If this many women have a sexual dysfunction, is it even a dysfunction?
If someone told me 15 years ago I would be writing about how much sex I wasn’t having, I would’ve laughed in their face. By the time I was 21, I had racked up sex partners in double digits and boasted numerous sex adventures.
In my mid to late twenties I acquired a journalism career, a husband, and two babies. Also, a dwindling sex drive. To be clear, I didn’t hate sex. I liked sex. I really enjoyed sex with my husband. We just weren’t doing it. To admit this out loud to anyone felt like the ultimate embarrassment, so I privately scheduled a series of medical tests, hormone labs, and vaginal examinations. I wanted answers. I wanted cures.
A lower libido is acceptable when you’re six weeks postpartum, but any longer is medically and socially unacceptable. There were seemingly only three valid explanations for my disinterest in sex: 1. I was a selfish wife 2. There was something wrong in my marriage 3. There was something wrong with me, medically. At least, these were the messages I received through the Facebook comments section when I first wrote an article about it. I also received many “thoughts and prayers” in my inbox from those who thought a lack of sex was a terminal illness. People took an intense and bizarre interest in how much sex I wasn’t having.A lower libido is acceptable when you’re six weeks postpartum, but any longer is medically and socially unacceptable. Click To Tweet
In the end, all tests came back “normal,” but I couldn’t let it go. Why wasn’t I enthusiastically rumping like a screaming beastie in the night? I turned to Google and discovered Female Sexual Dysfunction.
According to a 2016 study in the Sexual Medicine Reviews, 40.9% of premenopausal women around the world suffer from Female Sexual Dysfunction (FSD). The symptoms include: low libido or lack of sexual desire, diminished vaginal lubrication, painful intercourse, and decreased arousal. That means almost half of women have a sexual dysfunction. Given how widespread FSDs supposedly are, are this many women really suffering from sexual dysfunction, or are their “symptoms” not symptoms at all?
In contemporary sexual culture, it seems the line between dissatisfaction and dysfunction is increasingly blurred. Women with any level of sexual decline or discontent have been cleverly convinced they are defective and need treatment. As such, feminists and clinicians have started to question the possibility that FSD was constructed by pharmaceutical companies through inflated epidemiology and our culture’s sexual illiteracy.
Take my situation as a new mom. Years ago, sexologists would’ve classified my waning lust as a typical postpartum-related sexual decline, but the criteria for FSD makes it a full-blown disease. A temporary stress-related sex decline is now a sickness. A prescription drug side effect causing low libido is now a disorder. Age-related vaginal dryness is pathologized. Dissatisfaction with your partner is now a bona fide medical illness. Lack of interest due to fatigue, work obligations, and child-rearing all fall under the FSD umbrella.In contemporary sexual culture, it seems the line between dissatisfaction and dysfunction is increasingly blurred. Click To Tweet
“While we are consistently deprived of useful, relevant, and meaningful information about women’s motivations for sex, how sex works from a pleasure perspective (and not a reproduction perspective), and the tools to manage the anxiety associated with the discomfort we feel about discussing sex, we are left open to interventions that reinforce big pharma, false narrative of “normal” and not pleasure, connection, sensuality, or eroticism,” New York City based therapist, Cyndi Darnell, says.
Despite it being 2018, American girls and women are still left in the dark about their own sexual health. Currently, only 24 states and the District of Columbia mandate sex education and 34 states and the District of Columbia mandate HIV education, according to the Guttmacher Institute. It’s important to note, these sex education programs vary widely in instruction and content. Some states require abstinence to be stressed (without receiving information on contraceptive methods). A number of states require negative information about sexual orientation to be included. Some require the instruction to emphasize the importance of only engaging in sexual activity within a marriage.
As a child growing up in the ‘90s in New York I had access to sex education. I learned to be terrified of having sex (thanks to loads of AIDS hysteria) and I could recite all medical terms for male genitalia. But I couldn’t locate my clitoris. I didn’t know anything about pleasure, masturbation, or female orgasms. I didn’t know sex could exist outside of penis-in-vagina penetration. I didn’t know that across cultures, relationships, sexual orientations, and identities there could be different types of sexuality. And I sure as hell didn’t learn about consent.I learned to be terrified of having sex and I could recite all medical terms for male genitalia. But I couldn’t locate my clitoris. Click To Tweet
With sex education still largely lacking in accessibility and information, no wonder flocks of women think a difficulty on the sexual radar is a full-blown medical problem. They’re combining what they learned about sex in school, what they learned from their parents, and what they learned through media portrayals of heteronormative sexuality. Additionally, women and men have internalized commercial marketing schemes which promote adventurous, anything-goes, heterosexual sex as the gold standard, while stigmatizing anyone who doesn’t look “sexy” enough and anyone who doesn’t orgasm a certain way. In fact, straight women are less likely to orgasm, because their partners are more likely to insist on penetrative sex, and ignore other erogenous zones.
“We have become a society more adept at watching sex than talking about it or doing it in ways that are satisfying for all involved. The tendency is presently to consume it rather than create it,” Darnell says. “The further removed we are from its meaning and purpose in our lives, the more likely we are to feel awkward and dysfunctional – and thus open up erroneous diagnoses designed to reinforce a performance “standard” rather than a fulfilling exploration based on mutuality and eroticism.”
Because of this “standard” women are likely to feel sexually inadequate. But, no worries, there’s a little pink pill for that ill too.
Unlike Viagra for men, which concentrates on the genitals, Addyi, or “pink Viagra” as it’s nicknamed, focuses on the brain. A bright pink slogan in block letters on the home page reads, “Your Brain May Be Working Against You When It Comes to Sex.” Call me crazy, but when my brain tells me I shouldn’t have sex, it probably means I shouldn’t have sex. I thought we were all supposed to be saying “no” to sex we don’t want?
Not only is the company’s message concerning, so is the disease it claims to be treating. According to the website, Hypoactive Sexual Desire Disorder (HSDD) is characterized by the following criteria: your desire for sex has decreased, your decreased desire for sex has persisted for six months or more, or your decreased desire for sex is bothering you. It’s pretty obvious that these “symptoms” are extremely broad, and as such, widely open to interpretation. It appears the drug’s maker, Sprout Pharmaceuticals, is good at expanding their definition of dysfunction in order to cast a large net on those even mildly affected.
I’m not a total pharma hater, I benefit from modern medicine in many life-saving ways. I’m also all for sex positivity. I support clinicians and researchers investigating women’s sexual problems. I love scientific and technological advances just as much as anyone else, but there seems to be several key elements missing from the conversation about women’s sexual health. You can’t claim to care about women’s sex lives and welfare, whilst ignoring crucial and omnipresent social and political components which form our sexual health. In our culture we are abused, we are raped, and we are shamed. We don’t have full body autonomy. Those facts alone might make us less inclined to have sex. Then there are the biologically natural hormone fluctuations a woman goes through in her lifetime which play a large part in our sexual response.
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“There are hormonally driven cycles that women go through that drastically affect our sexual health,” says Dr Sherry A. Ross, women’s health expert and author of She-ology. The Definitive Guide to Women’s Intimate Health. Period. She cites a woman’s menstrual cycle, pregnancy, postpartum, breastfeeding, perimenopause, and menopause as a few examples. While she believes FSD is a real medical condition, her approach to it isn’t solely concerned with organ functionality, physiology, or ability to orgasm, like much of the mainstream and newslike medical literature on the subject. She’s concerned with the big picture of a woman’s health.
“The daily stresses of work, money, children, relationships, and diminished energy are common issues contributing to low libido in women. Other causes may be depression, anxiety, lack of privacy, medication side effects, medical conditions such as endometriosis or arthritis, menopausal symptoms such as a dry vagina, or a history of physical or sexual abuse,” Ross says. But often, we’re not not having sex because there’s something wrong with us, but because there’s something wrong with society.
Looking at the social contexts through which women live and have sex is crucial to the research of women’s sexual health and treatments. Equally important is an intersectional approach to studying sexual experiences of people who are LGBTQ and gender nonconforming, which big pharma and their little pink pill are not addressing.
No one will deny that there are absolute medical issues impacting women and their sex lives that should be investigated and treated. Vaginismus, vulvodynia, endometriosis, STDs, and fibroids, all can cause painful intercourse and make women abstain from sex. Prescribing “pink Viagra” isn’t going to effectively treat or heal those conditions. It just makes the women suffering from them consent to more sex. Sex they might not really want to have.
When pharmaceutical companies hijack the narrative about women’s sexual health and attempt to make a universal or standard version of it, we all lose. We lose our freedom to say “yes” to sex, and we lose our right to say “no” to it. We lose our sexual power. We might even lose our sex drive.
These days, my fantasies about sex have nothing to do with pink horny pills. Instead, I fantasize about my daughters demanding pleasure and enthusiastic consent from their future sexual partners. I look forward to a self-determined sex life for me and my sisters, full of empowerment, connection, and exploration.