Book review: The Adventurous Couple’s Guide to Strap-On Sex

01/28/2012 at 10:07 pm | Posted in Uncategorized | 12 Comments
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I recently picked up and finished reading the sexual guidebook, The Adventurous Couple’s Guide to Strap-On Sex, by author & blogger Violet Blue. It’s exactly what it sounds like – an in-depth guide to integrating strap-on sex toys and techniques into partnered sex.

Why are we reviewing a book about pegging on a blog about sexual dysfunction? For much the same reason cited last time we read a book by Violet Blue: Personal reasons + it was in the book queue. Besides, I’ve said it before and I’ll say it again: Sometimes when you have sexual dysfunction, you gotta get real creative, real quick.

The short version of the review is…
Well… I liked the Ultimate Guide to Fellatio better…

The Adventurous Couple’s Guide to Strap-On Sex – let’s call it TACG from here on out – the book is short. I was able to burn through the book start to finish within just a few hours. The Kindle edition I read has 1568 locations (sentences, I think,) which translates to about 160 pages in paperback format. There aren’t any pictures in the Kindle version – there’s not even one of those cut-away academic diagrams of male pelvic anatomy. All of the descriptions of anatomy and how-to are written out in paragraph form.

TACG‘s target audience is cis, heterosexual couples interested in pegging – and pegging, by definition, takes place between cis, het partners. But strap-ons are used in LGBTIQA communities too – so to me, it was weird to see so little coverage of strap-on use outside of straight sex. There was a lot of reassuring the reader that an interest in pegging does not necessarily mean you or your partner is gay. Definitely a book aimed at cis, het couples primarily.

The book includes just about everything you will need to know about strap-on sex and maybe some stuff you hadn’t thought about – anatomy, history, myth debunking, what gear to look for, how to go warm your partner up and then go through with pegging, and safe sex. Actually, I would have preferred to see the section on making strap-on sex safer close to the beginning of the book, instead of at the very end, but there is precedent for saving the best for last – Sex Toys 101 did it that way too. Remember that anal penetration is a risky sex act in terms of passing along infectious agents between partners, because the tissue is delicate, and there’s a lot of bacteria behind the anus. Blue includes a table detailing your risk of infection from anal sex, pegging and related activities and describes tools like condoms & dental dams you can use to reduce the risks.
Remember also that if you’re inserting objects anally, they really need to be designed specifically for that. If you just grab whatever’s handy, you or your partner could wind up with a toy lost inside the body and/or a serious injury – either scenario requires a trip to the emergency room. Blue addresses what kind of butt-friendly toys to look for. Shape, size, and materials all matter, so shop smart. Don’t forget the lubricant, since the anus can’t produce its own secretions the way a vagina can.

Where TACG really shines is when Blue talks about the importance of communication. Pegging isn’t something you can just spring on your partner, and a desire to engage in it isn’t something you can just pantomime out using secret code gestures (no matter what Cosmopolitan tells you.) If you’ve been slacking off in the sexual communication department, Blue lists a few suggestions for how to bring strap-on sex up in conversation – most of these suggestions can easily be applied to other various sex acts as well. Blue also reminds the reader to think about their partner’s perspective, since talking about sex can be (but doesn’t have to be) nerve-wracking. Blue suggets a few areas for exploration if one partner or another is reluctant – what are you the most uncomfortable with, the potential for pain? Insecurity with flipping around gender norms? Cleanliness/messiness/poop? You don’t even know where to start or what else there is to do during? There’s ways to address these concerns.

I liked the section about the history of the terminology of strap-on sex and why you may have noticed a glimpse of pegging here and there in mainstream sex shops, films and discussions. I was also pleasantly surprised by the inclusion of a chapter on how to have strap-on sex with a third party. Opening up a relationship is a little too advanced for me but the book is clearly polyamory friendly. There’s a lot of coverage about various reasons couples might want to try strap-ons during sex in the first place – some reasons include (but are not limited to) the potential for prostate stimulation, aesthetics, and/or fantasy fulfillment.

TACG contains a little information about strap-on sex and disability. Author Blue suggests using a double-ended dildo if you have a wrist injury or mobility problems (location 1188,) and she suggests a vendor from which to procure a harness designed for cis men. (Specific item is here; NSFW; similar products may be available elsewhere.) Why would someone who already has a penis want a harness for a dildo when their equipment is already present? The idea is double penetration of a cis female partner, but in my mind I’m imagining something like it might actually come in handy for couples dealing with erectile dysfunction – especially since Blue states that an erection is not required to use a double harness. TACG describes other harnesses as well; there’s one kind that the wearer can strap onto their thigh or even their head.

A couple of considerations for folks with pelvic pain issues who might be interested in harnesses:

Blue writes that “If you worry about [your pubic bone] getting sore from thrusting, you can buy a specially made pad of thin foam to cushion your pubic bone” (location 1159,) though where exactly one might buy such a pad is not explicitly stated. If this type of pad has a specific name, I don’t know it.
One of the double-ended dildos described in TACG is the Feeldoe, a double-dildo with one bulbous end. It’s designed to have the bulbous end inserted vaginally, leaving the phallic part exposed, for your partner’s enjoyment. However I don’t know how accessible this toy is to folks with pelvic floor dysfunction and/or pain – It looks like something I would find uncomfortable, if not outright painful, to the point of impossible to use as intended. Supposedly it can be used with certain harnesses with some adjustments, but it’s designed to be inserted in the wearer’s vagina.

In general, I would recommend some of the other dildos from Tantus, because I own one I’ll vouch for, they’re silicone & many have a flared base suitable for a harness and anal stimulation – including a few smaller models and plugs.
If you’re a pelvic pain patient interested in a harness, I strongly recommend  sticking to two-strap harnesses only. Or harnesses that are worn over some other body part, like the thigh. The problem is that single-strap pelvic harnesses have to be worn between your legs like a thong and thus cover up more of the vulvar area. Two-strap harnesses go around your thighs and butt instead, leaving more area exposed. The distinction between single and two-strap harnesses is described in further detail in TCAG.
Also, Blue doesn’t mention this part, but beware of harnesses with a pouch for a vibrator… Harnesses with a bullet vibrator are supposed to make the experience more pleasurable for the wearer, but depending on how the vibe rests against you, it might just feel like a foreign, hard something digging uncomfortably into your pelvis. It’s like something out of the Princess and the Pea. I personally find it more comfortable to use a vibrator separately either before or after wearing the harness.
If you’re worried about causing your partner pain, then remember that anal stimulation doesn’t have to – and if you’re doing it carefully, shouldn’t – hurt. You might be tempted to share your prescription lidocaine or OTC novelty numbing gel with your receptive partner but that’s actually a bad idea: numbing gels dull everything, which makes deriving pleasure more difficult… and if you can’t feel what’s going on, then you won’t know if you’re getting injured. The book will tell you how to adjust your techniques to minimize discomfort & maximize pleasure.
Remember also that you are by no means obligated to peg if you’re thinking about getting a harness. After talking with your partner, you may decide instead to just wear it around for awhile or to engage in some other non-penetrative activities with a dildo equipped, just for show.

Overall, The Adventurous Couple’s Guide to Strap-On Sex is an okay book. It will be most useful for straight folks – especially cis women – just starting to consider strap-on sex, who don’t know what’s involved. Likewise, it will be useful for straight men who want to be on the receiving end, but never tried it before.
TACG becomes less useful if you’ve already had exposure to strap-on sex, either through experience or though some of the free how-to guides available on sexuality websites. The trick is, if you’re thinking about trying strap-on sex, then chances are you’ve already looked at those free how-to guides before picking up the book.
I wouldn’t recommend TACG be your first book purchase by Violet Blue. My overall impression is that IMHO I think she put more effort into some of her other stuff. There’s nothing wrong with the book; It contains good factual information & encouragement! I just liked some of her other sex guides more. Franky I thought that some parts of the book were drawn out longer than necessary – I basically skimmed through the chapter about male anatomy because I’ve seen it all before… And I skimmed over the erotic vignettes. The short stories are fine; I have no problems with the writing, though they are several pages too long. They’re just not my taste. Obviously, YMMV!

In summation: the $10-$15 retail price investment will be best for newcomers, with less bang for buck the more experience & knowledge you already have about strap-on harnesses & how to use them. More experienced readers may find it useful as a reference from time to time.

Disclaimer: As with all products reviewed on Feminists with Female Sexual Dysfunction to date, I had to pay for this book out of pocket with my own money, and I don’t get any compensation for writing this review.

Aren’t tax returns *Fun*?

01/01/2012 at 6:47 pm | Posted in Uncategorized | 6 Comments
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Is everybody excited for tax season?! January 15 to April 15, woo-hoo…!

I’m dreading it. My tax return is the opposite of fun; I bet yours isn’t much better. Certainly filling out tax returns can be headache-inducing, to the point where some folks hire out the service to a third party. But sometimes, examining financial statements and tax returns can reveal useful – if dry – information.

I don’t mean to get paranoid here, but since Jezebel pointed to a fascinating critique of anti-gay marriage group NOW’s tax records carried out by American Independent, and Feminist Whore pointed out the high salaries received by higher-ups at the Police Executive Research Forum (timely in light of their alleged involvement in suppressing OWS,) I figure it’s fair for me to point you in the direction of some feminist & health nonprofit organizations tax returns – if only to use them as examples of some interesting features to look for when choosing where to donate your hard-earned tax deductible donations. It’s a way for the public to hold charities accountable and a way for the charities to maintain transparency.

Caution: Among many other things, I am not a tax professional. There’s a limit to my interpretations of the following tax returns. I know enough to find public returns mildly interesting, but please address serious inquiries to a real pro. (Good luck with that – I knew a tax professional who replied to all questions about taxes from laypersons (including his friends and family) with, “Sure, I can help you with that, I’ll do some research – if you pay me!”) Nonetheless, nonprofit tax returns are publicly available information you have a right to review. All we’re doing today is stating the obvious. One additional caveat: This post is US-centric, since we’re dealing with US tax laws.

If you want to evaluate charities, there’s some decent guides available online. According to CharityGuide, excellent organizations put about 80 cents out of every donated dollar towards their stated purpose – and you’ll find that purpose explicitly stated within a tax return. In general, fundraiser, salary reimbursement and administrative costs should be relatively low. Good luck with that, since some charities classify fundraiser activities as something else. A shortcut to some strong charities is compiled here and here. I recommend this easy-to-understand 990 guide by Ronald Campbell, but it’s in Word .doc format – Google Docs can open it though.

Of course the financial criteria do not address the subjective, ideological importance a charity to you. That means organizations with high administrative costs may in your eyes still be “Worth it.” Or not – for example, the Salvation Army has an excellent financial rating, but it has been subject to criticism from sex workers and LGBT advocates. So there’s more to think about than money.

Protip: Usually you can use the IRS’s search pages, to confirm that donations to organizations are in fact tax-deductible by using the Search for Charities tool. Alternate searches for financial records can be conducted at Guidestar and Foundation Center. However, according to the IRS’s site, small tax-exempt organizations with revenues below a minimum thresh hold (Between $50,000 or $25,000, depending on the year,) don’t need to file a regular tax return. Such small organizations can report in using an e-postcard instead. And the IRS search function to look for 990-N e-postcard organizations is located here.
It can be a little tricky to find some organizations since the DBA (“Doing business as” – how you know an organization) names might be different from the name on their official tax return. Bitch Media’s official name is “B Word Worldwide.” And to make matters more complicated, some nonprofit orgs accept tax-deductible contributions through a loophole via a pass-through.  In order to make a tax-deductible donation to sex education site Scarleteen, you have to go through the Center for Sex and Culture. (You can donate any amount at any time – but you can’t necessarily deduct the amount at year end unless you do it a specific way.) UPDATE 1/3/11: Heather Corinna stopped by (*excited gasp*) and pointed out that you can make tax-deductible donations to Scarleteen through the NetworkforGood nonprofit organization.

Speadking of Bitch Media! Let’s start off with this feminist organization as an example. You’ll find that there’s a lot of jumping around to do when you look at a tax return.

The most recent tax return is from 2009. Here’s some highlights about how Bitch did that year: I’m seeing negative income (loss, so their expenses were greater than income) for the year – which can happen when you run a non-profit – and negative assets. Non-profits place a higher priority on goals other than making “Profit,” so losses can happen from time to time. But according to the tax professional I quoted earlier in this post, ultimately nonprofits still have to run like a business… I’ve seen nonprofits collapse for financial reasons.

Next up are some yes/no disclosure questions. When I do a quick rundown of this part of the return, I look for check marks that don’t line up with everything else – a “Yes” where most other answers are “No.” For Bitch’s return, I find most of the answers to yes/no questions in the return to be mundane, except for one indicating that a loan to a major stakeholder was outstanding at year end. We can learn more about this loan by jumping to Schedule L, which indicates about $5k remained to be paid back by Lisa Jervis – she’s the founding editor of Bitch.

Parts VIII, IX, and X break out the yearly revenue, expenses & balance sheet by category. Basically, most of the 2009 revenue came from “Other sources” and sales of inventory (magazines?) The revenues in Part VIII Column B & C add up to the $117,386 listed back in Section III as revenue toward Bitch’s goal – analyzing pop culture from a feminist perspective. The biggest expenses (Part IX) were labor related, and about half of their expenses (Column B) went most directly towards Bitch’s mission statement (for tax purposes anyway.)
(FYI I’m not using shorthand for ‘section,’ ‘part,’ or ‘schedule’ – these all have unique meanings and locations so don’t mix ‘em up.)

Turning towards women’s health, here’s a copy of the Boston Women’s Health Book Collective’s (AKA Our Bodies, Ourselves) 990 for 2009.

What I find most interesting about this return is that, between 2008 and 2009, the amount of net income this non-profit earned netted to almost zero. There was a loss one year and a profit the next. The net income between the two years was ever so slightly negative – something like a loss of -$1660+ total. Interestingly, OBOS lobbied for political activity, as described in Schedule C, $1400 worth of lobbying. Most of their revenue came from “Other sources” and royalties (books?) Most of their expenses were program-related and again, labor-related costs made up the biggest chunk of expenses. If we jump down to Schedule A, we can drill down farther and see that the revenue from “Other sources” came from the public. Schedule F is included, and it lists the value of activities outside of the US.

Readers with vulvar pain problems may be interested in the National Vulvodynia Association’s tax return for 2009. Here’s some highlights of how the NVA did:

The organization had net income (“Profit,” if we were talking about a business,) of a little over $100k for 2009. One interesting response to a yes or no question is that, we see that under part VI (page 6) that there’s a familial or business relationship between at least two of the key stakeholders. A disclosure like that can indicate a potential conflict of interest, so it’s something to keep in mind as a donor. If we drill down to schedule O, we can see that the board president & treasurer are married. Part VII lists out compensation to officers & directors – with this return, we can see that executive director Christin Veasley (you may recognize her name from the website and from interviews, etc.) received about $50k for the year for her work with the NVA.

The NVA generated most of its revenue (almost $300k) from “Other sources,” which means the public at large – and over $50k from investment income, with another $20k from selling assets. The balance sheet shows that the organization holds over $1 million in investments. The NVA’s 2009 tax return lists limited fundraiser expenses. The NVA funds grants for research & treatment of vulvar pain. Labor and grant allocation were the largest expenses – the NVA distributed about $75k worth of grants. Schedule F & I break out where the research grants went – about $50k (doled out over 6 grants to medical and educational facilities) stayed within the US, and $25k (2 grants) went abroad. There are printing, internet, mailing and publishing related expenses broken out as well – keep in mind the NVA maintains a website and produces pamphlets & guides, etc. for patients & doctors. So per Column B of Part IX, most of their operational expenses were related to the NVA’s mission statement.

At this point, I would like very much to show you all the tax records for the New View Campaign, a feminist nonprofit organization dedicated to spreading the social construction view of sexual dysfunction and combatting the medicalization of sex. After all, Dr. Petra Boynton has recommended directing donations to the organization for the last two years. However I can’t find their records on Foundation Center, GuideStar, or on in New York’s state’s registry of corporations (including nonprofits) and businesses. I can’t find the group listed in the IRS charity database. I’m both fascinated and frustrated that I’m having difficulty confirming the organization’s tax-exempt status. It’s not just that I can’t see the 990 document – nonprofits are not obligated to make the forms available online - it’s that I can’t confirm the group’s exemption using the IRS’s publication 78 database.

I’m stumped, however the lack of confirmation doesn’t necessarily mean anything. The New View Campaign could be operating under a different DBA name. The most likely scenario is that the tax stuff isn’t readily available because the revenues are small (I’m comfortable estimating under $25k/year,) and that if I just ask politely, a representative from the group would be happy to send me the New View Campaign’s public tax records. I may yet do something like that – we can always swing back around to analyze the records later.

In conclusion, I hope I have provided readers with some tools about how to follow the money trail at non profit organizations, how much cash you’re willing and able to provide to charities, and what charities make the most efficient use of funds. Keep in mind that there’s limits to the information though, and it can be hard to find this information in the first place if you don’t know where or how to look. Understanding nonprofit finance isn’t easy, and the tax froms can’t tell you everything, but sometimes you can quickly find interesting answers to burning questions.

As for other blogging news – every blog and their grandmother is posting 2011 retrospectives in light of the new year! Expect to see mine, listing 2011′s don’t-miss posts from this blog, later this month.

Where are all the good advice columnists?

12/16/2011 at 11:31 am | Posted in Uncategorized | 7 Comments
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I can’t find an advice columnist I like.

I’ve been searching for the right agony aunt for years. It shouldn’t be too hard, since advice columnists are a staple feature of most major news outlets and magazines. Even smaller media outlets and blogs recruit advice columnists to generate new content.
Besides, sooner or later, just about everyone goes through a period where they believe they are equipped to start giving advice, so some folks take the “Dear so-and-so,” mantle upon themselves, without solicitation.

Perhaps I should put an ad in the paper – “Single (not really) white female seeks competent sex, relationship and general life advice columnist. Must maintain a predictable schedule, be open minded, patient yet firm, and be knowledgable on every topic addressed… Must never screw up.”

Part of my problem is timing and schedules. I liked the Feministing.com column, Ask Professor Foxy when it was still active, but the eponymous Prof. Foxy hasn’t written a new Q&A column for the site in about a year. Good Vibrations Magazine occasionally answers reader submitted questions in the feature, GV Housecalls, but this feature is irregular. There can be weeks or months between new columns.

I believe that folks gravitate towards the advice they want to hear. So how open-minded your agony aunt is, is likely a function of how open-minded the advice seeker is. In other words, if you value spiritual guidance, you probably wouldn’t reach out to a secular agony aunt for relationship advice. You’d probably look for an advice columnist with a spiritual bent instead. “Dr.” Laura Schlessinger is one such spiritual agony aunt, but for multiple reasons her programs, which include racist rants, repulse me.
With regard to advice columnists in general though, that desire for certain types of advice means different agony aunts will attract certain types of audiences. I’m sure that agony aunts figure out their target demographics. Advice columnists then hone their responses to better meet their readers’ expectations.

Advice columnists specialize in certain areas too. Although one agony aunt responded to every submitted query, I think this is an absolutely terrible idea. The sheer amount of research required to give yourself a crash course before answering curveball questions would draw time away from more relevant queries. I wouldn’t ask a self-described expert on cooking about when it’s appropriate to move out-of-state. (I might ask a financial advice columnist though.)

And so much advice-giving is really permission granting. I notice that the way questions are written offer clues as to what the the submitter already perceives to be true – submitters want confirmation from someone perceived as an authority figure. I remember reading an article about the real Erin Brockovich a number of years ago, in which she described talking to herself when facing dilemmas. (An Amazon review of her book provides backup that Brockovich does indeed describe talking to herself.) I think a lot of advice seekers could similarly find the answer they seek by looking within and confronting themselves.

Frankly I’m not even fond of the direct question-and-answer format of advice columns. With Q&A columns, there’s no way to get all the relevant information required to make an informed decision on behalf of the submitter. Printed letters have to be edited for space, too, which can be even more confusing for readers.
An example of a format I especially want to avoid though, can be found in Wayne & Tamara’s column. The authors usually respond to questions with unrelated stories, with the advice buried in parables. I love it and I hate it all at the same time – the responses can be so cryptic it’s funny.
I prefer blogs, since bloggers frequently follow the “Show, don’t tell” principle – though there’s still some telling involved with blogging. Even then, personal stories & experience work well as examples to illustrate a larger point – the personal is political, after all.
But not all bloggers are agony aunts.

So there’s still plenty of popular advice columnists left to consider, right? Maybe not. My last criteria may be unfair, since everybody makes mistakes sooner or later. And what I view as an error, someone else may perceive as a positive feature. (The social justice blogosphere frequently critiques examples of ignorant “Advice.” Feminist & social justice readers probably recognize the problems in this recent gaffe, but if you’ve been swimming in privilege, you may be all like “I don’t get it.”) But when an advice columnist is recommended and has a strong reputation, I expect more. I’ve been disappointed and disgusted by popular columnists, and once I’m disappointed enough I just stop reading. From that point on I’ll be more reluctant to trust the agony aunt and whatever advice zie have to offer. Sometimes advice-givers apologize after getting called out for obvious screwups, but it may be too little, too late… Doubling down on privilege doesn’t help either. For example:

I stopped reading Dear Abby on June 27, 2007 when I saw this Q&A posted. In her response to a 33-year old virgin woman with anxiety over the prospect of her first gynecological exam, Abby wrote in part:

DEAR SCARED: A woman should be seen by a gynecologist if she is sexually active, or if she has reached the age of 18. She should DEFINITELY see one if her regular doctor tells her to — so please start acting like the 33-year-old adult you are and stop listening to “horror stories” from friends. Pap smears are not painful, and women do not normally bleed after having one.

Sounds spot-on, right? Wrong. Pap smears can be painful for some women – Abby’s response makes it sound like anyone who says otherwise must be a drama queen or a liar – instead of someone who may have a treatable medical problem that any competent gyno could make accommodations for.

Abby doubles down and adds insult to injury with the snide implication that “Scared” is acting like an immature child, just like a childish woman who can’t suck it up and deal with it at the gyno’s.

I never got into Dan Savage’s advice series because by the time I found out about him, it was because his reputation had been recently marred – and not for the first time. I know he’s done good things for the gay & lesbian community in particular, notably the “It gets better” project and comically redefining “Santorum,” but I can’t get over his history.

I’m certainly not going to read Dear Prudence, who recently gave some fucked up “Advice” to a gentleman regarding his wife’s prolonged therapy and the lack of sex after marriage… because she had just started therapy to cope with the abuse her father committed on her.
Do I really need to delve into why Prudence’s advice terrifies me? To make matters worse, Prudence’s answer was heard ’round the tubes, so hundreds of folks saw fit to comment on this couple’s sex life. As always, things got real ugly, real fast.The myriad terrible answers to this particular question, unfortunately, are how I know looking for any better advice is ultimately an exercise in futility.

I used to read Carolyn Hax’s advice column (When it was still called Tell me about it,) until I got bored with it. I decided that much of her romantic relationship advice boiled down to “DTMFA,” because it looked to me like relationship problems, minor or major, could be solved with a breakup. In fairness, that is always an option. But her recent advice is pretty good, so maybe I should give Hax another chance.

Then there’s the self-described agony aunts of the Internet – they’re not featured in mainstream media, but they’re still popular (On the internet!) Some of these advisors have qualifications that lend credence to their advice – Ph.D. Degrees, M.S.W. degrees, certificates reflecting formal training, etc. Others are bloggers with no formal training, yet have a wealth of experience to reflect upon. And for a lot of readers, I’m sure the advice in Internet agony columns works out well.

The problem is that when the advice I want or need is sexual in nature, I can’t turn to a lot of agony aunts, even the popular ones. I saw some professors and sex educators recommended by commenters in blog posts on places like Jezebel or Feministe, so I read and have since screened out a few recommended agony aunts who write general observation stuff.

Sometimes the posts are great and well-researched. Other times, they’re as airy & fluffy as cotton – and personally, I would rather not post anything, then inflate my post count with fluff. (Everyone reading this now is thinking to themselves, “Yes, K, we’d all prefer it if you didn’t post too.” Haha.) That quality variation is pretty typical of any writing though, so no big deal.

But when it comes to problems most near & dear to my heart, sexual dysfunction specifically, the recommended agony aunts let me down. Some just vomit up yet another uncritical iteration of the New View’s rhetoric: The problem you describe isn’t an actual problem you are experiencing; it’s just part of being a woman. You can’t take medicine for sexual problems today because in the past women didn’t get a choice and you dishonor their memory. Doctors and Big Pharma are in cahoots to fleece potential patients so you can’t trust the sexual health research out there co-authored by medical doctors and certainly you should never visit one for a sex problem. Wait, you have pain with sex? Go see a doctor.

To be fair, I’ve seen this very blog you are reading get plugged by commenters offsite too. I’m flattered. So what’s the difference between me and professional or amateur agony aunts?
The difference is I have never described myself as an agony aunt. I’ve repeatedly stated, I am not here to give you advice. I prefer to be a general nuisance, presenting evidence in contrast to conventional advice, since the usual advice backfires on me anyway. I may on occasion, when pressed directly, offer up some link or sound byte, but ultimately, I believe that individuals are the only ones who know what’s best for themselves when it comes to personal & health decisions.

That said, there are some bloggers I still look to for advice, though they aren’t necessarily in the business of answering questions. Keep in mind even you may find the following bloggers repulsive, for the same reasons I’ve outlined above! They aren’t always perfect, and I’ve seen some of the below make mistakes too.

People I still find credible most of the time:
Holly of the Pervocracy, Violet Blue, Corey Silverberg, Heather Corinna, the archive of Go Ask Alice!, Matt Kailey

Tier 2 (Generally like but with some reservations,)
Greta Christina, Carol Queen, the Sexademic, Marty Klein.

Readers, have you found a decent agony aunt that might fit the bill for what I’m looking for? Now I want your advice as to who’s good & why.

Doctors debate dyspareunia (painful sex)

08/01/2011 at 1:26 pm | Posted in Uncategorized | 7 Comments
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No one knows what to do with sexual pain.

If you have experienced long term sexual and/or genital pain, you’ve probably seen multiple doctors about it. You may have started with a general practitioner, who referred you to a gynecologist or urologist, who referred you to a sex therapist, who referred you to a pain specialist. There may have even been a dermatologist or psychatrist in there somewhere. And you may have noticed that each of these professions have their own ideas (or lack thereof) about how to best handle the situation. When getting refered to yet another doctor, you’re getting clued into who your current caregiver thinks is likely to have the most knowledge about treatments. (Of course, this assumes you have the health insurance and cash to cover medical treatments.)

But having been through the doctor shuffle already, I have come to the conclusion that no one really knows what to do with sexual pain.

Part of the reason chronic pelvic pain patients get bounced around so much is that, behind the scenes, doctors themselves are still debating how best to handle sexual and genital pain. Are we dealing with a chronic pain syndrome akin to something like back or neck pain? Or are we dealing with something purely sexual? A gynecologist may feel inadequately prepared to deal with long-term genital pain that doesn’t resolve following standard operating procedures. But when the pain takes place mostly during, or most acutely, during sexual activity, a pain specialist may think the problem is purely sexual – and some pain specialists may feel uncomfortable addressing unwanted pain during sex. Sexual dysfunction as we in the US know it is a relatively new and highly controversial area of study. And it will take time for doctors, scientists and philosophers to sort out the defining characteristics and treatments of dysfunction – if indeed such standards can ever be decided. It is the nature of science and medicine to go through revisions and changes.

I just wish these doctors and professionals would make up their minds already about which one of them I’m supposed to go to for treatment.

One such behind-the-scenes debate about the appropriate way to address sexual pain took place in early 2005, when Dr. Yitzchak M. Binik, Ph.D. wrote in to the peer-reviewed journal, Archives of Sexual Behavior. You can view an abstract of Dr. Binik’s piece, Should dyspareunia be retained as a sexual dysfunction in DSM-V? A painful classification decision here. If you want to learn more, you can view the full text on Dr. Binik’s website. (I can’t determine if what we’re going to look at today is considered an editorial piece, a study or a research review.)

So who is this guy? Dr. Binik is the director of Sex & Couple Therapy Service up at McGill University Hospital in Canada. He was one of the contributors to the textbook, Female Sexual Pain Disorders, (wrote the foreword) and he has written many articles about dyspareunia. According to his website, he’s also been involved with research on painful sex – there are three grant-funded projects listed as of 2011. But wait, there’s more – his whole resume is up for perusal.

At the time of Dr. Binik’s submission to the Archives of Sexual Behavior, dyspareunia (painful sex – usually when professionals say it, they mean “Cis-heterosexual intercourse,”) was classified as one of the four female sexual dysfunctions then-recognized by the DSM-IV. (The DSM-IV is the Diagnostic and Statistical Manual of Mental Disorders – basically it establishes guidelines for recognizing and treating various mental illnesses and disabilities. Professionals that rely on the DSM include psychologists and medical doctors. As of today a fifth revision to the manual is pending.) The other three sexual dysfunctions recognized by the text are arousal, libido and orgasm problems. Until then, there was not much debate among professionals who deal with dyspareunia about how appropriate its classification as a sexual dysfunction is.

Dr. Binik set out to challenge the classification of dyspareunia, with the goal of shifting it out of the sexual dysfunctions and into the pain category of mental disorders in the DSM. Reclassification of dyspareunia as a pain disorder instead of a sexual dysfunction would not remove it from the DSM completely – it would just move the problem around and give it a different name, grouping dyspareunia with any other pain while recognizing non-sexual pain in the crotch – such as the pain of a gynecological exam or attempted tampon insertion.

In Binik’s discussion of the history behind the term, “Dyspareunia,” he makes it sound like sexual pain was pretty much just thrown in with the other dysfunctions for lack of any better ideas at the time. But painful sex presents some unique problems compared to the other three sexual dysfunctions – after all, sexual pain frequently bleeds out into non-sexual areas of life. He talks about the differences between pain during sex (an act) vs. arousal or desire dysfunctions (physiological reactions,) and how dyspareunia is a broad term – to Binik, its breadth is a weakness instead of a strength.

There are several sexual dysfunction issues that Binik didn’t explore, and these omissions mean something. He did not challenge or question the existence or appropriateness of the term “Dysfunction” for any other sexual problem. He excluded a discussion of vaginismus, though this may be because vaginismus isn’t technically a dyspaerunia issue in the current DSM for some reason. (I’m not yet 100% clear on what the reason is for vaginismus to sit on it’s own tier of dysfunction; I think the folks behind the DSM fixated on how it prevents vaginal insertion of objects as the main feature, instead of the pain associated with attempts at insertion. This distinction is likely to change with the DSM-V.)

As examples to bolster his reclassification argument, Binik focuses almost exclusively on vulvar vestibulitis (VVS) patients – so he’s talking about people like me. Binik did not talk about dyspaerunia and endometriosis, or dyspareunia and interstitial cystitis, or dyspareunia and cancer. For this discussion, dyspareunia and VVS are used almost interchangeably… even though VVS is not the only cause and kind of painful sex.

I summarize Binik’s main agruments to move dyspareunia out of the sexual dysfuctions and into pain as:
1. Dyspareunia is similar to any other pain in self reports.  Genital pain is similar to other pain conditions when visualized using brain scans (pages 14, 16.)
2. There’s more research on pain. “By contrast, there is a relatively large literature onhow pain is represented in the brain (Casey & Bushnell,2000; Talbot et al., 1991).” (page 16.) So there’s more material to work with.
3. Treatment plans for sexual dysfunction don’t usually include pain management. If professionals take a pain perspective of dyspareunia, it opens up more complementary treatment options. That means potentially better outcomes for patients (page 18.)
(Unfortunately, Dr. Binik doesn’t address this – it also means more anxiety about seeking treatment in the first place, since pain management can include oral medications – and certain feminist anti-FSD activists in particular and bootstrapists in general dedicate extensive resources to opposing medication for sexual and health problems. Just think of all those sensationalist news stories about celebrities becoming addicted to pain pills.)
4. Socially, pain is a more dignified, less controversial subject than sex – “Finally, as a seeker of research funding, I have noted that there have been several recent new governmental funding initiatives for pain related to dyspareunia (see National Institute of ChildHealth and Development, 2000). As far as I know, this is not being matched in the sexuality area where funding is constantly under attack” (page 19.) This is an unfortunate reflection of how sexual issues are downplayed and sneered at by the public. It’s just easier to get funding, research and respect if you’re exploring pain than it is if you’re exploring sex.

Judging from the passionate responses included with the same issue of Archives of Sexual Behavior, Binik’s article was quite controversial at the time. There were at least 21 responses, plus however many other e-mails and memos were written up and sent around but didn’t get published. Eventually Binik wrote a follow-up statement in response to professional criticism, which I’d like to look at with you later.

My biggest schtick with Binik’s article and the responses is: I honestly don’t get why this has to be an either/or question. 
I’m saying this as a patient: This isn’t a simple either-or issue. Dyspareunia isn’t something that fits neatly into a single box. Try to stick it in the sex box, and the pain stuff will still leak out into every day life. Try to place it exclusively in the pain box, and sexual problems will jump in. You can have pain AND another sexual dysfunction, like problems with arousal or orgasm.
If you ask me, pain in the genitals should be recognized as both a pain and sexual problem. For some patients, it may very well fit neatly into only one category. But whatever professional field is assigned as having the final say on the best way to treat dyspareunia – you need to be prepared to go outside of your own comfort zone, in order to bring me the comfort I need.

Unfortunately my perspective as a patient isn’t given much value. Just the location of publication presents a problem – the insular nature of being part of a peer-reviewed journal itself acts like a firewall to keep out non-professionals and non-academics. Which means ordinary folks probably don’t even get a chance to find out when debates like this happen, and we probably won’t be solicited for feedback. These debates excluded most women with FSD from participating.

It’s a bummer, too, since I got more to say about this article, which I’ll spell out here instead.

A major weakness of Binik’s argument and one that Binik had to address in a later, separate response, is that he did not really consider the sexual part of sexual pain.
Like it or not, pain in the genitals takes on a different meaning than pain in the arm or neck. And no it’s not fair, I think it sucks that it is socially unacceptable to say, “My vulva/penis/clitoris hurts today.” Not that its easy to talk about chronic pain to begin with though! Non-sexual, non-genital pain still gets heaps of stigma and able-bodied folks going, “Deal with it.” But right now, in the US at least, genitals are all tied up with issues of gender, identity and performance. So looking at dyspareunia exclusively as a pain problem won’t address the ways in which pain can impact sexuality. Even if the pain resolves satisfactorily, dyspareunia patients may still have to deal with long-term insecurity and body memories. If other dysfunctions like difficulty or loss of orgasm have gotten tied in with the pain, then those non-painful problems may not resolve at the same time as pain. To ignore the sexual component of genital pain, to the extent that it is present, is inadequate.

ON THE OTHER HAND, for some folks, skipping the sex part and addressing the pain is exactly what’s needed. This was actually more the case for me – what I needed the most when I went through the most intense period of genital pain and treatment wasn’t sex therapy or a better understanding of social construction. Gender roles and patriarchy, as much as they do hinder me in many other ways, did not reach inside of my body and cause my cells to rebel. What I needed most was something to address the physical pain and discomfort.
That urgent need is lessened now, but it’s not completely gone and it will probably never go away completely. So I remain open to medicine in my sex life now and in the future.

Now, of all the people who wrote in, who do you think would have been the most likely to agree that dyspareunia should not be classified as a sexual dysfunction? I’ll give you a hint: After all, sexual dysfunction is a controversial term – part of the resistance against it stems from concern that the medical industry will throw around the term to convince able-bodied women that they have physical problems, thus increasing sales of medications and devices to address it. Who’s to say whether a libido is low in the first place, and how exactly are we supposed to measure such a subjective experience?

So I was shocked, absolutely shocked, to see Dr. Leonore Tiefer, Ph.D., organizer behind The New View Campaign, sex therapist, educator, author and editor, write a negative response to Dr. Binik’s proposition. You may remember Dr. Tiefer from such posts as a 5-part series on Sex is not a Natural Act and A Review of A New View of Women’s Sexuality. You may also recognize her name from prolific writing on feminism, social construction and female sexual dysfunction. Dr. Tiefer is a critic of female sexual dysfunction, particularly the way it is handled by organizers of the DSM and its end-users (the end users being doctors and other professionals.)

So if, in other cases, Dr. Tiefer supports the view that female sexual dysfunction is a myth manufactured by medicine (even if she herself is careful to avoid using that exact phrasing,) then what’s she doing getting involved with the reality of dyspareunia?

To be continued…

Here, just swamped

05/24/2011 at 11:57 pm | Posted in Uncategorized | Leave a comment
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It’s been a little over a month since my last post, in which I talked about needing to consider the possibility of interstitial cystitis as one of my pelvic problems. I’m no closer to an answer or resolution on this front, so that’s not exactly the reason for the lack of posting. (In case you’re wondering, I did change my diet and the times when I eat certain foods, and I’ve dropped cranberry supplements from my regimen entirely. Still peeing noticeably more often than everyone else I know.)

I’ve been swamped with meatspace stuff – mostly work (and the commute to get there.) Let me put it to you this way: I cannot work 14 hours of overtime per week AND crank out blog posts at the same time. I haven’t had to work that much overtime in about one week but I probably should if I want to get anything done.

We’re not out of material to write about, but I am facing some bottlenecks in terms of getting the hard stuff like research done. I hope you’ve all been keeping up with at least one or two of the other blogs on this one’s blogroll. I won’t be able to catch up to all the political news that’s been coming out at this point. At this point, I’m starting to adapt to the increased workload on the job and a reduction in free time in which to write or relax. So I’m ready to get back to writing now – or soon, at least.

The most likely scenario is that, I’ll probably put up some less research-intense posts like product reviews as I get back up to speed – there’s still a number of blog posts sitting in draft that require more work and it will be awhile yet before I’m satisfied with them. You’ll probably see some other topics posted here first though: I still need to finish a book so that I can crank out a book review, for example, and I may or may not review a few interesting sex toys as well. If there’s something you’ve been working on or thinking about, now would be a great time to submit guest posts.

Anyway, that’s what’s up. The blog is still here and I am still wanting to continue the discussion of sexual dysfunction – especially so long as that discussion actually includes the opinion of folks who actually have a personal stake in the topic of interest. I may need to slow down, but I think that’s worthwhile if it means keeping the quality of posts up to my satisfaction.

Book review: The Ultimate Guide to Fellatio

04/07/2011 at 9:53 pm | Posted in Uncategorized | 4 Comments
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Case in point from the recent Shorties II post: Presenting a book review for the purposes of sex education + product evaluation. The book in question at this time is, The Ultimate Guide to Fellatio: How to go down on a man and give him mind-blowing pleasure, by Violet Blue. Now in case you’re wondering, “K, why is there a book review regarding fellatio on a blog about female sexual dysfunction?” The answer is, “I decided to read & review this book now, mostly for personal reasons. Also I need to clear away some stuff in the book backlog before I can justify making any new literature purchases.” I read the Kindle version, second edition, which tops out at about 2,400 locations or 256 pages. Here’s a Google Books preview to get you started if you want to look at it.

The Ultimate Guide to Fellatio covers a lot of ground. It’s not just a book of tips written just for people who perform oral sex; it’s for the recipient of oral sex as well. For both the giver and receiver, there’s a lot to think about – what to do, what’s happening to you and your partner, and ways to make sure both parties feel physically & mentally comfortable during the act.

The book provides a detailed anatomical explanation of the relevant body parts – mouth, tongue, throat, penis, testicles, and yes the anus, prostate and pubes. Body fluids are described in frank terms. Blue does present some bullet point lists of tips, but she also provides detailed, how-to instructions that wouldn’t have fit in a short list. She also addresses the cultural baggage and negative attitudes around fellatio – sexuality, especially men’s sexuality, tends to get oversimplified (“Insert tab A into slot B…”) and fellatio in particular is often associated with dominant & submissive gender roles. It doesn’t have to be that way. On the other hand, for some folks, D/S gender roles are a turn-on, and Blue acknowledges this flipside as well in the discussion of BDSM and fellatio towards the end of the book.

The Ultimate Guide to Fellatio is particularly helpful when it comes to safe sex. There’s a chapter talking about ways to make oral sex safe between partners (the pros and cons of various barrier methods are discussed at length,) and the safe sex chapter even includes charts detailing the probability of contracting STI’s from giving or receiving oral sex. One interesting feature about the charts was the inclusion of the probability of contracting vaginitis (a vaginal infection not necessarily caused by STI pathogens,) from giving or receiving fellatio – the risk, according to the chart is, “N/A,” (location 661) or not applicable. Still I thought that was neat to remember it at all. I guess a chart including the risk of contracting vaginitis would be more relevant in the related Ultimate Guide to Cunnilingus book. Which I should probably also read and review.

Throughout the book, Blue addresses erectile dysfunction and disabilities - not just limited to physical disabilities; she explicitly wrote a paragraph on Attention Deficit Disorder, for example. I appreciated the inclusion of these topics. Blue makes it clear that, even if you or your partner are dealing with erectile dysfunction, chances are that fellatio will probably still feel good. (If you’re not certain, ask – the book emphasizes over and over again that communication is important.) Interestingly, Blue points out that certain disabilities may make sexual stimulation painful, even when there’s a penis involved rather than a vulva – she focused on Multiple Sclerosis in particular as a potential cause of sexual pain. With disabilities, erection, orgasm and/or ejaculation may be impaired, but that does not necessarily mean that the penis is non-responsive and that the owner of it does not feel and react to sexual stimulation. For people with disabilities such as spinal cord injuries, she also mentions “Phantom orgasms,” something I’ve seen talked about elsewhere – orgasm isn’t just a body reaction; the body is a shortcut to the brain. There’s still some parts about disability we can push for improvement on though; for example she uses the term “ADD sufferers” (location 1445) which implies that ADD equates with suffering, and at one point she says “You should never consider a disabled man asexual” (location 1432,) by which she probably means that it isn’t fair to de-sexualize people with disabilities… but then again with this quote, you get the whole asexual erasure thing going on. So it’s probably better to not make assumptions about the sexual orientation of people in the first place.

The last part of the book covers resources for learning more about fellatio, and these resources often coincide with learning more about sexuality in general. For example, the contact information for sex-positive retailers is printed (some of it may be outdated at this point though, because the book was originally printed in the early 2000s – you may have to Google some information to confirm if its still current.) There are some suggestions for pornographic yet educational films and how to enjoy them.

For the most part, I felt the book was written with a cis-gender heterosexual audience in mind. The book does talk about how to give and receive fellatio when performed on a strap-on dildo and how the act of fellatio can be subverted into a means to bend gender roles, but for the most part, penis = man = cis man. Most of the illustrative vignettes sound like they were provided from the point of view of opposite-sex couples, although I did see some gay and lesbian content as well. Speaking of which, there are some illustrative sexual fantasies described between chapters – these erotic short stories did nothing for me, but I am certain that is a personal thing. Your mileage with the written sexual fantasies will vary.

One thing I did not like about the book at all was the drawings. The illustrations are just terrible: The line art is shaky and near the end there’s an illustration of a guy receiving oral sex on the beach and one of his eyes is all like 0.- and it just looks weird. Technically speaking, Amazon isn’t supposed to sell pornography, (enforcement is another issue,) so I think the drawings maybe had to be below optimal in order to get the book past the censors.

So who might be interested in pursuing the pages of The Ultimate Guide to Fellatio? Who would gain the most benefit from reading a how-to on how to give or receive “Mind-blowing pleasure?”
Well for starters I’m actually becoming skeptical & jaded when it comes to any guide that promises such a claim. I know that book sellers gotta be able to move stuff off the shelves, but there’s so much human variation that it’s too hard to guarantee that anything can create that kind of sexual pleasure.

This would be a very good book for people who have not yet had any experience with oral sex, or who have had only limited exposure to it, yet who nonetheless have an interest in being the recipient or provider of such an act in the future. Because it covers such a wide berth of content, from Anatomy to X-rated films, (I couldn’t think of anything that starts with a Z – unzipping pants, maybe?)  the book will provide plenty of  information with which to brace yourself. I would suggest reading the book start-to-finish if you’re on the newer side. If you do not yet have a partner but expect to find one later, Blue makes some suggestions for practicing fellatio in a solo setting. (You won’t get the body language feedback but you’ll be under no pressure while tweaking your own techniques.)

One potential problem newbies may have with the book though, is that since it’s so detailed, it can seem overwhelming at times. As I was reading through some of the how-to suggestions, I found myself asking at points, “How is anyone supposed to remember all this?!” So if it’s too much to take in all at once, you may have to go back and skim parts of the text again later.

It would be an okay book for people who have some experience with fellatio and expect to continue participating in it, but do not yet consider themselves to be experts. If you are such a reader, then you can probably skip around to whatever parts you’re most interested in.
So for these two kinds of audience members, the book is most worth it.

I think the book would be less useful (and thus less worthwhile) for people who already have a lot of experience with oral sex. So if you think of yourself as “Advanced” in fellatio, (even theoretically!) then The Ultimate Guide might not be worth it. At that point, chances are you’ve already seen & heard most of what Violet Blue talks about. It’s still worth something; because it’s so dedicated to its topic, there may still be a few things you can pick up here and there… However, I think you’ll eventually pick up on those few things that you didn’t know about, by reading sexuality & sex education blogs, for free. Just hang around a few favorite blogs long enough (try some of the ones listed on my blogroll) and you’re bound to see the same subjects pop up, eventually.
For example, since I have read a lot of related sexuality material elsewhere, I found myself anxious to speed through the stuff that I already knew. I felt obligated to read everything for the purposes of this review but there was a lot of stuff I could have just passed over without a look back.

The Ultimate Guide to Fellatio may or may not be of use to people who do not expect to give or receieve fellatio in the near future. This is because if you have decided that it’s an act with no appeal to you, then the book may still provide you with insight into what’s on the minds of folks who do engage in it and why such folks will often defend it. But if you’ve already made up your mind that fellatio is off the table, then chances are no book will be able to change your mind and in some cases it will just be a waste of time. It could be irrelevant to you in this case.

I am not sure if this would be a good bet for sexual abuse survivors, because there is only a very brief mention of fellatio and past abuse.

So if price is a factor, then I think the $10 for the e-book version or ~$15 for the printed copy is worth the investment if you are new-to-medium in fellatio. If you feel that you’re advanced, then I think the $10 for an electronic copy is cost-effecient only if you are already heavily interested in sexuality books. Otherwise, if you know what you’re doing, then save your money and read some blogs instead. And if you know that fellatio isn’t going to happen then whether you would benefit from the book depends on your political or philosophical inclinations.

Compare and contrast

12/02/2010 at 9:16 pm | Posted in Uncategorized | Leave a comment
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My last post presented a review and critique of the feminist sexology text, A New View of Women’s Sexual Problems. It’s a different kind of review. The book was inspired by the efforts of the Working Group on the New View of Women’s Sexual Problems, a group of about a dozen North American women who came together to present an alternative view of sexual problems and dysfunctions, just in time for a  medical conference held about 10 years ago. A New View of Women’s Sexual Problems, the book, builds upon the original New View manifesto.

Today I’d like to present to you a different kind of feminist response to sexual dysfunction – a response from another woman who is intimately familiar with gender studies, feminism… and vaginismus.

As I noted in the New View book review post, I felt like some elements were missing from the essays – notably, it remains unclear to me whether any of the contributors to the original manifesto or the book actually know what it’s like to live with sexual dysfunction – to be torn between what you “Know” is the “right and proper” feminist response to sexual dysfunction vs. the daily grind of living with and responding to it, sometimes just managing. It’s possible that one or more of the contributors did have some kind of sexual dysfunction, and just didn’t disclose such status for whatever reason. But since I can’t know for sure, I still feel like I’m left on the outside of a circle of folks who are not me, yet who nonetheless decide my fate for me.

Alas, my time available for blogging is shrinking, and will continue to do so until some time in January! So instead of presenting another dissertation-length blog post, I’m just going show you an essay today and give some reasons as to why I liked it.

The essay is, A certain remoteness telling vaginismus, by Fulvia Dunham. I thoroughly enjoyed this essay. If you usually like what you see here on this blog, then I would strongly recommend that you read it. It’s one essay in the anthology Illness in the Academy, published by Purdue University (whom I would like to thank, along with Google Books, for making A certain remoteness in its entirety available to me as of today. I did have difficulty viewing it on my mobile device, however, and I am not certain if Google Books format can be picked up by all screen readers. Keep in mind, allocate your page previews carefully if you want to read the essay in full online.) According to Amazon, Illness in the Academy:

investigates the deep-seated, widespread belief among academics and medical professionals that lived experiences outside the workplace should not be sacrificed to the ideal of objectivity those academic and medical professions so highly value. The 47 selections in this collection illuminate how academics bring their intellectual and creative tools, skills, and perspectives to bear on experiences of illness. The selections cross genres as well as bridge disciplines and cultures.

Other essays in the book talk about life with chronic illnesses, conditions, and disabilities – to mention a few, some contributors have or are close to someone with diabetes, endometriosis, depression, autism, cancer.

And yet vaginismus – a sexual problem, a sexual dysfunction, a variation of normal, a medical condition, a gynecological disorder, a disability, a symptom of a relationship problem – what is it really? – is included right alongside these more readily-recognized health conditions – though certainly the conditions included have varying degrees of public awareness and social acceptance. The editor of the anthology, Dr. Kimberly R. Myers, did not excise the essay on vaginismus as too titillating due to its sexual nature or as irrelevant due to being a relationship problem. Here, it is unquestioningly given the same treatment as any other medical problem. Seeing vaginismus included in the same place as more readily recognized chronic conditions was a shock to me. And this book was published in 2007, so it’s ahead of the curve! I find myself asking if, because vaginismus was part of this collection, if that means there’s openness to the idea of looking at sexual dysfunction as disability even offline…

Clearly, there is a need to understand vaginismus as a matter of health:

Exchanges with family members were uncomfortable; people were usually tentative and shy, occasionally asking if I’d fixed “my little problem,” implying that it was a bad habit of aversion I had to correct rather than a problem or illness with which I needed help… I think the unspoken assumption in many of their minds was that if you can’t perform normally in sexual terms, you’re unfortunate – but not in need of a hand, as you would be if you had a recognizable illness (151).

All the emphases in the quotes are in the original.

The author of the essay in question talks about how she sought assistance from professionals trained in treating vaginismus, though she herself does not appear to be an expert herself – there’s no pH.D or M.D. or M.S.W. or other certification given next to her name. She’s a regular person, like me. Much of what Dunham writes about appears to have taken place while she herself was a student (which makes sense, given that the anthology is titled Illness in the Academy!)

What I like best about Dunham’s essay is that there’s no filter in A certain remoteness. Dunham was given the opportunity to speak in her own words. No one is presenting snippets of what she said in the greater context of some other theory. She’s just saying: What she did, what she went through, what she saw and heard, and what was on her mind when it happened.
I suppose right now, I’m creating a lens, an artificial filter, just by framing this post the way that I have chosen. But that’s what the link to the essay is for – you can see for yourself.
In contrast, in the New View book, short statements from women with sexual dysfunction were presented by professional women, as case studies in support of the New View manifesto. When someone says or does this, she really means that.

Because there’s no filter, there is a stream-of-consciousness, indicated by italics and bolds in the text, which weaves throughout A certain remoteness; usually flitting under a sea of text, always near the surface,… then *Boom!* it pops out for just an instant, and is gone… only to leap out again a few paragraphs later, a brief flash of uncensored turmoil over a carefully constructed treatsie.

But here and there we can catch a glimpse of it, Fulvia’s free stream-of-consciousness,  jumping out of the formal, the factual, and the philosophical:

and if your body is closed, if you can’t let anyone in, if you can’t talk about it easily because no one knows what you’re talking about, if you’re obligated to remain closeted because people often forget what you’ve told them, then you’re simply repressed – closed – out of the loop – out of circulation – unable to come out because you can’t let anyone in, because there’s no language with which to come out, and because nobody cares (149)

(As a side note, some of my unedited draft posts look like this before going live!)

Another interesting feature of Fulvia’s essay is the way she addresses language. In an eerie coincidence, frequent commenter Flora and sometimes contributor left a note here last night addressing how Dr. Tiefer in particular treats language – it’s a very important tool. It has power. Words mean things. But not everyone thinks that way, and to emphasize language over other modes of communication can create new, unique hurdles.
And sometimes, words have limits. Sometimes, language isn’t as powerful as it should be – because there are no words to express what you are really feeling:

Then they ask me about the man with whom I have parted ways two months before, after having been with him for two years. I say that things are fine; everything’s amicable enough, and he usually calls me every couple of weeks from Los Angeles. when he told me, it was new year’s eve, and then waking up in the middle of the night just after, him near me, trying to tell him that he was all over for me, that i’d never have intimacy with anyone now, because no one would have the patience, that this was the last dance, impossible, that he was relegating me to life among those who remain alone – trying to explain – the words were broken – that although i wasn’t sure i wanted children, i wanted the possibility I say that we’re exchanging emails and phone calls fairly often. and it would never be possible again and doomed and no access cut off a certain remoteness – his looking at his watch to see if it was midnight yet They have to catch me as I begin to fall backward off the chair. (153)

Dunham explicitly says, “The words were broken.” Fulvia was trying so hard to articulate everything she was feeling at the time of her breakup. But she just didn’t have the words available. How do you talk about vaginismus when you’re not even supposed to talk about vaginas, about pain, about sex? So you grope around looking for words, looking for something that comes close to expressing what’s on your mind in a way that another person can understand but the language that’s available doesn’t match what you want to say, so you wind up saying something that maybe has a totally different meaning. Maybe what really conveys the emotion is a scream, or a work of art, or a song, or something that does not yet exist.

Dunham herself may even be familiar with the New View’s work:

Given my later training in gender studies, it became tempting to try to believe that this wasn’t a “problem” or “dysfunction:” it was simply a “difference.” But given the imperative we receive in our culture to express ourselves as sexual beings, the messages we’re sent that suggest we’re incomplete, uptight, wound-up, or repressed if we can’t or don’t, it doesn’t feel like merely a difference; it feels like a defecit. It also doesn’t feel like just a difference when the desire is there, but the means of expression are not. It feels like an insurmountable obstacle. (151)

Being familiar with gender studies and possibly with the New View’s work in combating the medicalization of sex, Dunham struggles with questions about what that means for her, as someone living with vaginismus; as someone who needed and sought medical assistance to address it:

am I succumbing to compulsory heterosexuality, the heterosexual imperative, the pressure to become more valid through an ability to participate legibly in the sexual economy? Their sign says “No passing zone.” Rather than seeking to overcome this, perhaps I should use this with which I have been fated to disrupt the usual equation between “intimacy” and “penetration.” Should I question the usual assumptions about what constitutes sexual success and fulfillment? – challenge the commonplace equation between sexual fulfillment and fulfillment? (154)

She knows. She knows she knows. You know? Dunham is familiar with gender studies and feminism. She’s heard it all before. The critiques of sexual dysfunction from a social construction perspective are there. But she also knows that there’s something more going on… something that even feminist-informed social construction sometimes cannot breach:

Is it wrong to want my vagina to open? (154).

This simple question. This one, simple question… is the same one I find myself asking after reading through books like Sex is Not a Natural Act and A New View of Women’s Sexual Problems. Am I doing something wrong? Am I now obligated to expand my sexual horizons rather than having that available as an option? Is it okay for me to get medical help for vulvodynia & vaginismus, and whatever else I may encounter in the future? In so doing, am I medicalizing sex and making it harder for TAB women to enjoy sex as they are? Or do I have the one and only free pass to sexual medicine, because dyspaerunia is the only valid and important sexual dysfunction? But if that’s the only valid sexual dysfunction, then what about my friends? Dunham seems to understand what it feels like, to be stuck in the middle.

And open her vagina did. Dunham continued to seek help addressing her vaginismus, and eventually, after 15 years, she did find satisfactory resolution through physical therapy in Montreal, Canada. She no longer needs to talk about vaginsmus – “Perhaps I am at the point where I can – and even should – put all this to rest” (154). But Dunham still remembers the whole experience, vividly – and much like Susanna Kaysen, it has left her sexual identity fundamentally changed… Dunham, in the end, came out of the experience, as Q for Questioning, or possibly even Q for Queer, inspired by a definition proposed by Eve Sedgwick. Dunham now has the option to engage in heterosexual PIV intercourse, if she so chooses… will she so choose? Even if she does not exercise this option, Dunham does not express resentment towards the doctors who helped her reach this point; she has nothing but gratitude towards them. I suppose the social system of medicine available in Canada helps – in the USA, she may have faced a different set of challenges with the cost treatment and insurance.

There’s a lot more to the essay I didn’t address here; I just picked a few parts that resonated with me. Reading A certain remoteness alongside A New View presented a refreshing contrast, and I would like to see more essays and creative works like it.

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.

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.

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.

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