sexual orientations. Figure 18.1 contains
two important messages. The simplest one con-
cerns classification into four sexual orientations.
Categorization is familiar. Both in the general
population and scientific community, a prefer-
ence continues for thinking about and conduct-
ing investigations by classifying individuals into
sexual-orientation groups. The number of groups
has expanded over the years, for example, the focus
on asexuality is relatively new. In addition, subclas-
sifications are now investigated within quadrants.
Thus, research on “mostly” (as compared with
“completely,” “entirely,” or “exclusively”) hetero-
sexual or homosexual orientations (e.g., Ott et al., …

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