February 28, 2007

What Women Want: A More Nuanced, Well-Rounded Approach to Female Sexuality

We approach a report on the sixth annual meeting of the International Society for Women’s Sexual Health with a little trepidation — especially since Judy Peres of the Chicago Tribune focuses almost exclusively on the session entitled “What Is Sexual Desire and How Do We Know?”

In web-exclusive companion content to “Our Bodies, Ourselves,” The Working Group on a New View of Women’s Sexual Problems chronicles how the traditional medical model of “Female Sexual Dysfunction” — codified by the American Psychiatric Association — presents a “fundamental barrier to understanding women’s sexuality.”

In its reduction of sexual problems to purely biological disorders — which is a rather handy complement to Big Pharma’s commercial pursuit of “a female Viagra” — the traditional model works from distorted assumptions about female sexuality. The three major assumptions are “a false notion of sexual equivalency between men and women,” “the erasure of the relational context of sexuality” and “the levelling of differences among women.”

Peres’ article, thankfully, reflects an admirable attempt to address these very concerns.

While many scientists at the meeting are searching for the magic pill, many more take a more nuanced approach, clearly influenced by the feminist critiques of the existing “understanding” of female sexuality. Dr. Stephen Levine, a psychiatrist from Case Western Reserve University, admitted that the “diagnostic guidelines” that define and delineate sexual desire and sexual arousal in women are not very useful.

“Science must measure,” Levine said, “so we measure how many times the patient said she had sexual thoughts or desired sex in the last four weeks. But we don’t know what we’re measuring.”

Obviously, many researchers at the meeting embraced Levine’s skeptical view and have been inspired to try a novel approach:

To some members of the society, fearing that women’s sexual complaints are being turned into medical illnesses for the convenience of doctors and the economic benefit of Big Pharma, that admission was a breath of fresh air.

“I think it’s progress that we can spend two hours in this performance-driven society admitting that maybe we don’t know what we’re talking about,” said Ellen Laan, a psychophysiologist from the University of Amsterdam.

Michael Sand, a sexologist who works in Germany, agreed.

“We don’t understand normative, healthy sexuality well enough to make judgments about what’s dysfunctional.”

Since the 1960s, researchers have operated under a variation of the simple model proposed by William Masters and Virginia Johnson that says the human sexual response starts with desire, progresses through excitement or arousal and ends with orgasm. But experts argued that notion might reflect the experience of men more than women, many of whom don’t see orgasm as a goal.

In recent years the field has moved toward a more complicated model based on the observation that many women go into a sexual encounter without being in the mood — perhaps they’re seeking intimacy or hoping to please their partner — and may not really want sex until after they become aroused.

But it wasn’t until very recently that anyone thought to test those theories by asking women.

It’s amazing how helpful real women can be.


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