For many, it has no set sexual meaning but gets it only by context.
"The modern use" presumes you know how 330 million Americans and hundreds of million more English-speakers in other countries use it.
I find that I know how the social networks I'm part of use it, and that often includes tv shows. "Whackadoo" was a very common word in some of my networks, but in others it was rather less common than "cricoid". When I said I'd never heard that word, the response was, "But it's really a common word, everybody knows is." Yes. Everybody in that woman's social networks.
Even then, you can get the sexual meaning without assuming that's its primary or a set meaning. It's like calling a hot girl a "tomato" or "hamburger." I've never known anybody who did this regularly, but at one point you'd encounter those meanings. Similary, when I first moved to Los Angeles there was a frat scandal involving the use of the phrase "fish taco." I'd never hear the phrase with that meaning--in fact, had never heard the phrase. Still don't think of that as the phrase's primary meaning. But for some of the undergrads I knew, sadly, that was its first and foremost meaning. The actual Baja dish consisting of corn tortilla, cabbage, and grilled fish hadn't become all that popular yet.
It was like McWhorter when he commented on the word "thug" as obsolete and never used in any other than its racist meaning, and then said with a straight face that the various groups that used it in its established, straightforward meaning were archaic and out of touch so you really couldn't count them. He had to know he was violating one of the first principles of modern linguistics, which is that usage rules; and a second, among more functionally inclined, that not only does usage rule, but language is a set of styles and registers and dialects, with splitting and merging happening all the time. But he had a political and social point to make, and as soon as you advocate you stop fretting over accuracy and start fretting over winning. (His linguist side kicked in later, at least for the most part. Still couldn't let his ego get entirely out of the way of his art, though. Wouldn't want to be his student.)
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