The ugly things people say about FSD Part 3: The Redeadening08/11/2010 at 7:47 pm | Posted in Uncategorized | 8 Comments
Tags: blogging, female sexual dysfunction, Feminism, flibanserin, FSD, health, HSDD, medicine, sex, sexology, sexual dysfunction, sexual health, Sexuality, social construction
Trigger warnings for ablism and rape.
Previously in our hopefully never-continuing series about what people online are saying about female sexual dysfunction…
Last week, I re-opened an old wound, the ugly things people say about FSD, the women who have it, and what treatments (if any) should be acceptable for it. I directed your attention to the comments section of a Feministe post, FDA Wants YOU! to Have Sexual Satisfaction. That’s a brief heads-up that the FDA was about to have hearings on whether or not to approve the drug flibanserin, which in early testing had an ever-so-slight positive impact on women’s sexual satisfaction, but with the cost of a small payout and potential side effects. In the end, the FDA did not approve the drug and it’s back to the drawing board for Big Pharma and for women with HSDD (hypoactive sexual desire disorder.)
But I’m not here to talk about flibanserin today. I need to show you something else – I need you to see what was going on in the comments section and why what was being said there is harmful to women with sexual dysfunctions.
I already addressed some of the comments, like the comments that stated some of the key social construction perspective points of female sexual dysfunction. Those points may be of some use for folks with sexual dysfunction. Social construction isn’t all bad, but it grates on my nerves every time I hear it, because when I see it presented as though it’s something new, it’s actually the millionth time I’ve heard it. But you can’t really have a discussion about female sexual dysfunction without bringing up the social construction perspective so that’s out of the way.
Then, I went into some of the stranger comments. Comments where the social construction model of FSD decayed away and revealed widespread problematic attitudes underneath. Comments that presented entirely new-to-me and far-out arguments about FSD. Comments that started developing serious problems.
Since I already presented the context of the discussion last week, we’re going to pick right up where we left off, where things started to get weird:
I agree that lack of interest/arousal/orgasm is distressing. But terrifying? Is it healthy to have so much invested in our sexual identity? How much of that thinking is behind this pill?
What? If you have sexual dysfunction, you had too much invested into your sexual identity. If you find yourself experiencing a strong emotional reaction due to sexual problems, perhaps even grieving over the loss of your sex life as you knew it (or hoped for), you have no one to blame but yourself. There are many other important things to attend to in life and you should have imposed an arbitrary artificial limit on your sexual self, putting more of yourself into other hobbies instead. Like macramé. Moderation in all things and such.
It goes on with a hard-line stance against medicalization:
I’m in the ‘this is not a really good idea’ camp. The problem ISN’T physical as a rule- it’s that we live in a shitty society with shitty prospective/ current partners and far too many rapists around.
See, this is what I was talking about earlier, when I said that on paper, the social construction model of FSD leaves a little wiggle room for physical problems… but in practice, there’s very little interest in exploring and addressing what some of these physical problems are and how to address them. Now, low libido, as a rule, is not physical. The rule is (who set the rule?) low libido is due to “Shitty partners” and rapists. It sounds like a very rigid rule – is there any wiggle room at all for rare exceptions? Any room for hormonal changes? I wonder what the penalty is when you break the rule.
Someone anonymously spoke up about having sexual problems and about the possibility of a physical cause, and zie mentioned some of the problems in the thread up to that point.
Look, you just can’t ignore that sometimes women can’t get their rocks off due to purely physical causes. And that they would like to get that fixed. And that doing so may require drugs.
Please don’t fall into that godawful trap of assuming that scientists and drug companies are all evil woman-hating pushers. It’s anti-science, in practice it’s often anti-woman (HPV vaccine paranoia, anyone?) and it’s just plain ignorant.
It’s obnoxious to have otherwise reasonable people go off on wild tangents about the evil FDA taking cruel advantage of undersexed lasses, and it’s not helpful to the undersexed lasses either. (The right to self-define and all that: I’m “undersexed” because I would like more sex. Simple.)
This is the response that the anonymous commenter received:
ADTMI: Do you really think that pharmaceutical companies have our best interests at heart? Because, yeah, vaccines are great, and I’ve taken anti-depressants and have a friend that might not be alive without them, but let’s not pretend that there aren’t such things as side effects. Most of them are survivable, but there’s always gonna be someone who really suffers.
Anything that can be used, can be abused. Like the actual Viagra, there’s more demand for this drug then there is a need for it.
I am not seeing the point in which the anonymous commenter said anything at all resembling “Boy howdy I sure am glad Big Pharma’s got my back!”
Around this point, I decided to speak up in the Feministe thread again.
…Ok hold the phone. Are you suggesting then, that women who have HSDD believe that Big Pharma really is watching out for their own best interests? Are you operating under the impression that women with HSDD believe medicine is always best and never hurts anybody? Are you suggesting that women with HSDD have exclusively that one problem and have no experience with other chronic conditions, and so have never run the gauntlet of modern medicine before and so are blissfully ignorant of the abuses of big pharma? Are you suggesting that the real suffering of women with sexual problems is unimportant compared to the suffering of women who have side effects from drugs?
You say you have used antidepressants, and yet in the next paragraph you say that in this case you’re worried about side effects broadly. Do you have the same worries about the antidepressants you were given? Why is it okay for antidepressants to be used but not a drug to treat sexual problems?
The drug isn’t the root of the problem in that case, it’s medicine & abusive doctors & partners at large. The drug would be used as a tool, by bad people. Just as with any other drug. Like antidepressants.
Yet some people still really need the tool. And would benefit from it.
I am continually frustrated with conversations about HSDD and FSD in general that do not center women who have the experience of interest.
Let’s look at some components of the response I got:
K:In this particular case, the women who have HSDD and FSD seem to be saying ‘Full speed ahead and d*mn the side effects.’ Secondly, yes, I have experienced a wide range of side effects from anti-depressants. And from other meds, to, so you can be sure that with any med I’m taking, I will ask about the side effects, and raise my concerns about them.
Where is the commenter getting this information from? Did zie speak with any women with HSDD and FSD? Did zie listen to any of the responses from the few women who spoke up in the comment thread?
Is that the impression of women with HSDD that the commenter has?
This is what people are really saying about women with FSD: Broad, sweeping generalizations, without listening to them. It’s archetypes and stereotypes allover again.
Perhaps we can rectify this situation, starting with small steps. Shall I introduce myself?
Hi! I’m K and I’m a blogger on Feminists with FSD, and I have female sexual dysfunction! Specifically, my crotch hurts! I sought medical intervention for this and I think it’s totally unfair to say that my physical pain is any more or less real and important than someone else’s distress from non-painful sexual problems! I am capable of independent thought and I think about side effects all treatments that I use even if I’m supposed to use something as mundane as an antifungal! Sometimes, the risk of side effects or the side effects themselves are worth it! Other times, they’re not! This one time, I had to go off of The Pill due to side effects!
(I don’t think anyone is listening…)
There’s no room to recognize intersectionality in this comment. There’s no room to recognize that women with HSDD and FSD more broadly have quite probably thought about, and have been distressed by, life with a low libido for a very long time. There’s an assumption that women with HSDD are unfamiliar with side effects from other medications and that women with HSDD and other forms of FSD will not think about side effects to new medication.
The same comment goes on:
And the reason I favor anti-depressant over libido enhancements is simple: anti-depressants keep people from killing themselves, libido enhancers just add an extra thrill to life.
This is a clear ableist statement that prioritizes one type of disability over another. The distress from living with HSDD (remember we’re talking about a sexual dysfunction here, not just a low libido) is unimportant compared to other chronic problems that sometimes warrant medical intervention. But hey, it’s not like women’s sexual pleasure matters or anything. After all, it’s not like you’re going to die or something.
“An extra thrill?” That’s what a satisfactory sex life means now? It’s true that individuals do not need sex to live, but for many people – not everyone, but for a lot of folks – a satisfying sex life is an integral part of a good quality of life. I have no problem with consensual sex for thrills, but we should recognize that for many folks, it’s about more than the sheer excitement – a satisfying sex life can be a way to let off steam, express comfort, intimacy, playfulness and love.
There’s more to this comment:
Just out of curiousity how the h*ll can anti-depressants be abused? I’ve never heard of a black market in prozac, although I’ve heard of black markets in ritalin and other ADHD drugs.
Wait a moment – let’s backtrack. Am I seeing things? I thought that just a few minutes ago, the same commenter explicitly said (emphasis added,)
Anything that can be used, can be abused.
It seems that antidepressants are the one exception ot the rule that anything that can be used, can be abused.
However even this is not true. Antidepressants can be abused by caretakers or spouses pushing ther partner to go on medication – much the same way some commenters in this thread fear filbanserin will be abused. Doctors may over prescribe antidepressants, or prescribe the wrong type for an individual. But here, in this comment, there is no protest to keep antidepressants out of the hands of the mentally ill due to the risk of medication being forced upon people who do not need or want it.
(There is, however, backlash against antidepressants and other medication in other blogs and books elsewhere. Depression and mental illness are also subject to a social construction critique.)
With regards to abuse and the black market, I also once had a dear friend who became dangerously sick after overdosing on prescription antidepressants following a bad break-up. And every once in awhile I’ll get spam e-mail offering to sell me Prozac and other antidepressants on what might be considered a black market.
Things may get triggery from here on out, if they haven’t gotten there already:
One last thing: Is the wide-spead abuse of a libido enhancer an acceptable risk if this drug goes on the market? ‘Cause the way I’m seeing it, this is the next date-rape drug.
This is a new-to-me claim in discussions of FSD. Just when I thought I’d seen it all. Date rape drug?
Widespread abuse of a libido enhancer means that someone somewhere has to be distributing this medication, maybe a doctor, or else folks are getting this medication through the same black market I could potentially obtain antidepressants through. But again and again when it comes to sexual dysfunctions, especially pain (which is something most people readily acknowledge as “Real,”) I’m hearing from women who struggle to find doctors who take their sexual complaints seriously. Based on what I’ve been through and on what I’ve heard, I believe that even if flibanserin made it to market, I speculate that most doctors would still be reluctant to prescribe it to women.
But this misunderstanding about flibanserin used as a date rape drug appears to be widespread:
If a man slips a drug in a woman’s drink that makes her so aroused she has sex with him when she otherwise wouldn’t, you’re talking about rape.
A drug that would, shortly after consumption, instill an irresistible impetus for sexual activity would raise serious ethical problems! But flibanserin won’t work like that. Times like this I’m glad that women’s sexuality is complicated, and can’t be instantly turned on or off with the flick of a button – or consumption of a pill. (Furthermore would such a hypothetical drug instill a desire for partnered sex? Why not masturbation?)
To begin with, this comment demonstrates a misunderstanding of the difference between desire and arousal. This misunderstanding is probably only exacerbated by the media and the New View Campaign’s insistence on calling flibanserin “Female Viagra,” which it isn’t. Desire and arousal are closely related, and hopefully the two match up when you’re looking for consensual sexual activity. But you can have conscious sexual desire but low or absent arousal (physical response, like lubrication or erection) or you can be physiologically aroused but lacking in desire. You do not have to act on either. From About.com:
Libido refers to a baseline interest in sex and might be redefined as sexual appetite. Arousal refers to the physiological response to sexual stimuli. Women with higher libidos generally have a greater response to sexual stimuli, or greater arousal. Physical manifestations of sexual arousal include vaginal lubrication and increased blood flow to the labia, clitoris and vagina.
But framing flibanserin as a date rape drug, again, seems to come from a fundamental misunderstanding of how the drug works. It’s not an instant aphrodisiac, and it won’t work on bloodflow like Viagra does – it takes several weeks for the ever-so-slight effect on sexual satisfaction to kick in. That means slipping it into someone’s drink won’t do anything to someone’s sexual desire and will not make someone consent to sex (but it would still be predatory.) According to Dr. Petra Boynton,
Early trials claim the drug boosts sexual desire, but (as with other SSRIs) this drug must be taken every day for 3-6 weeks before any effects will be noticed and continuously thereafter.
And even when reading Sex is Not a Natural Act, I didn’t see the specter of “Female Viagra” raised as a date rape drug. I haven’t gotten around to reading the New View book yet, but rape isn’t even listed in the index to the book. In Sex is Not a Natural Act, Dr. Tiefer examined several angles of the medicalization of sex, for better or worse – and from what I’ve seen so far, sexual medicine used as date rape drug isn’t even on her mind. Furthermore I did not see Dr. Petra’s blog talk about using flibanserin as a date rape drug either, nor did I see Dr. Klein say anything about that. Credit where credit is due: critics of sexual medicine do their homework, and examine the issues from multiple sides (just not all sides, and different experts weigh their pet arguments differently.) I think that it means something then professionals who put their reputations on the line writing about sexual dysfunction do not give any credibility to this possibility.
The other part of this argument about flibanserin as date rape drug moves away from a critical fact: Rapists are predators. Someone who is a rapist will use whatever tools are available at their disposal to rape. That may mean alcohol, GHB, force, coercion, abuse, threats, drugs – anything. What you wear, or what you do, or who you’re with, won’t change that. Flibanserin won’t change that. The difference in whether or not you are raped is the presence of a rapist.
This argument, as with many others made on the Feministe comment page, de-centers women with HSDD. Based on what what I’ve just described, I think it’s safe to say that flibanserin as date rape drug is a red herring. We’re moving farther away from women who actually have sexual dysfunction and instead we’re sacrificing their concerns, supposedly for the greater good.
That’s enough. I certainly hope you’re starting to get the picture.
So, what did we learn about sexual dysfunction from the comments thread at Feministe? To summarize, I saw the following:
- Social construction arguments against medicalization – not completely irredeemable but can become just as prescriptive and corrupted as medicine is supposed to be
- Misunderstandings about the way flibanserin would work
- Misunderstandings about the difference between arousal and desire
- Dismissal of sexual pleasure as important
- Disregard for what women with sexual problems were saying
- Partner blaming
- Sexual medicine as date rape drug
- The further stigmatization of sexual dysfunction
Ouch. And all of this took place within an explicitly feminist space – a place where, of all places, I should have felt relatively safe talking about my point of view of sexual dysfunction. Now are you starting to understand why I was motivated to start this very blog? Is anybody listening?
So I think we should turn our attentions back to the women who filbanserin and other sexual medicine would most effect – women with sexual dysfunction. Women with low libido who are disturbed by their low libido, to the point where they actively seek out help for it.
There will probably not be a new post by me for next week. You’ve drained all that I am out of me for now, feminist blogosphere. I hope I never have to do this again.
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