Sexual segregation is the norm in confinement. Most prisons, jails, and institutions for the mentally retarded and mentally ill are sexually segregated. Only infants, the physically handicapped, and the elderly are sexually desegregated in confinement, apparently on the assumption that they cannot do much about sex. However, even these people generally lack opportunities for private sexual contact. In confinement, sex is generally unavailable; and when sex is possible, it is usually furtive, degrading, and sometimes brutish. Homosexual rape is common in prisons and takes on a certain racial character (Most rapists are black and their victims white.) Rape is less frequent among males in institutions for the mentally ill and retarded because most of these persons are not as aggressive and for other reasons. Masturbation is pervasive in confinement. The State has been vigorous in repressing the right of the mentally retarded to sexual expression. Recent controversies in Vermont and Connecticut over sterilization of the mentally retarded illustrate the difficult choices that must be made. Scandinavian institutions allow mildly and moderately retarded and mentally ill inmates to date and to receive counseling about contraception. They also provide more opportunities for heterosexual relations in prisons. Swedish prisoners are permitted private visits with wives or girlfriends in special rooms provided for these purposes at each of the country's prisons. Conjugal visits with wives are allowed only in Mississippi and California. Institutionalized persons should be provided opportunities for private heterosexual sex since the current nature of sexual relationships in confinement is among the most degrading and brutalizing aspects of institutional life. No references are cited.