Doctors debate dyspareunia part 4: The debate continues

09/19/2011 at 10:51 pm | Posted in Uncategorized | 3 Comments
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“The sad truth is that at our current state of knowledge, sexual dysfunction is whatever sexologists or others say it is” – Yitzchak M. Binik, Ph.D.

The above quote comes from the person responsible for setting off the 2005 sexology debate about how doctors should address dyspareunia (painful sex,) and it succinctly reflects my own frustration with the field of sexology.

Recently, I have directed reader attention to a debate that took place amongst doctors and other professionals tasked with treating sexual pain problems. The debate started when Dr. Yitzchak M. Binik wrote in to the peer-reviewed journal of the International Academy of Sex Research, Archives of Sexual Behavior, on whether dyspareunia should be viewed primarily as a pain problem or as a sex problem. To catch up with this blog’s review of the debate, read part 1 here, part 2 there, and part 3 last.

Dr. Binik’s original article outlined his position that sexual pain is best classified as a pain condition under the DSM-IV-TR criteria. Currently it remains classified as a sexual dysfunction, though the soon-to-be-released DSM-V will likely change the name and the definition.

Dr. Binik’s publication in the Archives received 20 responses, expressing varying levels of support. I did not read all 20 of the responses he received. In parts 2 and 3 of this blog’s dyspareunia-as-pain series, I zeroed in on Dr. Leonore Tiefer’s fascinating and contradictory response, because I’m already familiar with the rest of her work with regards to sexual dysfunction.

Dr. Binik reviewed each response to his original article, and finally addressed them in a sequel, Dyspareunia Looks Sexy on First But How Much Pain Will It Take for It to Score? A Reply to My Critics Concerning the DSM Classification of Dyspareunia as a Sexual Dysfunction. Now this is another article behind an academic firewall, so most readers can’t see the full text. In the interests of spreading knowledge about sexual dysfunction, I can only provide an executive summary.

The first thing that jumps out at me in reading Dr. Binik’s final answer is that, this article is almost intolerable.
Basically, Dr. Binik says that he was late in getting back to everyone who replied to his original article because he was distracted by baseball season. I find it ironic that, in light of the continuing debate among sexologists about the appropriate use of the term “Sex addiction,” here Dr. Binik flippantly refers to his interest as “my baseball addiction” (63.) My amusement eventually gave way to groans of annoyance with all the sports metaphors and puns strung throughout the rest of the article. Clearly, Dr. Binik still had baseball on the brain when he penned this reply. That in no way diminishes the validity of his arguments; it just annoyed me on a personal level.
Remember, there is already a baseball metaphor used in casual conversations about sex – “Bases.” Each base represents an arbitrary milestone in heterosexual sex, where running through all 4 bases means you’ve progressed to hetero, PIV intercourse.
Fortunately, the article is short – about 4 pages, as opposed to the original 10+, so I didn’t have to put up with the sports jargon for long.

Dr. Binik acknowledges that his original article met with mixed reviews from his colleagues & peers. For the most part, Dr. Binik’s assertion that sexual pain should be reclassified as a DSM-approved pain condition did not go over well. Three respondents endorsed Dr. Binik’s original position that sexual dysfunction should be reclassified as a DSM-approved pain problem. Five vehemently opposed the change. Nine responses agreed with part of what Dr. Binik said, but not everything. And three didn’t really address the question at all (63). You can find publication details about the 20 responses here. PubMed does not provide full text or abstracts for any of them, but I have GOOD NEWS, everyone! Today I found a compilation of all of the responses to Binik’s article on Ohio State University’s website! If you’ve got hours of free time, you can read and analyze each individual response, spanning some 40 pages! Except for the response we’re looking at today.

Dr. Binik interprets the disagreements as stemming from four basic positions:

(1) I overgeneralized from one typ eof dyspareunia – vulvar vestibulitis syndrome (VVS); (2) my reclassification strategy for dyspareunia was of dubious clinical utility; (3) I did not recognize that dyspareunia really is a sexual dysfunction; and (4) I confused symptom and mechanism in my discussion of classification (63).

Dr. Binik did not deny focusing exclusively on VVS, even though it is not the only type of pain one can experience during sexual activity (63). It is, however, the best researched type of sexual pain, and the research on it provided the most support to Dr. Binik’s position (64). He talks about how post-menopausal dryness & vaginal atrophy may be another sexual pain – except for the part where, due to lack of systemic research on the topic, he isn’t convinced that these problems can account for dyspareunia (64).

To the criticisms that reclassification (moving dyspareunia from sexual dysfunction to pain condition,) wouldn’t solve any problems, Binik responds that the outcome results couldn’t possibly worse than they are now. Some critics pointed out that both the sexual dysfunction and pain condition categories in the DSM-IV-TR both have problematic elements (64). What those problematic elements are, is not discussed in this particular article; we need to examine the primary source responses in question for supporting details. Dr. Binik, however, contends (perhaps somewhat blithely,) that if professionals fix the problems inherent with the DSM pain classification, then sexual pain would fit in with that category (64). And with regards to concerns that pain clinics may not be prepared to handle sexual complaints, Dr. Binik says,

Several commentators (e.g., Carpenter and Anderson, Strassberg) implied that the sexual concerns of women with dyspareunia might get ignored if they go to pain clinics. I think they underestimate clinicians/researchers, such as Masheb and Richman, who work at such multidisciplinary clincs and are very sensitive to sexual issues. It is no more difficult for professionals at a pain clinic to learn about sex than for sexologists to learn about pain (65, emphasis mine.)

In that case, my fellow folks with sexual pain, we are fucked! And not in the good, clean fun way; I mean, I am so completely frustrated with how poorly some notable sexologists handle sexual pain! If I have to look to sexologists as an example of how professional disciplines handle overlapping issues, then I am hopeless that pain professionals could possibly do any better with sex! I have seen sexologists and popular sex bloggers online who write about dyspareunia, and the extent of their writing is, “Refer to your doctor.” That’s it; that’s the extent of their learning, to this day in 2011. Since there are still sexologists who can’t be bothered to learn about the intricacies of sexual pain, I remain unimpressed. So given sexology’s poor track record of handling dyspareunia, why should I believe a pain doctor could do any better at handling sexual problems?

Facepalm Carl Pictures, Images and Photos

[Description: Carl – a heavy, hairy white guy from Aqua Teen Hunger Force – looking exasperated and doing a Facepalm. Wearing a white tank top and tacky gold chain.]

Moving on, other commentators maintained that sexual pain is and should continue to be recognized as a sexual dysfunction. This was Dr. Tiefer’s surprising, contradictory argument. However, when Dr. Binik explicitly addressed Dr. Tiefer’s response directly, he clearly missed her point.
See, Dr. Tiefer’s whole schtick is that sexual dysfunction is an artificial construct designed to benefit the medical industry, Big Pharma in particular. The New View Campaign’s social construction perspective dictates that most sexual problems stem from social problems and can be addressed through broad, non-medical interventions. But Dr. Binik clearly is not familiar with The New View or with Dr. Tiefer’s work, because he said,

For example, Tiefer argued that “dyspareunia is the only true sexual dysfunction,” because “…sexual problems [are best defined] as discontent or dissatisfaction with any emotional, physical, or relational aspect of sexual experience.” (p. XX). While I have some sympathy for this definition, it is too broad since everything that intereferes with sex (e.g., watching too many baseball games?) becomes a sexual dysfunction (65).

Wait, what the f—?! Gaaah!!! That’s not what she said! She never said that! That’s the opposite of what Dr. Tiefer’s been saying for ten years!!! I cannot believe — I can’t deal with this shit! The right hand doesn’t know what the left is doing!

[Description: Captain Jean Luc-Picard, a bald white guy from Star Trek, doing the Facepalm.jpg thing. From Know Your Meme.]

One area where Dr. Binik and Dr. Tiefer agree, is that the current classification of sexual dysfunction in the DSM-IV-TR is so problematic that it probably needs to be scrapped entirely and done over – and this is, apparently, one of the reasons why Dr. Binik wants dyspareunia moved out in the first place (65).

The last main argument against Dr. Binik’s reclassification scheme is the one I’m having the most difficulty understanding. Some commentators questioned whether Dr. Binik was endorsing a classification scheme based on symptoms or one based on mechanisms (the underlying causes of pain, like inflammation.) Dr. Binik clarifies that he doesn’t like symptom-based classification schemes, but we’re pretty much stuck with that until researchers figure out what the mechanisms behind sexual pain actually are (66).

Dr. Binik then responded briefly to a few additional criticisms of his original article, like the fact that he left vaginismus out of the discussion (an oversight he didn’t want to make but felt obligated to do since vaginismus is treated differently in the DSM for some reason) (66). Binik actually retracts one of his arguments in favor of moving dyspareunia over from sex to pain. Initially, Binik suggested research funding as one of the reasons he supported making the switch, thinking that pain research is easier to fund since it’s less controversial than sex research. He was called out for this claim by Black and Grazziotin (66).

In the end, Dr. Binik was not convinced by the respondents that sexual pain is best left as a sexual dysfunction. He is glad to have started the conversation though, and it’s possible that this discussion did play a role in the changes to dyspareunia as described by the DSM-V. Unfortunately, Dr. Binik uses a baseball metaphor with a double-entendre to conclude his article with an expression of gratitude with participants in the conversation,

“It is clear that my article did not hit a home run; however, dyspareunia is looking sexy enough to have finally gotten to first base. I think it will finally score in the major leagues” (66.)

He means his article wasn’t met with the adulation and acceptance he was expecting. This is an awkward way to put it though, considering that dyspareunia, in my experience, is the opposite of sexy and here again all I can think of is the sexual double entendre of baseball metaphors. Either I have a dirty mind or else Dr. Binik overlooked the phrase and how it might interfere with a serious discussion of sexual pain.

So what did we learn from this debate? Here’s what I learned:

If there’s only one lesson I want readers to take home, it is encapsulated in the opening quote to this post. Getting professionals involved in sexual research and medicine to agree on a definition of sexual dysfunction is like trying to herd cats. (Not to mention the fact that many professionals have neglected to involve their own patients’ feedback in the discussion – hint, hint!) We have an arbitrary definition spelled out by the well-known APA’s DSM, but in practice it’s more of a guideline than a hard set of rules, and there’s much it overlooks.

Different professionals may not agree with the DSM classification of sexual dysfunction for various reasons, and will come up with independent working definitions instead. These fractured definitons will reflect whatever agenda the professional(s) who developed it wish to spread and capitalize on. Different agendas may make some good points and thus be defensible, even when in direct conflict with one another.

I’ve seen examples of these contradictions illustrated before; One Ph.D. says porn addiction is a real thing that must be stopped, while another Ph.D. says there’s no such thing as sexual addiction, only sexual impulses. If both start sexual counseling clinics that reflect their views, then whose therapy the most appropriate? So in the end, sexual dysfunction remains a white-hot conflagration of controversy and disagreement – Looking at it pragmatically, to rephrase Dr. Binik, sexual dysfunction is whatever anyone wants it to be. You want it to be pain only? Boom, done. Wait, this other person wants sexual dysfunction to include lack of sexual arousal? Bam, here’s a phone number for a clinic you can call for that. Wait, this other person says all sexual dysfunction isn’t real at all? Boosh, here’s a whole lesson plan you can integrate into your gender studies program supporting that position. Even if some professionals manage to come to a stalemate and agree with each other on certain points, on others there will inevitably be disagreement.

I suppose this is the way science is supposed to work. Doctors and researchers are supposed to go back and forth at each other in order to find the correct answers to life’s big questions. It’s all part of the process.

But sometimes when I see these contradictory perspectives of sexual dysfunction, I get so frustrated! Then all I can do is think of the sexologists involved as chasing each other around, re-enacting the Yakety Sax scene from Benny Hill. Then I feel better:

(I couldn’t find the original Benny Hill chase scene in YouTube. Deal with it.)
[Description: Black-and-white chase scenes from Charlie Chaplin silent film, “The Tramp,” set to the fast-paced & wacky music, “Yakety Sax.” Charlie and co. generally cause mischief and misery to a team of cops trying to catch him and another character. Features running into some kind of fun-house boat with a hall of mirrors; Charlie and another character pretending to be animatronics in order to hide in plain sight from police, messing up a spinney Coney Island-era ride inside of a circus setting and general mayhem.] 

One interesting part of this debate is how it contrasts with the history of sexual dysfunction as presented by Dr. Tiefer in the chapter, “‘Female Sexual Dysfunction’: A New Disorder Invented for Women,” (quotations are hers not mine,) included in the anthology Sex is not a Natural Act. When she reported on sexual dysfunction conferences attended by medical professionals, she made it sound like a bunch of rich doctors all went in, bullshitted with each other, slept in the fanciest hotel suites, maybe bathed in goats milk and children’s tears, had a few drinks, and all agreed unanimously about a common definiton of FSD – a definition conveniently designed to line their own pockets. But instead, here, we’re seeing a much more lively & varied debate unfold.

Meanwhile, patients with sexual problems find varying levels of treatment and in some cases may be blocked from having sexual dysfunction treatments made available to them in the first place, whether that’s for safety reasons or purely political & idealogical ones. But its all in our best interests, right? …Right…?

On the other hand, I’m somewhat relieved that there isn’t a universal accord on sexual pain, precisely because that means there’s still a chance for patients to influence doctors along and get them to listen. But it’s a very slim chance – A notable omission in this debate is the involvement and perspective of patients. It’s possible that some participants in the debate themselves had experience with sexual pain, but judging from the credentials provided by the respondents, they were not answering as lay patients. These doctors talk to each other, but not to us; they talk about us, and that’s something disability advocates in particular have long recognized as a problem. Furthermore, the academic firewall helps reinforce doctors’ various levels of power over patients – I didn’t even know this debate happened until relatively recently. Then, I had difficulty researching it as someone no longer affiliated with an academic institution.

Other lessons include: Although sexual pain does not effect only women, it is still looked at as primarily a women’s issue. The most common reason I’ve seen cited for this is that sexual pain disproportionately impacts women. However, by focusing on women exclusively, professionals are probably hurting men and folks who do not fit onto a gender binary.

But as far as the original question goes: Should dyspareunia be classified as a pain or sex problem? Whether painful sex is best classified as a pain condition or as a sexual dysfunction, there is no final answer. Jury’s still out deliberating. Dr. Binik and commentators made good points defending their opinions, but no one budged from their original positions. There was no argument so logically perfect, it had the power to change minds.
Sorry gang, I don’t have an answer to this question.

Happy 3rd birthday, Feminists with FSD

09/07/2011 at 6:19 pm | Posted in Uncategorized | 6 Comments
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Today marks the 3rd anniversary of this blog. Three years on the internet, blogging about first-person perspectives of sexual dysfunction and feminism – that’s a long time to blog!

I think this calls for some small celebration and a few more pictures on this mostly-text operation. (We especially need some filler right now because I am still working on part 4 Ina blog post series about doctor’s views of sexual pain.) We already have pictures of cupcakes and unicorns here, but there is one very special type of unicorn I neglected to include during my little April Fool’s prank:

[Description: Unicorn pony Rarity leaning into also-unicorn pony Twilight Sparkle. From the MLP:FIM wiki. You can’t actually see Rarity’s horn in this picture, but it’s there.]

Yes that’s right: It’s a Pony post! Deal with it. This blog needs about 20% more Ponies in order to be cool. (Don’t tell me you didn’t see it coming.) Now let’s get this pony stuff out of our systems pronto.

See more on Know Your Meme

[Description: Animated .gif of Twilight Sparkle jumping mid-air and black glasses landing on her face. She talks and text appears saying, “Deal with it.”]

As is tradition, let’s take a break from usual serious posting to do some retrospective navel-gazing. (See the first-year anniversary here and last year’s post here.)

2011 has been a quieter year for Feminists with FSD than in previous years, because I didn’t write anything during the summer. We lost some time we could have spent blogging. On the other hand, taking time off gave me a chance to recharge and shed some burnout. I may have to do that again next year.

But even with that break, things are likely to remain quieter around here than they have been in the past – you may have noticed the lack of weekly blog link roundups. My excuse for this is that I still work full-time in a completely unrelated field and receive zero compensation for putting anything up on this blog. I cannot offer compensation to guest posters, because I have nothing to give. And since my commute got a lot worse this year than it has been in the past, I don’t have as much time to blog as I used to. But I keep trying to chug along and plug along as much as I can.

There’s still a lot of stuff left to talk about with regards to the intersection of feminism & female sexual dysfunction. I’ve addressed only a few of the outstanding issues I brought up in last year’s anniversary post. Your undying patience with my snail’s pace at getting new content posted is appreciated.

On the other hand, there are new topics posted now that I hadn’t thought of last year – such as our still-continuing series on how doctors think sexual pain should be addressed – as a pain problem, or as a sex problem? Hmm. So much work left to do… and it needs to be done.

I am 100% confident that there is still a need to present these first-person perspectives on feminism & sexual dysfunction. I’m still finding posts online and in articles written by people who present themselves as experts on sexuality – yet articles about sexual dysfunction still fail to speak for me, or even, to me. So many articles by folks who have never experienced sexual dysfunction firsthand, yet claim to know more about it than I and my friends do. The authors don’t talk to me as an equal deserving of respect and with a mind of my own, capable of making thoughtful decisions on what to do about my health and sex life. Instead, what I’m seeing as someone who actually has sexual dysfunction, is condescension and stereotypes presented as helpful “Advice.”

I don’t know about the rest of you, but most of the advice offered in these contemporary articles about and critical of sexual dysfunction do not address my problems. Instead, the advice presented just adds bullshit onto my growing pile of crap I gotta deal with – and makes it harder for me to slog along way to a satisfactory resolution. I’m thinking to myself right now, Oh look, another so-called “Sexpert” just implied that anyone who even considers using medication to manage a sex problem must be a pill-popping shill incapable of critical thought re: the pharmaceutical industry and potential side effects. What do these journalists think we do? I think they think we all go to a big city with fistfulls of cash and bang on the door of the first corporation we can find, saying, “BIG PHARMA TAKE MY MONEEEEY!!!”

[Description: Stylized unicorn with a gold tiara and rainbow wavy hair Princess Celestia shrugging with this look on her face: >:/]

I think to myself, And look over there, another journalist just explicitly stated that women who don’t have orgasms are holding themselves back because of peer pressure brainwashing by the patriarchy. I can’t believe this is still a thing.

Remember, I am not an Agony Aunt. Most of the time I hate giving out advice, because I can never have a complete story of what’s going on in your life, what you’ve already tried, where you want to be in the future, etc. I don’t want to be the one to give you the wrong advice that winds up causing more problems in the end.
And please, for the love of god, no one ever refer to me as a “Sexpert.”

I will proceed to make one exception to my general guideline about not giving advice though. Here’s something that the sexual dysfunction writers to which I am referring need to know:

Protip: if you yourself do not know what daily life with sexual dysfunction is like, yet you still want to write about female sexual dysfunction, maybe find some women who actually have sexual dysfunction ask for their opinions and experiences first. Having trouble finding women who identify as having sexual dysfunction and who are willing to open up to you about it? Then maybe you should read the archives on this blog for examples of why it’s risky to come out as having a sexual dysfunction in the first place. There is still tremendous stigma attached to it as a diagnosis, whether you’ve got a low libido, pain, or any other seriously distressing sexual problem. Is your blog post or magazine excerpt going to be yet another one of these problematic articles?

So instead of copying the way I see most articles about sexual dysfunction, here’s what I prefer to think when I write stuff for this blog. I start off from these general points of view to serve as guidelines:

People with sexual dysfunction are smart.
People with sexual dysfunctions are capable of making rational decisions about what to do about their health and sex lives.
People with sexual dysfunction have probably already sought advice, are currently seeking advice, or will seek advice in the future. That means that whatever advice you as an individual have for someone with a sex problem, it probably isn’t that new or revolutionary. Whoever you’re writing for has probably seen some iteration of your advice, or will see it again in the future. So that’s why I like to take things in a different direction here – I like to show off stuff that I haven’t seen before, or stuff that I’ve only rarely seen.

It’s a different starting point from how I usually see sexual dysfunction patients handled. Most articles and essays about sexual dysfunction start off from a position where the patients are ignorant, gullible and easily manipulated.

Hmm… No, sir, I don’t like it.

What th— wait a minute! This was supposed to be a pony post! Who let Mr. Horse in here?! Get out of here, Mr. Horse. You’re from a different show.

[Description: Mr. Horse from the Ren & Stimpy show standing on two legs and wearing a gentlemen’s coat and tie. Standing in front of an abstract yellow & gray background with a sour look on his expressive face.]

A problem holding me back is that since I am not an Agony Aunt, Sexpert, Ph.D., M.D., M.S.W., or anything other than an ordinary lady with an extraordinary crotch, I still lack something critically important: Credibility. Who is going to listen to a young lady’s views of sex and feminism when she herself has not actually even had any penis-in-vagina activity in over two years, despite being in a long-term heterosexual relationship? Who is going to take seriously a critique of peer-reviewed journal articles, as written by someone with no relevant academic credentials? What publisher would ever take an essay about sex by someone like me seriously? There’s no two-or-three letter acronym before or after my real name, other than the generic “MS.” So although This blog has a decent number of readers – as many as some college classes – I remain painfully insecure about my own perceived illegitimacy. I feel like it doesn’t matter how much research I do or if I do a good job of pointing out flaws in the way people present sexual dysfunction; without something to make me look like I’m important, no one will ever listen.

And that makes me sad.

[Description: Light purple winged unicorn Princess Luna crouching on the ground. She is looking up at something off-screen.]

I suppose the solution to this dilemma is to go back to school to get a two-or-three letter acronym to put in front of or behind my name. Except I already have a Bachelor’s degree in another field, and school costs money. Money and time, which I am also short on. It is a conundrum… Plus, in principle, you shouldn’t need to have professionally recognized credentials in order to talk about what’s going on in your life.

So for some reason I keep on blogging anyway. It’s one of those things where you do it because you have to do it. Not that I’m being compelled by any outside force; just something inside pushing for more. So more comes out – and hopefully, will continue to pour out for the foreseeable future.

Thanks for reading, we shall return to our regularly scheduled non-pony blogging shortly.

Product review: Jimmyjane Afterglow massage candle

07/17/2011 at 4:42 pm | Posted in Uncategorized | 10 Comments
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(Not into product reviews? I’m still in warm-up mode after having been out of practice with blogging for awhile. Stick around for the social-political-feminist-disability-sexual stuff down the line.)

I thoroughly enjoy a relaxing, firm massage. Unfortunately, such massages are a luxury I rarely get to indulge in. A professional massage can easily cost over $100, and a full-body massage at home with my partner still requires some up-front costs in the form of supplies – not to mention the amount of time required to give a satisfying massage. And there are a lot of spa and body supplies out there, all tempting me with pretty packaging and promises of pleasure. Which ones should I go for?

Awhile back, on a whim, I bought a Jimmyjane Afterglow massage candle. I had tried a different brand of massage candle once before, and enjoyed the whole experience very much. But to avoid suspicion from people who are not me, I had to throw it out before I finished using it. I don’t need to worry about nosy people getting all up in my stuff anymore, so I picked up the Afterglow as a replacement. My only reason: “Because it was there.” I hadn’t actually done any research on the product first, but I figured since a reputable adult shop was selling it, I could probably rely on the staff to pick out something satisfactory to sell. I don’t generally recommend this strategy of impulse buying. In this case, however, my purchase worked out just fine.

What we’re looking at today is a cucumber-water scented massage candle:

[Description: A white, square candle holder with wax filling it about 3/4 of the way. The wick is unlit. There is a logo that says “JIMMYJANE” on the lower left side.]

Most of the ingredients in the candle are easy-to-pronounce and recognize – the first six components listed are soybean oil, shea butter, palmarosa oil, jojoba oil, aloe vera, and vitamin e. After that you get into the “What?” stuff & stabilizers – cis-3-hexaenyl acetate? Galaxolide 50 DEP? I don’t know what that is, but I know it’s not entirely all-natural. Furthermore, the instructions state that the massage oil is intended for external use only, so don’t smear the melted wax onto anyone’s genitals. You may even want to test patch a small area of your own and the recipient’s skin before going all-out with the melted wax, just to make sure no one is going to have an allergic reaction.

What it feels like: The melted wax is surprisingly slippery. It won’t feel like ordinary candle wax – when melted, I think it feels just as fluidy as liquid massage oil. When I use it on my partner, I can apply a lot of pressure to whatever I’m massaging and my hands still glide around without getting stuck. At some points I needed to wipe my hands off on a paper towel because they were getting too slippery and I was losing my grip.

The advantage of a massage oil candle is that when it is poured onto skin, the oil feels significantly warmer than room temperature. I tense up when I know my partner is about to pour oil onto my back. I can’t see when it’s about to land and I’m always afraid that it’s going to be too hot. However in practice, the temperature has been comfortable, and after awhile I realize I have nothing to be afraid of. So if you are interested in wax play, this candle might be a good option for beginners.

[Description: White, square candle holder from the side. From this angle the pouring spout is clearly visible, protruding from one corner. The “JIMMYJANE” logo is clearly visible.]

Whether or not you’re getting enough or too much slip from the oil to give a decent massage may be up to each individual couple or group. Communication between recipient and giver is important when engaged in massage. I thought my partner was being stingy with the oil initially, so I had to tell him to pour more on when I was on the receiving end. Once he did that, I felt much more comfortable and relaxed. On the other hand, I tend to pour it liberally because the slipperyness amuses me to no end.

[Description: White, square candle holder with lit wick. The melting wax inside looks yellow and reflects the candle flame.]

Using the Afterglow candle involves some time constraints, so using it will require some planning and an open schedule. Once you light the candle wick, it will take about 30 minutes for the wax to melt enough so to have something to work with. This is sufficient time for me to set the room up for a massage. Once you and the massage recipent are in place, you’re supposed to blow out the wick, for safety reasons. Then you can start using the melted wax.

[Description: White lady’s hand tilting the square candle holder at an angle. The yellow melted wax is a liquid flowing into one corner of its ceramic container.]

About 30 minutes after extinguishing the flame, the melted fluid starts to thicken. Shortly thereafter, (I would say somewhere between the 40-45 minute point) it will begin to congeal back into solid form. If you’re still working with the wax at this point, it’s still usable as a massage oil but it will begin to feel granulated. I squished it between my fingers to make it fluidy again for awhile longer.

[Description: White lady’s hand holding the candle at a different angle. The wick is out and blackened. Now the yellow wax is looking lumpy.]

After the candle has had sufficient time to cool down and return to a solid state, I store it inside of its original box. The packaging the Afterglow candle comes in noteworthy – a sturdy square box for a (mostly) square candle holder. When you open the box up, the inside top flap greets you with the written words “Melt me.” In addition to the 3 brief steps for use listed on the outside of the box “Light, pour, then massage into skin,” the candle comes with a detailed instruction book printed in several languages.

A couple of caveats to keep in mind when using the Afterglow candle:

The candle is designed to have its melted contents poured onto skin, so it has a low melting point. You are literally playing with warm-to-hot wax.
Friendly reminders: Be careful when playing with fire. Do not leave the candle burning unattended, do not place it on or near any flammable objects, and do not engage in wax play unless you are using a candle specifically designed for such an activity. What I mean by that is, if you try to use an ordinary $0.30 generic emergency candle on your partner’s skin, someone could wind up with 3rd degree burns. More information on safe wax play can be found via Go Ask Alice! for starters.

The scent from the cucumber-water candle is strong – to me the smell was pleasant, but it’s highly noticeable and long-lasting. I could still smell the scent of cucumber water lingering in whatever room the candle burned in, for 48-72 hours after extinguishing it. Since the smell is so potent, this may not be an appropriate product to use if you are sensitive to strong odors; for example, if someone in your household has multiple chemical sensitivity you may want use an unscented massage product instead.

The candle itself is somewhat heavy in the hand – after all, it’s made of densely packed wax and ceramic. It actually weighs in at a little under 5oz when new. The mass isn’t a problem for me, but if you experience tremors or have difficulty gripping objects, you may want an alternative. Some alternatives include: A massage candle with a lightweight brush to paint the melted wax/massage oil onto skin; a bottle of liquid massage oil; or a semi-solid massage bar that melts when exposed to heat.

Finally, one of the downsides of the Afterglow candle is the initial sticker shock. The Afterglow candle costs about $30, whereas my go-to bottle of massage oil ranges from about $7-$10. I have not yet determined how many uses I will actually get out of the Afterglow candle vs. my go-to liquid massage oil.

If price is an issue, then as of today I have Good News, everyone!

[Description: Professor Hubert J. Farnsworth from Futurama. Both his hands are raised and open. I can’t say the line without using the picture. I couldn’t resist.]

Or at least it’s good news for if you want the Afterglow candle but have important bills to pay. Until July 31, 2011, is running a promotion on a Jimmyjane Afterglow massage oil candle – so long as the candle you want is the Fig-scented one. Details are listed here, (as of July 10th) so make sure you read the terms before making your purchase.
I took advantage of this deal, after having already tried out the cucumber water Afterglow candle.

The promotion of interest today is the one where you make a $5 donation to SEICUS (Sexuality Information and Education Council of the United States,) through’s website. In return, you receive a Fig-scented Afterglow massage candle, for “Free*.” Free*, in this case, means you’re still spending money to get something, but you’re technically spending it on a donation rather than the product. This link takes you to the donation-for-candle offer.
FYI, there’s other donation-related promotions and general sales going on. You can donate $5 to SIECUS straight-up, without receiving anything in return. A third option is to spend $75+ on a Jimmyjane product, AND make an additional $5 donation to SIECUS, in exchange for a Jimmyjane vibrator worth $20.
Don’t forget to factor in shipping costs if your order has any. Shipping isn’t included as part of these promotions, and if there’s any on your order, you will still be responsible for it.

Note that in addition to a different scent, the fig-flavored Afterglow candle comes with changed packaging. The ceramic container for the wax is transparent instead of opaque. The instruction book that comes in the box is printed on textured instead of glossy paper. There is a small book of matches inside of the box, so for safety’s sake don’t let any little kids open the package containing this candle. And the fig-scented Afterglow candle includes a little lightweight brush like what I was talking about earlier in this post – with this brush, you can paint the melted wax onto your partner instead of pouring it on.

Here’s what I got when I made this purchase:

[Description: A square, transparent candle holder with an unlit wick and off-white wax inside. Behind that, a box labeled “AFTERGLOW.” The lid on the box is open and white lettering says “MELT ME” on one flap. Inside of the box there sits a wide, black-bristled brush and a tiny rectangle box. You can’t tell from the picture but FYI there are matches inside of the tiny box. Next to that is a square instruction book.]

For having made the $5 donation, also throws in a thank-you envelope containing 3 coupons. 2 of those coupons are good online in August or August + September, the last one good at brick-and-mortar Babelands only. And there’s a floppy magnet in the thank-you envelope.

[Description: Colorful, happy looking rectangle coupons, a bright pink rectangle magnet, an envelope with “THANK YOU!” typed on it.]

And then here’s a picture of the two candle packages together, just for fun.

[Description: the same coupons as above. Two cube boxes that both say “AFTERGLOW” on them. One has a green top and the other has a cyan top. The white, opaque candle holder is sitting on top of these two boxes.]

As with all reviews posted on Feminists with FSD so far, I had to pay for this product(s) out of pocket with my own money. I took advantage of the $5 donation program, but, only after having bought the cucumber-water Afterglow candle reviewed here at full price at an earlier date. But the promo is available to anyone so I didn’t have to agree to write anything to get it, so in the end I receive no compensation for having written this. I still foot the bills around here.

A change of pace

04/01/2011 at 1:06 pm | Posted in Uncategorized | 3 Comments
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Everyone, today, I have a very importnat announcment to make. Starting today, I am turning over a new leaf. With this the first of the month, we are going to take the blog in a different direction.

My friends, I know that over the last two & a half years you’ve all enjoyed (or not) an alternative perspective on female sexual dysfunction. But this morning, I woke up seized by a fey mood; a humours, if you will; and suddenly it all became clear. Truly, female sexual dysfunction is but a well-organized conspiracy perpetuated on women by sinister doctors and fat cats with none but the intent to make us all miserable. As such, I can no longer write about it in good faith.

Which presents the dilemma: But what to do with the blog then? Though it pains me to have to scrap the drafts in the queue, I must nonetheless shift gears. Alas, I will no longer be able to work on a post about human sexuality studies in academia and a critical look at companies & organizations which provide funding to non-profits. Likewise I will no longer be able to write sexuality book reviews. For such topics were going to somehow tie into female sexual dysfunction, which as we all know, no longer exists and it never did.

So instead, on this day, I would like to announce, Feminists with Female Sexual Dysfunction will become a blog about Unicorns.

That’s right, Unicorns. And their friends like the kirin and narwhale, although that last one is a real thing. Mythical and real one-horned beasties from around the world. Ever hear of the Karkadann? That critter was was all sticking its head out from its mom’s uterus womb (sorry US Government – I forgot we’re not supposed to use the proper terminology for reproductive organs anymore) and eating fruit before popping back in there and chillin’ till it was time to get born. (No, seriously.) Kind of a jerk once it was born, though.

It seems only fitting to become a blog about mythical animals, seeing as how according to experts like these female sexual dysfunction is in fact a myth. And so, unicorns and other symbolic critters that do not actually exist will become the spiritual successor to discussions about actual pervasive personal distress caused by sexual problems which do exist. Or don’t exist, per the most important opinion, which also happens to be the most objective opinion, meaning the opinion of people who do not themselves have FSD.

So from now on, starting today on this the first day of a certain month*, we are no longer going to critique feminist critiques of female sexual dysfunction and sexual dysfunction broadly. The mainstream feminist critiques of female sexual dysfunction are the only valid ones and certainly they are 100% problem-free. Nope. No problems there. Not a one. Everything is fine and nothing needs tweaking anymore. I have seen the light.

From now on, this is a blog dedicated to further the unicorn agenda. I don’t actually know what that means, but I think it involves posting pictures of unicorns.

So, instead of a blog link roundup, I hereby demand a unicorn picture roundup. Post pictures of unicorns if’n you got’em. This blog needs some more fucking unicorns. I better be up to my ass in unicorn shit by the time this post is done! (THEY CRAP RAINBOWS!)

Picture of the Unicorn in Captivity, which is not actually a painting but art on fabric:

Unicorn in Captivity

[Description: Unicorn in Captivity, borrowed from Wikimedia Commons. A long-horned unicorn with goaty legs and tail in repose, surrounded by a fence. It is underneath a tree and there are a lot of plants on the ground.]

Sometimes unicorns are used as an allegory for chastity and purity, because of that thing where they only like to hang out with virgin women. Perhaps in an alternate dimension, I could have written something about unicorns + virginity but I can no longer do so because it would remind me too much about vaginismus.


[Description: Domenechino’s Fanciulla con liocorno, 1604 – 1605, borrowed from Wikimedia Commons. A smiling white woman in green clothes loosely holding a small horse-type unicorn. Trees and water in the background.]

Here’s a picture of that Karkadann I was telling you about. Sadly I could not GIS a picture of the baby sticking its head out of its mom’s womb and birth canal. I know it’s from a seventeenth-century manuscript, but I don’t know who drew it. The Karkadann was said to live in India, North Africa and Persia (Iran.)


[Description: A possibly-baby karkadann laying on pink dirt under a tree, looking up at two birds. The karkadann itself looks like a rhino with both a nose-horn and a forehead-horn, but it has spindly little goat legs.]

Sue Dawe is an artist who draws a lot of modern-looking airbrushed unicorn pictures. When you think of unicorns, you probably think of Sue Dawe or Lisa Frank. I think I may have owned a poster or greeting cards by her at some point. You probably saw Dawe’s stuff on the interweb before. Here’s one that’s copyright Sue Dawe:


[Description: 5 horse-type unicorns  frolicking under an Aurora Borealis. The highlights and shadows are overwhelmingly done in purple & white.]

And then here’s one from my childhood, the cartoon version of The Last Unicorn, written by Peter S. Beagle but animated by the Rankin-Bass studio.

amalthea face

[Description: Close-up of The Last Unicorn‘s head & neck. She has big rabbit ears, anime eyes and although you can’t tell from this picture, she has a horse-ish body with goat legs & tail.]

Coming soon: More unicorns (Yay!)

*Spoiler alert: In case it still isn’t clear by now, I wish you all a happy April Fool’s Day. We shall return to our regularly scheduled FSD blogging shortly. Till then, don’t believe everything you see online today!

Shorties II

03/21/2011 at 2:10 pm | Posted in Uncategorized | 4 Comments
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In the same spirit as the original Shorties, I bring you: A series of posts which were each too small to constitute blog entries on their own. Divided we are weak, but together, we are strong!


The National Vulvodynia Association’s newsletter for 2010 is posted on their website, here. It includes updates on research and funding, and profiles of researchers who have received NVA-related grants. There are also profiles of medical professionals working towards a more comprehensive understanding of vulvodynia. There’s also updates on educational materials and programs provided by the NVA.


There’s a couple of reasons I like to post book reviews on this blog. I may post product (vibrator, dilator etc.) reviews in the future; I haven’t decided yet. Again, a reminder: Any reviews I posted here so far, I had to pay for the product in question & I haven’t gotten any compensation for my services.

It’s a blog about sexual dysfunction, especially that greatest bone of consternation, female sexual dysfunction. One of the common themes I read in feminist analysis of FSD is that a lot of it is actually sexual insecurity which stems from ignorance and lack of education. The idea goes something like, men & women are socialized differently and grow up with different expectations & pressures when it comes to sexual behavior. (In other words, differences in sexual behavior between men & women aren’t necessarily inborn.) Women are discouraged from learning about sex & pleasure. Combine this with shitty sex education and you have a pretty good chance of not understanding the influence of gender roles and how your own body works. This in turn is misinterpreted by the individual as “There must be something wrong with me” when experiencing a normal, understandable reaction to sexual stimulation. And the cure for this is better sex education instead of medication. Go read a goddamn book or something!

Improved sex education is great, so that’s one reason to post reviews of sexual guides and products. So every one in awhile you’ll find such a review here – it’s my way of saying, “Hey, here’s something that’s good and worth your time,” or, “Hey, here’s an overrated product that isn’t worth the packaging it came in. Save your money.” Or I’ll post something more nuanced –  “This is good, this is bad, and this part I don’t understand at all.”

However there’s another reason I post the reviews here…
Sometimes all the sex education in the world cannot fix a sexual problem.
Because it doesn’t all come from sexual ignorance.
Many of the sexual guides I’ve read, some of which come highly recommended, do not do a good job of addressing my problem in particular – pain. Maybe it’s because they’re not medical advice books so they can’t recommend treatments. Liability issues, maybe.

I’m doing what I’ve been told to do. I’m getting better sex education. I read the blogs. I buy the sex toys from the feminist sex shops. I have explored my sexual fantasies and will continue to do so. I masturbate to orgasm. I am in love with a supportive partner (the feeling, I understand, is mutual.)

The lady with sexual dysfunction is reading a goddamn book or something.

So why do I still experience dyspareunia?
Why do I still have vaginismus?
Why does my vagina still take so long to recover from vaginitis?
Why is medical intervention the treatment that best addressed the sexual and chronic pain?

Hey wait a second, this isn’t working. I still want to have some penis-in-vagina sex over here and that’s still like, really hard to do. Maybe I’m just not reading books and trying to learn hard enough.

The sex education helps – it’s definitely worth something. But it’s not comprehensive enough for me.

Now we could say here that I am the special snowflake exception to the general rule that FSD is a fake invention designed by Big Pharma and evil doctors; Dr. Leonore Tiefer, organizer of the New View Campaign, said as much when she wrote, “Dyspareunia is the only valid sexual dysfunction and certainly the only important one,” in response to the suggestion that dyspareunia might be better considered a pain condition rather than a sexual problem.

So hypothetically I suppose I could say, “Fuck you all; I got mine.”

Hypothetically. I have no desire to actually do that and in fact I feel dirty for having spelled such a phrase out in text. Excuse me while I swish some mouthwash and/or wash my hands. Is that what I’m supposed to say? Is that the way I’m supposed to feel? Is this the signal that, as someone with dyspareunia, I’m supposed to shut my pie hole when I see folks with other dysfunctions belittled for it?
I maintain that elevating one or some forms of sexual dysfunction as more real than others creates and crystalizes an artificial hierarchy. And it throws folks with sexual dysfunctions other than or in addition to pain under the bus.

And if, for me, all the sex education in the world fell short of actual medical help from professionals, then why should I believe that it would be any different for all of my friends who have sexual dysfunctions that are not painful?
Not that sex education has been completely useless; far from it. I have taken advantage of the information I found useful. (I also tripped over the parts that were counter-productive.) But to deny medical options to women with sexual dysfunction is to remove an important potential treatment, which for some folks may very well be necessary to find sexual satisfaction. And I find it highly disturbing when such options are removed through means of threats & intimidation, shaming, or ableist comments.


Speaking of dyspaerunia being “The only valid sexual dysfunction and certainly the only important one,” I made this Privelege Denying Dudette meme just for you:

[Picture: Background: 6 piece pie style color split with pink and blue alternating. Foreground: White girl wearing a green t-shirt, featuring an African-American Sesame Street muppet with nine different hairstyles, subtitled, “I Love My Hair.” Has a smug, arrogant facial expression and plays with her long, brown hair. Top text: “ [SEXUAL DYSFUNCTION ISN’T REAL, YOU DON’T NEED MEDICAL INTERVENTION IN YOUR SEX LIFE] ” Bottom text: “ [WAIT, YOU HAVE DYSPAREUNIA? YOU BETTER GO SEE A DOCTOR.] ”]

What? Wait, what’s it going to be, do I trust my doctors or not? Do they know enough about sex to help me or is it an exercise in futilty to even bring up a sex problem? Am I allowed to go to one of the heavily-marketed sexual dysfunction clinics Dr. Tiefer mentioned in Sex is Not a Natural Act when my regular gynecologist gets stumped and refers me to such a clinic? If I take a prescription for sexual pain, am I just feeding the Big Bad Phama Beast and looking for an easy, quick fix? If I get treatment for dyspareunia, does that count as medicalizing sexuality?


I recently came to a revolutinary conclusion. If your definition of sex positive does not include sexual dysfunction, then your definition isn’t positive enough.

I want to go out of my way to explicitly include sexual dysfunction in sex-positive discussions. Because ignoring it, outright denying its existence, or claiming that looking at sexual dysfunction = focusing on the negative, will not make it go away. Insisting that sexual dysfunction is a lie erases people who actually have sexual dysfunction. As a result, people with sexual dysfunction are excluded from sex-positivity – and I hate that. There is push-back against excluding people with a history of STIs from the sex-positive community by means of negative, stigmatizing language – why not push back for people with dysfunction?

You know what? I have sexual dysfunction. I exist. This is a long- term thing for me that I do not foresee changing any time soon. It will not go away just because you are uncomfortable with dysfunction (and, by extension, disability. These two phobias tend to go tovether, possibly because dysfunction may be viewed as a sub-type of disability.)

Yet even with the dysfunction, somehow, in spite of everything, I am sex-positive. I have made peace with it – or, at the very least, I have made a truce with myself until I can figure something better out.

Insisting that sexual dysfunction isn’t real or that medical options are unwarranted is just going to make it harder to get the care that I and my friends need. It’s true that most people will never experience sexual dysfunction, and so will not require medical options to address it. Nonetheless, inevitably, some people are going to develop sexual dysfunction. Isn’t there a way we can focus on getting support to such folk, instead of trying to sweep ’em under the rug?

Sexual dysfunction and sex-positivity do not need to be mutually exclusive.


Sometimes, I worry a little bit about my reliance on a vibrator for orgasm. I think that, with enough practice, I probably could masturbate to orgasm using only my (or my partner’s) hands. But until then, I orgasm easily enough with a battery-powered vibrator.

I’m not worried about spending money on vibrators and thus supporting a capitalist system. I’m not worried about using my vibrators during sexual activity with my partner. I’m not worried that he’ll feel inadequate compared to my vibrator. I’m not worried about becoming addicted to masturbation. I’m not worried that I’m supporting the tyranny of orgasm.

The real reason I sometimes worry about using my vibrator is…
…I have this paranoid fear that some day space aliens or a freak accident or a Hollywood movie-esque disaster will unleash an electromagnetic pulse over the USA (home) and all elecronics will lose functionality.
Including my vibrators.
And then I’ll have to find a techno wizard to SteamPunk some kind of hand-cranked or steam-powered vibe for me. Possbily incorporating or inspired by one of the old-time antiques like those found in the Museum of Sex. And it’s just going to be really awkward and frustrating and I’ll probably have a lot of other important things to worry about post-EMP.

Obviously I don’t really know how EMPs work and I don’t really care. Everything I learned about them, I learned from movies.

I think about this with about the same frequency that I think about the Zombie Apocalypse as a real thing. Which is to say, not very often except for maybe after watching a movie about a zombie apocalypse or a post-apocalyptic setting.

Conceptualizing the FSD hierarchy

01/12/2011 at 12:04 am | Posted in Uncategorized | 8 Comments
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A couple of times on this blog, I and guest posters have briefly mentioned something called the female sexual dysfunction hierarchy. This is an idea that formed in my mind while reading various interpretations of  female sexual dysfunction – I noticed that not all forms of FSD were handled equally in terms of social (and professional) acceptance and priority for treatments. But what is the FSD hierarchy, exactly? What do we mean when we talk about it? Let’s think about it and see what we can come up with.

To me, the FSD hierarchy means that certain types of sexual problems are more readily recognized as sexual dysfunctions than others, and are given a higher priority for treatment by doctors and therapists. It means that if you have some sexual dysfunctions that are not recognized as serious and real you’re more likely to have to present some reason, a justification, for the dysfunction to exist in the first place and you may face barriers to satisfactory resolution. Conversely, the FSD hierarchy means that other types of sexual dysfunctions are more readily recognized as valid health problems for which medical treatment (and insurance reimbursement) is more likely to be available and socially acceptable.
It’s not that all forms of FSD can or should be treated with a single magic bullet. Different types of FSD need different treatment options, including the option to not treat at all. A woman with low libido may not require a pain management program and a woman dealing with orgasm difficulties may already have an otherwise high sex drive. However, what the hierarchy does is prioritize some women’s personal experiences and feelings with regard to sexual dysfunction, but it dismisses others.
Basically you get shit about having certain types of FSD but not others. The hierarchy does not necessarily mean that women with any form of FSD will be treated the way as they should be – that is, with respect and dignity.

Ultimately, I think it means that some sexual dysfunctions are “Okay” to have and treat, while others are not okay to have or to view as dysfunctions, regardless of how much a sexual problem is interfering with your life. I believe that a hierarchy of FSD is something that both medicine and social construction contribute to.

And I don’t like it. No sir, I don’t like it.

I hate the hierarchy of sexual dysfunction. It isn’t fair. It’s artificial and hegemonic; it compartmentalizes different types of sexual dysfunction, so you lose a chance explore overlap. Coupled with the stigma of having FSD in the first place, keeps women with sexual problems broadly from sharing experiences with one another. Unfortunately the hierarchy of FSD in and of itself adds to the stigma – since some kinds of FSD aren’t valid in the first place, it’s hip to make fun of anyone who thinks they have sex problems.

Medicine is rigid in defining what is recognized as FSD. Generally, under the medical model of FSD, (hotly contested and informed by the DSM) there are four broad categories of sexual dysfunction – pain, lack of arousal, lack of orgasm/pleasure, and/or a low or absent libido (sexual desire.) To this day, as evidenced by the JAMA study citing a 43% prevalence rate of FSD in the US, a sexual problem may be considered to cross the threshold into “Dysfunction” regardless of the feedback of the individual. To ignore a patient’s personal feelings is a problem in and of itself, for it’s fairly common to experience snafu sexually from time to time. And even if you do experience what might be considered a “Problem,” if you are comfortable with that, then it’s less of a problem in the first place.

The social construction model, particularly the New View model of women’s sexuality, is looser in recognizing sexual problems and their causes, but stricter in defining limits for the term dysfunction.  Stricter limits on the use of the term sexual dysfunction are called for because of a long history of abuse at the hands of those who had the authority to dispense with such terminology in the past. Additionally, sexual dysfunction is stigmatized and so a diagnosis of FSD can in and of itself create anxiety – you lose your status as a “Normal” person, sexually. (If you ask me, it makes more sense to take out the sting of sexual dysfunction in the first place rather than to elevate TAB status to its position of privilege. There’s nothing wrong with having a sexual problem, so, what’s wrong with having sexual dysfunction?)

Here’s a picture of what I think the FSD hierarchy looks like. I whipped this up in Excel so the graphic is Butt-Ugly. My hierarchy is based on the four broad medical categories of FSD, because that’s how I most often  see sexual dysfunction talked about. That medical model of sexual dysfunction certainly does have a long reach. What does the FSD hierarchy mean to you, and how would you describe it?

[Description: The sexual dysfunction hierarchy pyramid, version 1.0. A 4-tier pyramid sitting on top of a brown rectangle. Each tier in the pyramid is a different color and labeled, in descending order, “Pain,” “lack of arousal,” “lack of pleasure/orgasm,” and “low/absent libido.” Caption next to the pain tier says, “Pain is generally recognized as valid. May be considered a pain condition, disability and/or sexual dysfunction (depending on the individual with pain and who you ask about it).” Caption next to the lack of arousal tier says, “can sometimes be a problem may be addressed with lubricants or medications ED in cis men usually recognized more readily”. Caption next to the lack of pleasure/orgasm tier says, “Starting to get controversial as sexual dysfunctions now since these problems may be social, physiological or both”. Caption next to the low/absent sexual desire tier says, “The illegitimate child of FSD Desire, libido, HSDD – all highly contested Is it a dysfunction or just part of your personality?”. The rectangle under the pyramid is supposed to represent underground and it’s labeled “PGAD, Endometriosis, Overlap and Intersectonality, Stuff I forgot about, Interstitial Cystitis and Stuff I hadn’t thought of.”] Caption next to the rectangle says, “Stuff underneath the pyramid Doesn’t get talked about much”.

Under both the medical and social construction models of sexual dysfunction, pain is generally recognized as valid problem that cannot always be explained away. It is the sexual problem for which medical intervention is the most acceptable, relatively speaking. Even Dr. Leonore Tiefer, proponent of the social construction model of sexuality, who organized the New View Campaign, has stated that sexual pain is the one and only valid and important sexual dysfunction – at least so long as we continue to use that terminology. Pain might be due to a vulvar pain condition like vulvodynia or vaginismus, or it might be part & parcel of another chronic health condition. It may be exclusively limited to sexual situations.
I’ve noticed that since pain is more readily recognized as a medical problem and a sexual dysfunction, it’s treated funny in discussions of FSD. Even though pain falls under the broad umbrella term of FSD, it’s frequently ignored or gets at best one-line mention in an article. So there’s a poor exploration of overlap between pain + other sexual problems. And as someone with sexual pain problems, I can’t ignore the way that other non-painful forms of FSD are discussed; the way sexual medicine is stigmatized – that’s a lot of stigma to get over, when you need to reach out to a medical professional for help. The take-away message stuck in my mind is, “Of course HER distress is palpable and important – she’s in physical pain! HER sexual problem is okay to treat with a pill or whatever, but YOURS isn’t. Why are you so worried about anything other than pain, anyway?” It is as though the distress I feel from experiencing pain with sex is more legitimate than the distress that another woman feels from lack of orgasm, or whatever else.
Even though sexual pain may be treated with relative respect in discussions of sexual dysfunction, the reality remains that it’s still viewed as a joke. Write frankly about dyspareunia and you may find trolls come out of their dark hiding places. In real life sexual pain gets no special treatment.
(For the record, I know that I talk about sexual pain with more detail than I do other types of sexual dysfunction on this blog. This is not because I think other forms of sexual dysfunction are unimportant – it’s because I have the most experience with sexual pain.)

I placed arousal problems on the second tier. This can be a problem because a lack of arousal in and of itself can contribute to physical discomfort with vaginal insertions of objects say, if you are not  producing sufficient lubrication. I’ve found that a little lubrication can also make vulvar stimulation more comfortable with a partner. I also placed this one second on the hiearachy chart because there are sex toys and some medical tools (I’m thinking of vacuum pumps and lubricants) available for women with arousal difficulties. (There’s also that Zestra thing that’s been going around stirring up double-standards in advertisements controversy too but I don’t know how effective it really is.) This is also where erectile dysfunction would go, as the presence of an erection is not necessarily the same as the presence of sexual desire (a distinction which in and of itself can be difficult to come to terms with.)

I placed lack of orgasm and/or sexual pleasure on the third tier, in orange. Things are really starting to get messy & controversial now. There’s sort of a medical treatment available for this (the Orgasmatron spinal cord stimulator) but it’s heavily sensationalized and it may not even work well.
And orgasm itself can be controversial – How much should an expert and an individual emphasize the importance of orgasm? Does emphasis on sexual pleasure create pressure to have an orgasm? What if you’ve tried everything and it’s just not happening? What if the reason you cannot orgasm is because of poor sex education; because no one ever showed you or your partner how? What about if you were previously orgasmic and subsequently developed difficulties orgasming – say, from an injury, antidepressant use, or something else? If you are having difficulty with orgasm because of a medical problem then should that be recognized as a sexual dysfunction in and of itself or as a symptom of something else?

The fourth tier is the one that sets off alarm bells most frequently. When the media covers sexual dysfunction, this is usually what journalists are talking about and what sexologists respond to – low or absent sexual desire. It’s very controversial as far as sexual dysfunction goes – How are we defining low sexual desire, what is the measuring stick? Could a low or absent sexual desire be part of your personality or sexual orientation (asexuality) and, if so, how do we make that distinction? What terminology should we use; should we call it a sexual dysfunction or a sexual problem? Does it have a cause and if so, what is that cause; are you stressed out or have you started on a new medication? If not, then have you stopped to consider social construction arguments to explain a drop in libido? Could low libido ever be more than one of the above or possibly all of the above?
In terms of the FSD hierarchy, this is the dysfunction that is most socially unacceptable to have (or at least to publicly disclose) and certainly the least acceptable one to seek medical treatment for. The New View Campaign’s activism during buildup to the flibanserin hearings explicitly stated, “Low sexual desire is not a disease.” This is a theme repeated throughout Sex is Not a Natural Act and A New View of Women’s Sexual Problems.
However, somewhat paradoxically, it may be acceptable to have low or absent sexual desire – so long as we don’t call it a dysfunction and so long as we avoid medical options to address it.

And then there’s the fifth tier, which isn’t even part of the pyramid. I put it underneath the pyramid, underground – because it contains stuff related to sexual dysfunction that rarely gets discussed. This is where stuff that gets swept under the rug goes. It’s where alternative views of sexual problems and dysfunctions are – brigid wrote about this in her guest post, On the FSD hierarchy and why it hurts all of us – here, she discussed endometriosis and the lack of discussion about how it impacts sexual functioning, and she said, “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.” Another example would be an alternative interpretation of sexual pain proposed by a co-author of Secret Suffering – that sexual pain can also mean pain in the sex organs.
This is where interstitial cystitis wound up when MTV ran the True Life episode, I Can’t Have Sex. One of the participants of the program, Tali, has IC and IC activisim is an important part of her life. So one of the criticisms with the True Life episode (and this is in no way Tali’s fault,) is that it did not even mention the words, “Interstitial cystitis;” instead the episode focused exclusively on sexual pain. It’s related, but not a purely sexual topic.
And underground, off the pyramid, is where overlapping issues go – for example, to have both sexual pain and a low libido. These two topics may very well be related – it’s possible to experience a drop in sexual interest due to sexual pain; I’ve also seen it suggested that women who have sex with a low libido may experience sexual pain. But what happens when one problem or another resolve? What happens when you find a way to address sexual pain but your libido does not rebound?
And underground is where intersectional issues go – to have a sexual dysfunction and be any sexual orientation other than straight; to be a woman of color with sexual dysfunction; to be a trans person with sexual dysfunction; to have a disability + a sexual dysfunction (which in and of itself may be another disability;) to be kinky yet sexually dysfunctional. (All topics which I’d like to see covered on this blog in 2011 – hint, hint.) Part of the reason I started this blog is because I felt like there weren’t a lot of good resources available specifically for folks with sexual dysfunction. Why would there be such resources, after all, if sexual dysfunction isn’t a real thing: If it isn’t real, then there’s no need for such resources and support – just use whatever anyone else is using. That ought to be good enough, right?

But then I was thinking to myself, this is the way that I’ve seen discussions of sexual dysfunction go in online interactions… but what drives these discussions in the first place? Usually, it’s media coverage. And the media prioritizes coverage of sexual dysfunctions differently than what’s shown here.

So here’s a different model of the way sexual dysfunction discussions might be pictured, as driven by the media:

[Description: another multi-colored 4-tier pyramid graphic, this one inverted so the narrowest point is at the bottom. Labeled The Media and sexual dysfunction pyramid V. 1.0. Representing how the media covers sexual dysfunctions and problems. On the top is “BONERS,” second tier is “Libido,” third tier is “Orgasm” and the bottom tier is “Pain.”]

And here’s an explanation of this pyramid:

1. BONERS – (inspired by Sady Doyle of Tiger Beatdown.) It’s okay to show commercials for erectile dysfunction but not a commercial for Zestra, which supposedly acts on sexual arousal in women. BONERS may or may not be equivalent to libido and orgasm.
2. Libido – after getting past all the commercials and in-print advertisements for Cialis and Viagra you might find yourself reading an article about some other such medication that’s supposed to increase libido or about relationship tweaks you can supposedly make to get more satisfaction.
3. Orgasm – then you may see some advice columns talking about figuring out ways to have an orgasm.
4. Then sometimes sporadically there’ll be an article somewhere about sexual pain.

Not pictured: My total lack of effort in making this graphic and my own amusement in using the word “BONERS” in a graphic on an otherwise serious feminist blog.

As with thinking about sexual dysfunction in terms of disability, this is something that’s very new even to me, and something I’d appreciate feedback on.

Female sexual dysfunction discussion Bingo!

09/26/2010 at 3:00 am | Posted in Uncategorized | 17 Comments
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[Description: A 25-square bingo board with light blue and lavender accents. The theme of the board is feminist bingo-worthy quotes in relation to female sexual dysfunction. A transcript is below the cut.]

Hey you! You there! At the computer! Everyone! Step right up folks, step right up and come on dooooown! *Fanfare plays, light bulbs flash in the marching ants pattern*

Have YOU ever run into stereotypes and archetypes about what sort of women develop sexual dysfunction? Have you been offered unsolicited advice on what to do about your sex life, which perhaps has quite a few major complications going on? Have you become frustrated with a lack of satisfactory resolution to your problems and feel like you have nowhere to go to talk about them? Are you tired of hearing the same tropes over and over again when talking about female sexual dysfunction?

Well then step right up folks, yes step right up and get ready to play Female Sexual Dysfunction Discussion Bingo!

It’s easy to play along! All you have to do is hang around any discussion of female sexual dysfunction long enough or experience in real life some variation of the experiences described above, and then mark the corresponding box off on your Bingo board. Fill in five in a row up, down or diagonally, and you “Win!”

(Unfortunately I’ve been cleaned out of prizes to give to the winners of this game and in fact if you have FSD then lurking in the comments section of a discussion of female sexual dysfunction is likely to be upsetting at best and triggering at worst…)

Impress your friends!

Annoy your enemies!

Stop in your tracks with the sudden realization of, “Oh my god but I’ve done stuff on this board! I never realized how much it piles up on the folks I’ve been talking about!”
[I am pessimistic that anyone will have this reaction in real life; the most likely scenario that will play out is probably more like: Upon realizing that someone has used variations of the above and upon meeting this bingo board, that same someone will say, “Well this blogger is clearly a bitch and is much too close to her own experiences to be able to look at FSD ~objectively~.”]

Think you can’t play because you don’t got FSD yourself? No problem! Simply support someone who does! You can start by checking your own privileges at the door and listening without judgment to a friend who does have a dysfunction!
Don’t know anybody with FSD? Yeah maybe you should think about that for more than 5 seconds and see if you can think of any reasons why no one has felt comfortable disclosing their sexual health problems to you.

With FSD Bingo, everyone’s a winner!

Yes folks this right here is a brand-new, limited edition addition to the collection of social justice Bingo Boards! Trade with your friends! Complete the set! Gotta catch ’em all! Collect ’em all!

Right-click save (or click and hold) your copy of FSD Bingo today!!!

But seriously folks,

This is another collaborative effort brought to you by me and frequent commenter and sometimes guest poster Flora. (Hence, version 1.2 presented here – I have incorporated elements and feedback from boards we came up with.) You asked, and we delivered.

Everything in the bingo board box is based on real stuff we’ve seen & heard. I’m not making any of this up. Read the archives back far enough, and you’ll probably be able to trace a lot of these boxes back to their original inspiration.

There were even more valid candidates to make it onto the board – I just ran out of room and couldn’t include them all. Unfortuantely there are more than just these 25 pieces of sexist, rampantly disablist rubbish floating around in discussions of female sexual dysfunction. Perhaps some day I’ll release a version 2.0 if this one gets enough feedback to warrant revisions.

Until then, enjoy. Don’t leave home without it!

Transcript follows below the cut in case you can’t see the above image.

Continue Reading Female sexual dysfunction discussion Bingo!…

Adult toy store review: Lovers Package [NSFW]

06/28/2010 at 6:28 pm | Posted in Uncategorized | 6 Comments
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While I was on break earlier this month with my long-term, LDR partner, we shared many adventures together. Two of our adventures took us to local sex toy shops (because one such adventure just wasn’t enough!) The first shop we visited was Lovers Package. Lovers Package (no apostrophe) is a sex toy retailer with an online presence and several locations in Washington State. Lovers sells a wide variety of adult products ranging from novelties to high-end luxury vibrators, and participates in sex-positive activism events. A recent such example was Lover’s hosting a visit made by sex therapist and author Dr. Marty Klein, and participation in PrideFest June 27. This was not our first visit to the store, although it is the first one I’ve made since I started blogging here.

Although I did not take any pictures of the interior of the store for this visit, I do have a photo of our haul, and links to photos of inside of the store in question. Since this post contains some pictures and frank sexual descriptions, it’s going behind a NSFW cut now. Everything should show up in your RSS feeder, and if you’re visiting on the main page, you’ll need to click through to continue at your discretion. Thanks!

Continue Reading Adult toy store review: Lovers Package [NSFW]…

Picture post – Antique prophylactics [NSFW]

05/05/2010 at 6:56 pm | Posted in Uncategorized | 24 Comments
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If a picture is worth 1,000 words, then I believe this week’s picture-heavy post should just about cover my weekly quota. However, I must warn you: The following post will contain pictures of antique prophylactics – that means, old condoms & contraception devices. (I am deliberately choosing the word “Prophylactics” instead of “condoms” because the former is an outdated, antique term. Much like what I am about to show you today.) While there are no full frontal nudity pictures in this post, the content & some of the box art is definitely Not Safe For Work. Let me repeat that: NSFW. All links and pictures in the post should likewise be considered NSFW. For this reason, I’m going to try using the ‘more’ tag and (if I’ve done this right) you’ll need to click to continue on. The full content should still appear in your RSS feeder if you’re using one. Thanks!

Continue Reading Picture post – Antique prophylactics [NSFW]…

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