August 18, 2004
The APA’s “Monitor” features has an article by Deborah Smith entitled: Women and sex: What is ‘dysfunctional’? and subbed, “Sex experts disagree on how to define and treat women’s sexual problems.”
Philadelphia sex therapist Julian Slowinski, PsyD, sees a range of women with sexual concerns–from middle-aged women worried their sexual desire has decreased to young women “dragged in” to therapy by husbands who are upset their wives don’t have orgasms.
“The question is, how much of that is because the mental health profession says they have a problem?” asks Slowinski. “Do women have a problem because their partner says they have a problem…or is it because they themselves say they have a problem? And is it causing them personal distress?”
Although psychologists have been studying sex and treating sexual problems for decades, a hot debate is brewing over how to define sexual dysfunction–and whether the pharmaceutical industry’s interest in developing drugs to treat sexual problems will help women or medicalize their difficulties. While some believe that developing better definitions of women’s sexual problems will lead to better treatment, others worry that such classifications won’t reflect the diversity of women’s sexual experiences.
“Many physicians are approaching this as a largely biological phenomenon,” says psychologist Dennis Sugrue, PhD, a past-president of the American Association of Sex Educators, Counselors and Therapists. “They’re doing a disservice to the fact that a woman’s sexual experience is an incredibly complex phenomenon that is shaped by cultural scripting, family-of-origin experience, relationship dynamics as well as biological factors.”
What I found most interesting was this:
Other ideas on the table include emphasizing that women are different from each other within and across cultures, giving more attention to accurate diagnosis of sexual pain and stating that reduced sexual interest is normal with age, length of relationship and other factors.
However, [Leonore Tiefer, PhD, of the New York University School of Medicine] and others are pushing for a more drastic rethinking of women’s sexual problems. With the Campaign for a New View of Women’s Sexual Problems, she and others have created an alternative classification system outlined in “A New View of Women’s Sexual Problems” (Haworth Press, 2001). Women’s sexual problems are seldom medically based, they propose. Rather, they more often are attributable to:
* Sociocultural, political or economic factors, such as inadequate sex education or fatigue from family and work obligations.
* Partner and relationship problems, including discrepancies in desire for sexual activity and loss of interest due to conflicts over commonplace issues.
* Psychological factors, such as past abuse, depression or fear of pregnancy.
Tiefer says she worries drug companies’ development of FSD [Female Sexual Dysfunction] drugs–and the subsequent marketing of them–will leave some women thinking a pill or cream can fix sexual problems that are actually rooted in, for example, a fear of intimacy or a stressful relationship.
Personally I’m very uneasy about the creation of an atmosphere in which women whose sexual desire and activity do not meet some given standard of libidinous health are considered sick or flawed, so that “professional” intervention is necessary. Pressure on a woman, gentle or otherwise, to “improve” herself sexually or (yikes) “get better” is TOTALLY counterproductive.
And…wait a minute…what happens to a woman’s sexual self when her husband or doctor encourages/urges/forces her to take a pill that’s supposed to make her Hot Stuff and it doesn’t work as advertised (given, say, that he still hasn’t cleaned his fingernails and she’s still overanxious about household details)? Will she EVER be able to regain her erotic confidence and interest after that, or will every thought of sex become “I’m Not Good Enough, I’m Not Healthy Enough, So Doggone It, I’m Never Having Sex Again”?