In defense of “Dysfunction”

10/25/2010 at 7:25 pm | Posted in Uncategorized | 5 Comments
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I identify as having female sexual dysfunction. For me, it’s an accurate and neutral term, as honest as describing my eye color or my gender as feminine. (It is, however, a personal thing which I won’t disclose to everyone in my social circle, and you’d never guess with a first impression.) I wouldn’t say I’m exactly happy about having sexual dysfunction, but I’m no longer ashamed of it, either. (At least, I try not to be.) Some folks may question why I say I have sexual dysfunction, since it’s such a controversial term. …Then they find out that the main sex problems that are causing me so much trouble are pain due to vulvodynia and vaginismus. So long as folks know what those two conditions are, the questions about my self-identification tend to back off. Still, there are some experts in the professional field who question the validity of sexual pain as a sexual dysfunction, questioning if it should instead be classified as purely a pain condition. Then, even if sexual pain was considered a chronic pain condition independent of sexual dysfunction, that would still place me on the disability spectrum.

Since I have FSD, I have vested interest in learning more about it – what it is, what treatments are or aren’t available, how it impacts individuals’ lives (if at all,) etc. It’s not just reading though – I’ve talked to and received feedback from women who themselves have FSD in one or more forms. I’m especially interested in how FSD is perceived and what people say about it! It’s meta, and its fascinating. So what are people saying about it? When I read about FSD, I notice a few familiar themes pop up repeatedly…

Again & again I’ve run into mainstream articles and published journal studies like, “Big pharma’s newest fake disease.” “Female Sexual Dysfunction: A Case Study of Disease Mongering and Activist Resistance.” “The making of a disease: female sexual dysfunction.” Magazine articles like “Lust, Caution.” Slogans like, “Sex for our pleasure? Or their profit.” Blog posts covering FSD – or rather, not covering it, because it’s not a valid diagnosis to cover in the first place. Instead, almost all of these articles focus on the role of Big Pharma in the promotion of sexual dysfunction, with the end goal of selling medication for huge profits. The idea goes something like, if a commercial enterprise can create and then capitalize on sexual anxiety, then there’s a potentially huge market to make big bucks off of. After all, who hasn’t dealt with some sexual insecurity issues?

But who is the target audience of these articles? What do these articles say to and say about women who experience sexual dysfunction? How am I, someone who actually has sexual dysfunction, supposed to react when I see “‘Sexual Dysfunction’ in women: Myth or Fact?” as a header on page 543 in my 2005 version of Our Bodies, Ourselves? I’m standing right here, so my immediate reaction is to wonder how much able-bodied privilege (in terms of not having FSD) the editors were stewing in to overlook the fact that FSD is a broad topic that goes beyond libido alone and that perhaps some of their readers would have sexual dysfunction. The above articles make some good points to consider, but I feel very shut out of these conversations. There’s plenty of talking about, but not so much talking with.

To put it very simply, with both the medical and social construction models of FSD, sexual dysfunction is “Bad,” it’s something you don’t want. Both models contribute to the stigmatization of sexual dysfunction.

Briefly, the medical model is like, “You don’t want to be dysfunctional, right? So here take this pill/use this device/have this surgery and you’ll be cured! BTW here’s the bill…” (In practice however, it doesnt always work out that way – it can take a very long time before patients find a doctor who will be willing to listen to sexual problems and then offer intervention. And even prescriptions can have only minimal effects on the problem, plus they come with side effects.)

The social constriction model is more like, “You don’t want to be dysfunctional, do you? Not to worry; you’re not! It’s just that culture’s views of sex are so screwed up and limiting, these limits create sexual anxiety.” (If guided by a therapist through this process of coming to terms with sexual problems, there will still probably be a bill at the end of a long process of changing your world view.) Sounds great, however I’m uncomfortable with the promotion of guilt and feelings of foolishness if you do use sexual medicine that I’ve seen under the social construction model. I am concerned about the means used under the social construction model. For an example let’s return to this comparison of guys with erectile dysfunction to Jackie Gleason of the Honeymooners:

I am a 37 year old man with erectile problems for 2 years. I have used 50 mg. Viagra 4 times. All of those times have resulted in a very good erection and intercourse. The side effects are headache, upset stomach, stuffy nose, and facial flushing… About 30 mins after taking Viagra I take 2 Tylenol and a Tums and start drinking water. After about 15 mins I take another Tums and use a nasal spray for my stuffiness. I will continue this combination and it will work for me.

This sounds more like a Jackie Gleason routine rather than a romantic evening, but I think it is close to the reality of what life with these drugs will be like… How does his sexual partner feel about the whole drama with the Tums and the nasal spray and the Tylenol?

Found in Sex is Not a Natural Act, location 1109. No one wants to be a shill of the pharmaceutical industry, right? So don’t take that pill and whatever else you need to feel stable. It makes you look foolish anyway, bumbling around like that. The author, Dr. Leonore Tiefer, implies that this gentleman’s partner must think he’s a huge joke. Uh-oh – I go through a“Whole drama” with my stretching & dilator exercises when gearing up for PIV sex.

All of these articles I listed above imply that sexual dysfunction is something new and invented only within the last few decades, guided by the invisible hand of the marketplace. Sexual dysfunction, or increased awareness of it, is something to resist the spread of in the future. It’s something to fight against – like there’s something inherently wrong with being or thinking of yourself as sexually dysfunctional, and especially like there’s something wrong with wanting and needing medical help in the bedroom. The aim of the resistance is noble enough; protect women from being exploited medically, in relationships, and financially. But the means used to achieve that goal don’t always do a good job of acknowledging the reality of life with sexual dysfunction for those that do have it.

Some therapists who take a very strong social construction approach to sexual problems state that whatever you’re going through, it’s not a dysfunction:

So as this latest chapter in the medicalisation story closes, let’s be very clear. Women do experience sexual problems that cause them distress, discomfort and dissatisfaction. These are often linked to other factors and do need attention, but they are not a clinical condition or a dysfunction, and they do not require a new and separate diagnosis. A summary of common reasons women experience problems with sex can be found here.

(Emphasis mine.)

So one of the common themes I keep running into, particularly in feminist, social construction-informed spaces, is this idea that female sexual dysfunction isn’t a valid diagnosis. This view is gaining popularity – it’s covered in women’s studies classes: There’s so much sexual diversity that it’s not fair for doctors or Big Pharma to dictate who does and doesn’t have a “Normal” experience. We don’t really know what “Normal” means, even. And indeed, it is well within the realm of normal and fine to have low or absent sexual desire, it is normal and fine to have orgasms that don’t necessarily rock your world. Everyone’s different. Generally, authors who take a strong social construction approach to sexual dysfunction admit that yes, sexual problems do sometimes happen and yes, they’re real. However…

Nonetheless when sexual problems do happen, it’s not a dysfunction. Don’t call it that. Sexual problems are real, but sexual dysfunction isn’t.

What’s scary to me personally about the above quote is also that sexual pain in and of itself can be caused by a clinical condition (like vulvodynia.) My painful sex and all the issues that stem from that is merely a problem rather than a dysfunction?

The very existence of sexual pain is also a source of internal conflict that I haven’t been able to reconcile because depending on who you ask, sexual pain either is a valid and important sexual dysfunction or else pain as dysfunction is still a myth. I cannot figure out how sexual pain can simultaneously be a sexual dysfunction and not a dysfunction, and also sexual dysfunction is something that isn’t legitimate. I also can’t figure out why pain as dysfunction should be elevated to the pantheon of reality (whether it’s considered a pain condition or a sexual dysfunction) but other non-painful sexual dysfunctions shouldn’t be recognized as such.

The problem is that calling sexual dysfunctions by the euphemism, “Sexual problems” does not recognize the degree to which the sexual problem(s) interferes with someone’s life. According to this article from Harvard.edu,a key component of what separates a sexual problem from a sexual dysfunction is personal distress.

I have a few overlapping sexual problems, which cause a lot of anxiety to this day. My problems can (and do) bleed out into other, non-sexual areas of my life, so when that happens it’s impossible to ignore. To this day I can’t afford to slack off too much on my pain management exercises (like the stretches,) because if I do the muscle tension & pain comes back. Other times, the pain is well-managed but the fear remains. This is a serious problem for me; I think about it a lot and it interferes with my quality of life. And I’m one of the lucky ones who was nonetheless able to find significant improvement through medical intervention.

Lots of people have sexual problems that do not pass the threshold into dysfunction. These problems are nonetheless important and valid experiences, or at least as important as it is (or not) to each individual. But I suspect that the person who has a sexual problem does not experience the kind of anxiety and distress that I do from sexual dysfunction. Does someone with a sexual problem as opposed to a sexual dysfunction feel the need to think 12 steps ahead of every sexual encounter and have all kinds of contingency plans ready if and when something does go wrong? Do people without sexual dysfunctions even think of contingency plans in the first place? Do people with relatively minor sexual problems think about what’s going to happen as they age? How would I know? I would think that someone with a sexual problem but that feels overall pretty comfortable with themselves hasn’t had to spend buttloads of time and money searching for a professional prepared to compassionately handle their sexual complaints.

Calling sexual dysfunctions by the euphemism “Sexual problem” lumps all problems and dysfunctions together, and it minimizes the reality for those with major distress. Refusing to acknowledge the personal distress that accompanies sexual dysfunction equates my long-term pain (which I worry about) with the handful of times that I’ve been unable to orgasm from masturbation (which I’m not worried about. I do not perceive these two personal problems of mine as equal. I did not weep for months when I was unable to orgasm a half a dozen times in my life, but I did weep for the hundreds of times I was unable to comfortably insert something into my vagina.

But no it can’t really be that bad, right? It’s just a problem, strongly influenced by some intangible outside force.

It’s ironic when you think about it – part of the resistance against the term “Dysfunction” is because it’s totally not fair to classify every little sexual variation as a sexual dysfunction. Doing so maximizes the assumption of negative feelings regarding sexual performance. But by refusing to leave room for dysfunction, the distress that may be caused by a sexual problem in and of itself is minimized. The phrase “Sexual problem” misses half of what I’m dealing with here.

Refusing to acknowledge the reality of sexual dysfuction erases what is for some people may very well be a valid medical conditon. A few months ago, frequent commenter and occasional guest poster Flora picked up on the similarities between the way vaginismus and non-sexual, invisible chronic conditions were handled:

Some older studies on CFS/ME were on people who were told that their minds were unconsciously manufacturing their symptoms because they wanted to get out of a hectic work life, and called it “yuppie flu.” It happens with purely neurological things, also; it used to be widely believed that autism was symbolic of “withdrawing into yourself” due to child abuse or neglect. So it’s… nasty but also in some ways unsurprising that people would try to interpret vaginismus along the same lines.

This is really happened. But just because you can’t see it, doesn’t mean it’s not real. Not every bodily phenomenon has to have a deep symbolic meaning behind it… Sometimes things just happen.

So when someone insists that sexual dysfunction is a purely social construct with no medical validity, that is getting stacked on top of a long history of denying the validity of many chronic conditions and disabilities – some of which disproportionately effect women, and which may overlap with sexual dysfunction. I don’t see what’s so new & revolutionary about that.

It’s an act of erasure when someone who is not me, who doesn’t even know me, declares, “You don’t have FSD because it isn’t real.” Oh no; this is quite real. And I’ve worked really hard to accept and incorporate sexual dysfunction into my identity. It’s part of who I am, it will follow me into any future relationships I may have, and to embrace that was not a decision made lightly. But still I must be all wrong; I’m not dysfunctional… It must instead be the case that I am foolish, gullible and brainwashed. Snap out of it. Now isn’t that so much better than having something wrong with you?

But wait!

There’s widespread controversy about sexual dysfunction, yet even among sex therapists, there is not a unified agreement on what is and isn’t sexual dysfunction, whether or not it’s a valid terminology, and when/whether medical intervention should be acceptable. There are some sex therapists out there who accept the validity of sexual dysfunction and who would not rule out medical treatments.

For example here’s Dr. Marty Klein on anti-flibanserin activism:

It’s accurate, of course, to say that there isn’t a single level of desire that’s “normal.” But women who experience dramatic drops in their desire know there’s something wrong. And isn’t it obvious that one definition of “healthy adult” is the experience of sexual desire when the conditions are right?

Millions of women (and their partners) know their lack of sexual desire causes suffering. Whether taking a drug is the best treatment for any woman isn’t the point. Dismissing B-I’s drug and its marketing as “disease mongering” is terribly disrespectful to the many women who struggle with low desire.

You may know Dr. Klein as a Ph.D., sex therapist, as the blogger behind Sexual Intelligence, and as the author of several books about sexuality. So he’s been working at sex education and therapy for literally decades. Yet after everything he’s seen, after raising his own questions about the validity of certain diagnoses such as sexual addiction, still, he acknowledges the importance of potential treatments for low libido types of sexual dysfunctions.

Still don’t believe me when I say that there’s disagreement among sex therapists about what constitutes sexual dysfunction? Here’s another well-known sex educator, Dr. Carol Queen, on nomenclature, in response to a reader query:

Question: Hello. I am twenty years old and unfortunately suffer from sexual dysfunction. Before seeing your blog on Good Vibration’s website I had no idea this was an issue with other woman. I was wondering if you knew where I can find help, any kind of help with this issue. I didn’t know there were people who studied this or that I could talk to. So if you can, please help me out. Thank you so much.

…it is really pretty common for young women to have sexual issues that might be called “dysfunctions.” Keep in mind that it is only a dysfunction if you are unhappy about it. If you have low libido, or have a hard time getting aroused, and you don’t have or want much sex and don’t feel troubled by this, it is simply the way you are, not a dysfunction. If, however, you are concerned about it, then that language might be appropriate.

…In short, unless you have really gone on a hunt to get good information, the schools and the culture have not made sure you learned enough about sex to have *good* sex. And this does not make YOU dysfunctional — if anything, it means our society is dysfunctional!

…So far I haven’t really said anything about sexual dysfunction itself; I’ll do that now. It’s possible that in spite of what I said above, you *do* have some sort of sexual dysfunction, but it’s likely that it is something that can be helped via knowledge. It’s not as likely that you need some sort of medication, which is good, because so far, the pharmacological remedies available to women to help us with our sexual problems are, at best, untested and insufficiently understood.

Emphasis mine. What’s this? Dissent among the ranks! Here, Queen explicitly recognizes that every once in awhile, sexual dysfunction is a valid and proper terminology. Unfortunately even when it is, there still aren’t a lot of medical options available for many sexual dysfunctions. Knowledge helps, but it only takes me so far. You may recognize Dr. Queen as a prolific author and editor of sexuality anthologies and she’s a sex-positive Ph. D., sexologist and activist – so like Dr. Klein, she has seen plenty of shit go down in the realms of sexuality and politics.

So these two sex therapists who are open to recognizing sexual dysfunction and treatments for it, aren’t at all fly-by-night therapists, or in the pockets of Big Pharma. These two have been around long enough to have seen the positive and negative effects of sexual medicine.

Humm… I guess that if you’re seeing a sex therapist for sexual dysfunction, how you’re treated, what language you’re allowed to use to describe your experience, how you’re allowed to identify and what options are made available to you are going to depend on who you’re talking to. I guess that’s why it’s so important to find a sex therapist who’s right for you if you choose to go that route.

Of course, I speak only for myself here. I’m comfortable with the term sexual dysfunction, but not every other woman with a sex problem is, (especially since not every little problem is the same thing as a dysfunction) and probably very few folks will embrace it, perhaps for some of the reasons enumerated by experts on the social construction model of sexual problems. Remember though, I do not claim to be an expert on the topic by any means; don’t have a Ph.D. or a journalist resume to flaunt (yet); I just blog so I don’t know everything. But I’ve come to terms with it – I’ve come to terms with the term. I’m starting to think that this binary vs. mode between the medical model and social construction is creating some messed up language on both sides.

Interesting posts, weekend of 10/24/10

10/24/2010 at 10:08 pm | Posted in Uncategorized | Leave a comment
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Dear internet, good news, everyone! I’m no longer in the middle of a major life crisis. I’m now on the tail end of it. I think the worst is over with. I’m starting to get back on my feet, and I’ve even had a little time and motivation to work on blogging. Now I have too many new drafts that I don’t know when I’ll get around to finishing. Things will never go back to the normal that I had just a few short weeks ago. But soon, I will settle into a new normal. Life will take on a new pace and I’ll be facing new challenges. I could talk about the true nature of this major life upheaval I just went through in more detail, but I don’t want to. Most importantly I am (and feel) much safer now than I did before. Less creature comforts is the tradeoff, but, oh well boo-hoo.

And then we get to do it all again in another few months…

Friendly reminder: I am looking for Guest Posters. Did you see the guest post by Clarisse this week?

I want to hear more perspectives on the themes dealt with here at Feminists with Female Sexual Dysfunction. 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 sexual health and/or feminism on a public forum?!” that would probably be very invasive. For this reason, Guest Posters requesting to remain anonymous will also be taken seriously.
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.
Comments made by new e-mail addresses here are auto-screened before going live, so if you want to stay anon use an e-mail address that you haven’t used here before.

Can’t get enough of feminism and sexual dysfunction on the internet? You may want to think about following the Twitter feed, which is more accurately described as my Twitter feed since no one else manages it. Some of my daily mundane and/or angry thoughts sneak in there but I try to include trendy topics as well as a healthy dose of sexual dysfunction related news when I find it.

Now then, on with the weekly blog link roundup. Posts I found interesting over the last week. Share links if’n you got’em.

I Haven’t Forgotten – A good message: “It is possible to enjoy life with vulvodynia and pudendal neuralgia.”

September 2010 - This is the comments posted at the F-Word UK blog, including comments to their September feature, Honeymoon Cystitis?

Female Sexual Pleasure Is Too Hot For TV – My, my, my what’s this… so it’s okay to advertise drugs for erectile dysfunction but not drugs (of questionable value, unfortunately… but eh, there is that Enzyte thing on TV too so…) for women’s arousal disorders. Mm-hmm. I see…

Love reduces pain? Anyone over 30 knows otherwise. – Don’t be fooled by a recent newsbyte (I saw it too) that said something about love being a natural painkiller.

Disability Blog Carnival: Identity – In all the chaos, did I ever get around to posting a link to Astrid’s blog carnival about Identity? Hmm, no I did not.
The sex education website Scarleteen is also hosting a blog carnival to raise funding. You reap the benefits of lots of posts about sexuality! List of contributors is over here.

Open Question: What Does “Sex Positive” Mean to You? - [NSFW] The truth is, I still don’t know. How do you be sex positive and yet have sexual dysfunction? Can you still be sex positive even when you are critical of some elements of sex positivity? When does that criticism cross the line from helpful to wolf-in-sheep’s-clothing sex negativity?

Fucking While Feminist: A Conversation, for Ladies and Selected Dudes! – I still don’t know exactly what fucking while feminist means either. It probably doesn’t help that I still don’t consider myself to have even fucked yet. You might like this set of lines though:

Feminism is like a lot of ideologies; inconvenient and sometimes hard to live up to. Of the many varieties of Feminist Guilt, the I Didn’t Have an Orgasm Correctly Guilt may be one of the more obnoxious. All of the clear boundaries and open communication and healthsome respect for your ladybusiness and the assorted business of others isn’t guaranteed to work, especially not if the fellow business-owners you’re engaging with don’t plan on bringing the same thing to the table. And sometimes, things just don’t work.

Sometimes shit just don’t work and even feminism can’t fix that.

Self control. - This post is giving me an idea for a future blog post possibly… something about control & women’s sexuality… you must take control of your sexuality, you must do this thing or not do the other thing to take control of it, you must give up control to orgasm hmm… Something’s going on wrt control…

There’s two pieces about sex after rape, so these two come with a Trigger Warning: Sex After Rape, about coming to terms after, and some Savage Advice from Dan Savage – yes the same Dan Savage behind the “It gets better” project. Working on a good project does not negate the bad.

Tea Party Racism – The NAACP accused the Tea Party broadly of racism. Now the NAACP can prove it. Connections between major Tea Party groups and openly racist individuals and groups have been documented. Racism isn’t something limited to the Tea Party though – here’s some more racism from the US political right wing: Florida immigration bill would exempt white immigrants. Wait, there’s more: “Nazi Re-enactment” [Anthony McCarthy] – Further evidence presented that there’s strong ties between the Tea Party and white supremacy. (And now I’m thinking to myself about a certain not-friend who likes to dress up and play military and is a member of the Tea Party…)

Also political, What we can afford – where the US government’s spending priorities are. And then there’s Anita Hill and Me: An Overshare – I was too young at the time to remember anything about the Clarence Thomas court confirmation hearings while they were going on. Thomas’ wife, last Saturday, she called Anita Hill and demanded that Hill apologize for making sexual harassment claims against Thomas – even though there’s plenty of evidence to support her accusations.

These are dark days to be a young queer person… I had it hard enough as it was with the bullies growing up hetero. Justice Virginia Phillips ordered a stop to DADT and for about a day, DADT was supposed to be unenforced. Lt. Dan Choi even went to re-enlist when it was looking like DADT would be suspended but then the US government ordered a halt to the Judge’s orders – in other words, DADT is still active and in force. The influence of homophobia is global - Ugandan hit list further confirms an age of rampant homophobia [Trigger warning]. Then you’ve got conservative writer writing fake articles about shit that didn’t really happen, apparently in order to sneer at queer youth who commit suicide! [Trigger warning:In Jesus’ Name, Amen.Wtf… and as though queer kids are mutually exclusive from Christianity. I think it’s worth noting that this guy also wrote a “Politically incorrect” book addressed to feminists and I’m reading the description and I’m like, Holy shit.

Sometimes even the queer community is rough on who falls under the LGBTQQIAA spectrum, Who’s Queer? I thought asexuality was queer.

Next batch of links is loosely themed around mental illness. Women as sociological ducks – I like it for this line,

But I’m also me, and me happens to have a history of depression, for whatever chemical and psychological and personal reasons, and I resent being painted as nothing more than the inevitable outcome of Several Millennia’s Oppression Of Women. My name is Hannah, I enjoy knitting and swimming and melted cheese, and I take medication to deal with an illness. I am more than just a symptom of social malaise.

Relatable to me because I have a history with depression (it’s not at the forefront of my life right now so I don’t talk about it much) and because I’ve seen this argument used in relation to sexual dysfunction. Like, having a sex problem & think you need medical help for it? No! You’re just a product of the patriarchy! Except for the dyspaerunia would follow me everywhere into every relationship because something’s going on with my biology inside of me.

Then I found this one via FWD so some of you may have seen it already: Psychiatry and the Media — a Strange and Strained Relationship, and I when I saw these lines I was like *GASP* you mean most of the time it’s NOT TRUE??? I NEVER WOULD HAVE GUESSED!!! (not.):

Recently I had a conversation with someone who had no idea what I do for a living. He explained to me how the doctors and drug companies have a good deal going. He was under the misleading belief that most psychiatrists get money from drug companies when they prescribe medication…the more they prescribe, the more money they make. I suspect many people share this erroneous belief. Not only would this be morally wrong, irresponsible, and reprehensible if it were true, most importantly for the majority of practitioners this is patently false!

Again relatable… why does that sound so familiar… I read the rest of the article too and I thought it was p good.

Let’s Bust Some Myths: Depressed People Are Always Sad or They’re Faking! - Depression takes many forms.

I’m sure there’s more…

Guest post: GUILT, FAILURE AND A PRE-ORGASMIC FEMINIST

10/17/2010 at 1:30 pm | Posted in Uncategorized | 13 Comments
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[Dear internet, we have a guest poster today! This is a post by pro-BDSM activist Clarisse Thorn, who blogs at Pro-Sex Outreach, Open-Minded Feminism.]

I’ve been working on a long article about my experiences with sexual dysfunction. It’s a project that’s been in the making for quite a while, but now that I don’t have so many distractions I’m ramping it up.

This is a complicated and difficult subject for me. I have a satisfying sex life now — I’ve gotten pretty good at communicating with partners, setting boundaries, seeking what I want, and masturbating to orgasm. It took me a long, long time to get here, though, and I had to get through a ton of confused feelings. Not just about coming into my S&M identity, though that was certainly a factor, but also dealing with feelings around the orgasmic dysfunction itself — for example, feelings about how my apparent inability to have orgasms meant that I was broken. (I had and still have some vaginal pain, too. Not every time, not even most times, and nothing overwhelming — but enough that I’ve developed coping mechanisms.)

In order to write this article, I’ve been going through a lot of years-old journal entries. One quotation particularly struck me:

[My boyfriend] comforted me the other night when I broke down and cried. I wept and wept and he said it was okay, you’re not broken, there’s nothing wrong with you. It’s okay, he said, not to want sex. But I do want sex, I’m just sickened and terrified and disgusted by it, and I don’t want to be anymore. I want to be able to watch sex scenes and not be enraged and disgusted, to read sensitive ones and not collapse in tears.

I wasn’t entirely sickened and terrified and disgusted by sex, of course: I often liked it. Loved it, really. Sex usually felt good even before I could have orgasms, even before I’d found S&M, even before I’d parsed out my feelings and learned more about sexual media such as porn. And I’ve talked a lot about how awesome and sex-positive my sex education was.

But I knew I was missing something, something crucial and integral to my sexuality. And I hated the way society seemed to always be informing me how to sexually act: I felt crushed into approaches that obviously weren’t working, weren’t meant for someone like me. It was hard to walk the line between craving sex and being unable to stand it.

Here’s another excerpt from my journal, around the same time:

I really hate reading explicit sex scenes. I didn’t used to hate it as much as I do now, and since I broke down in tears during the last one, I guess it’s pretty obvious why. Jealousy and hurt and hatred of the ideals I feel like they’re trying to forge into me, [one ideal being] that love and sex and particularly orgasm are all irrevocably intertwined, and that by missing out on orgasm I’m missing out on not only an aspect of sex but of love.

But mostly I guess the discomfort does come from not wanting to read the intimate details of another’s sex life … and the jealousy for the orgasm, still there, too deep to banish. Christ, it’s fucking ridiculous. I shouldn’t be this miserable about this. It’s so fucking unimportant in the grand scheme of things. — but the tears that startled me in my eyes as I typed tell me just how unimportant it really is to me, I guess.

I started reading some sort of book on having orgasms and wept all through the first chapter because it was so miserably true. And because it was so miserably true I feel as though I ought to read the rest of the book, just give it a chance and go with it, and maybe make it that way, but it hurt so much and I’m so scared that it won’t work, and then I’ll be really unhappy. (A reaction the book even outlined, by the way. Yes, it’s about as true as it gets — the only thing I’ve ever found seems to understand how I really feel about this.)

The book that struck me so much is the monumental For Yourself, by Lonnie Barbach. It’s a famous book. I searched it out at the San Francisco library recently, and spent an afternoon sitting around the Mission branch, trying to locate the passages that once touched me so much. A few quotations:

Do you sometimes feel that you would be happier if sex were eliminated from your intimate relationships altogether? If so, possibly you feel abnormal in this regard, or like a misfit or not whole as a woman. Or, perhaps you just feel that you are missing something everyone else has enjoyed, a part of life that you’d like to have be a part of yours, too. You probably feel as if you are one of only a few women who have this problem. But the truth is that you are far from alone. (page xiii)

A real fear that can keep some women from doing anything to solve their sexual problems is the fear of failure. When Harriet joined the group, she didn’t believe she could become orgasmic. She said, “If I tried, I’d only fail, and then I’d be really miserable.” … Harriet eventually did defy her fears, as did all the other women mentioned. It takes time and effort to counteract these fears. It means saying “I’m afraid” and yet pushing beyond. (page 14)

Is it because you’re embarrassed to ask for what you want at a particular time; afraid your partner will refuse, get angry, or feel emasculated? (page 15)

Empathetic and accurate so far. (As it happens, the only lover I ever directly asked for help during this orgasm-discovery process refused and got angry, which just goes to show that being afraid he might react that way was not all in my head.) Merely confronting so much understanding was hard to face.

But, although I read it a long time ago, I think I’ve figured out what it was that made me unable to read further: the way Chapter 1 ends is a bit much. The last page of For Yourself‘s first chapter contains this:

You have to assume responsibility and be somewhat assertive. Our culture has taught us that a woman should depend on a man to take care of her, which means she can blame him for any mistakes. It’s nice to be driven around in a car, but it’s also nice to be able to drive yourself so you can go where you want to, when you want to. But to do that, you’d have to assume some responsibility.

Well, okay. Except that how do you assume responsibility for something if you have no idea where to even begin? If you know something’s missing but you’re not sure what it is? If you’re sure your partner will be frustrated and resentful when you ask for help?

This is especially complicated by the fact that along with the typical advice of “Take responsibility!”, the other typical advice is “Let go of control!” Over at Lady Sex Q&A, Heather Corinna writes:

Orgasm involves us surrendering to what we’re feeling, and really rolling with it, even if and when it feels very emotionally precarious. It’s control we’re letting go of, really, and that’s harder for some folks than others.

I’ve been an off-and-on sex & gender geek throughout my life, so I already knew these things intellectually. I’d already absorbed these ideas: that I must both take responsibility for my sexuality, and lose control in order to enjoy it. I think even then I knew that both of these ideas are actually good advice. But the problem is that they’re often put in patronizing and less-than-helpful ways. For example, “It’s nice to be driven around in a car, but it’s also nice to be able to drive yourself so you can go where you want to, when you want to. But to do that, you’d have to assume some responsibility.” Condescending as hell! To me, those words implied that I was making myself into a helpless child. Pulling a wounded-bird act and forcing other people to take care of me. I couldn’t stand the idea that I was doing that!

I am frustrated by the insensitive guilt trips that often happen, even (especially?) in feminist and sex-positive circles, where people will sometimes act as if these things are simple, as if it is oh-so-easy to stand up and take on one’s own sexuality and Just Deal With It. Especially when you’re in a situation where you know for a fact that some men you have sex with will resent you if you’re honest about not having orgasms, and yet you don’t know how to have orgasms and aren’t sure how to start on the journey. What then?

Some women end up faking in those contexts (I didn’t very often, back in the day, but once or twice I did). Of course, some feminists and sex-positive writers are especially unhappy about this:

I’m sure I’ll offend some choice feminist who thinks that it’s unfair to criticize women who make the totally autonomous choice to flatter a man with a fake orgasm instead of working towards a real one, but I’m taking a stand on this one. It’s un-feminist to fake, ladies!

I don’t advocate faking orgasms, and I actually also don’t advocate dating a man who gets angry and resentful when a female partner asks him to pitch in. (Oh my God, sometimes I have nightmares that I’m back in that relationship, and it’s been years.) At the same time, the idea that screaming “It’s un-feminist to fake!” will fix the problem is ridiculous. It’s the kind of idea that will just make feminists (like, say, myself many years ago) feel even worse about trying to figure out our relationships while not having orgasms. I see, so now not only am I failing to be responsible, I’m also un-feminist? Awesome.

This is not easy. It’s actually really hard. I get that people have to want to work on their sexuality, in order to do it — obviously I get that. But telling people that they’re being weak or self-centered or un-feminist because they aren’t sure how to do it? Or are actively pressured out of it?

Not okay.

Interesting posts, some time in October

10/12/2010 at 6:14 pm | Posted in Uncategorized | 4 Comments
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Dear internet, we sure have a lot of catching up to do. I’m still in the middle of a major life upheveal. Most people would probably be done with this sort of thing by now but I am literally receiving zero help from anyone else so it’s all on me go get through it alone. I still work full-time too so it’s not like I can just take some time off and get it over with.

It’s been awhile since our last roundup, so it goes without saying that a lot of shit went down in the news. Hope you’ve all been keeping up with the news and feminist blogosphere, because at this point there’s no way I can bring you up to speed with everything. So as with all roundups, if we’re missing anything after this, it’s not necessarily because a skipped topic is unimportant. I just got a lot of shit to do. Maybe you would like to help pick up the slack by dropping a link? Or perhaps I can interest you in putting together a guest post?

Friendly reminder: I am looking for Guest Posters. There were (technically) two guest posts this week – one that I wrote at Grasexuality, and one that brigid wrote for us here; did you see them yet?
I want to hear more perspectives on the themes dealt with here at Feminists with Female Sexual Dysfunction. 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 sexual health and/or feminism on a public forum?!” that would probably be very invasive. For this reason, Guest Posters requesting to remain anonymous will also be taken seriously.
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.
Comments made by new e-mail addresses here are auto-screened before going live, so if you want to stay anon use an e-mail address that you haven’t used here before.

Can’t get enough of feminism and sexual dysfunction on the internet? You may want to think about following the Twitter feed, which is more accurately described as my Twitter feed since no one else manages it. Some of my daily mundane and/or angry thoughts sneak in there but I try to include trendy topics as well as a healthy dose of sexual dysfunction related news when I find it.

Now then, on with the weekly blog link roundup. Posts I found interesting over the last week. Share links if’n you got’em.

I have some bad news for women dealing with low libido types of sexual dysfunction… Remember the great Flibanserin debacle of 2k10? Of course you do; how could we forget? Get ready to enter rage-rage-rage mode:
It’s over… The German company Boehringer Ingelheim has ceased its work on producing Flibanserin, an anti-depressant turned possible libido booster for women with hypoactive sexual desire disorder (HSDD.) Social constructionists, congratulations; you got exactly what you wanted, and now women with low libido types of sexual dysfunctions still have no medical prescription option in the USA. So now women who have tried everything else and exhausted every other resource, tried all the common sense advice, sought help from professionals, tweaked their relationships (if they’re even involved in one!), and run up against or even attempted to adhere to every other piece of rubbish that did and didn’t make it onto our new Bingo Board, still hit a wall. Happy now?
Obviously, I am in fact not happy. I am so pissed off. Even BI cited “Complexities!” as a reason for stopping. Figure it out!
I shoulda done more… I shoulda started a counter-petition to disregard the petition to block passage of Flibanserin. (Note my use of language: I didn’t say “Start a petition to fasttrack Flibanserin,” I just think it’s really messed up for activists to go around telling women that they no one needs something like this. Because how would you know?) The reason I didn’t start such a counter-petition, is not because I knew it would gain very few signatures… I’m really not worried about the number of signatures; it’s the principle of the thing… It’s not because I knew it wouldn’t have done any good, which it probably wouldn’t have. It would have been to show that women with FSD themselves are listening and paying attention, and some of us might even have an interest in a medical option… I didn’t start a counter-petition because I knew doing so would be what would draw the New View’s attention and I would really prefer to remain under their radar as long as possible, because I am selfish and seriously don’t feel like dealing with all the stress and insults and lectures on the history of FSD that I know is inevitable once the organization finds out about what we’ve been doing here.
To my readers with low libido types of sexual dysfunctions (and to friends of folks with libido dysfunctions,) brace yourself: I have a feeling we’re probably going to see another spike in coverage about Flibanserin, (I’m thinking certain feminist websites are more likely to cover it than others, and maybe some op-ed pieces in mainstream newspapers, as well as others) and when we do see it, I can guarantee you it’s going to get real ugly, real fast. Everyone, get your bingo boards ready to go if you’ll be doing any reading on the matter. If you see any new and bizarre arguments about FSD and why no woman, anywhere, ever, needs medication for sexual desire problems ever, in comment sections to the inevitable anti-Flibanserin posts, let me know; we may have to produce a version 2.0 if we keep running into the same old shit again and again.

Looks like we’re stuck with the same ol’ old timey libido boosters of questionable value… here’s a consolation prize, if you can get yourself to Mars New York: A New Aphrodisiac Café Catering To Your Passions.

You know how every once in awhile, like, maybe once every decade or so, a huge study of human sexuality comes out? The Kinsey report, the Hite report, 1990s JAMA study (the one that said up to 43% of women in the US have sexual dysfunction but that was actually a wrong figure to use because the study fucked up the language and should have said “Sexual problem, which may not actually be a dysfunction because not all sex problems are dysfunctions”? Remember when we talked about that already?) Well there’s another new one out – The National Survey of Sexual Health and Behavior (NSSHB). It’s sponsored by Trojan this time, I wonder what the reaction to that will be considering that the JAMA report had connections to Big Pharma and so there was a conflict of interest there… hmm… do we need to raise skepticism about the involvement of Big Condom…? Conflict of interest with Big Prophylactic…? I don’t know. It is part of the Journal of Sexual Medicine. Anyway, there’s quite a bit of coverage about the report going around the feminist blogosphere!
Unfortunately for reasons cited in the introduction to this post, I haven’t gotten a chance to actually sit down and read the damn thing!
This could be a neat topic to write about some time in the future, if no one else here would like to volunteer. If you will look at the right side of the the Indiana.edu page, you will find a link to the journal article, so it is available to the public (accessibility is another issue.)
Anyway, here’s some links about this big new sex survey in the US. Mind any comment sections, which may be fraught with land mines. Sex Survey! Condom Use Is Highest for Young, Study Finds. Largest Survey of American Sexual Behaviors Offers Snapshot of 21st Century American Sex. Sex in the US: the shocking truth

Hey, speaking of research! Here’s a month-old post I missed from Happy Bodies which is totally relevant to this discussion! This Week in Evaluating Research – some guidelines to keep in mind when we’re doing our homework. This post looks at studies of obesity but I’m pretty sure the same principles apply to sexual health research as well. In fact here’s a link to a post that Jill links to which is more general: Becoming a Critical Reader: Questions to Ask About Qualitative Research; try that on.

Meanwhile, in reproductive health (which for some reason is still sometimes separated from sexual health): Birth control breakthroughs on the horizon

Meanwhile, in Nobel Peace Prizes! IVF, The Nobel Prize, & Sexuality – Something that I rarely (if ever!) see covered in discussions of In-Vitro Fertilization, but that, if you are dealing with infertility, (and I know some of my readers here are) you may want to think about either before or during IVF treatments. This might be one of those times where talking to a sex therapist is worth thinking about, so if for some reason I had to go through IVF I might break my own rule and try it…

At 2600: Blacklisted Words That Google Instant Doesn’t Like - [NSFW] – Violet Blue is looking at the sexual terms that Google instant is blocking out but again you should probably check out her original source to see the rest of the list.

When Is a Sex Toy Not an Instrument of Pleasure? – The short version is, when it’s not used as such… like, in this case, when it’s used as a source of non-consensual humiliation. That guy James O’Keefe who was behind the Acorn fake pimp video was going to use sex to humiliate and slut-shame Abbie Boudreau, a CNN correspondent. At the last minute, Izzy Santa blew the whistle.

Here’s some stuff about living with chronic illnesses: Self-Diagnosis: Pudendal Neuralgia, very interesting when read next to On Living Without a Diagnosis. And chances are, if you are living with a chronic illness, problem, or sexual dysfunction… you may not hear about it often, but you are probably not alone. Why You Should Blog About Your Vulva

Something about who is critical about medicine, why, and the effects… in this case, vaccines and autism, but can be applied to other treatments as well. Right wing propaganda machine adopts anti-vaccination stance

Meanwhile, in nuanced discussions about selling empowerment vs. Empowerfulment! Overselling agency: a reply to Barry Dank on teacher-student sex (huh maybe I can ask him about that Disgrace novel; my teacher made a big deal about the goat testicles and dead dog thing and it’s 10 years later and I am still like “Wat”)

Is it really “Strange” sex? – A critical look at the television program Strange Sex, which covers and sensationalizes sexual problems… Including vulvodynia. (I don’t watch that show. Are you surprised?)

Mark Hyman – 5 Steps To Kill Hidden Bugs In Your Gut That Make You Sick – I’m less interested in the advice here – I’m not sure how well it’s been proven, and it’s got this curebie thing going on… What really has me interested is Dr. Hyman’s claim that there’s an autism-bacteria link. This interests me because, if you will recall, I was quite skeptical of a similar claim made in the documentary, The Business of Being Born. Now then: the gut-medicine doctor tells me that autism is linked to gut bacteria, the natural birth advocate openly speculates that it has something to do with a lack of natural hormones secreted during birth… HMMMM… Who do I believe here? Am I the only one seeing a potential conflict of interest? Whom do I trust? And furthermore, what’s missing?

Official: vb.ly Link Shortener Seized by Libyan Government – [NSFW] – Another setback for Violet Blue; this comes on the heels of the Facebook page for Our Porn, Ourselves being removed. VB.ly was a sex-positive link shortener, so, you could have used it to shorten links to adult content. So there wasn’t any adult content hosted on the server, it’s one of those dealies where it just re-directed you to such content. And that was supposed to be allowed but now it’s not.

As always, I’m sure there’s more

Guest post – On the FSD hierarchy and why it hurts all of us

10/05/2010 at 6:12 pm | Posted in Uncategorized | 9 Comments
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[Dear internet, we have a guest poster today! The following was written by brigid, who wrote me a moving e-mail a few days ago.]

Hi, my name is brigid and I asked K a few days ago if I could do a guest post for feminists with fsd. This is the first time that I have really spoke openly about my pain, ever. I mean it’s not like no one knows that there is something wrong. If the chants of frigid brigid that I dealt with since middle school are any indication a certain ex of mine was blatantly honest with the entirety of the boys locker room that there was something wrong.

So, what exactly is it that is “wrong” with me? My fsd is caused by a condition called endometriosis. Endometriosis is a condition which results in the tissue that lines the inside of one’s uterus to grow on the outside of the uterus, and the surrounding tissues. This can cause the tissues to become inflamed which can result in pain in the surrounding tissues, leading down into the vagina. I also have a condition called allen-master syndrome. This means that my uterus is hypermobile and will tilt at strange angles which creates problems for my cervix, further resulting in pain. So I am basically in pain all the time. It feels like someone is continually stabbing a hot poker into my uterus via my vagina.

Any and all kinds of sexual activity, even those that most people would say are not inherently sexual, result in increase of pain. Any kind of signal firing to my vulva and vagina causes the pain to increase. That means that things like kissing, cuddling, outercourse etc are all off limits to me. Each and every time I try any of those things I end up in agony which doesn’t go away for days and sometimes weeks on end. And don’t even think about masturbation and intercourse. I can’t even touch my vulva most days.

That brings me to the point of my post. A lot of support groups, both on and off the web do not want to recognize women with conditions such as endo as legitimate cases of fsd. We don’t have vulvodynia, vulvular vestibulitis, or vaginismus so we couldn’t possibly go through the same things as women with those conditions. I’m here to change that misconception. The term that K uses for this kind of thinking is the fsd hierarchy. I like that terminology. Because that’s basically what it is when other women with fsd say that their level of pain and suffering is more significant. No one person’s pain is more significant than any others. The levels of pain may be different. The things that one may be able to accomplish with treatment based on the individual and the condition at hand may be different, but we all have something in common. A problem which we can’t talk about. A problem which society tries to pretend doesn’t exist. A problem which for some of us consumes are lives and makes them hard to live. This is something we all have in common. Sexual activity is painful for us. That is something that should bring us together. Turn us into a united front. One which says that we will be treated with respect. One which demands research into ways to better manage our problems. One which supports each woman and encourages her to educate herself about these problems. One which encourages our partners to educate themselves about this. One which will allow all those affected to get an accurate diagnosis and a doctor who knows what they are doing instead of dismissing the pain as “something some women deal with”. I don’t think that that is too much to ask for. We should be striving to break down these barriers. We are all suffering from our problems with our sex lives. Some have it worse than others. Some choose to still have intercourse even though it is painful for them (I admit that I fall into the I have intercourse for more reasons than just it feels good camp) Some choose to be completely celibate, but regardless on your individual decisions, you still suffer from fsd. Our society tries to silence us. By playing the hierarchal game we are allowing them to get away with it. The only way that we as a whole are going to make things better for ourselves is if we talk about it, and encourage others to talk about it as well. By silencing other women who suffer from FSD just because it doesn’t fall under one individual’s narrow view of what fsd is and how it works, we are hurting every woman who needs help. We as a community need to share and embrace our differences. This will allow us to learn more about others and as a direct result about ourselves. So I encourage you today to reach out to another woman with a different type of fsd and talk to her. Share in a mutal discussion about the challenges of your conditions. I think you will be surprised to see how much overlap there really is between us all.

Guest blogging: Reaching out to the asexual community

10/02/2010 at 4:09 pm | Posted in Uncategorized | Leave a comment
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I guest blogged for Elizabeth @ Shades of Gray, an asexual blog. Here is a link to the post: Guest Post: Interview with K on Female Sexual Dysfunction. Elizabeth is trying to maintain a relatively safe space there for commenters including people with sexual dysfunctions; so far the comments have gotten fairly long.

The post went up just a few days ago, but it’s actually been brewing for months, literally, so there was a big time delay between when we first got in contact and when it went up. We both had life stuff going on. If you go there, you may want to check out the introduction to the post for more background. Elizabeth and I communicated first during the middle of the great Flibanserin debacle of 2k10. You are probably by now already aware of the resistance Flibanserin has received from multiple angles, like some sex therapists, feminists and activists. There are also concerns about the drug and the validity of the diagnosis hypoactive sexual desire disorder (HSDD) from within the asexual community.

During this back-and-forth across blogs re: Flibanserin, Elizabeth asked if I would be willing to answer some questions about FSD and flibanserin. I agreed, with the same caveat I’ve repeated before: I’m not a doctor in any way shape or form. So I can’t answer any questions with the same level of authority. (It didn’t come up there, but I also don’t feel comfortable giving out advice.)

But anyway, I tried. Asexuality and sexual dysfunction aren’t the same things. Neither side can ignore the other, especially since it’s possible to have overlap.

Here’s a snippet of what’s going on over there:

Some basics:
What is Female Sexual Dysfunction? What kinds of FSD are there?

Female sexual dysfunction is a broad term encompassing several types of sexual problems with a common denominator of personal distress. A good overview of sexual dysfunction can be found at harvard.edu. When discussing FSD in general terms it is important to remember there it is not limited to one specific manifestation. In addition to sexual medicine, there’s a lot to talk about with regard to female sexual dysfunction.

There are a few different ways of looking at FSD. The two ways I’m most familiar with looking at FSD are through the medical model and the social construction model.

I also had questions about female sexual dysfunction for Elizabeth to address from an asexual perspective. I eagerly await a response.

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