Interesting posts, weekend of 11/28

11/28/2009 at 8:48 pm | Posted in Uncategorized | 1 Comment
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Dear internet, the other night I found myself trapped on a bus that had a DVD player, and the DVD passengers watched was Dodgeball. It was pretty bad, I was about ready to climb out the window.

Before we start catching up with feminist/sex/sexual dysfunction news, I’d like to reiterate a friendly reminder: I am looking for Guest Posters. I want to hear more perspectives on the themes dealt with here at Feminists with FSD. Because I am dealing with such a sensitive topic, I don’t think I can actively recruit new posters, since if I went onto someone else’s blog and said something like, “Hey u wanna write a post about your sex life and/or feminism on a public forum?!” that would probably be very invasive.
At this time, criteria for inclusion is, “If you think you would fit in here, you probably would.” This may be subject to change but for now we’ll try that & see how it goes.
In an attempt to preemptively fight spam and rude comments, this blog’s email is private. Please leave a comment on this post if you want to write something. I’ll screen comments so you can remain anonymous if you want. That way I’ll have your email and we can collaborate. Have something you’ve been working on? Send it my way.
Please be careful when leaving comments on this post if you wish to remain anonymous though; if you’ve left a comment here previously, it will auto-go-through (It’s just a setting of WordPress.) Use a different e-mail address and your comment will remain screened so no one will know you left one except for me. Of course if you’re just using your internet identity anyway and aren’t too worried about being anon then just use the e-mail you used before and I’ll know it’s you. If you left a comment here before I mean.

There’s just a few older posts from a few weeks ago while I was on break & catching up, so let’s get those out of the way first.

Uh huh… – Interesting because I don’t understand the BDSM/sports analogy, especially when rough sex is compared to rough sports. So far with what limited BDSM activity I’ve tried, I’m not trying to “Win” anything by any means necessary, my partner & I are just trying to have fun. But then the only sports I enjoy are bowling & ice skating. I think I need some help figuring this analogy out, from both the “It fits” and “it doesn’t fit” side.

Why everyone should have pre-marital sex – This is a little different argument then I’m used to hearing. I don’t really like that “Everyone should” bit though since even that isn’t right for everyone… and if Jessica means “Intercourse,” well then that does a couple of things. Saying that adds another layer of pressure to perform (Before marriage this time, instead of on the wedding night,) and it assumes heterosexuality (not all couples can get married.)
On the other hand, if you do have premarital sex (broadly defined) then doing so may reveal if one or both partners has a problem with sex. For example if I had waited until marriage to have sex, then I probably would have found out about painful sex only on my wedding night. And nights subsequently after… which would have come as a big surprise to both of us and probably led to a lot of relationship stress & strain. Finding out early, and being in a long-distance relationship anyway, meant I could take my time & not have pressure to perform sexually, and I could cultivate my own idea of what sex means as I seek treatment. There is no rush, and I doubt I’ll be rushed even after I and my partner move in together.
However, I do not like to think of sexual problems & dysfunctions as being the same thing as sexual incompatibility. I prefer to believe that sexual compatibility is something that can be actively cultivated. All sex partners involved will probably have to be willing to make compromises & meet their partners partway if one does not want to or cannot perform certain activities.
But if one (or more!) night of disappointing sex breaks the relationship, if one partner interprets that as “Incompatibility” and doesn’t even try to compromise – then even I myself am doomed to failure.
And if you do decide to actively cultivate sexuality with your partner, while you’re cultivating that compatibility – is it fair to push the wedding date back, on condition of improving sex? I can see how this could still backfire…
But on another hand, pressure to remain pure & virginal can contribute to vaginismus, too. All that pressure not to have sex for years, then get married and, bam, put out. I’m talking about pressure like this – the Christian Side Hug, which is making its rounds around the blogosphere. What, we can’t even enjoy a firm frontal hug anymore, because our crotches might touch?

And onto the newer posts from the week:

Less boob squishing seems like a value add to me – You may have heard by now that the recommendations for breast cancer screening & pap smears has changed, to reduce the frequency of which these health screenings happen to women who are not a high risk. This change is producing a lot of outrage. In this article, I want to point out, Oh my god, this line:

Because feminism has a long tradition of critiquing the over-medicalization of female bodies, producing excellent must-read texts like Our Bodies, Ourselves and For Her Own Good.  Feminist critiques of over-medicalization of female bodies have produced much good: the introduction of midwifery, the willingness of therapists to take women’s concerns seriously instead of just drugging them, the legalization of emergency contraception, the promotion of breast-feeding, the end of the use of twilight sleep for childbirth, the invention of safe abortion techniques that can be performed even without electricity.  It’s also produced some bad, from overreaction: paranoia about the birth control pill and the HPV vaccine and bullying women who aren’t willing or able to tough out completely drug-free childbirth come to mind.  But the fact that we even have to control for overdoing it shows how firmly committed feminists generally are to pushing back against over-medicalization.  So why was there so much anger about recommendations that fit so neatly into feminist critiques of medicine?

Wow. I am definitely, definitely seeing the push-back against medicalization with regards to sex & sexuality. Definitely, to the point where I’m feeling bullied for seeking out treatment for vulvodynia and talking about female sexual dysfunction. But with this breast cancer screening, there’s a lot out outrage about reducing medical intervention. I … don’t know what to make of that. Why is it okay to medicalize one thing but not another. The rest of the post is good too, but that bit really stood out to me…
Need more insight into this breast cancer guidelines change? Two others among many – New Rules for people with breasts and The New Breast Cancer Guidelines: Debunking Some Myths

Insurance Company Revokes Depressed Woman’s Benefits Over Facebook Photos - This is a case in Canada not the US but that’s not the  point, the point is, it illustrates how people generally view mental illness. If you don’t fit a mold 24/7, you must be totally fine. Except not really.

Harpy Seminar: Ob-Gyns – After reading the Harpies’ experiences, the short version of my experience can be summed up as, “Wow you are so lucky… oh I wish my experiences with gyns was that simple, easy, straightforward. Oh I wish. How are you doing that anyway? Having a vagina does not a good, empathetic gynecologist make.” Actually, the last few visits I had with the local gyn weren’t completely miserable… the results of those visits were since I had to go on meds over & over again but the visits themselves were more comfortable than they had been. Still far from perfect though. I need that doctor to be less rush-rush.

do not forget: the rules of prime time homo hypocrisy – Adam Lambert from American Idol gave quite the performance at the American Music Awards.
I’ve never even seen a full episode of American Idol and I don’t watch the AMA. But this performer is openly gay and kissed another man on stage and simulated oral sex also on stage and everyone is all up in arms even though female performers are much less scrutinized (women performers don’t generally have their woman-on-woman kisses censored when they are replayed on tv over & over again.)

All the BPA that’s fit to print – AfterCancer speculates that, now that it’s been documented that BPA can lead to erectile dysfunction in men, maybe now companies will reduce their use of this chemical. I am much more cynical & I think they’re still going to do use it… ED still won’t be enough. Not unless ED happens to higher-ups who probably have less exposure to high levels of BPA, yet would have enough pull to make a difference in the health of many workers. And even if the powerful higher-ups do develop ED as a result of higher exposure to BPA, they’ll probably just use thier high incomes to buy ED drugs…

Police Brutality Against CA Protesters for Higher Education – this police brutality on Berkeley campus disgusts me. The tuition hike (So high!) disgusts me too but this is how they respond to students protesting those hikes?

The “myth of thanksgiving” linkspam – It was Thanksgiving in the US this week, a holiday with a lot of history behind it – history like this. If you still believe the myths & legends taught in elementary school, you need to click on this link, yesterday.
Definitely related: What Are We Really Giving Thanks For?
Unfortunately… this sort of thing is still happening. Encroaching on lands native to people not yourself, and displacing them. Conservation Refugees and other perils facing indigenous people and their environments…from environmentalists as well as the usual suspects.

Meet Tucker Max – All about Tucker Max & the women who love him.

Names - About growing up with your last name and taking on your partner’s when you marry. Yeah that sounds about right to me… Even if I were to change my name now, and take my mother’s maiden name – her maiden name is tainted with an abusive father, too. My maiden name is overrated.

real, honest female orgasm advice – Violet Blue makes a recommendation for books on female masturbation. Now, this is very interesting to me, because my first thought (And possibly yours too,) was “Oh Violet is talking about Sex for One, by Betty Dodson, right?” No! VB actually recommmends against Sex for One because Dodson comes on so strong in it, which is very off-putting for the very folks who need it most. I’ve been reading Dodson’s blog for about a year now and there’s … something… very… ehhhhhh… Dodson’s blog is not my favorite blog, let’s just leave it at that for now. So VB has a bunch of other recommendations for masturbation advice & erotica.

Now, we have a couple of links specifically about female sexual dysfunction this week.

Sungold @ KittyWampus pointed me out to a new article about Vulvodynia posted on AlterNet. When Sex Hurts, and No One Can Tell You Why: The Mysterious Condition Called Vulvodynia – I don’t have any major problems with the article itself, there’s one misspelling of “Vulva” written as “Vuvla” in there, but typos happen under deadlines… I didn’t rage out when I was reading the article, but there’s some heavily misogynistic comments posted under the body of the work. This article is a pretty realistic look at the high costs of treating vulvodynia pain and how hard it is to find specialists. It’s also very discouraging to hear that most med students have very little interest in vulvodynia :( One other thought that immediately jumps to my mind is, “I wonder why I’m seeing posts on other feminist blogs about labiaplasty, low desire/arousal/orgasm FSD but not pain, and Flibanserin, but not seeing any links to this here vulvodynia article.” Hmm…

And then we have another post by Violet Blue, female sexual desire a la the NYT Magazine, which links to a New York Times Magazine article, Women Who Want to Want. It’s another article about FSD, hypoactive sexual desire disorder specifically. My first thought was, “Oh god, brace yourself for another slap in the face,” because I was fully expecting it to be another condemnation of FSD, the women who have it and their doctors. But this… …wasn’t like that. This… isn’t bad. This… is well-researched, well thought out, and I did not feel insulted. The article still talks solely about FSD in terms of desire, so pain is still ignored… but this time, so is orgasm. The author David Bergner focuses solely on sexual desire, and with the help of researcher Lori Brotto, his examination goes pretty deep. Women Who Want to Want looks at how we define desire, where it comes from (which comes first, the chicken or the egg?) is there any way to cultivate desire, should alternative sexualities be pathologized, how female sexual desire is researched, and the questions surrounding research. There’s a lot of questions being asked here, & good ones. Dr. Tiefer makes an obligatory appearance towards the end of the article, but only briefly – the author acknowledges her concerns about Big Pharma but does not necessarily endorse them. When the new version of the DSM manual comes out in a few years, we may see some adjustments made to the sexuality categories, and Brotto’s research may shape what that new book says.

I’m sure there’s more…

Talking about FSD: how not to (part 2)

11/24/2009 at 7:08 pm | Posted in Uncategorized | 4 Comments
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A few weeks ago, The Nation posted an article about female sexual dysfunction, written by Joann Wypijewski, titled Sexual Healing. Rachel of Our Bodies Our Blog covered it with a link and some commentary. I saw several problems with the article in question, and have written about some of these problems not once but twice. And when it comes to talking about FSD, I’m still not out of steam yet.

How can I run out of steam, when authors, interviewers, doctors, therapists, and yes even feminists, keep on cranking out & covering new material about FSD, yet continue to make some serious mistakes when doing so? Wypijewski’s article has been joined by another in its well-intentioned but short-sighted spirit - “Restless Vagina Syndrome”: Big Pharma’s Newest Fake Disease, by Terry Allen.

What a funny title for an article about female sexual dysfunction, or at least Kate Harding over at Jezebel and the eponymous Kate Harding’s Shapely Prose blog found the title giggle-inducing and “Brilliant.” I’m sure she is not alone in her amusement – After all, Restless Vagina Syndrome – it’s like Restless Leg Syndrome (Is RLS inherently funny?) except this time it takes place inside your vagina. At first glance, without any further information, the term sounds like it must be synonymous with a high sex drive and frequent easy orgasms. How could anyone possibly label that a medical condition?

Actually, Restless vagina syndrome isn’t talked about for the rest of Allen’s article at all; whoever came up with that title merely exploited a documented condition (which we’ll get to in a bit) because it made the article more eye-catching and amusing to some.
No wonder Kate Harding thought RVS is a joke – Terry Allen provides zero information about the grain of truth he is riffing off of, and by labeling it (and more broadly, FSD in general) “Fake,” he preemptively discredits anyone who says otherwise, even if that means effectively calling the women & researchers involved in studying FSD fools and liars. And, after having done a little homework on Allen’s claims, I think he was counting on readers not to double-check him.
(No one with FSD read the comments section at either the Jezebel or Alternet article, as some of the comments are even worse and may cause explody-head.)

Allen’s article spends more time talking about the kind of female sexual dysfunction we all know and love (except not really.) He and Harding raise concerns about Big Pharma trying to invent and then market “Female sexual dysfunction” (Harding leaves the term in skeptic/scare quotes,) which she at one point refers to as “Listless vagina syndrome.” (I think that’s supposed to be another joke except that it backfires against me since I identify as having FSD. Do you mean to say that my vagina is lazy too?)

Interestingly, Harding uses skeptic quotes when talking about FSD, even as she acknowledges that, okay, maybe some of us really do have sexual problems that merit treatment… after all, she herself benefited greatly from a proper diagnosis of ADHD. But overall, the sentiment in Allen’s & Harding’s posts is that FSD must be a fake disorder invented by Big Pharma, in order to generate more money from a previously untapped market. FSD couldn’t have possibly existed before modern medicine (except that it probably did.)

But because folks like she and I exist, people with “Real” medical problems (and here I’m using quotes because I’m not comfortable with claiming my problems are more real & valid than anyone else’s, just because I can back mine up with medical records, which have also been and will continue to have their value questioned anyway,) we are putting everyone else at risk of exploitation by Big Pharma. Because I want treatment for my sexual health problems, I bear the responsibility & burden of enabling Big Pharma sneaking its phallic tendrils into all of our bedrooms & regulating our sexuality. That regulation might come in pill form designed to increase our libidios – but never too much, for if we become too sexual, too promiscuous, we may just be diagnosed with the dreaded Restless Vagina Syndrome.

I was really curious; is Big Pharma really trying to develop and then exploit a new, fake disease, by piggybacking on something that sounds similar to restless leg syndrome? (Only, it’s the vagina that’s restless.) What is this?

So I started searching for more information on this so-called Restless Vagina Syndrome. Luckily we live in the age of the internet, so my first starting place was Google. That search didn’t yield me much hard information about whether Big Pharma ever put out any material about RVS though – mostly it just points me back to Terry Allen’s article.

I was able to find an RVS parody video – Tranquivag on YouTube. The video pre-dates Terry Allen’s article by about 2 years; it was originally uploaded to YouTube in 2007. Is this what he was referring to? Did he get duped by a group of comedians?
It’s a comedy clip, so it’s not meant to be taken seriously. Or at least, I sure hope it’s not meant to be taken seriously. The viewer is supposed to find it amusing that a woman could be disturbed by invasive genital sensations that interfere with everyday activity and periods of rest – after all, who would find such usually pleasant sensations so bothersome, that you would have to take a medication with major potential side effects? I think the audience is supposed to think something like, “What a foolish woman; if she is bothered by her restless vagina, she should just have sex or masturbate.”  That’s not the way I processed the video though; to me it looks like hipster irony that backfires by re-enforcing negative stereotypes about FSD & the women who have it.
The video directs viewers to www.ivegotmunchies.com, which features other videos.
But no, this probably isn’t what Allen is referring to.

Maybe Google isn’t the best place to look for medical texts & research. I jumped through some hoops and got onto some online database systems. After several failed attempts on other databases, MedLine finally pointed me probably the right direction:

Waldinger, M., Venema, P., van Gils, A., & Schweitzer, D. (2009). New insights into restless genital syndrome: static mechanical hyperesthesia and neuropathy of the nervus dorsalis clitoridis. The Journal Of Sexual Medicine, 6(10), 2778-2787. Retrieved from MEDLINE database. [I'm linking to PubMed here instead of MedLine, since MedLine isn't accessible to everyone.]

Alas, even I don’t have access to the full text, and so I’m restricted to the abstract. Luckily, the abstract is useful for this discussion.
Based on what I’m reading in the abstract,
This doesn’t sound very funny at all… Restless vagina syndrome: “You keep on using that word. I think you do not know what it means.”

According to one sex therapist, RVS, or more properly Restless genital syndrome or Persistent arousal syndrome, sounds like it could be a form of pudental nerve damage.

I already know from reading other vulvar pain bloggers, that damage to the pudental nerve is serious – for some patients, it can be extremely painful to live with on a daily basis, and there’s no single cure for it. In this case, if nerve damage is the culprit for RGS, it manifests as hypersensitive genitals, prone to frequent orgasms even in the absence of actual sexual desire. There maybe other causes of restless genital syndrome besides nerve damage as well.

Regardless of the cause, the women involved in the study describe several related symptoms that would certainly cause me great distress -

Of 23 women included in the study, 18(78%), 16(69%), and 12(52%) reported restless legs syndrome, overactive bladder syndrome, and urethra hypersensitivity. Intolerance of tight clothes and underwear (allodynia or hyperpathia) was reported by 19 (83%) women…

To anyone who laughed at Allen’s title, did you even know what you were giggling at?
Why is this funny?
How is this fake?
Would you actually be comfortable having an orgasm in front of a stranger or in a medical setting, as three of the women in that study are reported to have experienced? What if you were sitting on a bus and the woman next to you started going into an uninhibited orgasm, what would your reaction be? Envy, discomfort, leering, slut-shaming… acceptance?
Why, when nothing else provides long-term relief, would this not merit medical research and possible treatment?

That doesn’t sound funny or something deserving stigmatization, nor does it sound to me like a condition that will be pushed onto the general, healthy population at large. I can only imagine how many doctors RGS patients are bounced around to in search of someone who is not dismissive of their concerns. And to be one of those women who lives with such a condition, and to read articles like this, must be humiliating.

PubMed offers just a few journal article abstracts about restless genital syndrome. The dates on the most relevant journal abstracts are all from 2009. That the dates are so recent, is probably why Terry Allen refers to it as “New.”
I get a few more research results when I search for an alternate term, persistent arousal syndrome. This is a relatively new field of study, according to Wikipedia. And, so far, I have been able to find one not-so-new article, from 2002, that details several other case studies of patients with persistent arousal syndrome, some of whom were desperate for long-term relief. One said of her experience, that it “Makes me so upset that I cry, as I cannot function normally; I make mistakes, get very hungry, and do not sleep… I would like the sensations to go away. I want to feel I can make plans and not have the strong sexual desire to make me miserable not knowing if I’ll get satisfied.” (She was also having difficulty reaching orgasm.)

Is Big Pharma really inventing this syndrome, or is could it be that only now is research being done, after years of neglect? I recall that in all my searches, I did not find much scientific research about Vulvodynia from years prior to the 1980s, and most of the books covering the topic in depth only started appearing within the last decade. Was vulvodynia such a controversial topic when the research was new, too? How long was its existence denied by so-called experts and laypeople? Perhaps that is what is going on here.

But really, RGS actually plays a very small role in Terry Allen’s piece. He just needed something that sounded interesting to grab the reader’s attention.

As is often the case, Allen’s article spends a lot of time talking about low libido and orgasm difficulties in women. Allen goes so far as to actually acknowledge that sexual pain exists, but he does not build on that topic. Allen even acknowledges the need to include the patient’s own feelings about their sex life in whether or not a diagnosis of FSD is appropriate. He gets this additional qualifier of personal distress needing to be present from a November 2008 article in Obstetrics & Gynecology, which pinpoints the statistic to about 12% of the population having FSD… but even this study excluded sexual pain in the researchers definition of FSD! I wonder how the figures would change if pain were included in the statistics.
(Also, as a side note, I’d like to point out here that when Jezebel covered that Obstetrics & Gynecology article, writer Tracie sounded shocked that more women aren’t distressed by their sex problems. I’m getting mixed messages here…)

Allen’s biggest concern, and one I’ve seen repeated elsewhere, is that Big Pharma has a vested interest in getting women to feel personal distress about their sex lives. The introductory line to his article goes so far as to claim that,

The pharmaceutical industry wants you to think that if you don’t have sex like a porn star, you’re in need of their drugs.

Even though I’ve been wandering the labyrinth of FSD for awhile now, I can’t say I’ve bumped into any doctors or reputable drug companies that say this to me. I’ve run into porn sites that tell me I should have sex like a porn star, and I’ve overheard conversations my peers have that tell me that. I’ve read that message in magazines and I’ve seen it on TV and in movies. And I’ve even gotten that impression while shopping for new sex toys. Sometimes, even the most sex-positive of sex toy stores, still manges to make me feel like I am somehow not measuring up, because I cannot or will not use one such toy or another, and because I cannot or will not have sex in certain positions.

Big Pharma doesn’t need to make me feel insecure about my sex life.
The culture in which I live does that already. Not only am I distressed by the experience of physical pain, but that pain is compunded by other messages I receive more broadly.
Why doesn’t Allen think about Big Porn, Big TV, Big Magazine and Big Body Image Distortion? For me, these are much bigger culprits I have to learn to navigate around in my sex life than Big Pharma.

Allen’s position is that if Big Pharma can get women convinced that there is something wrong with them for not having the sex life that Big Pharma (or, really mainstream media,) says they should be having, then Big Pharma can step in with cures, and thus make money. As examples, he cites the Orgasmatron, an accidental discovery stemming out of chronic pain treatment which has nonetheless been sensationalized by the media, (I wonder if the media raised the alarms when the Hitatchi Magic Wand first became readily available?) and LexaFem, an oral pill that has no entry on WebMD. (Must be an herbal stimulant or something. Not sure how likely it is that any doctor would prescribe LexaFem to me.) Allen is also sure to note Viagra’s use off-label for some women with FSD, and the dangers of using hormones to stimulate desire. (I’m not sure where that leaves me, as someone who had her hormone levels measured and found to be out of range for a healthy woman in her early 20s following birth control pill use. I’ve already used hormones, including estrogen & testosterone, to treat vulvodynia, although mine was a topical medication. That wasn’t in patch or pill form, but it’s still hormones. Am I supposed to be scared into not using them ever again? I still keep a little expired bottle of prescription hormone gel under my bed as a safety blanket.)

Allen then talks about conflicts of interest in medical research. Some of the studies on FSD have been sponsored by drug companies, including some of the bigger, more widely reocognized studies. It’s definitely worth taking a second look at these company-funded studies and thinking about how much influence that company may have had in the study’s outcome.

There’s two issues I can think of right off the bat that complicate matters regarding research independence. The first is, if these research studies, and others, about FSD including RGS are in fact independent of drug company funding, would Allen still be so quick to call FSD “Fake?” Does independence automatically redeem research? What about if independent studies draw the same conclusions that drug funded ones do?
One problem I myself am faced with is that, with the Restless Genital Syndrome articles I linked to above – I can’t tell from looking at the abstracts, whether these are independent research studies or whether they were sponsored by drug companies. I think I may need the full text to examine the full financial disclosure, if there is any provided.

The other issue I have with funding for research is, according to a recent NVA e-newsletter, some studies on Vulvodynia are also funded at least in part by drug companies. In this newsletter, I see Pfizer gave a financial award to Dr. Pukall of Ontario, Canada, for her research into vulvodynia & neuropathy.
Vulvodynia & pelvic pain conditions are still very much mysterious, misunderstood areas of women’s health. Can we afford to outright reject new research on vulvodynia and FSD broadly, on the basis that it is funded in part by drug companies? Or is it sufficient that patients, doctors and advocates be ready to closely examine these studies for possible bias?

Allen concludes his article with a quote by Liz Canner, mastermind behind the new film Orgasm Inc, which takes a critical look at the Big Pharma’s involvement in FSD. It is becoming increasingly clear to me that even though I don’t particularly want to watch this film and it will probably give me a brain aneurysm, eventually I’m not going to have any choice but to force myself to watch it sooner or later. Canner says,

“Maybe the best approach is not ineffective, over-hyped drugs with nasty side effects, but an end to disease mongering and a strong dose of comprehensive sex education”

Allen then tacks on, “Her film hits female erogenous zones that pharmaceutical fixes can’t find: your brain and your funny bone.”

What sort of sex education does Canner have in mind? How comprehensive are we talking here? In Canner’s sex education class, will we be focusing on the Masters & Johnson model of sexuality, or will we provided a wider variety of sex education materials? Will we be taking a Western point of view or a more global one that looks at many cultures and sexuality?
I ask because the sex education I went through a few years ago, was sorely lacking.
I would hope that Canner’s definition of sex education includes not just a critical examination of Big Pharma, but of the culture in which we live – a culture which both markets and condemns sexual activity. A culture that is uneasy talking openly about masturbation, consent and mutual pleasure. A culture which, in media depictions, often upholds sex and gender roles in sexuality, and leaves many subjects, such as BDSM, porn, open relationships, and certainly painful sex, taboo.

When Canner talks about sex ed, is she willing to spend any time educating the general public on the subject of dyspareunia, which can be (and for me is,) a form of FSD, and whether or not it’s worth treating? Or is dyspareunia to be overlooked in sex education the way it was during my high school sex ed, precisely because it can be a form of FSD?
I wish someone had taught me about vulvodynia earlier on. Would Canner consider that a form of “Disease mongering” too?

As for Allen’s last statement, he himself has to look a little harder to find my funny bone. Or perhaps I’m just one of those legendary dead-on-the-inside humorless harpy feminists, one who takes sexual dysfunction much too seriously.
Regardless, based on what I’ve seen Allen and others write about FSD & Big Pharma so far, I’m not so sure that I myself would find Canner’s film particularly funny. This is yet another example of an article about FSD which, rather than amuse and educate me, distresses & drains me.

Interesting posts, weekend of 11/22

11/22/2009 at 6:31 pm | Posted in Uncategorized | 3 Comments
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Dear internet, we’re back in business, and (mostly) caught up with my RSS feeder. That can only mean one thing: It’s time for the weekly blog-link roundup. Some of the links I put here are older, but I’m including them anyway because not all of my readers here keep up with the same sources I do.

Before we start catching up with feminist/sex/sexual dysfunction news, I’d like to reiterate a friendly reminder: I am looking for Guest Posters. I want to hear more perspectives on the themes dealt with here at Feminists with FSD. Because I am dealing with such a sensitive topic, I don’t think I should go around actively recruiting new posters, since if I went onto someone else’s blog and said something like, “Hey u wanna write a post about your sex life and/or feminism on a public forum?!” that would probably be very invasive.
At this time, criteria for inclusion is, “If you think you would fit in here, you probably would.” This may be subject to change but for now we’ll try that & see how it goes.
In an attempt to preemptively fight spam and rude comments, I still haven’t posted my blog email. Please leave a comment on this post if you want to write something. I’ll screen comments so you can remain anonymous if you want. That way I’ll have your email and we can collaborate. Please be careful when leaving comments on this post if you wish to remain anonymous though; if you’ve left a comment here previously, it will auto-go-through (It’s just a setting of WordPress.) Use a different e-mail address and your comment will remain screened so no one will know you left one except for me. Of course if you’re just using your internet identity anyway and aren’t too worried about being anon then just use the e-mail you used before and I’ll know it’s you. If you left a comment here before I mean.

Now then let’s proceed. Posts I found interesting (and was able to keep up with) since 11/1. Share links if’n you got’em.

From the WTF files -
Time Travelling God Particles – You have got to be f’ing kidding me. This is what they’re calling “Science” these days?
Marketing Wii to girls – You have got to be f’ing kidding me…
The “odd” news category is so “clever” when it comes to “women” – I’ve noticed this problem with Yahoo! News too; so much “Odd” news is actually “Horrifying” upon closer inspection, especially when it comes to women.

Sex and the Simpsons: Marge’s Playboy cover – Well I suppose that’s one grim way of looking at it, but, I’m interpreting this cover more as animation going mainstream, and growing up with a new generation (mine,) instead of being tossed aside as purely a children’s entertainment.

Doe “lady stupid” exist? – Thoughts that come forth from watching Idiocracy, which yes even I have seen.
I believe the counterpart you are looking for may be found in “Chick flicks.” They’re not necessarily “Stupid” though, just often insufferable. For example I tried to watch Mean Girls this weekend and I started getting a nosebleed. Not really but it was over-the-top.

Reclamation: thoughts from a fat hairy uppity lame bitch – lots of different points of view on reclaiming problematic words & turning them around into something positive.

The Appropriateness of Appropriation – I much prefer this nuanced point of view over the never-appropriate standpoint I often run into.

[Greta Christina] 101 Positions That Won’t Spice Up Your Sex Life – Greta Christina critiques typical sex advice books, including one by Marty Klein – he’s one of the authors who contributed to Let me Count the Ways, which I reviewed here!

Breast Cancer as Loss of Sensation – FigLeaf points to an oft-overlooked facet of women’s breasts. They’re for nourishing babies, yes, but they’re also sexual, and it can be hard to face losing that facet when you have been diagnosed with breast cancer.

Chris Surette: A Valuable Addition To Your Women’s Studies Classroom – Chris Surette is a college student who wrote an article for his newspaper that was so bad, he’s being charged with harassment by the school. But he took a women’s studies class! So that makes it ok! Right? No.
But who is the real Chris Surette anyway? Could he be, the Worst Person in the World? Well, maybe not but he’s up there along with other dewds like him.

Feeling and Passionate (by Phila) – Phila analyzes the way the authors of SuperFreakonomics respond to two different critiques, one by a woman and one by a man. Hmm…

Carrie Prejean Masturbating is  No No – She’s made headlines for her homophobic remarks before, but now she’s making headlines for… being slut-shamed, actually. Which still isn’t cool.

In the realm of women’s health care, we have a few items – Bearing Babies, Bearing Risk – or, How the Stupid Stupak Amendment Hurts Women’s Health - SunGold looks at the Stupak amendment & in so doing, provides links to more resources about it.
Just Say No To Being A Woman – Pete Sessions of Texas compares being a woman to being a smoker and that’s why it’s okay to penalize women by making them pay higher insurance premiums. What?
Is taxing plastic surgery sexist? – One proposed way to raise money towards health care reform in the US is by taking cosmetic surgery. I think this is not only sexist (since it’s going to target women more than men,) but potentially dangerous. I myself had my vulvar vestibulectomy performed in a plastic surgery outpatient center, and Botox – usually a cosmetic anti-wrinkle treatment – is a potential treatment for women with vaginismus & vulvodynia. It’s already hard enough to get insurance to cover Botox for pelvic pain to begin with, (The companies say “You don’t need to make your vagina look pretty!” the patient says, “That’s not what it’s for!” but it’s an off-label use so no one knows this,) this proposal could wind up costing women in pain even more!

Meet the Predators – [Trigger warning] – Melissa examines a post made by Yes Means Yes contributor about who really commits rape – and under what circumstances they may actually admit to this.
Rape is now a girl’s “Secret Sex Shame”, says Brisbane Times – [Trigger warning] – The media glossing over the fact that unwanted sex is actually rape.

The newest Twilight movie is out.  I have a horrible confession to make: I may or may not have been involved in the carving of a Twilight-themed Pumpkin for Halloween 2009. We can neither confirm nor deny these allegations at this time. Some Twilight related posts:
People read these books and then think about them – Presentations of violence and gender in the Twilight novels
The Edward Cullen Underpants Conundrum – Robert Pattinson is being objectified for the Twilight movie promotions almost as much as women in general are objectified, what a twist. Also, Frozen Dildoes.
Could “New Moon” be a feminist Triumph? – not because of the plot or problems therein per se, but becuase of the women involved in making it such a phenomenon – including the audience.

11/20 was Transgender Day of Rememberance.
Chally posted a link roundup to TDOR related posts – TDOR 2009
This post is a little older, but explains transphobia even within feminist circles. Let’s Get a Few Things Straight, Shall We?
“Gender is between your ears, not between your legs.”
– an interview with Chaz Bono.

BBC website advice on porn – a latecomer to the roundup posted yesterday; I very much enjoyed this analysis of porn as discussed on a BBC website.

I know there’s more…

Vulvodynia to be on TV again, interviewees wanted

11/19/2009 at 7:21 pm | Posted in Uncategorized | 1 Comment
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Found via Vulvar Vestibulitis Support Network and His and Her Health Forums:

Producers at a national television show are looking to interview married women who’ve been diagnosed with vulvodynia in the last six months. They’d also like to hear from single or married women who experience chronic painful sex but haven’t been diagnosed. If you fit these criteria and are willing to share your story on national television, as soon as possible, please send an e-mail to chris@nva.org with the following information:

- Name

- Age

- Are you married or single?

- If you’re married or in a relationship, is your partner willing to be interviewed? – What symptoms do you experience? When did they start?

- If applicable, what condition have you been diagnosed with? When did you receive a diagnosis? How many health care providers did you visit before being diagnosed?

- Have any treatments helped you? Is your vulvodynia better or worse? – How does vulvodynia or painful sex affect your life?

- How has the condition affected your sex life, marriage or relationships?

- Daytime phone number and e-mail address

- Current photo (please attach)

- Statement that you give NVA permission to forward your story and contact information to the show’s producers. Please try to limit your summary to 1-2 paragraphs.

No yet word on which television show is producing this episode, when we can expect it to be aired, or how it is going to be handled.

Back for more

11/18/2009 at 8:42 pm | Posted in Uncategorized | 1 Comment
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Dear internet, I have returned from some scheduled downtime. During my off-time, I had many adventures with my boyfriend, and did not check my e-mail or blog on a regular basis. As a result of this break, I returned home feeling refreshed, renewed & restored…

…and buried by work that piled up in my absence, and new content in my RSS feeder online!

Needless to say, I’ve got quite a bit of catching up to do. We’ll get to that in a few moments. First, to bring interested readers (all what, 8 or 9 of you,) up to speed with what’s been going on with me,

I picked a very good time to take a break in terms of not letting too much work pile up on the job or at home. The weather where I went was pleasant, the crowd levels minimal, lots of things to see and do, and my boyfriend and I had some private time together. We had plenty of activities to keep us busy and amused, and we ate so much good food… I really could not have asked for a more perfect vacation.
Well, actually, there is one thing that could have made our time together even better. A certain piece of jewelry presented to me with a certain flourish would have made my year… but apparently it is not time for that yet. So be it then.

This time around, although we’ve done it before and have very few opportunities to try this, we did not attempt to have intercourse. Nope. Did not even try it. We both wanted a pressure-free, totally relaxing time together. Intercourse is this whole big production for me and we’re both so new at this. Attempting intercourse can be nerve wracking. It’s definitely worth it when it happens, but it’s not too far off the mark for me to say that for us, the act of intercourse is about as intricate & requires about as much rehearsal as a Broadway musical.

That’s not to say that we didn’t have sex though – we had enough quality sex & intimacy to keep both of us satisfied. No pain on my end, however it looks like that Bartholin’s gland cyst is going to keep coming back whenever I spend a lot of time aroused (as I often do when I’m with my boyfriend.) The cyst is already starting to decrease in size and firmness on its own, so I’m not worried about it right now. But I know that sooner or later I’m going to need to have that gland looked at. Some day it will likely require a more complex and permanent intervention than warm compresses & sitz baths.
One thing at a time. Worry about that later when the time comes.

While my boyfriend and I are comfortable with the quality & quantity of sex we enjoyed while on break, unfortunately the rest of the world is not satisfied with it.

Upon my return home my family started in on me about whether we’d had sex – by which they mean intercourse. On one hand, it’s great that I have their support – they want me to have a happy, healthy sex life. My mother & sister especially supported me when I was recovering from vulvovaginal surgery. On the other hand, it’s not great that their support can often turn into invasive nagging & pressure to perform. “Did you do it? How was it? That’s all?! Aw K, you gotta put that vag of yours to good use while you can!”

Even my boyfriend had some family pressure regarding sex, or rather pressure to not perform. Even though he is an adult, and even though we’ve been together for years, his family still does not approve of our relationship. His family certainly does not want him sleeping with me, and so he returns home to a different kind of nagging.

Why is sex so heavily policed by peers & family?

Anyway, now that I’m back online, I mean to return to regular blogging about feminism & sex & female sexual dysfunction – and all the work I left behind before my break remains to be done. Those draft posts don’t write themselves. Even the “Fluff” needs more tweaking.

It’s probably going to be a few days yet before I’m all caught up with my RSS feeder, and even longer before I find time to pick up & read some books on my shelves. Unfortunately for me (fortunate for the interested & patient reader though,) more articles & editorials & blog posts were written about FSD in my absence. I must have picked a bad week to take off in terms of blogging. I won’t be able to put together a weekly blog-link roundup for awhile longer, yet I still want to bring attention to a few pieces you may have missed:

For instance, that Nation article I had such a big problem with a few weeks ago – it’s been joined by yet another anti-FSD cohort. So someone (probably me) is going to need to sit down and analyze this article & see if it contains any troublesome (even if well-meaning) implications and dismissive language (hint: it does.)

Meanwhile, there’s a new drug for female sexual dysfunction on the horizon, and I’m sure it will set the feminist blogosphere abuzz once word spreads – so far Violet Blue is on the ball, a sex therapist sees the potential benefit for patients, and a sex educator takes a comprehensive look at it, including the history of FSD. This drug, Flibanserin, is a type of antidepressant – it’s an SSRI rather than a tricyclic. (Tricyclic antidrepessants, in low doses, are sometimes used to treat pelvic pain, including sexual pain.) It won’t work like Viagra, which increases physical response but doesn’t necessarily instill a craving for sex in and of itself. Flibanserin is designed to increase libido.
This drug actually sounds like it would be less appropriate for me than Viagra, as I am comfortable with my current libido. My main problems in sex are with this physical body of mine.
So I may need to talk about Flibanserin, Viagra, et al soon.

Regarding vulvovaginal surgery (labiaplasty in particular – always with the labiaplasty to the exclusion of other genital surgeries and/or surgeries done without aesthetics in mind,) we have some Fightin’ Words:

Angelica Kavouni, a cosmetic surgeon who carries out labioplasty, said it was wrong to “terrorise patients” with suggestions of long-term consequences.

Them’s fightin’ words! Strong, unequivocal language – you may be wondering what sort of anti-surgery/surgery awareness tactics could possibly terrorize a patient about to undergo vulvovaginal surgery, whether the surgery is for purely cosmetic reasons or not. I may be inclined at a later date to tell you some examples of tactics which yes, even I would consider over the top and counter-productive.
Also, if Kavouni is a surgeon, I wonder why the editor did not include “Dr.” or “Ph.D.” in the title of her name… she does have a medical degree, yes?

Brie is keeping up with Private Practice, the ABC television show which a few years ago aired an episode about a patient diagnosed with vaginismus and vulvodynia. The show now includes a recurrent theme of a female sexual dysfunction clinic, but it is not doing a very good job of actually talking about FSD.

There’s a LOT of news going on outside the realm of FSD that I’m trying to stay abreast of. One of most frequently-spotted topic in my RSS feeder is about US health care reform, including discussion of the Stupak amendment. I’m also overwhelmed & appalled by the amendment itself – this is bad news for women’s health. Health insurance reform, but at a very high price. One particularly good post on the topic I’ve seen is over at Female Impersonator. I, too, speak legalese (although possibly not as fluently as Jenn.) This isn’t the only news topic going on; I’ve seen posts about the Carrie Prejean slut-shaming scandal, the Ft. Hood shooting, and more. Then there are the posts that are not necessarily political in nature, but are interesting invitations into bloggers’ personal insights.

And that’s just for starters. Stay tuned – we’ve got a lot of work left to do.

Talking about FSD: How not to

11/03/2009 at 9:48 pm | Posted in Uncategorized | 5 Comments
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I want to go back and revisit a post from a little over a week ago, my response to an article at The Nation about female sexual dysfunction, and Our Bodies, Our Blog’s coverage of the same. At press time, my reaction was to be consumed with rage. The anger has settled down so I’m merely fuming at this point. That’s about as much of an improvement from me as anyone is going to get.

Let’s go back, and take a closer look to address some other problems that The Nation’s article has. Keep in mind, from what I’ve seen online, this is a pretty typical example of FSD literature. This is just one recent example of attitudes towards FSD, the women who have it, and the doctors who treat them. I am likely going to run into these same problems over and over and over again. I know this, because I already have.

I won’t be able to tackle everything in one night. I need to break this down over a few nights. The post is going to get too big to digest if I try to address everything at once anyway.

Last week, I said that one category of FSD was completely left out of The Nation’s article – dyspareunia, sexual pain. Perhaps we should first look at some definitions of FSD so that you can understand why this omission grates on my nerves.

Under a very common definition of sexual dysfunction, (common enough to appear in Wikipedia,) there are four categories of female sexual dysfunction – Desire, Arousal, Orgasm, and Pain. You can have a problem in any one or more of these categories. Usually when we think of a problem in those areas, the problem is too little desire or arousal, too few or nonexistent orgasm, or too much pain. Wypijewski touches upon only three categories, to the total exclusion of pain.
This is distressing to me, because I fall into that last category of female sexual dysfunction, the one that is all too often overlooked and the one which I have sought medical treatment for. You may also note that Wikipedia mentions that dyspareunia is almost exclusively a female problem – it’s rarer (but still definitely exists) among male-bodied individuals; for example anybody can develop Pudental neuralagia, which is associated with chronic & sexual pain regardless of the patient’s sex.

One problem with this definition of FSD though is that, it doesn’t leave much room for the patient to determine whether or not she actually thinks she has FSD. The definition makes the determination for her – “You have FSD if you have this, that, or the other thing, regardless of your own feelings about this situation.” That’s not fair to the patient, and that’s where we get that big 43% number from – the one that says up to 43% of people have some kind of sexual dysfunction. That big percentage came from a study that made that distinction of sexual dysfunction arbirtarily, based on survey responses. If a survey-taker replied that one event or another did or didn’t happen during sex (Ex. orgasm, erections, etc.) then that study decided it was a dysfunction, without regard to how participants felt about those events.

This study has been criticized for that very reason – shouldn’t participants in these studies have some say over whether or not their sex lives are a source of distress or satisfaction? It’s not fair to make that decision for individuals.

The thing is, even under a definition that includes patients’ own feelings about their sex lives, I still identify as having FSD. For me, the vulvodynia & vaginismus (and recent, recurrent vaginal infections) are strong enough to cause distress in my sex life, which in turn spills over into anxiety in the rest of my life. The anxiety was even worse a few years ago, before I started treatment, since I had no idea of the road ahead – and I was still dealing with some invasive physical symptoms (notably itching & irritation not due to any infections.) For me, I’ve seen quite a lot of improvement in the pain and anxiety from a few years ago, but I need to manage the residual vulvodynia & vaginismus with my physical therapy & alternative medicines, among other things. It’s looking like I have a long road ahead of me yet.

However, it is not fair for me to say that all other vulvodynia & vaginismus patients have FSD. This is not the case for all other pelvic pain patients, as not all will be as distressed as I was. I can speak only for myself.  But I, and I alone, am comfortable with this label. To me, it is as neutral and thank-you-Captain-Obvious as, “White, female, cis, heterosexual, monogamous. Has sexual dysfunction,” or “Sexually dysfunctional.” Yes, those fit me.

Yet vulvodynia itself is somewhat unique in that, it’s not necessarily isolated to sexual pain. It can become, for some patients, a chronic pain condition in general. (And even if the pain is isolated to sexual activity, there’s a pretty good chance that the sexual pain is still going to stick around for a long time. It may just be provoked with certain activities.) That pain can bleed out into other non-sexual areas of life, including sitting, working, playing… It can be a sex pain disorder, but it can also be a chronic pain problem in general for some patients.
A difficult pain problem to talk about openly too, since it involves a mysterious, taboo area. I have a feeling the mystique of the vulvovaginal area and women’s sexuality has contributed to maintaining silence about these conditions up until the last few years. Thanks to the internet, I don’t feel so alone.

It’s also worth noting here that, for some reason, pelvic pain can sometimes overlap with other chronic conditions, like irritable bowel syndrome, intersistial cystitis, endometriosis, fibromylagia, etc. I do not know why this is, and I do not know why I myself do not have these other chronic conditions (to the best of my knowledge.)

So by completely ignoring the existence of sexual pain, Wypijewski has, deliberately or not, contributed to that taboo and ignorance that such pain conditions even exist.

Yet, even though it has not been acknowledged, that sexual pain is still there – it’s just not paid any attention.

Anyway, these four areas – desire, arousal, orgasm and pain problems – are not necessarily the only definition of sexual dysfunction. In response to criticism about the way the medical community handles sexual dysfunction, alternative models have been presented, notably one put forth by someone whose name appears in the article – Leonore Tiefer, pH.D.

Not coincidentally, OBOS has itself reprinted Tiefer’s also-four category definition of sexual dysfunction. Here, it takes an even looser and non-judgmental name, “Sexual problems.” The four new categories are, broadly,

  • Sexual problems due to socio-cultural, political, or economic factors
  • Sexual problems relating to partner and relationship
  • Sexual problems due to psychological factors
  • Sexual problems due to medical factors

Click through the link to read some bullet points & examples under each category.

Even here, under Tiefer’s new grouping, I still exist, since I have sexual problems due mostly to medical factors – vulvodynia, vulvar vestibulitis, and recent infections. At least, I think these count as medical factors, since they can potentially be measured and treated medically. Some folks say that vaginismus is largely a psychological problem; I would disagree with that for my own self, since I’m seeing a very physical basis for mine, and my vaginismus responds very well to physical treatment. Plus counseling with talk therapy would not be the right treatment for me, as I have zero interest in getting sex therapy. (I’m still not fully comfortable with saying vaginismus is purely psychological, because it sounds too much like “All in your head.”)

One interesting note is that, the last section of Tiefer’s new categories actually sounds similar to the traditional definition of FSD – “Pain or lack of physical response during sexual activity despite a supportive and safe interpersonal situation, adequate sexual knowledge, and positive sexual attitudes.” [Emphasis mine.] That sounds very similar to having problems with libido, arousal, and orgasm – and it acknowledges pain. The difference is that Tiefer first turns to and then rules out non-medical reasons for the lack of response before jumping in with doctor referrals. Another notable feature of this definition is that that last category, medical factors, isn’t as well fleshed out as some of the other groupings. Not a lot of sub-bullet points under category four. I don’t know why this is; my guess is that because Dr. Tiefer herself is not a medical doctor, she has a doctorate in philosophy and is a psychologist, perhaps she felt that it’s best to leave medical factors to the medical doctors?

“So many times I don’t think sex is a matter of health,” Dr. Leonore Tiefer, a sex therapist and founder of the New View Campaign to challenge the medicalization of sex, told me the other day.

Or I could be totally wrong.

This kind of statement – that sex is independent of health – terrifies me because I fear it is making it harder for me to find treatment. After all, I’ve run into enough doctors who tell me that my pain is not physical in nature, but all in my head. Because the pain must be psychological, there is no reason to treat me medically. Have a glass of wine and relax. I must not really love my partner then if I’m experiencing pain & anxiety around sex. Maybe I should dump him or work out whatever relationship problems the doctor assumes we’re having. Or maybe he’s not contributing to the relationship enough; maybe I’d want to have sex with him if he would take out the garbage/walk the dog/do the dishes/pick up the kids after school. Or maybe I’m just stressed out in general and somatizing that stress physically – I’m somehow making my vagina sick.
Except not really.

To me, to say that sexual dysfunction – the broad umbrella under which sexual pain falls, including vulvodynia which also intersects with chronic pain – isn’t a matter of health, is like saying that other chronic conditions such as pain in general shouldn’t be treated. And okay, not everyone needs medical treatment for pain… but what about those who want it and seek medication for their chronic conditions?

Well, if you visit Tiefer’s New View Campaign website – you’ll have to Google it because I still refuse to link to it – one of the first images there is a clear anti-pill picture.

Does this anti-pill sentiment apply to pain management & medications used off-label, like tricyclic antidepressants and antiseuzire medication sometimes used for managing vulvodynia? Some of my friends need to take oral pills like those pictured just to make it through the day… Pain management medication. And I needed those antibiotics & antifungal pills because I’m too scared to use traditional at-home remedies for infections. (It’s not a fear due to a lack of empowerment, or ignorance of my own body, or not wanting to touch myself, or not knowing how to use the at-home treatments… it’s fear of upsetting the balance in vaginaland even worse than it already is.)

Does this anti-medicalization backlash apply to researching and developing treatments for vaginal infections like the bacteria & yeast I kept developing over the summer? Does it apply to researching causes & treatments of pelvic pain?

What does medicalization even mean?

Where do we draw the line between researching the how the body works vs. reducing it to component parts? When does a shielding against reduction to component parts turn into maintaining ignorance?  When does protecting women from manipulation by a Patriarchal medical community cross over into patronization? When does protection for our own good become Matriarchy?

I don’t know where those lines are drawn in the sand, but I think it’s been crossed. My metaphorical toes hurt from getting stepped on & steamrollered over, as someone who does identify as having FSD and is told that FSD doesn’t exist. Ow, my toes. They hurt from being told that anyone who does think they have FSD and so seeks treatment for it, is a “Slave,” as Wypijewski has done in her Nation article. Ow, my pride. Ow, my feet. Ow, my vag.

To Dr. Tiefer’s credit though, she did, once, say that dyspareunia is a valid sexual dysfunction & one worth treating. She said it, once, that I know if, in a journal that I had to jump through hoops to get my hands on. I’m referring here to the Archives of Sexual Behavior, 34, 49-51. The title of the article (or editorial, really, it wasn’t a research paper,) she had published is, “Dyspareunia is the only valid sexual dysfunction and certainly the only important one.”

So okay, I guess that I have a Tiefer-approved Hall Pass to go to use the restroom during class and get bugged by hall monitors along the way go to my doctor to get medical treatment.

The thing is, having dyspareunia myself, and seeing how much distress it has caused me, I do not agree with the statement that it is the only dysfunction that is important and worth treating. Who gets to decide what is & isn’t important? Don’t the people directly effected get some say in this? Or are we to disregard what the patients say they want, because they have been brainwashed by unrealistic media images of sexuality, and so do not know what they really want?

It just doesn’t seem fair to me, to minimize the very real suffering that other people experience if their sex life is not even minimally satisfactory, or if someone is genuinely dissatisfied with some parts of their body. It seems so unfair to say that a lack of orgasm is unimportant to a person who feels that it is & is distressed by an inability to achieve one. I don’t think it’s fair to decide on other people’s behalf, what is & isn’t worth pursuing in their unique sex life as they see fit.

Who am I to say that another person’s emotional pain is any less real and less important than the physical pain I experienced? Who is to determine what the best course of action towards resolution is for that person, other than she herself?

Now maybe the resistance to FSD comes from one word in it in particular – dysfunction. It’s a pretty heavily charged word. It says, “There is something wrong with you if your body does not operate like the rest of ours,” ours being whatever majority has organs (in this case) that operate with some predictability and “Success,” however that majority defines success. Dysfunction implies that something is lacking. So the message I hear from outside myself is, “You don’t want to be dysfunctional. You don’t want to be one of those people. You don’t want to have a bad & wrong sex life.” I think I’m kind of an exception since I actually embrace the term. I still say, only half-jokingly, “I have a broken vagina,” when I’m down on myself, even though I know I’m actually very warm & loving sexually. I may be dysfunctional, but that doesn’t make me bad. Seeking medical treatment shouldn’t make me a bad person, either, but, reading articles like this, that’s the message I get. There must be something wrong with me, not because there’s something causing me physical discomfort – there’s something wrong with me because I want to stop being uncomfortable.

But convince other ordinary folks that thier sex life is somehow lacking, and therefore their sex life is bad and wrong, and that they are dysfunctional because one thing or another does or doesn’t happen in bed, and it leaves those folks vulnerable to sneaky marketing designed to make money off such insecurities. “Oh no, I don’t want to be dysfunctional. I want to be normal just like everybody else!” I see pills marketed towards men who have erectile dysfunction, although we do not know whether that target audience is genuinely bothered by a lack of erections. I see creams & gels in the backs of magazines, marketed to women who want to increase sexual sensation, arousal, and/or lubrication, although perhaps those targeted women never really even thought about such factors before.

It sounds to me like one of Tiefer’s big concerns is that Big Pharma is going to play up ordinary folk’s insecurities about having sexual dysfunction and milk the insecurity for all its worth, by cranking out sex-enhancement treatments, like pills, hormone patches, surgeries, etc.

The thing is, I don’t think that the making of sexual insecurity comes from Big Pharma alone. Some of it does, sure; I’ve seen the commercials for Levitra, Viagra and yes, even Enzyte on TV. (Remember Smilin’ Bob? and all the phallic imagery of those commercials?)
But I’ve also seen lots of movies, books, tv shows, magazine articles, internet websites, sex advice columnists, sex therapists, blogs, sex toy retailers, etc., also put out this message that sex should or shouldn’t be a certain way.
Sex should be sacred; sex shouldn’t be taken so seriously; you should be able to have g-spot orgasms; g-spot orgasms are overrated; the clitoris is the primary female sex organ; the brain is the primary sex organ for all; give a girl an orgasm like this guy on TV; learn how to give a great blow job so your husband never leaves you; light a fire under his balls by wearing this lingere; if your boyfriend doesn’t respond to your advances he’s seeing someone else; try this big giant dildo because women like ‘em big; enlarge your sex organ because women like ‘em big; it goes on….
It’s exhausting and confounding.

And it dosen’t come from Big Pharma. Those conflicting sex messages that say sex should be like this or that and try this toy or that condom – that comes from the culture I live in (I live in US culture.)
Why are we focusing so much on Big Pharma, which hasn’t even yet produced the magic pink equivalent of Viagra for women? Are there enough non-medical treatments for sexual pain so that we can completely turn away from medicine as an option?

I’m not so sure we should be looking at Big Pharma and Big Surgery alone, as the sole source of sexual insecurity and therefore sexual dysfunction. No, I think we may need to look at some other well-meaning but still counter-productive so-called experts on the matter. And I think we may need to look closer at the body’s own cells & chemistry – why did my body manifest vulvodynia in the first place? Why does this happen to some but not others?

Isn’t there a way we can acknowledge the reality of FSD and the value of the medical community in treating it, while still taking a respectful, holisitic view of the patients who have it? I don’t think we should have to completely divorce medicine from sexual health. Can’t we critique how our cultures market sex AND help people attain the sex life we want?

There’s a couple of areas of FSD that Nation article brought up that I still I have left to talk about. I’ll need to flesh out some other ideas over the next few days/weeks/however long it takes. I don’t mean to tease anbody who made it this far without getting bored to tears, completely lost or grossed out, but I need to put this list up for my own reference later, so I don’t forget:

“Female sexual dysfunction” in quotations marks and believing patients at their word – why do I need to prove myself? What about those who have nothing to prove?

Vulvovaginal surgeries (I could probably expand this into genital surgeries in general… there’s enough material…)

The voices of patients themselves – where are they? And how patients are treated in this kind of writing (Hint: Not very well.)

I’m sure there’s more…

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