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Tuesday, December 02, 2008

i'm having a sexual problem



I believe in sexual pleasure—yours and mine. From hawking sex toys to telling teens about the clitoris, I have spent my adult years proselytizing on the subject of pleasure. And no wonder; desire and pleasure--especially for women--are the stepping stones to sexual knowledge, rights and justice. For teen women, as Deb Tolman revealed in Dilemmas of Desire, knowing when you want to have sex is the pre-cursor to knowing when you don’t, and helps women assume self-protective behaviors. For adult women, desire and pleasure allow for a more equitable and satisfying relationship with self and others.

So let me say it again. I want you to get off, I encourage you to get off. In fact, go get off right now and get back to me.

Hi. Feels good, right? Which is why it might come as a surprise that I am so angry about a recent study looking at sexual dysfunction in women. Decreased libido=decreased pleasure=not so good, right? Sometimes, but that’s not where the real problem lies.

The study, published in the November 2008 issue of Obstetrics and Gynecology, aimed to examine self-reported sexual ‘problems,’ such as decreased desire, arousal and orgasm, in US women (nothing that in my house wouldn’t get fixed by SOMEONE finally taking their turn with the dishes). The results, as trumpeted by the Washington Post, “Almost half of women have sexual problems.” 40%, to be precise.

Sounds like a problem to me. But wait—only 12% of women actually reported having a problem with their problem. If an orgasm doesn’t fall in the forest and there’s no one around to not hear it, did it really not fall? As any budding psych student can tell you, self-reported distress is one of the key components to actually having a problem. And these women didn’t think they did. At least not yet. Wanna hear the questions they were asked?

Response of “never” or “rarely” to questions:

  • “How often do you desire to engage in sexual activity?”
  • “How often do you become sexually aroused?”
  • “Are you easily aroused?”
  • “Do you have adequate vaginal lubrication during sexual activity?”
  • “How often do you experience an orgasm?”
  • “Are you able to have an orgasm when you want to?”

And response of “no enjoyment or pleasure” or “little enjoyment or pleasure” to the question,

  • “How much pleasure do you get from your orgasms?

Who has the problem? 40% answered rarely or never to any of those questions—not being easily aroused, not lubricating enough—but they didn’t see it as an issue. I wouldn't mind having an orgasm right now...but I wouldn't say it's a problem that I'm not having one. And easily aroused? Compared to what--or whom? Those measures--in the sexual information vacuum in which virtually all of us exist--mean nothing without desperately needed context.

Meanwhile, the 12% who did report some concern over their ‘dysfunction’ were much more likely to be in poor health, exhibiting true problems such as depression, anxiety, irritable bowel system and urinary incontinence. Making not being able to lubricate seem like a drop in the bucket. I can imagine that, with a touch of urinary incontinence, I might not get a lot of pleasure from my orgasm—and I don’t think that it is the orgasm part that needs fixing. So who’s having the problem, again?

Maybe it’s their partners. Perhaps their partner—particularly if they’re all hopped up on Viagra—wants to hit it all night. But that isn’t any one person’s problem, per se—in sex therapy talk it’s called a desire discrepancy, and seen as a couple’s issue. Kind of like cinematic discrepancy, where he wants to watch Dark Knight and she wants to see The Notebook. You don’t blame anyone, you just work it out. Christ, no one wants to see The Notebook All Night Long.

If it’s not her, and it’s not her partner, who could it be? Surely not study author Dr. Jan Shifren—she’s an associate professor at Harvard Medical School (I’ve heard of it), so she’s gotta be objective. That’s good enough for me. But wait, what’s that fine print on the front page of the study?

“Dr. Shifren has received research support from Proctor & Gamble (Cincinnati, OH) and consulting fees from Proctor & Gamble, Boehringer Ingelheim (Ingelheim, Germany), and Eli Lilly & Co. (Indianapolis, IN).”

That would be P&G Pharmaceuticals. Eli Lilly Pharmaceuticals. And yup, Boehringer Ingelheim Pharmaceuticals.

I don’t want to go out on a limb here, or some other appendage, but it makes me wonder just a little bit. Could it be possible that someone was looking for problems—even, creating them? After all, there are incredibly easy ways to deal with decreased lubrication. Babelube, a little more sex warm-up, even just some info about how vag lubrication fluctuates according to menstrual cycle and peri- and menopause transition. Could it be that big Pharma has a stake in turning normal sexual variation into a problem, just so they can create a little pill to fix it? Could it be that they are actually playing on the lack of sexual knowledge and resources that exist in order to create shame, embarrassment and perceived dysfunction just so they can get a little more bang for their buck?

The real problem I’m having is with how sexuality is increasingly being framed as problematic, and the people who are having—or not having—sex are being labeled as inadequate. The real solutions, those that build communication, intimacy, trust and pleasure, are being submerged behind a wave of medical interventions (women can boost their flagging libido with this testosterone patch, but oops, watch out for the breast cancer!) that are, at best, expensive and inadequate bandaids for the complexities of sexual expression.

I’m not buying it, and neither should you.


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