Where are all the good advice columnists?

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

Doctors debate dyspareunia part 2: Is pain the only valid FSD?

08/17/2011 at 9:51 am | Posted in Uncategorized | 3 Comments
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Previously on Feminists with Female Sexual Dysfunction…

Many folks who experience sexual and/or genital pain share the experience of getting bounced around from doctor to doctor when seeking satisfactory resolution to their problems. In a recent post on this blog, I explored one of the many reasons the doctor shuffle occurs: there’s no definitive class of doctor designated to handle sexual & genital pain. And behind the scenes, doctors themselves are debating what medical specialty is best prepared to address this type of problem.

In 2005, a peer-reviewed journal published an article by Dr. Yitzchak M. Binik, Ph.D. His idea was to start a serious debate on how best to handle dyspareunia (painful sex.) Currently, under the DSM-IV, dyspareunia is classified as a sexual dysfunction. When the DSM-V revision comes out, it is likely to be kept there (though under a different name, genito-pelvic pain/penetration disorder.)

Dr. Binik made some compelling arguments in favor of of changing the classification of sexual and genital pain from a DSM-recognized sexual dysfunction to a pain disorder. But his position was controversial, and generated many professional responses against making the switch.

One such published response came from Dr. Leonore Tiefer, a feminist sexologist, author, college professor and organizer behind the New View Campaign, an organization opposed to the medicalization of sex, with a particular focus on the role of Big Pharma. I have read and reviewed some of Dr. Tiefer’s previous work on this blog, bringing to it my own unique perspective as someone who actually has FSD.

Unfortunately this time I won’t be able share the full ~2 page text of Dr. Tiefer’s response, Dyspareunia is the only valid sexual dysfunction and certainly the only important one, because it’s locked down behind an academic firewall. I think I can share a summary of what’s in it (with my own commentary,) but unless you’re enrolled at a school with journal access, you’ll have to take my word on good faith.

Dr. Tiefer’s disagreement with Binik’s reclassification argument focused exclusively on one argument: Nomenclature; the power of names. It’s a familiar theme in Tiefer’s earlier work – language is a powerful tool capable not only of reflecting reality, but of shaping it. And Dr. Tiefer has serious concerns about the language used to describe sexual problems in particular. In light of this, I was surprised to find that in her response to Dr. Binik’s article, Dr. Tiefer argued in favor of keeping dyspareunia classified as a sexual dysfunction instead of a treating it as a pain problem – At least, so long as such terminology is used by the American Psychiatric Association.

Dr. Tiefer starts her article by describing the origins and goals of the New View Campaign. One of Tiefer’s criticisms of female sexual dysfunction is that it’s based on the idea of deviations from a “Normal,” universal sexuality, but normal is arbitrarily defined and doesn’t account for all of the human population. In this case, the “Normal” sexual response cycle was defined by Masters & Johnsons’ work – the four-phase model that goes, excitement, arousal, orgasm and resolution. Sex doesn’t work that way for everyone, and so over the last few years – decades at this point – she has challenged the medicalization of sex, with a particular interest in libido and orgasm.

“My criticisms have, however, focused on the universalized notions of desire, arousal and orgasm in dysfunction nomenclature, and not on the inclusion of dyspareunia and sexual pain. Immersed in the feminist literature on women’s health, I was more than aware of the disgraceful history of neglect and mishandling of women’s complaints of pelvic pain and thus it seemed that dyspareunia was the only sexual dysfunction with validity in women’s lives (50, emphasis mine.)

(And that’s where the title of the article comes from. I don’t know whether Dr. Tiefer picked the name out herself, or if some editor arbitrarily decided it, but we have the same sentiment reflected in the body of the text.)

However, when criticizing female sexual dysfunction, Dr. Tiefer has in the past included pain. It’s true that she doesn’t talk about it much, relative to her body of work on orgasm and desire. But in the past she has let pain stay under the broad umbrella of the term, “Sexual dysfunction,” complete with scare quotes:

We believe that a fundamental barrier to understanding women’s sexuality is the medical classification scheme in current use, developed by the American Psychiatric Association (APA) for its Diagnostic and Statistical Manual of Disorders (DSM) in 1980, and revised in 1987 and 1994. It divides (both men’s and) women’s sexual problems into four categories of sexual “dysfunction”: sexual desire disorders, sexual arousal disorders, orgasmic disorders, and sexual pain disorders. These “dysfunctions” are disturbances in an assumed universal physiological sexual response pattern (“normal function”) originally described by Masters and Johnson in the 1960s.

In the New View manifesto, Dr. Tiefer kept sexual pain disorders lumped with all the other dysfunctions that merit feminist skepticism and critique. Feminist critique, such as the perspective that DSM criteria for dysfunctions (including pain) are excessively genitally, and therefore reproductively, focused (Sex is not a Natural Act, location 737.) However in 2005 we see support for leaving dyspareunia behind, as the only valid sexual dysfunction.

Dr. Tiefer’s quote about the importance of dyspareunia as dysfunction is problematic for additional reasons: The implication here is that no other sexual dysfunctions recognized in the DSM have any merit as a health problem. That’s a key point of the New View Campaign: Desire, arousal, and orgasm problems may not be problems at all, and when they are, the problems can be addressed with lifestyle and social change instead of medicine. But here I interpret the idea that pain is a sexual dysfunction, and the only valid one, as maintaining a sexual dysfunction hierarchy. It elevates physical pain above all others. My problem matters; yours doesn’t. My physical pain is real, your emotional or psychological pain isn’t.

So what does this mean for folks who have one of the less-important, invalid dysfunctions? To whom can they turn when they have exhausted virtually all of the non-medical interventions for long-term sex problems?

Dr. Tiefer then briefly expands on some implications of Masters and Johnson’s work. In the next section of her response, she describes an alternate, benevolent way of looking at the inclusion of sexual dysfunction in the DSM: Recognizingsexual problems as health and medical problems legitimizes such problems in the public’s eye. Suddenly, sexual problems are no longer just about sex, which (according to vocal conservatives anyway) is dirty and wrong and immoral – sexual problems are now about the body and health, which is (relatively) socially and politically acceptable to talk about. “Looked at from this perspective, the inclusion of women’s problems with sexual pain in the sexual dysfunction classification system was a positive step” (50,) because then the ISSVD and NVA can harness that legitimacy for raising awareness and research funding.

It strikes me as odd that Dr. Tiefer mentions the NVA and ISSVD by name as working for the benefit of patients with pelvic pain problems. Not because I have any question that both organizations do good for the public, but because in Sex is not a Natural Act, Dr. Tiefer had this to say about patient advocacy organizations:

These advocates for medicalization include self-help group and newsletter promoters who have created a market by portraying themselves as something between consumers and professionals. The formation of Impotents Anonymous (IA), which is both a urologists’ advocacy group and a self-help group, was announced in the New York Times in an article including cost and availability information on penile implants. (Organization helps couples with impotence as problem 1984.) … The advocates for medicalization portray sexuality in a rational, technical, mechanical, cheerful way. Sexuality as an area for the imagination, for political struggle, or for the expression of diverse human motives or as a sensual, intimate, or spiritual rather than performative experience is absent (locations 2277-2282.)

Basically, according to Dr. Tiefer, patient advocacy groups – at least those for erectile dysfunction – existed partly in order to sell sexual health problems, to promote a select few doctors qualified to treat the problems, and then to sell medical treatments for big bucks. In these earlier statements, Dr. Tiefer made it sound like patient advocacy groups were just part of the packaging that came with so-called selling sexual dysfunction. In fact, the formation of patient advocacy groups is one piece of what motivated Dr. Tiefer to organize the New View Campaign in the first place:

This backlash dovetails with the analysis and critique of “medicalization” over the past several decades within sociology, the women’s health movement, the “anti-psychiatry” movement, and newly, from cultural historians examining the social construction of illness and disease. All these scholars argue that the medical model, with its hallmark elements of mind-body dualism, universalism, individualism, and biological reduction, is not well suited to many of the challenges of contemporary life and suffering.

Yet, at the same time, patient advocacy groups are clamoring for medical legitimacy, increased funding and research, and, above all, new drug treatments. And the drug industry continues to expand.

Allying with the backlash, I convened a “Campaign for a new view fo women’s sexual problems” in 2000 to provide a feminist anti-medicalization perspective in the debate about “female sexual dysfunction” (location 3550.)

Given these prior statements on patient advoacy groups, I’m surprised that Dr. Tiefer didn’t skewer genital & sexual pelvic pain advocacy groups in her 2005 response to Dr. Binik.

Furthermore, by classifying dyspareunia as a sexual dysfunction, isn’t dyspareunia and its treatment subject to the same criticisms that Dr. Tiefer has previously made about sexual dysfunction and Big Pharma broadly? I’ve seen the rhetoric used by the New View used (and unfortunately warped) in feminist arguments against sexual medicine. And let me show you, it can get real ugly real fast. Leaving sexual pain as a sexual dysfunction might lend medical and social legitimacy, but not when you do everything you can to undermine the legitimacy of sexual dysfunction broadly and stigmatize those who experience it.

This post is getting way too long, so we’re going to stop abruptly here and come back after you’ve had a few days to digest our story so far. To be continued…

Doctors debate dyspareunia (painful sex)

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

To be continued…

About Northwestern University

03/08/2011 at 1:53 am | Posted in Uncategorized | 3 Comments
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A recent controversy in sex education involves one Prof. John Micheal Bailey, from Northwestern University. Professor Bailey teaches a Human Sexuality class to some 600 college students. He is a controversial figure, as described on the wiki page linked to – previous work includes his theories about homosexuality (he believes it is largely an inherited orientation,) and a book about transsexuality, which has been heavily criticized by trans activists for racism & transphobia (Plus Bailey engaged in unethical conduct while making the book.)

Bailey’s sexuality class includes optional events with guest speakers who talk frankly about sex & sexuality. The controversial event in question was titled, “Networking for Kinky People,” and the guest speaker was Ken Melvoin-Berg, associated with the Weird Chicago Tours group. Melvoin-Berg brought his partner and a kinky, engaged, exhibitionist couple with him to the event. (The couple has been named by some sources while others are keeping them anonymous; I’ll stick to the anonymity route here since outed kinky folk face safety risks.)

According to this Salon.com article, during the day’s lecture, Bailey presented a lesson on the G-spot. The Chicago Tribune says that the lecture included an educational video about the G-spot. Melvoin-Berg, his partner & the kinky couple arrived early, so they happened to be there for Bailey’s lecture and video. Melvoin-Berg’s group members were all unimpressed. So just before their speaking part was about to begin (after the lecture was officially over,) Melvoin-Berg asked Bailey for permission to demonstrate to the class what a g-spot orgasm looks like, in person, with a fucksaw. (Exactly what it sounds like: This is basically a modified power-tool with a dildo on the working end.) Bailey hesitated but decided that the demonstration would fall within the bounds of the scheduled speaking event, since such a demonstration is undeniably kinky.

So that’s what happened. The couple Melvoin-Berg brought with him, did exactly that – after giving an hour & half speaking lecture with a Q&A session first, according to Rabbit Write (the same Rabbit Write who organized Lady Porn Week.) When Melvoin-Berg’s crew finished the speaking portion of their presentation, the boyfriend used the fucksaw on his girlfriend and she had several g-spot orgasms in front of about 100 or so present students.

After that, the student newspaper reported on the event. From there, a lot of mainstream news sites picked up on the story. Reports about sex are easily sensationalized & they sell well or generate page views, whatever. So now there’s a lot of backlash & controversy going around now.

I can’t decide whether I’m in favor of this event or not. At first I was all for it – I thought, “That sounds useful,” and I understand that sometimes, written instructions, diagrams and educational videos fall short because they do not provide experience. I needed help learning how to find and then use my own pelvic floor muscles. Although I had anatomy diagrams and written instructions on how to dilate, I eventually hit a wall with my at-home dilator kit and needed to get physical therapy to progress with treating my vaginismus. (It was an incredibly clinical, non-sexual and useful experience – not really all that much different from rehabilitating any other muscle group, except for all the cultural baggage and weight assigned to people’s genitals.) But that was something I initiated, and since it took place behind closed doors, there was no risk of making anybody else know what was going on.
But then the more I read about Professor Bailey and the Northwestern University event, the more I started to change my mind & think to myself, “Hmmm… maybe this wasn’t such a good idea…”

Even Bailey himself has issued a formal apology, of sorts, for drawing such negative media attention to NU. If he could do it over again, he wouldn’t.

However, demonstrations like this have taken place before – just not on campus. Let’s all turn to Page 13 of Sex Toys 101: A Playfully Uninhibited Guide by Rachel Venning and Claire Cavanah. Some of the relevant parts are available on pages 13 & 14 from Google Books. Unfortunately not everything got scanned in – it looks like all the pictures are missing, and page 14’s relevant text is blocked out (It should be on the left side of the page.)

To summarize the relevant passages, the book says that a couple of years ago, sex educators affiliated with Babeland (then still known as Toys in Babeland,) took their G-spot program to a “Carnival-style book release party of a friend of Babeland…” (The next page says this event took place at a bar.) The sex educators set up a tent and one of them called out to passers-by, asking patrons to go in. People who went into the tent (up to 10 at a time) received a lesson in human female anatomy, complete with some suggestions for ways to find the g-spot. But the lesson didn’t end there, “Once they were inside, we gave them more than just a lecture.”

One of the sex educators took safe sex precautions (a glove and lubricant in this case,) and said, “Okay, who wants to experience it [a g-spot orgasm]?” So one lady and her boyfriend stepped up and the lady sat down in the hot seat. The description on page 14 says that this volunteer took off her underwear & used a vibrator on herself, so onlookers would have her masturbating. Then the sex educator with the lubricated glove on inserted two fingers into the volunteer’s vagina & found the g-spot. It’s not clear from the text on this page whether the volunteer had an orgasm on site. The text makes it sound like this scene was repeated throughout the evening.

So one reason I don’t fully understand exactly what the problem with the February 2011 demonstration is that there’s precedent for g-spot demonstrations just like the one at Northwestern University. This already happens. The show-and-tell described in the Sex Toys 101 book didn’t use a video, puppet or a piece of fruit as a stand-in.
On the other hand, this article from GoodVibes says that events which GV hosts do use stand-ins or clothed volunteers. So okay, sex educators can go either way when it comes to live demonstrations.

At first I thought the reason the school program caused so much controversy is that it must have been paid for with school funds, because that’s what was going on when feminist pornographer Tristan Taomino was initially un-invited from speaking at Oregon University. The student newspaper says that NU has events sponsored by Weinberg College of Arts and Sciences, and this Chicago Tribune article says that NU provides funding to Bailey & his speakers (including Melvoin-Berg but not the kinky couple) via this organization. But according to this statement from Bailey, he arranges the class events at “Considerable investment of my time, for which I receive no compensation from Northwestern University,” which makes it sound like he pays for the class’s extra-curricular speaking events out of his own pocket. So now I can’t follow the money trail because there’s like 3 different things going on there. (Maybe the school doesn’t pay him for the time it takes to arrange speakers but it does cover their fees? Like, no overtime pay for whatever networking is required to set everything up?)

So far what I’ve read about the event says that, participants who stayed for the demonstration aren’t the ones who are upset about it – as of 3/6/11, Bailey says that all the feedback received from attending students was positive. It is people who were not present for the show and found out about it afterwards that are registering complaints. They’re upset that it took place at all. I’m seeing similar complaints in comment sections of articles summarizing the event, and the negative comments usually contain some variation of “Immoral,” “distasteful,” “exploitative,” or “sick.” Something to that effect, which focuses on the content of the demonstration. Since kink is widely misunderstood & berated, I’m thinking that such comments would inevitably be made of such a demonstration or sex act regardless of the setting.

Every once in awhile a commenter will bring up the viewers’ ability to fully consent, which I think is a stronger argument against the demonstration, since it was spur-of-the-moment. An event like this should have required time to plan it out and better distribute information about the content. There wasn’t time to include this on the syllabus, basically (though being an optional event, it wouldn’t have been required either.) But even then, the articles say that Bailey & Melovin-Berg took steps with the limited time they had to make sure that the students understood what the content of the demonstration was going to have & that they had the option to leave without penalty, which some students did exercise. Yet, one student Bailey’s class explicitly told the media, “Then, just out of nowhere, the girl just takes her pants off, takes her shirt off, takes her underwear off.” That the student used the phrase “Just out of nowhere” suggests to me that adequate preparation for the students was nonetheless lacking. It should have come from somewhere. This student, though, also acknowledges that students were given adequate opportunity to leave.

So with regards to what the real problem is with this NU event, I keep getting different answers – including the “Nothing wrong” answer. I can’t pinpoint it down. But having done just a cursory background check on Bailey himself, even I am now resistant against throwing all my support behind him too. Will NU administrators be more translucent with their investigative findings now than they were when claims of impropriety were previously leveled against Bailey?

P.S. Good god almighty can I just express my own frustration with this entry –  this was hard to research; every source I checked had different pieces & I couldn’t get a comprehensive tell-all! And then before I knew it I had 1600 words and okay fine, up it goes.

For (belated) Lady Porn Day: What are the experts saying?

02/26/2011 at 7:39 pm | Posted in Uncategorized | 9 Comments
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February 22 was Lady Porn Day, a blogging event organized by Rachel Rabbit Write. This is the same blogger who, last year, organized “No makeup week.” In this case, “Day” is something of a misnomer, as today is actually the last day of the week-long Lady Porn event. (A good thing, too, considering my recent writer’s block.) In an interview with the Huffington Post, Write said the purpose of Lady Porn Day was to, “Essentially to celebrate porn and masturbation. I’m inviting everyone to talk about their porn experiences, share stories and to ultimately share their porn recommendations. This is about not only opening up a dialog about how porn is good, but also how porn is hard, how it can be an issue for women, in terms of dealing with guilt or body image or their sexuality.”

What’s been on my mind for awhile and has finally been knocked loose by this event is the subject of pornography and sex therapy. I’ve been thinking about this topic because I’m seeing a conflict between sex therapists who embrace pornography as a healthy & valid part of human sexuality vs. those who view it as the source of all kinds of sexual problems. Sex therapy is a possible treatment option for some folks with sexual dysfunctions and problems, so clients could find themselves in the middle of a political, academic & psychological tug-of-war between experts.
I’ll show you what I’m talking about, but with a caveat: you must bear in mind that I myself have not had sex therapy and I have absolutely no desire to do so, to the point where I’m actually quite resistant to sex therapy as a treatment for my dysfunction.

Whether or not sex therapists and sex educators are pro-porn or anti-porn looks to me like it’s largely a function of their own personal politics.

Notable sex educators who have articulated porn-positive arguments include the following:

Dr. Marty Klein is a long-term sex therapist and author who is very much anti-censorship and who consistently defends the use of pornography. He does identify as feminist and is clearly pro-choice; however one theme I’ve noticed in some of Klein’s writing is that he is critical of feminism – or at least, select vocal feminists and feminist groups. Oh well, so am I.
Dr. Leonore Tiefer, a feminist sexologist who is highly critical of female sexual dysfunction and so spearheaded the New View perspective of FSD (a perspective which I myself am highly critical of,) likewise recognizes a valid place for pornography in women’s sexuality.
Jessi Fischer is a sex educator who you may know better as The Sexademic. She recently got into an academic debate about pornography, opposite Gail Dines and Shelley Lubben – two notable anti-porn activists. (Each side of the debate was joined by additional activists, so it wasn’t just Fischer Vs. Dines & Lubben.) The pro-porn side of the debate came out on top – the audience members voted on who made the more convincing argument and decided it was Fischer’s team.
Dr. Carol Queen, sex educator with GoodVibes, wrote a post in favor of porn and Lady Porn Day – which makes sense considering her involvement with instructional & graphic sex videos. Most porn is not for educational purposes, but there’s some out there that is.

Nonetheless, porn-positive activists can be critical of porn. Pornography can, and often does, have problems. Criticisms of porn from sex-positive therapists may consist of something like, “This element is good, that element is neutral, and if you will look over there there, there is the element is the inherently problematic one that needs fixing.” And the element that needs fixing may be something like, the marketing of porn rather than the content itself. A great example of this took place a few weeks ago when actress Nicki Blue elected to film her first vaginal intercourse experience for the pornographic website, kink.com. The initial marketing for Blue’s film shoot was highly exploitative and inaccurate.

But I’ve seen activists, educators and licensed therapists go in the opposite direction too, and come down hard against pornography. Often this stance against pornography is lumped with a warning against sex and masturbation addiction – which is another extremely controversial topic. However, I’ve repeatedly seen more acceptance of the term “Compulsion” instead of “addiction” to describe obsessive sexual behaviors, to the point where such behaviors interfere with someone’s personal or sexual life.

Dr. Mary Anne Layden is a clinical psychotherapist and Director of Education at the Center for Cognitive Therapy, part of the University of Pennsylvania. In 2004, she went before the US Senate to talk about the so-called dangers of pornography. In another interview with the Washington Examiner, she talked about the process of becoming addicted to porn when she said, “There’s always an escalation process. We don’t know what the threshold is, and those with addictive personalities will start it earlier. But I see a lot of people who didn’t show any psychological problems before [viewing porn].”
Jason McClain is a UK therapist who considers himself to be a former porn addict. He runs an organization, Quit Porn Addiction, and now he counsels clients who likewise want to break away from porn.
Dr. Alvin Cooper is a sex therapist and director of the San Jose Marital & Sexuality Center who contributed to a documentary, A Drug Called Pornography. According to the linked synopsis, this film’s thesis is that, “Pornography is an addiction. Its effects on users and their loved ones are just as habit-forming and destructive as heroin, tobacco, or any other addictive agent… The program features disturbing interviews with pornography addicts, many of whom are convicted sex offenders. They talk frankly about how pornography affects their psyches and systems, coloring all their activities and relationships.” And according to this Time article, Cooper also gives seminars about addiction to cybersex.

In addition, Googling search terms such as, “Sex therapy addiction” or “Sex therapy porn” brought up many, many more results for therapists and organizations that prominently feature treating sex and masturbation addiction among their services.

I am confounded, though not surprised, to see that sexuality experts with licenses, teaching jobs and more credibility than me have not come to a unified agreement on porn’s place in sex therapy. It’s not surprising that sex therapists haven’t come to a standard approach on how to deal with pornography, because there’s precedent for a lack of resolution: Pro-and-anti- porn debates in politics, academia and feminism remain unsettled.
But it is confounding, because who am I supposed to believe, and why?

Actually, I have been convinced by the arguments of the porn-positive side. I especially appreciated Violet Blue’s analysis of the for-profit agenda of major anti-porn activists. This analysis, and others like it, also note that anti-porn rhetoric is also often anti-masturbation – a healthy sexual activity. There are numerous other arguments in favor of pornography that I have heard which have contributed to my “Up with porn” POV… the only reason I’m not getting into them right now is because it will take too long to document everything.
Though I’ll also admit that most porn has problems which could and should be handled better (but won’t,) and, like just about any other tool, it can be used for the forces of good or for evil… and everything in between.
(Plus I’ll admit to some potential bias – I have a subscription to a porn site which I regularly check on. I have not noticed any ill effects from doing so…)

So there’s a couple of scenarios with regard to porn use that I envision as potential problems in a sex therapy setting. While I have no experience with sex therapy myself, I nonetheless speculate that these scenarios have probably come up before many, many times in clinical practice. So I would be surprised if practicing therapists and educators didn’t have tools in place to address such situations. How could such conflicts not come up?
The problem is, because so many google search results for “Sex therapy addiction” or “Sex therapy porn” result in facilities looking to treat addiction to porn & masturbation, I am not able to find out what these client-therapist conflict-resolving tools may be. The search results are too bogged down with stuff I’m not looking for. (Little help? Anyone?)

One of my concerns is with regard to pornography and sex therapy is that if you’re entering into a therapeutic relationship with a licensed professional, there’s inherently going to be a power imbalance. The therapist has probably had more exposure to educational materials, which may have their own biases & agendas. You and your therapist are probably going into that relationship with some ideas about pornography to begin with. If there’s a match between your beliefs and your therapist’s, then in terms of personality you may not have a problem, and you may be able to swiftly work out a plan of action. But if you and your therapist have conflicting beliefs about pornography as a tool in your sexuality, then you may have a problem.

So what happens if you are someone with a sexual problem or dysfunction who just happens to have a history of porn use? If you find a sex therapist who is anti-porn, will your previous or current use be zoomed in on as the source of your problems to the exclusion of other contributing factors?

Or what happens if, due to the conflict between you and your therapist re: use of porn in sexuality, you decide to find another therapist? That may be possible, depending on your geographic location. Finding a good therapist may take time and transportation, depending on where you live and what sort of resources are available in your area. Checking my own local area via the American Association of Sexuality Educators and Certified Therapists, I was surprised to find one licensed sex therapist! The next “Local” one, though, would be about 45 minutes away by car – not exactly the worst commute, but certainly not convenient, either. Finding Kink-aware therapists may be another option.
I’d like to imagine that sex therapy may be easier to provide now and in the future though, thanks to technology like Skype, though this is speculation – I do not know if there are any therapists willing to use this remote communication service with clients. But,  hypothetically, if I were very unlucky, then I might be stuck with a therapist I don’t agree with, or no therapist at all.

Basically, for Lady Porn Day, like many bloggers my concern is what happens to the porn users and their partners who are stuck in the middle of it all. This conflict between professionals is unlikely to be resolved  any time soon. The most neutral article about porn use in a relationship was this one from About.com, which says, in the end, “Whether or not pornography will add to or lessen a couple’s sexual enjoyment is up to each couple.”

Book review: A New View of Women’s Sexual Problems

11/16/2010 at 10:14 pm | Posted in Uncategorized | 5 Comments
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Several months ago, over the course of a five-part series, I reviewed sexologist and feminist activist Dr. Leonore Tiefer’s nonfiction anthology, Sex is Not a Natural Act and Other Essays. It presents her critique of contemporary discussions of sex, sexuality and sexual dysfunction, from a social construction perspective. (Basically that means that Dr. Tiefer gives significantly more weight to cultural influences on the formation and expression of sexuality than to biology.) While reading it was certainly an informative experience for me, it was also rough – at several points I tripped over apparent contradictions between what Dr. Tiefer had written in one chapter vs. another and multiple instances of disablist language. Overall, while I learned a lot about social construction and criticism of female sexual dysfunction as a diagnosis, the book left me feeling isolated and unsatisfied since biology and the availability of medical options have a strong impact on how I have sex.

So for awhile I and guest posters wrote about other stuff in the wide world of female sexual dysfunction. And then I had to take a hiatus from blogging so I could deal with real-life chaos. After settling into a new routine, I felt motivated to read something… Now seems as good a time as any to pick up A New View of Women’s Sexual Problems, another nonfiction essay collection detailing an alternate model for looking at women’s sexuality and dysfunctions. A New View doubles as an in-depth manifesto for the New View Campaign, complete with examples of how the New View model can be applied to real-world women’s sexual complaints. Let’s see what it’s all about.

Overall Impressions:

A New View is and feels significantly shorter than Sex is Not a Natural Act – it’s about 218 single-spaced pages, divided into three parts. Each chapter is short, ranging from just a few bite-sized pages up to around thirty, so it’s easy to digest. Each chapter was published simultaneously in the journal Women in Therapy, volume 24, issues 1 & 2, so you’re actually reading academic journal articles. Except for a few essays towards the end of the book, most of the time it’s generally not heavy on academic jargon.
Downsides unrelated to the writing: A New View is not available in e-book format and at about $30 on Amazon (new) it’s a little outside my sweet spot price range for something sans illustrations. I went in to the book hoping for a list that would explicitly spell out which biological problems get the green light for medical treatment but I’m still not clear on exactly when sexual medicine is appropriate (and why.)

On paper, the New View looks good. Overall, the book is nuanced and presents the perspectives of many professional women familiar with sexology, sexuality, women’s studies, feminism, psychology, health, and related fields. The responses to the New View manifesto illustrate its merits and practical application…
On paper.

In practice, I’m still wary of the manifesto and the eponymous organization. Reading the entire body of work has not sufficiently addressed my apprehensions.
Because in practice, I’ve seen the New View’s positions and activities turn into another prescriptive theory, one that creates new complications and restrictions for women even as it attempts to free them. For example, in practice, the strong emphasis on relationship problems can also oversimplify women’s sexual problems and turn into partner blaming. The New View’s insistence on referring to “Female/Pink Viagra” further obfuscates understanding the difference between arousal and desire, even when drugs like flibanserin do not work like Viagra. I was horrified to see New View organized petition to stop FDA approval of flibanserin, since I felt like the petition organizers overlooked whatever small number of women might actually benefit from such a drug, questionable though it is. Anti-Big Pharma arguments can easily turn into anti-medicine rants and rampant disablism. Looking for the deeper meaning behind sexual problems can turn into so much ‘splainin and Freudian analysis. And I think that by questioning the very existence of such a thing as female sexual dysfunction, the New View contributes to the further stigmatization of FSD. Basically, when used irresponsibly, the New View lends itself to Bingo Board fodder.

But on paper, the ideas are great. There’s even wiggle room for medical problems and biological factors as causes of women’s sexual problems (though the contributors are less interested in examining biological and health problems.)

In practice, the New View raises new questions and creates potential problems that warrant further examination.

Reading between the lines, you may notice some elements missing…

The New View Manifesto which guides the campaign was written from the perspective of professional women – psychologists, anthropologists, sexologists and related fields; however none of the original twelve named contributors to the succinct document had qualifications in medicine. There were no physicians, gynecologists or obstetricians involved in drafting the original manifesto. However, the document has subsequently received endorsement from several medical doctors and many therapists.
None of the contributors to the New View book disclose whether or not they have personal experience dealing with sexual dysfunction. The only clue we have as to whether an author with sexual dysfunction was included in this anthology may be found in Gina Ogden’s essay, which said, “I have been able to relieve much personal relationship angst by understanding sexual dysfunction as a manifestation of cultural dysfunction” (19). So there’s an “I” statement that touches upon sexual dysfunction and Ogden probably meets the New View’s definition of having had “Sexual problems,” but it’s not clear to me whether she ever considered herself to have a dysfunction. However even this statement ultimately rejects sexual dysfunction as an actual bodily phenomenon that women experience in and of itself. The rest of the book is likewise resistant to the very idea of sexual dysfunction as a valid medical problem.

There’s an expression in business, “Management sets the tone,” which means upper management, through actions and words, dictate the general atmosphere of an organization. It was Dr. Tiefer who pushed for the New View Campaign to come together, and throughout Dr. Tiefer’s essay, she consistently keeps the words female sexual dysfunction in “Scare quotes.” A footnote details the reason why: “4. I will put “FSD” (female sexual dysfunction) in quotations in this paper to indicate its questionable legitimacy” (92). Based on this, it seems highly unlikely to me that the contributors to this book would have actively reached out for feedback directly from women with sexual dysfunction. After all, if a condition is not legitimate and real, then who has it? There isn’t anyone with it to recruit.
Women who definitely had relationship and sexual problems and/or dysfunctions are presented as case studies in support of the New View model. Sometimes these women are quoted briefly, other times a contributor presents a summary of what brought a client in. Our words are presented through the filter of professionalism.
The omission of responses by women with sexual dysfunctions is a problem since such women are critical stakeholders in the New View model of sexuality and sexual problems. The New View is meant to be applied to women who experience sexual obstacles. But did anybody run the New View by the women who it most deeply effects before going to print? Based on one of Dr. Tiefer’s essays, it looks like the answer is No – the New View was drafted by about a dozen North American professional women based on their interactions with clients and with feminism (87); women with sexual dysfunction were not explicitly solicited for feedback. This is especially ironic in light of Peggy J. Kleinplatz’s essay, On the Outside Looking In: In Search of Women’s Sexual Experience in which she says, “Women’s sexual experience is conspicuously lacking from popular and sexological discourses of female sexuality” (124) and,

“Alternative models of female sexuality are called for which embrace the entire range of female sexuality from the vantage point of lived experience… A new epistemological stance is required which features women’s subjectivity at the center of inquiry. Female sexuality is best understood by listening to women’s own voices rather than attempting to peer from a safe distance and have our views filtered through the distorting lenses of conventional and sexological images of sexuality and female sexuality” (130).

Without follow through, calling out for the voices of women is little more than lip service. Nothing about us without us. (This is a continuing problem in the wide world of feminist writing, and writing in general.)
On the other hand, even if women with sexual dysfunction had been consulted when the New View document was first drafted ten years ago, I doubt it would have raised many objections or concerns. It looks fine on paper; it’s when and how you use the document to guide your activism that problems become are either solved or manifest.

I was surprised to see some criticism of the New View contained within the book’s pages: according to Gina Ogden, it may not have much to offer women who are extroverted in their sexuality. Jaclyn Friedman comes to mind, because Ogden says such women are labeled “Sluts” (19) and Friedman self-identifies as a slut, in the best way possible. So what does the New View, which focuses on negative sexual outcomes, have to offer her if she experiences sexual dissatisfaction? Good question.

The New View does a better job looking at causes for sexual problems than it does at offering guidance for what anyone should to do about it. I suppose that’s true of the DSM too though. One thing that’s clear in the New View is that medicine should generally be avoided, since medicine won’t address social forces, and it has been hijacked by for-profit entities.

And unfortunately the book doesn’t say anything about the grieving process you may go through (I went through it…) when it turns out that your sex life is not, and may never be, anything like what you had expected.

The book itself:

The first part of the book is the shortest – it’s the New View Manifesto document itself, which you can find online if you know where to look. It has been re-published on the Our Bodies, Our Selves blog supplement. (A later chapter goes into more detail about Dr. Tiefer’s connection with the Boston Women’s Health Book Collective, which I was curious about.) The document itself, not so bad. It does not use the label “Sexual dysfunction,” instead using the term “Sexual problem,” which is defined as, “discontent or dissatisfaction with any emotional, physical, or relational aspect of sexual experience, may arise in one or more of the following interrelated aspects of women’s sexual lives,” and then there’s the whole bulleted point list of stuff that makes sex hard for women to enjoy. This alternative definition is similar to the DSM’s criteria of “Personal distress” in sexual dysfunction since it acknowledges the importance of personal dissatisfaction, but it’s more flexible in acknowledging what causes dissatisfaction, and the language is supposed to be less hurtful. It’s meant to acknowledge social influences and reassure women that there’s nothing wrong with them if they experience sexual problems. To the best of my knowledge the document has remained unchanged since the final draft was put together in 2000 (88).

The second part of the book consists of 10 contemporary responses to the New View. Professionals read it and wrote in about how it could be applied to their practices and/or demonstrating ways in which women’s sexuality is shaped by local culture – often with negative outcomes for the women, since culture is frequently patriarchal. Throughout this section, there is a strong emphasis on relationship factors as being the main culprit for women’s sexual problems. So what about all the single ladies who are not in a romantic/sexual relationship? Well, you still got a relationship with your friends right? Or your parental figures, or if you’re reading this blog then surely you have some kind of relationship with the media. Relationships! You can’t get away from ’em.

The essays have merits, yes. But there’s flaws too. Here’s some examples of what I mean…

In the first essay response to the New View model, Dr. Lucy M. Candib presents a case study of a patient with sexual problems and lists elements of her problems that fall under all four of the main areas of the New View classification. It’s a compelling case. Yay! But then Dr. Candib says,

Practitioners may attempt to address the anger that women hold about both the division of labor and the experiences of abuse, but such anger is usually chronic, and many women develop symptoms in relation to it – headaches, chronic pain, fatigue, or depression – especailly when the relationship appears to be an inescapable trap (13).

Emphasis mine…Wait, what am I looking at here? I don’t think I like where this is going… didn’t DW user beautyofgrey talk about looking at “Unresolved anger” as a way to explain away what was actually a chronic, invisible illness? And didn’t she talk about how people interfere with her treatment decisions out of fear of Big Pharma?

Beth A. Firestein’s essay, Beyond STD Prevention: Implications of the New View of Women’s Sexual Problems talks about how a strong focus on sexually transmitted infection prevention fails to address the concerns of people who have or have had a STI. Prevention is great, but what happens if it isn’t enough? What happens when prevention fails and you catch a sexually transmitted infection? This chapter explicitly mentions the role of STI (or the fear of them) s in developing vaginismus, and this is the only chapter that explicitly mentions vulvodynia. Yay! However, this is the context:

3. Women who have partners that suffer from recurring outbreaks of a viral STD, such as veneral warts and herpes, or neurological pain disorders, such as vulvodynia, that cause pain with sexual activity or penetration, need to be helped to seperate fear from fact and to determine a personal range of safe and pleasurable sexual behaviors – behaviors that allow for sexual satisfaction of both partners while decreasing the risk of exposure to their partner’s disease. Such women could also benefit from coaching in ways to deal with a partner’s STD that protects the woman without eroding their partner’s sexual self-esteem or healthy sense of sexual self-expression (30).

I’m actually not put off about talking about vulvodynia in the same chapter as STIs, because Firestein’s view is meant to go beyond STIs and take away some of the stigma associated with them. This paragraph is somewhat awkward though, since vulvodynia is not actually an STI and it is not contagious, my partner does not need to worry about being exposed to it. A simple grammar tweak would likely strengthen this passage. I’m more concerned that this passage does not provide guidance with what to do if you are someone who has a chronic condition or infection… and you still want to go beyond your current safe range of activities. I already know facts about vulvodynia, probably more than the average sex therapist or general practitioner. My fear does not come from ignorance about my own health. Some women with vulvodynia still want to, or do, have sex even if it is painful, and this paragraph does not address what steps might be taken in those situations.

Dr. Lisa Aronson Fontes’ essay on Latina sexuality, The New View and Latina Sexualities: Pero no soy una maquina! compares the New View vs. the DSM classification of sexual problems and where each classification schema centers the causes of women’s problems: Within the individual vs. with external forces in an individual’s life. She provides examples of Latina women with a history of sexual abuse or shame for whom the DSM does a poor job addressing the causes sexual problems, and she shows how the New View fits better. Yay! One client, Sarita, told Dr. Fontes her frustration with her pushy priest and doctor – they were urging Sarita to have sex with her husband, even though she was dealing with abuse triggers which made her uninterested in sexual activity. (Sound familiar to anyone?) This experience resulted in the expression contained in the title, translated as “But I am not a machine!”
So Dr. Fontes’ comes down pretty hard on a diagnosis of sexual dysfunction, at least for sexual abuse clients:

The “dysfunction” categories of the DSM-IV imply pathology as a variation from a theoretical normal pattern. It is more helpful to use an injury model – that connects suffering with the environment in which it occured an dthe person who caused it – than an illness model, which locates the source in the sufferer (Lamberg, 2000). An injury model implies recovery for victims of abuse. Yolana is on the mend – being labeled as “dysfunctional” at this time cannot help her recovery (36).

So for another client, Yolanda, a diagnosis of sexual dysfunction is a poor fit or outright counter-productive. But what about women like me, for whom incorporating the label “Dysfunctional” is part of my recovery – if you can call it a “Recovery” at all. At what point are you recovered, knowing you can never go back to the “Normal” which you once had? It may be worth noting here that according to Dr. Fontes’, Sarita did not meet the criteria for PTSD (35). But what about if she had? We get a clue as to Fontes’ feelings regarding an illness model in general with the following line:

“Using the New View, we are able to consider and treat Sarita’s discontent in its historical and current relational contexts, without reducing her to a body with a dysfunction, as if she were a broken machine” (35.)

Emphasis mine, because the problem with this statement is No no you know why am I even still doing this I am not doing this anymore I should not have to explicitly spell this out: If you think that diagnosing someone with a sexual dysfunction reduces them to a broken body, like they are a broken machine, then that’s your problem! Except that then it becomes my problem because then I have to struggle against this idea that there’s something wrong with me not just for having sexual problems but for needing medical help addressing them. You can have a sexual dysfunction and still be a rich, individual person. There has got to be a way to support abuse victims without using disablist language, especially since some abuse victims may very well have chronic illnesses – in fact, folks with chronic illnesses are more likely to be abused.

The third part of the book details the origins of the New View and contains more supportive materials. It’s the biggest and the most difficult section.

The longest chapter in the third section is Dr. Tiefer’s essay, Arriving at a “New View” of Women’s Sexual Problems: Background, Theory, and Activism. It’s very similar, even parallel, to Sex is Not a Natural Act. If you don’t have time to read all of Sex is Not a Natural Act, you could probably get a good idea of what it’s all about from reading this colorful essay. Dr. Tiefer shares her perspective of the history of the medicalization of men’s sexuality (and by extension, women’s,) the influence of Masters & Johnson’s human sexual response cycle research, criticism centering orgasm as the endpoint of sexual research, etc. This essay provides a lot of background information about why and how the New View Campaign came to be in the first place at about the turn of the millennium – with Viagra approved and prescribed, Dr. Tiefer and feminist colleagues wanted to challenge the supremacy of male-focused medicine defining what constitutes female sexual dysfunction, (no skeptic quotes from me) but they had to do so under time constraints – there was a sexual dysfunction conference a-brewin’.

Remaining chapters in this third section address gender and gender roles, sex education and coming of age, lesbian sex therapy, female sexual dysfunction, etc. The essays on lesbian sex therapy were interesting and they draw attention to this often-marginalized group, but even the authors seem disappointed by what they have to offer to their lesbian sex therapy clients. Much of sex therapy is informed by the work of Masters & Johnson and is heterocentric. You may think the same principles in heterosexual sex therapy should apply to same-sex couples but in practice, it frequently cannot. In response to the failures of Masters & Johnson’s sex therapy models, Marny Hall once tried a revolutionary therapy with lesbian clients that she called “Anti-sex therapy,” (168) with disastrous results.

As was the case in Sex is Not a Natural Act, I found myself tripping over problematic elements in these later chapters, which made it difficult to find redeeming elements. Jennifer R. Fishman and Laura Mamo in their essay What’s in a Disorder: Cultural Analysis of Medical and Pharmaceutical Constructions of Male and Female Sexual Dysfunction (about exactly what it sounds like) describe prescription drugs as,

…fast becoming popular consumer products, a capitalist fetish, where one is encouraged to think of such drugs as a means through which to improve one’s life. The shift to the biomedicalization of life itself is indicative of a cultural and medical assertion that one’s life can always be improved” (182).

(Emphasis original.) There is no consideration here for folks who need prescription drugs for mental illness or chronic pain or for folks who cannot afford much-needed medication. What stung me the most was the complete erasure of my existence as a once-adolescent young lady with sexual dysfunction when Deborah L. Tolman explicitly stated, “Female adolescent sexual dysfunction is an oxymoron” (197.) How am I supposed to react to that? Is this slap in the face supposed to snap me out of my reverie? I came away from many of the later chapters feeling very much as though some of our bingo board squares were staring me right in the face.

Overall, it is a challenging book, esoteric, though for readers of this blog it might be one worth reading. But it should be taken with a grain of salt — The New View may not be the panacea for women’s sexual problems it was hoping to be. In breaking away from the problems contained in the medical model, the New View stumbles into and creates new, different problems. It could be strengthened with revisions following a deeper understanding of disability activism and the potentially harmful consequences of stigmatizing both illness and medicine. The goal of the New View is to recognize that sexual problems are often caused by forces outside the body, and then to work for social change to address the causes for these problems. But social change takes time, and some of us cannot wait that long for revolution, especially when there are so few support structures in place to begin with. Some of us genuinely do have sexual problems that originate from within. Some of have problems that are so complex, we cannot isolate the body from the social, and we should not have to choose between social change or medicine. This really isn’t an either-or situation; people want better sex education with which to make good sexual choices and access to medical options. Others face problems so widespread that even feminism can’t fix everything. We have problems and dysfunctions now. While I can see some merits to social construction in looking at sexual problems and dysfunctions, overall with regard to the New View, I remain unwilling to co-sign.

Symbolism, archetypes and stereotypes: What experts have said about vaginismus

07/21/2010 at 7:03 pm | Posted in Uncategorized | 6 Comments
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While browsing for interesting (and often outrageous) coverage of sexual dysfunction via Google Books, I’ve occasionally stumbled across experts (doctors, sexologists, laypersons, etc.) interpretations of vaginismus and the women who live with it. I’d like to present some of my findings to you now. Full disclosure: I haven’t been able to finish every book I’d like you to look at today.  But on the other hand, I’m not doing a full book review today either and I am not certain what context, if any, could redeem the following passages.

One of the points Dr. Leonore Tiefer made in Sex is Not a Natural Act (yes we’re returning to this title again) is that we need to look at sex symbolically. Sex has meaning beyond the obvious that we can see and feel, and to understand sex and sexual problems, we need to figure out the meaning behind it. Consider some of the following quotes with emphasis added by me (thanks to Kindle’s word search feature:)

“It’s the symbolic investment that makes sex ecstatic” (location 1215).
“The first [story about doing the ‘Viagra tango,’ as she puts it] is about how Viagra the pill, but more importantly, Viagra the symbol, may affect the sexual conduct and experience of women and men in many parts of the world” (location 1315).
“[Orgasm is] just a reflex. It’s the symbolism that makes it feel so good” (location 1195; available online.)

And it goes on like that at a few more points throughout the book. We need to look at the symbolism of sex, phalluses, the Viagra family of sexual medicine, etc. We need to pull the curtain back and understand the why behind a woman’s libido crash. Some contemporary examples of where understanding sex and symbolism would be helpful are with the very expression “Sex symbol” and with sexual imagery used in advertisements.

There’s just one potential problem: Some so-called experts on women’s sexuality have already done that – looked at sex, women, women’s sexuality and sexual problems symbolically – and the results haven’t been pretty. Sometimes the ugly things people say about FSD and the women who have it doesn’t come from hack journalists and misogynist comments on message boards. Sometimes – often times – it comes from the professional sphere and trickles down.

Let’s focus on vaginismus as an example. Vaginismus, if you didn’t already know, can be described as an uncontrollable spasm of the pelvic floor and vaginal muscles, usually during sexual activity. It’s most obvious when attempting penetrative activity, like sexual intercourse, but it may also occur with a dildo, tampon use, or during gynecological exams. The spasm may be strong enough to completely prevent an object from entering the vagina, or it may be possible to insert something, but with pain. As such, it can be the cause of dyspareunia (painful sex.) Vaginismus is often recognized as a sexual dysfunction, however, some sexologists question the validity of sexual dysfunction broadly as a diagnosis at all and vaginismus in particular. For some folks like me, vaginismus a chronic problem connected to medical issues, other times it’s situational.  Some folks say it’s purely psychological and can be treated without physical intervention, others say there’s a physical component and that it can be addressed physically.
Vaginismus does not necessarily require any treatment at all, but when folks with vaginismus do seek assistance to address it, that assistance may come in the form of talk therapy with a counselor or sex therapist, dilator use, learning how to kegel, or more extreme medical intervention such as botox injections (not for cosmetic purposes) or physical therapy.

And some sexologists have described vaginismus symbolically.

One of the first, if not the first, books to deal with vaginismus exclusively is 1962’s Virgin Wives: A Study of Unconsummated Marriages, by  Leonard J. Friedman. It’s out of print now, but you may still be able to find a used copy online or through your library. I first came across this title while slogging through Linda Valin’s When a Woman’s Body Says No to Sex: Understanding and Overcoming Vaginismus, a book about vaginismus, from the perspective of someone who has personal experience with it. Valins acknowledged Friedman’s contributions to her own book, but alas Google Books does not offer me the complete text of Virgin Wives or a preview version to pursue at my leisure.

However, because authors like Valins have referenced Friedman’s work, we can get a pretty good feel for what he thought about women with vaginismus. Valins is a big fan of his, so it probably isn’t all bad – but I found the following disturbing.

Last week, I tweeted one of my findings regarding symbolism and vaginismus, from Google’s preview of 1987’s Sexuality and Birth Control in Community Work, by Elphis Christopher. Based on what I can see in Sexuality and Birth Control in Community Work, Friedman described three archetypes of women who tend toward developing vaginismus:

(1) ‘The Sleeping Beauty’: this occurs where the woman denies her own sexuality and waits for the man to awaken her sexually. Unfortunately, she often chooses a ‘safe’ partner, i.e. a man who is uncertain of his own sexuality and may suffer from impotence. He is often praised as a ‘good,’ nice boyfriend because he did not attempt pre-marital intercourse.
(2) ‘Brunhilde’: this refers to the woman who is always looking for a man strong enough to conquer her. She usually chooses as sexual partners men whom she despises.
(3) ‘Queen Bee’: this refers to the woman who manages to get pregnant without allowing penetration so that she can claim the pregnancy for herself.

What… the… fuck…?

I have no reasoned, rational response to this. Do I need to explain the multiple layers of Wrong with this picture to you?

We got here, above all, the assumption of heterosexuality, and according to these personality types, if you have vaginismus you are likely to be:

1. a woman who refuses to own her own sexuality and instead waits for some guy to come along and give it to her. But for some reason the author decides that a man with basic human decency who did not coerce his partner into sex simply must be sexually insecure and possibly “Impotent” (as if there’s anything wrong with having erectile dysfunction.)
2. I don’t know wtf this is – Some kind of Viking archetype I think where a woman who doesn’t settle down with any ol’ jerk and who doesn’t take shit is asking too much. Or else if she’s got vaginismus, it means she must hate her partner.
3. I don’t know wtf this is either. I think term is dated because I had to look it up. I think this archetype is supposed to conjure up images of a bossy lady who, frustrated with vaginismus, gets pregnant the “Wrong” way – minus the ejaculation of a penis inside of her.

So, what the fuck, which one of these archtypes am I then? Anybody here identify with one of these three archetypes? Does anybody here appreciate being described like this? Does anybody here in a relationship appreciate having your partner described like this?

“Now wait, K,” you may be saying. “That paragraph starts out talking about non-consummation generally, and then the next paragraph is about vaginismus.” Fair enough, so let’s make an effort to double-check and make sure that we’re talking about the same thing. Here’s a website that mentions the three archetypes of women who are prone to vaginismus, and it says:

Friedman (1962) describes three types of women inclined to vaginismus:
* the sleeping beauty (father-type relationship with partner and various feelings of guilt)
* the Brunhilde (the woman perceives sex as a battle between the sexes, and the male dominance has to be opposed)
* the queen bee (the woman perceives sex as dirty and sinful, she is afraid of pain in coitus and, in principle, she wants to get pregnant)

Again, what… the… fuck…?

Still don’t believe your eyes? I’ve got one more piece of evidence I can present, from the Science/Fiction of Sex: Feminist deconstruction and the vocabularies of heterosex. I’ve been picking it up and putting it down every once in awhile, browsing random passages – because every passage is so cerebral. This book is hard. Alas, unless you’ve got a copy of the book you won’t be able to read page 210 so let me fill you in. This is, as the title says, a feminist deconstruction of sex, so the author does not necessarily endorse what I’m about to show you.

Annie Potts references the work of Eve Adler, who submitted an article to the British Journal of Sexual Medicine in 1989. I have tried to access the journal article myself but have not yet been successful through my usual means. Adler described several archetypes of women with vaginismus, including one of particular interest to Potts:

Less commonly seen today is the primary vaginismic patient, Sleeping Beauty; an emotionally immature woman awaiting a sexual awakening without taking responsibility for it. These ‘good girls’ have often been brought up to believe that sex is bad or dirty; she had to save herself for marriage! This type can appear quite ‘little-girl-like,’ pristine, clean an tidy and very controlled generally; or she may look quite sexy, enjoy sex play and experience orgasm with clitoral stimulation. Her partner is often ‘a gentleman’ in every sense: an unassertive, gentle, literally non-pushy man who may well have hidden anxieties about his own sexual abilities (Adler 1989 in Potts 2002)

What… the… fuck… What is the meaning of this bullshit?!

“Emotionally immature?” “Little-girl-like?” “Unassertive?” This is in print, people! This is how women with vaginismus and their partners have been described. In books and journal articles. What about descriptions like “Creative and resourceful?” Or “Resilient?” How about some of that?

Don’t be too angry with Annie Potts for re-printing that passage above though; she analyzes it, though you may not agree with her analysis either…  It gets far out there when she starts talking about vaginismus as a form of political resistance against a phallocracy, and hey did you ever notice how phallic your fingers and a newborn baby are.

Let’s go a little deeper and focus on Sleeping Beauty since she keeps popping up re: vaginismus. The myth of Sleeping Beauty has been reinterpreted by various authors. According to one interpretation by Joan Gould, when Sleeping Beauty pricked her hand and fell into an enchanted sleep, the spindle that cut her represented a phallus and sexual maturity; the blood that came out of the injury represents menstruation. Sleeping Beauty was protected from spindles (sex and puberty) by her royal family up her 15th birthday – the age by which many girls reach menarche. The sudden appearance of sex and adulthood upon her (and Snow White, too, for that matter) was too much to bear all at once. The sleep she fell into was not necessarily a passive time; she spent the century mulling over impending adulthood and all the responsibilities that came with it. At a predetermined time, a prince came to wake her up and she was transformed into a woman ready to act as an adult. Usually we think of the awakening as romantic, stemming from a kiss but some versions have her shocked out of her sleep by rape or nursing her babies – conceived in sleep during rape, the perpetrator long gone (Gould, 86-126). Gould’s explanation of the myth of Sleeping Beauty, coincidentally, also addresses the myth of Brunhilde. However we cannot ignore the well-known 1959 Walt Disney version of Sleeping Beauty, in which Aurora was at last rescued from an evil witch’s spell by an active, handsome prince – who she was scheduled to be married to anyway. We need to think about that version too, especially since Disney’s Sleeping Beauty was released by the time Virgin Wives was printed.

Edit 7/22/10 – The boyfriend suggested I add more pictures to the blog. Here’s a picture of Disney’s Princess Aurora, Disney’s Sleeping Beauty.

Disney Aurora

Disney Princess Aurora

[Image description: A picture of Disney’s Princess Aurora wearing an iconographic pink dress.]

Is this the true face of Vaginismus? What the hell does she have to do with vaginismus? You think of vaginismus, what’s the first thing you think of, Disney, right? No. (Via.)

But wait, there’s more! Last week, when I Tweeted a link to my findings about archetypes of women with vaginismus, @NevillePark responded back with a very good question:

Wow. Uh, dykes, genderqueers, masculine folk, trans guys, etc., can’t have vaginismus? NEWS TO ME #youreadthisstuffsowedonthaveto

Indeed, good point! Because Friedman was looking at unconsummated marriages back in the 1960s, the most likely scenario is that he wasn’t interested in anyone who wasn’t cis- and heterosexual. After all, marriage was then (and remains to this day in the US on a federal level) defined as a legal union between man and woman. I would love to get my hands on a copy of Virgin Wives just to confirm that he had no interest in queer sexuality and vaginismus.

Alas, I cannot offer a complete answer to the question @NevillePark raises. However, we can turn to another body of work for partial credit.

Last week on Google Books I found Sexual Salvation: Affirming Women’s Sexual Rights and Pleasures, a book about women and sex, with an interest in often marginalized groups of women. I’m surprised to report that it does have a Kindle e-book edition (though the Kindle version is out of my price range right now! $63?! For a sex therapy textbook!? That’s not on the budget!) Overall it sounds interesting and potentially valuable – the Amazon summary says the author spends time talking about feminism and marginalized groups of women, including seniors, disabled women, and sex workers. And I can see from looking at the indexes to Sexual Salvation and (once again for the millionth time,) Sex is not a Natural Act that the authors, Naomi B. McCormick and Dr. Leonore Tiefer, respectively, reference each others’ work. Hmm…

The discussion of vaginismus starts on about page 190, preceded by a discussion of dyspareunia (painful sex) and followed by a discussion of sexual dysfunction, especially in men, and then sex therapy.

There’s a lot we could talk about with this one section of the book, but for now let’s focus on the following:

Taught that the only “real sex” is sexual intercourse, heterosexual women are susceptible to two sexual problems that are largely unknown to lesbians, dyspareunia, painful coitus, and vaginismus, involuntary spasms of the vaginal musculature which prevent penetration. (McCormick, 190).

Well there’s an answer. This leaves room for the possibility of lesbians to experience painful sex and vaginismus, but according to McCormick, that’s almost unheard of. (An unfortunate side effect of establishing profiles of ‘typical’ patients for diagnosis of problems though, is that if you don’t fit the profile, you may have to work even harder to get a caretaker to take your complaints seriously.) She does, however, go on to describe situations in which a lesbian may find herself in a heterosexual relationship and experiencing vaginismus, and some pages later, she describes a lesbian couple coping with cancer and sexual problems including genital pain. Meanwhile, the Vaginismus Awareness Network goes on to address two myths about vaginismus and sexual orientation (Emphasis mine):

A woman MAY be a lesbian if she has vaginismus, just like she may be a lesbian even if she was able to have painfree intercourse with a man.

This myth seems to spread from the belief that lesbians won’t have penetrative sex. Though that may be true for some of them, others will use strap-ons etc and have ‘intercourse’ too. So clearly vaginismus has little to do with one’s sexual orientation since so many heterosexual women in love with their partners have it. It has more to do with lack of knowledge of one’s private parts, lack of information on their PC muscles, lack of sexual education and lack of kindness…

You know, I don’t always agree with the VAN. I have the sexual education I need to understand my own anatomy and how to do a kegel, and my partner is kind to me, yet somehow I still have vaginismus. Maybe we shouldn’t paint all women with vaginismus as one big homogeneous group. But compared to the other Freudian analyses described above, even I prefer this. I’m very uncomfortable by the way women with vaginismus have been described in literature like what I’ve shown you today. For how long were these archetypes and stereotypes repeated and used in clinical settings? To what extent do the myths and stereotypes about women with vaginismus still exist, and what effect do they have now?

Let’s read books part 3 – Sex is not a Natural Act, con’t

02/23/2010 at 7:26 pm | Posted in Uncategorized | 1 Comment
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Part 3 in our continuing series on the feminist & sexology book Sex is not a Natural Act and Other Essays. Last time I posted about my journey into Sex is not a Natural Act and Other Essays, I left off at the end of the second section, Popular Writings on the Theme. (See part 1 here.) So far all my analysis relating to the book consists of ridiculously long posts, so if you’re wanting to read along with me, you may want to read my posts in little bits & pieces. Or just burn through, whatever.

After posting part 2 in our continuing series, I got dragged into jury duty and with nothing else to do but read, I plowed through more of the book. It’s time to talk about the next few chapters, the theme of which is Feminism and Sexuality. The six chapters contained in this section takes us to about the halfway point of the book.

My overall impression of the feminism-themed chapters in Sex is not a Natural Act can be briefly summarized as, “Not completely miserable.” There’s valuable thought on feminism and sexuality here, and this section contains my favorite chapter, which is about censorship and feminist analysis of sexually explicit materials.

Unfortunately, Feminism and Sexuality is also a return to heavy academic language and theory:

“Diverse erotic lives and new methods of reproduction are possible because of psychological processes such as symbolization and conditioning that are connected to ever-changing cultural formations.” (Location 1526.)

Oh goddammit.
Thinking caps on, everyone! Oh, you’re all already wearing your thinking caps, and so am I… Better make mine a double then!
By now I’m more used to Tiefer’s academia, but I still needed to re-read several passages from Feminism and Sexuality in order to absorb their messages. And sometimes, even after re-reading sections, I remain unconvinced of Tiefer’s position. Sometimes, I think she’s too heavy on the academia, too willing to sacrifice concrete practice and to overlook real, if uncommon, lived experiences.
And, now that I’ve read ahead and am almost finished with the book, I feel comfortable saying that… I’m  picking up on a couple of potentially problematic areas, especially in language she chooses and some inconsistencies…
Oh well, nobody’s perfect. Let’s dive in and get exploring.

Some of the essays in Feminism and Sexuality, particularly the first essay, are autobiographical. In the first chapter, An Activist in Sexology, the reader gets a better idea of Tiefer’s experience and history as a sexologist, especially as it relates to feminism. This first essay consists of a paper presented to the Society for the Scientific Study of Sexuality in 1993 upon receiving their Kinsey Award. Tiefer describes herself as an activist in the field of sexology, merging academic research, sexuality, politics and second-wave feminism into an expertise that she herself recognizes as controversial.  Tiefer seems to relish her position as a controversial figure, describing two incidents in which she was invited to speak about specific sexual subjects at meetings, and instead talked about completely different (though still relevant to sexuality, and with a strong flavor of feminism) topics (Location 1444, 1476). The gamble paid off in the end, as she is now recognized as an expert in the field of sexology. At the end of her paper she concludes, “There is really no way to be apolitical as a sexologist – every action supports some interests and opposes others,” (location 1490) and she implores others to incorporate feminist themes into their work – particularly “race and class analyses” (location 1491.)

The second chapter, Biological Politics (Read: Propaganda) is Alive and Well in Sexology, Tiefer takes a critical look at gender essentialism as it relates to biological arguments. That is, she critiques claims – including those from within the feminist community – that women and men are different due to their biology rather than differences in socialization & culture: “I have observed that arguments about sexuality emphasizing biological differences between men and women’s sexual lives as well as those emphasizing biological similarities have been used to ignore the sociocultural components” (location 1530). The critique is still relevant today, as some feminists continue to attribute gender differences to sex hormones and/or the presence of what kind of genitals you were born with. Attributing gendered differences to biology goes by different names, depending on what field is popular at the moment, be it “Regional brain anatomy, brain lateralization, evolutionary theory, gene effects, hormones, etc.” (location 1506). Tiefer’s career as a sexologist put her in a unique position, as working in that field allowed her to watch as medicine & biology became incorporated into sexuality research and clinical practice. The results of this biological views are restrictive when it comes to individuals’ sex lives, as under this sort of view, heterosexual intercourse is – or rather, it used to be – the only act that results in procreation and the continuation of the species (location 1525).

Next up is Gender and Meaning in the Nomenclature of Sexual Dysfunctions, and this chapter looks at the gender politics in the DSM – “The DSM, because of its powerful social location and its relations to most of the elements identified above, can be read as a work about gender” (location 1568, emphasis original.) She states,

“The language of the DSM overtly and covertly speaks the language of gender and of the most biologically reductionist version. By using only the terms males and females, never men and women, the gender language fixes people in the world of animals and locates whatever governs sexuality as in ‘the animal kingdom'” (location 1602, emphasis original.)

She doesn’t mention this part, but of course by using terms like “males and females,” the DSM also ignores folks who do not identify as belonging to a gender binary.

Now, in this chapter, Tiefer focused on gender…
But I looked at it from a different angle.
I noted the gender politics, yes, but I also gleaned clues about looking at FSD as a disability in and of itself, under the broad category of mental (and physiological) health. Tiefer provided a brief history of how sexual dysfunction has been treated within the DSM over the last few revisions. Currently, sexual dysfunction is listed in the DSM – this is a hotly contested feminist issue.
Looking at FSD as under the spectrum of mental illness, and thus under the broader spectrum of disability, is a different way of looking at FSD, and one I’ve not encountered much. Tiefer doesn’t do that in this book; she doesn’t look at FSD as a disability in and of itself. In fact, in an earlier chapter, she says,

“Using the clinical standard with regard to psychology is more difficult than using it for physiological matters because it’s harder to prove psychological disease, deterioration, or disability. Who’s to say, for example, that absence of interest in sex is abnormal according to the clinical definition? What sickness befalls the person who avoids sex? What disability? Clearly, such a person misses a life experience that some people value very highly and most people value at least somewhat, but is avoiding sex “unhealthy” in the same way that avoiding protein is? Avoiding sex seems more akin to avoiding travel or avoiding swimming or avoiding investments in anything riskier than savings accounts–it’s not trendy, but it’s not sick, is it?” (Location 240, emphasis mine.)

The “Clinical standard” she’s talking about is the clinical definition of normal, given just a paragraph earlier:

“The clinical standard… uses scientific data about health and illness to make judgments. A particular blood pressure or diet or activity is considered clinically abnormal when research shows that it is related to disease or disability. It shouldn’t matter to the clinical definition whether we are talking about the twentieth century or the tenth, about industrial Europe or rural Africa” (Location 235).

By placing sickness behind sexual problems, in this case avoiding sex, Tiefer is overlooking individuals who are bothered by sexual problems, due to sickness or disability. We’re taking opposite views here. From my point of view and in my experience, the sickness or disability comes before, or in conjunction with sexual problems.
(I also seem to recall reading personal stories from PWD who are pushed to avoid certain activities, including travel cited as an example above, due to society and companies not making their facilities accessible enough. I seem to recall hearing something about airline companies which have refused to serve PWD and other transportation services making travel difficult… In which case, avoiding travel isn’t a sickness in and of itself – it’s part of being disabled. Needlessly so – it shouldn’t have to be like that, if society was willing to be more attuned to the needs of PWD.)

Looking at FSD in and of itself as falling somewhere on the broad spectrum of disability is a very new idea to me and, I think, one that merits further investigation.
It is only within the last few months that I’ve started to look at FSD through the lens of disability, so I’ve got a lot to learn yet. And I’ve only been able to start thinking about it thanks to running into a handful of feminists on the internet who suggested that’s a valid point of view, or who were at least open to the idea of a broader definition.
Basically, I feel like I needed permission to explore FSD as a disability in and of itself, even though living with vulvodynia threw me onto the chronic pain spectrum to begin with. In this regard, those who question the validity of FSD act as gatekeepers, questioning the identification of those who would try to pass through those gates. The narrative goes something like, “Are you certain it’s not your partner’s fault or due to your own body insecurity; don’t you realize that you’re acting as a tool to Big Pharma and the patriarchy; you are too close, too deeply involved with your own lived experience to be able to make a wise objective decision.”
I needed permission to choose my own identity. Why did I need a permission slip? And actively choosing to identify as having sexual dysfunction and thus as falling somewhere on the broad spectrum of disability, is likely to remain controversial, since FSD is so hotly contested, and the women who experience it are so strongly stereotyped & stigmatized.

After all, “Diagnoses listed in the [DSM] manual are generally recognized in the courts in making legal decisions, by hospitals and psychotherapists in keeping records and by insurance companies in reimbursing for treatment (New Psychiatric Syndromes Spur Protest, 1985)” (Location 1561, emphasis mine). The emphasis in that statement is mine, because I have personal experience with this. The IC code for DSM is used in reimbursing pelvic pain patients… 625.x… and I’ve seen some of my friends get diagnosed with code 625.x… I want and need treatment, I need insurance to cover treatment, and so I need that diagnostic code to stay in place. I dread to think that in the worst case scenario FSD, and under it the specific sub-category of dyspareunia, is at risk of being removed from the DSM in future revisions.

But there is more at stake than just myself. There are other diagnostic codes under the broad category of sexual dysfunction listed as well – erectile problems, orgasmic problems, vaginismus… And some of those diagnostic codes are indeed questionable. It’s not all about me, and I do not have all the answers; I will likely never have all the answers. I’m likely to be faced with and generate more questions as long as I continue down this road.
Not everyone wants and/or needs treatment for sexual dysfunction, nor will everyone who experiences a sexual problem identify that problem as a dysfunction. Not every variation from Master’s & Johnson’s Human Sexual Response Cycle is in and of itself a disorder. It’s not fair to slap labels onto people or to force them into anything. One way we can think about when intervention is appropriate would be to ask the individual if zie feels personal distress; however Tiefer would likely point out here that the drawback to asking is that socialization rather than intrinsic factors could be exaggerating the amount of distress an individual would otherwise feel in a different environment.

The next chapter was more palpable to me – Some Harms to Women of Restrictions on Sexually Related Expression is so far my favorite chapter in Sex is not a Natural Act. If you haven’t burned through your Google Book Preview yet, it might be worth spending your available preview on this chapter; I actually very much enjoyed it.  Tiefer states her thesis very early on – “I have concluded that women are in more danger from the repression of sexually explicit materials [including pornography] than from their free expression” (location 1634, emphasis original.) That’s pretty strong, unequivocal language! She says, “The fundamental context of women’s sexuality in our time is ignorance and shame (location 1640, emphasis original,) and that, “Although antipornography arguments seem to rely on scientific research or moral principles, I often see just the projection of these internal feelings of shame and dirt that were taught at an early age” (location 1647). This is still true today! I still hear about this within sex-positive circles!

Basically in this chapter, Tiefer argues that, because women are generally socialized to sexually self-regulate & restrict themselves to begin with, it doesn’t make sense to add to the restrictions women encounter by censoring erotic & pornographic material. These materials have the potential to be harnessed for good, in the form of stimulating the imagination. But wait, what kind of message does it send if a woman watches degrading porn and is turned on by it, is that a long-term good idea? Keep in mind that Tiefer is big on symbolism, she loves it. And instead of interpreting porn literally, she says the other way to look at it is take the symbolic approach –

“The antiporn feminists argue that pornography is to be interpreted in a literal way – if it’s a picture of a woman being fucked while lying across three tall stools in a coffee shop, it’s a picture of an embarrassed, uncomfortable, and unhappy woman. But this isn’t the way sexual fantasy actually works.” (location 1670).

And this is particularly relevant, sine I’ve heard sex-positive feminists try to explain this concept over & over again on thier own blogs – it’s fantasy. That still happens today! As an example, Tiefer cites one of her patients who derived some pleasure (and shame) from masturbating to a sexually degrading fantasy, and Tiefer says,

“Is it correct to interpret this woman’s fantasy as the straightforward story of a degraded and humiliated and subjugated woman? No. Such a simplistic assessment does not accurately characterize the ‘meanings’ of her fantasy… The vicissitudes of her upbringing and this misogynist culture produced the more negative elements – the undesirable setting and partners and the lack of her own arousal in the fantasy. She couldn’t feel entitled to openly enjoy sexual arousal, which was exactly what was going on with her husband” (location 1685.)

And she concludes,

“Anyway, the point is that pornography is about fantasy and identification with the characters in stories as symbols. It cannot really be understood just on a literal level. And if pornography is suppressed, women will not learn things about themselves and their imaginations that they can learn through experimenting with and reflecting upon their reactions to pornography” (location 1690).

I don’t have much to add to that or to critique here. I’m in agreement.

The rest of the chapter is neat too – she addresses sex worker rights and religious restrictions on masturbation. The only thing is – this chapter may have been stronger if Tiefer had more directly engaged anti-pornography crusaders. I know who she’s talking about, but I think it would have been better if she’d named them anyway.

But the next chapter, Towards a Feminist Sex Therapy, wasn’t as enjoyable. It’s not bad, I just didn’t connect with it. “It’s not you, it’s me.”

I personally do not wish to go through sex therapy, because so far I still haven’t found a sex therapist I can relate to. Mostly I’ve been reading blogs online written by or featuring sex therapists who dole out sex life advice. And most of the time I’m like, “Ehhhhh… not for me… no thx. Pass.” I might start out liking one sex therapist or another. I want to know more about what this or that person has to say.
Then I read further and see flaws in what experts have to say and I can’t reconcile it. I see the sex therapists online or in print say things I find problematic or just plain don’t like, and I get turned off, nitpick and/or refuse to get on board with it.
It doesn’t help that I’ve heard too many stories from other pelvic pain patients who tried sex therapy and had negative experiences with it.
So I’m not into sex therapy right now. “She’s just not that into you!”

Buuuut if you happen to be interested in it, then, in this chapter Tiefer reviews current mainstream sex therapy (or current as of the time of writing,) and talks about how it would be beneficial to inject a healthy dose of feminism into it. It’s a good idea, and basically what I’m trying to do on my own without outside aid. Feminism lets me look at sex, gender, mainstream media, etc differently and asks questions that a not-feminist sex therapist probably wouldn’t think to ask.

The problem is, sometimes it backfires…
In the worst case examples, disagree with one school of thought in feminism or another, and you can be excommunicated. Disagree with an experienced master, and it all goes straight to hell. You get called a bitch or other slurs with a long, charged history in oppression. Or you get kicked out of a feminist clique. Or outed and actively hunted down. Or start cross-feminist blog flamewars.

So what happens if you are assigned to a feminist sex therapist whose school of feminist thought clashes with your own? That therapist is in a position of power over you, after all. Do you disagree and potentially derail the rest of the therapy sessions? Especially if finding a feminist sex therapist was hard to do in the first place. How do you tell your feminist sex therapist “My understanding of feminism is too different from yours for your homework exercises to be of any use to me”?
I guess Tiefer is assuming here that most sex therapy patients are not feminists to begin with, or else they are but are not well educated on even the most basic tenets and local history of the movement. And in many cases, that’s probably true. So I may be overthinking things.
But what if a sex therapist gets someone like me? I already identify as feminist, yet I still struggle with sexual dysfunction. I have a feeling I’d drive any feminist sex therapist I could be assigned to up the wall. Or else the therapist would drive me up the wall and it just wouldn’t work.

So feminism plus sex therapy can sometimes add up to double-edged sword. Not always. But for me, I think I see the potential for stress & needless conflict.

Not only that, but this chapter frustrates me, because of a contradiction buried in the text. At least I’m perceiving it as a contradiction; what do you think?
At one point: Tiefer says, “I fail to see why there can’t be such a thing as ‘sex talent,’ akin to talents for music, athletics, dance, mathematics, humor, or maze-learning directionality – the various other special psychomotor or cognitive gifts we already recognize and celebrate” (location 1829, emphasis mine.)
Hey, wait a minute… Time out, huddle up – isn’t that “Sex talent” statement in direct conflict with the premise of the rest of the book? That is, that sex is not a natural act? How is certain gifted individuals being in possession of sexual talent not conflict with the idea that sexuality is socially & culturally constructed?

Talents can be lost or cultivated but my understanding is that if you have a talent for something, you have a natural knack for it without any previous exposure to training. I have relatives with a natural, seemingly inborn talent for art, spatial analysis, math, etc. Tiefer doesn’t define “Talent” either so I’m forced to double-check my understanding against dictionaries and – well my doublechecking backs me up – talent is generally understood to be something natural, innate.

So where does that leave you if  you lack sexual talent? Why do you not call it “Skill” instead, which is something learned? I think that “Talent” is not the best choice of words to use in the context of the rest of the entire book…
And, I prefer to believe that even if you lack talent in some area you want to explore, it’s possible to develop skills from training which will make you just as skilled or even better at some activity than someone with talent. (Especially if someone with talent chooses not to cultivate it.)

Whew, almost done with this post. Did you make it this far?

Last one in this section is, The Capacity for Outrage: Feminism, Humor, and Sex. This chapter contains Tiefer’s thoughts on feminist humor – and she fancies herself quite funny indeed! I still haven’t found her quite as funny as Sady Doyle, but Tiefer is some kind of funny anyway – the kind of funny that compares men with erectile dysfunction to Jackie Gleason bumbling around with bugged-out eyes, for example. In addition to symbolism, Tiefer clearly loves humor.

Feminist humor is a tricky, thin wire to tread upon – “There is no clear line between good “feminist” humor (constructive, political, reformist) and bad “nonfeminist” humor (hostile, women-are-good-men-are-bad, simpleminded) although we can make some meaningful distinctions” (location 2025). What makes a joke funny? What makes a joke political? What makes a political joke inherently feminist?

Well, one of the key elements, is intent.

“As with manslaughter vs. murder, the essential element in deciding whether something is political or not is intention. Is the comedian, cartoonist, or satirist identifying with a movement or struggle, or just ou to get a laugh? Oh, gee, I didn’t mean to upset you by mentioning manslaughter” (location 1875).

Okay I have absolutely no idea what Tiefer meant with that last bit about “Oh, gee,” I can’t quite tell from this bit if she’s being sarcastic there or not but…

But wait a minute – I though that from a feminist point of view, looking at intent alone is not enough. Or, even if you do look at intent plus the other features required to make a feminist joke, you need to look at the consequences. Evil, real consequences spring forth from well-meaning actions, and that includes telling jokes. It might seem funny to whatever group you’re a part of at that moment, but what if, due to various privileges, a joke (or contemporarily, performance art) steamrollers over already marginalized groups you hadn’t thought of?

What happens when you don’t look at consequences?

Well, when you ignore consequences of joking around about FSD, even within a feminist context, you might just get this shit. You get a bunch of partner-blaming, bullying, condescending comments, denial of real medical conditions, and potentially as a result of the above, flagrant misogyny. Perhaps you yourself do not engage in these behaviors, but others with a less sophisticated understanding of feminist humor go there. So in the end, you get a bunch of people who deny that FSD is real, because after all they don’t have it themselves and it’s all a bunch of made up hysterical hooey right? Maybe if your husband would do the dishes once in awhile you’d have enough energy for a sex drive. You just need to get out and think about getting laid and make it happen and it will be better.
When you don’t look at the consequences, you get further stigmatization and you either don’t know, don’t care, don’t believe it, or some combination of the above. And for oppressed groups and individuals, these attitudes can be translated into real-life, dangerous actions.

No. Intent is not enough.

And indeed, this chapter mentions other critical components of what makes feminist humor. But that bit about intent really stood out to me… I think it’s entirely possible to meet all the criteria required make an inherently feminist wisecrack, and still, due to privilege, cause long-term  harm.

Admittedly, the intent discussion takes up only a small part of the rest of the chapter on feminist humor. Much of the rest of the writing here is enjoyable, educational and sometimes amusing. This chapter would be especially useful for a comedian. Seriously, if you want to be any kind of comedian and have any interest in feminist humor, read this chapter. It’s heavy on the theory of humor, but there’s a lot of concrete examples, including pictures, in this chapter. And if you’re a comedian anyway, you’re probably interested in the theory of humor to begin with.
Just remember to think about the consequences of whatever joke you’re telling.

Aaand that takes us to a little over the halfway point of the book. Overall, this third section contained some useful feminist theory and some exploration of the theories in practice, but it wasn’t perfect. (But then, what is?) The next few sections of Sex is not a Natural Act examine medicalization of sexuality (particularly male sexuality) and FSD in greater detail, so these next few chapters should be of particular interest to regular readers. A note though – the 4th section is proving more difficult to analyze & so I may post a follow up after taking a break for awhile, we’ll see how it goes. (I need a better outline of where I want to go with it.)

Let’s read books – Sex is Not a Natural Act, con’t

02/02/2010 at 8:06 pm | Posted in Uncategorized | 4 Comments
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When last we encountered the non-fiction feminist book on sexuality by sexologist by Dr. Leonore Tiefer, Sex is Not a Natural Act and Other Essays, we had just wrapped up reading the first section on my new-to-me (slightly used) Kindle. The book is a real challenge, heavy on academia & theory as it relates to feminism and sexuality. However I’m relieved to say that the chapters in the second section, Popular Writings on the Theme feel less academic, and so it’s a bit more accessible to the general public. Although it contains 6 sub-chapters, Popular Writings on the Theme is shorter and feels shorter than the first section – I didn’t have to use the Kindle’s built-in dictionary feature as often, and I didn’t need to re-read as many passages to absorb their messages. In these essays, Tiefer was writing for a different audience, so she decreased the frequency with which she used postmodernist language.

I also found this second section of the book funnier than the first section, but unfortunately, the humor is not because I found Tiefer’s writing in and of itself funny… No, rather, I often found it funny due to the large gulfs separating Tiefer’s reality and the one in which I live. The grins I made were due to my jaw cynically clenching, my laughter a hoarse, half-choked “Lolsob.”

The first chapter of the second section consists of a series of sexuality columns written for the New York Daily News back in 1980-1981. That’s 30 years ago, waaaay before the internet was readily accessible and long before printed media started to enter its death throes. Most of these essays would probably be helpful to someone who is brand-new to studying sexuality, or who is looking for general sex life advice. Unfortunately, as of the book’s second printing in 2004, these columns are showing their age, and provided very little new material to me. By the time I got around to reading the essays re-printed from the newspaper, I had already encountered elsewhere most of the ideas contained in Tiefer’s old columns. Yes I know sexual spontaneity can be hindrance to a fully enjoyable sexual experience, yes I know that when we (and especially the media) think of “Sex,” our definition is likely very intercourse-centric and that it’s helpful to expand the definition of sex, etc. etc. etc.

But I found myself getting hung up on some changes that have happened since the essays were first printed. For one example, (There’s several other examples I could pick out…) when Tiefer talks about the joys of petting, she states, “It’s joyless and burdensome to cuddle and embrace with someone you neither know well nor want to know better” (Location 875.) But wait, aren’t there cuddle parties nowadays where folks who have never met before can come together and learn to do exactly that? Cuddle parties are designed to be non-sexual, but they may still involve embracing, and that’s not meant to be joyless at all – quite the opposite, from what I understand.

One of the funniest newspaper essays is “Free Love and Free Enterprise,” and the humor comes from how dated the situation described now is. (This essay might be worth burning through your available Google Book preview. You need to be careful with how much you use the GB previews because eventually it will prevent you from going any further. I’ve been able to “Go-around” this limitation by using a second computer or my mobile device, but not everyone has that option…) Tiefer takes the reader through a hypothetical tour of  “A sex show at the New York Coliseum (location 934,) with the goal of showing the reader who stands to profit from the sexual revolution and how… and that includes sex toy retailers, by taking advantage of consumers. Oh, consumers may well benefit, she concedes at the end of the essay, but only as a side-effect.
As I was reading, I thought to myself, “That hypothetical sex convention sounds awesome! How do I get in on that? How do I RSVP for the next show?” Then I remembered – we HAVE a sex & sex toy convention open 24/7 – it’s the internet! Just replace the use of the word “Booth” (used over & over again) with “website/GoodVibes/Babeland/Craigslist.”
Plus, some of the fears Tiefer expressed in this chapter didn’t come to fruition even 30 years later, while others were prescient:

“The next booth moves us into the world of stuff. Under the banner ‘Bare-handed sex is boring,’ we find equipment to enhance the senses and the imagination. Massage oils and flavored lotions lie next to vibrators and dildoes. Alarming displays of bondage equipment are shown along with phony organ enlargers. There are life-size ‘sex partners’ in different colors of plastic” (location 944.)  [It goes on in that manner for a few more paragraphs.]

Now, I did a Google search for the term, “Bare-handed sex is boring,” and as of today, I got nothin’. (Chances are that in a few days one result will link back to this blog entry.) Who would try to sell sex toys under this slogan? Would something so negative even move any stock out the door? I looked up this expression, because in all my sex toy shopping, I have never encountered a sentiment like that from a retailer – have you?
I’ve definitely seen retailers push G-spot toys in particular… but in terms of tactile sensations & calling outright certain sexual activities boring?
Maybe I’m not looking at the right retailers, since I prefer to patronize organizations that market themselves as woman-friendly and sex-positive.
As for the rest – I’m not understanding what message I’m supposed to take away from these passages… am I supposed to be reluctant to explore my sexuality with what’s available to me now because of the motivations behind the companies that sell sexual advice and devices? Am I still doin’ it wrong? Am I supposed to feel sexually inhibited at the conclusion of this essay?

The next few chapters touch upon the symbolism behind sex, sexual acts and sexual medicine, notably Viagra.

Ily already beat me to the chapter on the anthropological approach to kissing, which also explores symbolic kissing in art. For anyone curious as to the contents of this chapter, a slightly different version appears for free at this Kinsey Institute page, so go knock yourselves out. I don’t have much to say on this chapter.

The next chapter talks about how hard it is to have frank & open dialogs about sexuality, even in a sexual relationship. I’m certainly open to talking about how hard it is to frankly talk about sex too, but, I’m still getting tripped up on some of the finer details, particularly the passage about the asexual couple.

Tiefer then goes on to talk about Viagra a a symbol – symbolically, it’s looked at as magic pill that can fix all non-pain sexual problems (Tiefer doesn’t mention anything about sexual pain in this chapter; location 1100.) In reality, the drug isn’t perfect, and it may cause unpleasant, potentially dangerous side effects.

I have no idea what Tiefer was trying to say about Viagra when she then included a Viagra user’s own words followed by her analysis of his situation, because the following passages threw me into rage-rage-rage mode. I think she was trying to make a point about side effects or something:

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

This sounds more like a Jackie Gleason routine rather than a romantic evening, but I think it is close to the reality of what life with these drugs will be like… How does his sexual partner feel about the whole drama with the Tums and the nasal spray and the Tylenol? (Location 1109)

Woah, woah woah, waaaait a minute. Hold the phone. Jackie Glea… Jackie…. Gleason? Like, from the Honeymooners?
What the f…
Is that supposed to be a joke? Is this Tiefer’s idea of humor? This essay was given as a lecture in 1999; did Tiefer pause for applause & laughter when she finished reciting this passage?
Since when is Tiefer is the arbiter of what constitutes a romantic evening? Didn’t Tiefer state not a few chapters earlier that actively thinking about and taking steps toward making sex happen is a healthy thing? Is this the same person who said “Some people complain that all this groundwork is too mechanical and time-consuming. Working at sex, they say, defeats the whole purpose, (location 853,) when she debunked the myth of spontaneity? What happened to that?
You know, for someone who claims to want to expand the frank & open dialog of sexuality, Tiefer sure doesn’t make it easy to talk about physical problems and potential treatments for them… that’s a hangup I’m having with her social constructionist approach, it sacrifices biology. I still have the impression that it’s “Either/or” for Tiefer, but not both, and both is what I need.
Okay, someone needs to sit down and explain to me, in great detail, exactly how a guy who uses Viagra in order to maintain an erection for intercourse, and who has found ways to manage the side effects, is like re-enacting a Jackie Gleason comedy routine. I don’t get it.
We don’t have much else to go by as to the background of this person who left himself open & vulnerable by talking about his Viagra use. For all we know, he and his sex partner already incorporated an expanded definition of sex into their lives, and, like myself, decided that that definition was not completely incompatible with occasional intercourse. I say, using Viagra or other prescription drugs, treatments and devices is not necessarily in conflict with a healthy sex life. If using medical treatments leads to a satisfactory sex life, how is that an inherently bad thing?
And if it is an inherently bad thing, then what does that say about me? Is my sex life a big joke to Tiefer? Who am I to her – Lucille Ball? After all, when my partner and I decide we want to try PIV intercourse, I have to go through a  routine involving pelvic floor stretching, lubricant and dilators. Am I supposed to feel embarrassed about doing this in front of my partner? Or about openly talking about it?

There’s not much left of the chapter after that Jackie Gleason bit. Which is good, because I remained in rage-rage-rage mode for the rest of the chapter and was unable to absorb anything more from it. Something about sexual education outside of the  US, I don’t know.

The next chapter, The Opposite of Sex, is another free-to-the-public article originally published online. It consists of Moria Brennan interviewing Dr. Tiefer. It’s part PR for Sex is not a Natural Act, part feminist discussion, part sexuality discussion. The most interesting part of the discussion comes when Brennan asked, “Do you think our understanding of sex also affects our understanding of gender?”:

lt: Gender affirmation is a phenomenally important element in the current construction of sexuality–at least for heterosexuals, who have been the bulk of my clients. Reproduction used to be the essence of gender affirmation for women. And for men it was employment. Now there are fewer and fewer ways of proving gender, and yet it’s as important as it ever was. So how do you prove your gender? You’ve got to be able to have sex–not just any old sex, but coitus. Talking about this in the context of feminism is crucial. It’s men’s investment in a particular kind of masculinity that is fueling Viagra. Part of the work of feminists has been to question accepted notions about masculinity, whereas you could say Viagra is affirming them.

Not being able to have an orgasm is like the epitome of not being normal. It’s the epitome of not being a man or not being a woman. So I would tell them that there are ways to cope with this. Let’s be a man in other ways. No, they couldn’t accept that. To them, this was the proof. (Tiefer, online.)

This isn’t an unfounded idea – I’ve heard this sentiment elsewhere… there’s something familiar about it… I remember; it was that 20/20 segment on vulvodynia. One of the patients interviewed said something about, part of being a woman, is having female parts. Of course, it’s so much more than that. But it’s hard to get that message out, about gender, that it’s more than biology as destiny. So that’s something worth exploring.

The next chapter, the McDonalization of Sex, talks about the standardization (McDonalization – the description on this wiki page matches what’s in the book, so it’s probably a good place to start if you haven’t heard that term before) of the everyone’s sex lives. Although this chapter  is not heavy on academia, I still needed to re-read it a few times before I could understand it… it’s not academic, but it’s difficult because Tiefer jumps around a lot in this chapter. It feels disorganized.

Tiefer  identifies two forces behind the McDonalization of sex – mainstream media and medicine. Ever see very similiar but unrealistic sex lives depicted on TV or hear about it in song? There’s a right way & a wrong way to have sex & be sexy, and if you don’t match what’s in the media, you automatically have a dysfunction. If you’re familiar with this sort of depiction of sex in the media, then that’s an example of McDonaldization.

But in real life I’m not seeing medicine participating in this phenomenon… This is where the gulf between my reality & Tiefer’s is the most pronounced. For example, with regard to how McDonaldization comes from the medical profession, Tiefer claims that,

“There’s another source of the new standards that you may be less aware of. It’s the medical profession, with its new men’s sexual health clinics and the even newer women’s sexual health clinics. These things are popping up all over, almost as fast as new McDonald’s. And they really are fast-fod franchises that specialize in efficiency, predictability, numbers, and control. Everyone who comes in with a sexual complaint gets an expensive workup with genital measurements that seems superscientific. But nine times out of ten, the customer walks out with a prescription for Viagra, and since in the future there will be a dozen or two dozen such sex drugs – for both men and women – if the first one doesn’t work the patient – or is it now merely a customer – will be encouraged to try another and another.” (Location 1270.)

And I’m like… where do I find one of these geometrically growing sexual health clinics? Who are we talking about, what should I be looking for, and how do I get their phone number? Are any of these clinics local? If so, when is their next available appointment? How do I get in on this?
Tiefer doesn’t provide any hard examples of who she’s referring to so I’m left wondering – general OB/GYN practices? Vulvovaginal specialists? (Which, in my experience, are hard to find, especially if you’re not nearby a major metropolitan area…) Planned Parenthood? I typed “Sexual health clinic” into my Google Maps but the nearest results – which are questionable at best – would still take me close to two hours to get to at best.
I guess I’m the odd one out again, because if you consider the vulvovaginal specialist I visited to be a sexual health clinic, I never got a prescription for Viagra (I wonder how I can verify that 9 o ut of 10 statistic claim?) – but I did get a prescription for generic valium (no refills) that’s about $10 a bottle under my insurance plan, and I needed that for general anxiety anyway. At the specialist’s office, we didn’t take genital measurements… although we did use a device to figure out how much pain I was in; does that count? And a hormonal blood test revealed that the birth control pill I was on at the time certainly wasn’t doing me any favors. And I’m still wondering where my two dozen sex drugs are… right now vulvodynia patients, at least, have fairly limited options when it comes to oral medication, and at least two of those options are off-label use anyway. And I’m surprised Tiefer left out the mention of non-drug interventions that sexual health clinic doctors might suggest, including but not limited to diet & exercise, or, perhaps for a very few patients such as myself, surgery.
Indeed, the NVA lists several books of interest that do talk about expanding the definition of sex beyond biology. However the NVA is not in and of itself a sexual health clinic…

Tiefer’s solution is more comprehensive sex education.

The last chapter, Doing the Viagra Tango, is another free-and-available-to-the-public essay (I’m glad I paid only $20 for the Kindle edition of this e-Book instead of $40 for the paperback version! I’m finding several of the essays re-printed elsewhere.) The Tango in the title has two meanings – it’s referring to an old Viagra commercial featuring a couple doing a tango,and Tiefer frequently uses dance as a metaphor for sex. Here, she raises philosophical questions about Viagra – What effects will it have in many areas of life? She raises concerns about negative unintended consequences of Viagra (though I’m not fond of these passages, particularly the line that states that “In the worst-case scenario… The drug eliminates [women’s] sense of desirability and sexual efficacy,” (Tiefer, online) because if someone is taking Viagra, then isn’t it just possible that in a heterosexual relationship, the woman may already be feeling like she is not as desirable, due to her partner’s difficulty in maintaining an erection? Tiefer is not interested in exploring ways in which this family of drugs may be helpful, she is mainly concerned its potential dangers.)  She also explores problems in pharmecutical research, problems with insurance in general brought to light by Viagra, and even politics.

And that’s the way the second section of Sex is Not a Natural Act ends. We’re almost 40% of the way done.

At times, passages from Popular Writings on the Theme seem to contradict statements that were made earlier in the book. For example, Tiefer explicitly uses the words “Effective stimulation” in the greater context of the passage that says, regarding sexual activity, “There’s no way but trial and error to identify forms of effective stimulation” (location 907.) But wait, at locations 672 and 684, didn’t Tiefer herself question the value of the terms “Effective stimulation” when used by Masters & Johnson in their Human Sexual Response Cycle study?

One of the biggest questions I’m left with is, if the essays were written today, would they look the same?

I’ve already started chipping away at the 3rd section, which goes into detail about feminism and sexology – it’s a return to academia so I’ve got a ways to go yet before I finish slogging through.

Let’s read books – Sex is not a Natural Act and Other Essays

01/26/2010 at 6:23 pm | Posted in Uncategorized | 6 Comments
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One of the most prominent voices in the realm of feminism as it relates to sexual dysfunction is Dr. Leonore Tiefer, who has been involved in sexology roughly three decades & has had various roles over the course of her career – author, researcher, psychologist, counselor, teacher, activist. Tiefer’s work has been strongly influential (and popular) in the context of female sexual dysfunction. For many people I’m sure it’s even been helpful. Tiefer’s work & campaigns have appeared in various media outlets, including the print and online versions of Our Bodies, Ourselves, and has been incorporated into college-level classrooms. Frequently when FSD is the topic of online articles, I see Tiefer’s name (and one or two of her quotes) pop up. Yet even Tiefer’s work is not without controversy – and I am not the first feminist with FSD to question her. But if I hope to analyze & critique her work (and become a better feminist/blogger in general,) I am going to first need to become even more familiar with it. I can delay it no longer.

Because I have already raised questions about just how natural sex truly is, I decided to start with Sex Is Not a Natural Act & Other Essays, originally printed in 1994 and then re-released in early 2004. The book is a series of her essays that were produced at various times (1980-2004) in different media outlets – newspapers, lectures, journals… For the record, I read the Kindle edition because it was cheaper & immediately available. That means I won’t have page numbers to reference for you when I use quotes or paraphrases from the text, I’ll have location numbers instead. To give you an idea of where to look for a cited passage, there are 3561 locations in the Kindle location, so lower numbers happen closer to the beginning of the book, and higher numbers are towards the end.
My use of the Kindle edition also means that this is the first book I’m reading on the Kindle, so I’ve been futzing around with the device’s features & settings. For example, the text-to-speech feature works – in the sense that, it does something… but the reader sounds far from organic, as compared to listening to an audiobook read by a human. If you use text-to-speech on a Kindle, you’re may have to read along with the text at the same time.

I’d like to take a real quick look back in time for some surrounding context around the book’s original publication. The first edition of the book came out a few years before Viagra was readily available. 1994 was also the year that the NVA was formed, so we know vulvodynia still existed back then. The so-called feminist sex wars of the 1980s had gone down but since their influence reverberates today in 2010, I think it’s safe to say that different feminist perspectives on porn & sexuality were still clashing back then in ’94, too. Several of the essays included in Sex is not a Natural Act were likewise written during the 1980s, and it shows – among other things, I’m picking up on some hints that suggest Tiefer was on the pro-free speech side during those clashy days (She says in one of her late 1980s essays,  “Censorship statutes are being passed to limit production and distribution of explicit sexual images to ‘protect’ women and children” (location 294) – note that she put “protect” in quotes there.)
Technologically, 1994 was right around the time of Windows 95’s release, so I can vaguely recall access to home PCs and the internet was becoming mainstream around that time, but… no blogosphere, so that means the feminist blogosphere as we know it wasn’t available to bounce ideas off of. It would be four more years before my family could finally afford a PC – a 300mhz, 6gigs and blazing fast 56k modem ready to connect to AOL PC.
As I often say, “I’m sure there’s more” we could say about the time in which the book material was written…

Anyway, Sex is Not a Natural Act is broken into five sections (not including the intro & conclusion) with 4-6 sub chapters in each section. Each major section has an overarching theme. My goal is to write a review/analysis of each section, mostly to make it easier for me to process.
We’re saving the best for last… the sections on medicine & female sexual dysfunction are the final chapters, although so far I’ve seen the early seeds of anti-medicalization in the first few chapters too.

The first sections we’ll be looking at today are the introduction & Part One: Sex is Not a Natural Act: Theme and Variations.

The introduction in the revised edition serves as a catching up point for old and new readers – but mostly old readers. The very beginning of the book is addressed with a “Welcome back,” (location 76) instead of a more general welcome, so there’s already an assumption that if you’re reading the book, you’re familiar with the older edition. (There’s a reason I mention this, we’ll get to it later…) In the years since the first edition was printed, Viagra hit pharmacy shelves, same-sex marriage was made legal in some countries, and of course there’s an obligatory mention of 9/11.

Early on in the intro & first few chapter, the reader gets a taste of what Tiefer’s big themes are – she places a strong emphasis on the social & cultural construction of sex & sexuality rather than leaving it up to innate biological processes. In fact early on Tiefer states, “I now believe that my dissertation [mating habits of hamsters] and other similar biological work are largely useless for understanding human sexuality” (location 118). For Tiefer, nurture greatly outweighs nature when it comes to sex, so that means that even your sexuality has been largely shaped by the culture in which you live. Indeed, as explained later on in chapter 3, the word “Nature” itself is a loaded word with multiple meanings & a fragmented history, and therefore whenever it’s used, nature has to be eyed with some skepticism. Tiefer quotes Raymond Williams when he said, regarding the word “Nature,” it’s “Perhaps the most complex word in the language (p. 219)” (location 471.) It also means that for Tiefer, biological functioning & sexual health have a lesser role in shaping sexuality.

You notice how I linked to a webpage about Raymond Williams just now? Well, there’s a reason for that too…
A couple of notes so far: the book is really fucking hard. This isn’t an easy, pick up & go book. Tiefer is writing from a point of view I’m not used to – she’s heavy on philosophy & anthropology, to the point where the writing is almost inaccessible to me. (Coincidentally, accessibility is a feminist issue this week!)
Tiefer frequently references previous studies, books, authors and researchers. While I feel no rush to become an expert (I’ll probably never a sexologist anyway, oh god who am I even kidding…) it will take me many, many years to catch up with all the primary sources she’s drawing from – if I can access them all; let’s keep in mind that library use may be free but journal articles are often locked up behind academic firewalls and price tags that I can’t break through. So a lot of these authors cited are New To Me, but not all of them are… I’m seeing some names I still see batted around in feminist circles in the year 2010… wait, I recognize these people… Michel Foucault… Shere Hite… Germaine Greer… and… Shelia Jeffreys? She’s in here too? Jeez, I’m never gona be done with this learning & cross-checking. Additionaly Tiefer sometimes cites her own pervious work.
As for the writing itself – well, it’s probably going to be easier if I just show you an example:

Kenneth Gerger (1985) defined the social constructionist approach as a form of inquiry indebted to intellectual trends such as symbolic interactionism, symbolic anthropology, ethnomethodology, literary deconstructionism, existentialism, phenomonology, and social psychology. (Location 301)

Did you get all that? Social constructivism, which Tiefer advocates as the lens through which to view sex & sexuality, sounds like a simple, straightforward enough concept to grasp, right?
Welp if you absorbed all that without having to re-read the sentence 2 or 3 times then you’re a smarter person than I am. (I wonder if Ily had this same problem – Ily? Little help?)

I should be used to writing like this! I went to college, (I recognize that that in and of itself is in large part a function of my own class privilage (and pure dumb luck! – Long story about that luck part; not important right now) I took 18 credits in psychology and in 3 in philosophy, and I’ve got the Internet available for more research – but I gotta tell you, Sex is not a Natural Act is an academic book, some of these essays conjure up images of literal ivory towers in my mind. Adding to my struggle to slog through the text, Tiefer’s expertise is not the field majored in while I was still working my way through academia, so I’m starting out a little behind. Most of the time I can follow along and figure out what Tiefer is talking about – but it takes every ounce of my concentration, and I find that I need to re-read sections often. Thank god that Kindle has a dictionary built in because I used it often.
That is why I mentioned Tiefer’s “Welcome back” note above – So far this isn’t an easy piece of work to grind through as a newcomer.

Coincidentally, at a comment left on one of SunGold’s recent posts, redmagaera explicitly said that, “Most feminists are social constructionists,” so it’s possible that I’ve been looking at feminism in terms of social construction this whole time without actually recognizing it as such.
Basically what this social constructivist point of view means is that it places “An emphasis on the person’s active role, guided by his or her culture, in structuring the reality that affects his or her own values and behavior. This perspective is to be contrasted with empiricism and positivism, which ignore the active role of the individual in favor of the impact of external forces that can be objectively examined and analyzed.” (location 302.) If I had to sum this up quickly, I would say something like, “Reality is what you make of it.”

All that said – Tiefer makes some good points in the intro about how culture – at least, US culture for sure – views sexuality. I’ve run into the idea that sex is natural and I’ve questioned that assertion independently, but it turns out Tiefer went down that road years before I started thinking about it,

“Despite the cacophony of messages about sex, many people still believe that ‘sex is natural’ – that is, that sex is a simple and universal biological function that, wtihout any training, all humans should experience, enjoy, and perform in roughly the same way. Many doctors believe this, too.” (location 131)

Tiefer’s goal is to challenge this view – that sex is natural – and the consequences of it. The idea is that, sex is mysterious, yet you’re supposed to just know how to do it. And when things don’t go the way you expect them to, it leaves you vulnerable to exploitation – from what I’ve seen of her quotes & work elsewhere, Tiefer’s big beef is with so-calledexperts & especialy Big Bad Pharma.
Tiefer challenges so-called experts too – “The media have created a class of sex ‘experts’ who write magazine columns, give radio advice, talk on TV… [etc]… Is anyone with an M.D. or a Ph.D. after his or her name qualified to speak authoritatively about physiologically and medicine, normal and abnormal psychology, couple interactions, child-raising, or sexual abuse and assault?” (location 271.)
The thing is, I’m not completely satisfied with who Tiefer thinks should be recognized as the true experts on sexuality – “Maintaining that ‘sex is a natural act’ identifies as experts those social actors who know a lot about body mechanics rather than those who understand learning, culture, and imagination” (location 162.) To me it just looks like she’s shifting power & control away from one elite group (medical doctors), and into the hands of yet another still-elite group (philosophers,) and never the twain shall meet.

Tiefer does a pretty good job breaking down sexual normalcy & nature – she presents the multiple meanings of these words, starting with “Five Meanings of Normal” in chapter 1, locations 225-239. There’s subjective normal, statistical normal, idealistic normal, cultural normal, and clinical normal – so when you talk about what’s normal sexually, which of these normals do you mean? It’s similar when talking about nature – starting at location 220-282, we’re presented with natural in terms of, an essential quality, an inherent force, and as the fixed material world untouched by mankind’s culture; in any event in terms of sexuality, the term is rhetorical. Tiefer says, “I submit that the term natural is used to frequently in sexological discourse because of rhetorical needs for justification and legitemacy. Nature and natural are used to persuade, not to describe or give information” (location 490, emphasis hers.) Why would you do this? “…Not just to endorse the value of sexuality but to increase their [sexologists’] own respectability as scholars of sexuality. Respectability is a chronic problem in this field.” (location 493.)

But I’ve run into an area that I’m getting stuck with: Tiefer doesn’t give a solid, reliable definition of sex and/or sexuality – at least, not in these first few chapters. This might be a deliberate reaction to the way doctors – particularly Masters & Johnson with thier Human Sexual Response Cycle – define sex as certain activities & bodily reactions, but, it’s a tripping point for me… because what do I know about sex & sexuality? What right do I even have to talk about sex, I don’t know what I’m doing, who do I think I’m fooling? The only degree I have is one completely unrelated to medicine or philosophy. So with regards to pinning down the kind of sex we’re talking about in this book, I wish Tiefer had given me something more tangible to go by than,

“So, if sex is not a natural act, a biological given, a human universal, what is it? I would say it’s a concept, first of all – a concept with shifting but deeply felt definitions. Conceptualizing sex is a way of corralling and discussing certain human potentials for consciousness, behavior, and expression that are available to be developed by social forces, that is, available to be produced, changed, modified, organized, and defined. Like Jell-O, sexuality has no shape without a container, n this case a sociohistorical container of meaning and regulation. And, like Jell-O, once formed it appears quite fixed and difficult to re-form.” (Starts at location 167.)

I’ve seen sex defined in terms of ideas & energies before… Anne Sprinkle comes to mind in that Spectacular Sex book. I’m reading Tiefer as presenting a theoretical definition of sex,  but, in practice, how does that look in real life? Tiefer also uses the terms “Sex” & “Sexuality” basically interchangeably, which I’m also tripping up over. I thought one was an act and one was an orientation or drive (or lack thereof.) Is sex & sexuality the same exact thing? On a related note, I haven’t been able to figure out yet where orientation fits in with Tiefer’s views on sexuality – if it fits in at all.
The impression I’m getting from reading Sex is not a Natural Act and from elsewhere is that, there’s a theory of sex, and then there’s the practice of sex… and when someone talks about one to great length, the other is overlooked even if it’s quite different. They don’t always match.

Speaking of Masters & Johnson above, Tiefer spends chapter 4 examining thier work on the Human Sexual Response Cycle (HSRC) in detail. Masters & Johnson probably already had an idea of the HSRC in mind when they started research, instead of letting the results just happen. For example, the researchers were investigating response to “Effective stimulation,” but Tiefer raises the question, “What is ‘effective’ stimulation?” (Location 672). Masters & Johnson didn’t say exactly what the rules were for meeting that criteria. So according to Tiefer, “Effective stimulation is that stimulation which facilitiates ‘progress’ from one stage of the HSRC to the next, particularly that which facilitates orgasm” (location 684.) Since the HSRC went on to be considered the normal response to sexual stimulation for everyone, Tiefer’s concerned that it “Contributed significantly to the idea of sexuality as proper parts-functioning,” (location 731) so deviations from the HSRC are interpreted as dysfunctions. That includes pain conditions.
Tiefer also presents feminist critiques of the HSRC, namely, the researchers required “experience and comfort with masturbation to orgasm as a criterion for all participants,” (location786) which favored men’s sexual experience. Culturally speaking, women are still discouraged from masturbating (think of Carrie Prejean,) and from having a wide variety of sexual experiences (think Purity Balls or the Purity Myth book.) This particular essay was written in 1991, so I’d like to believe that female masturbation at least has somewhat less stigmatization now, thanks to sex-positive advocates & even retailers like Babeland & GoodVibes. But obviously since this topic pops up from time to time even today, if Masters & Johnson re-ran their sample today with the same criteria, the resulting sample still probably wouldn’t be representative of all women everywhere.)
I have a hangup with Tiefer’s wording re: the sampling issue though. Tiefer states, “As has been mentioned earlier, by requiring experiene and comfort with masturbation to orgasm as a criterion for all participants, the seletion of research subjects for Human Sexual Response looked gender-neutral but in fact led to an unrepresentative sampling of women participants (location 785, emphasis mine.) I’d feel more comfortable with this statement if it were worded differently… because right now I’m inferring that if you are a woman who met that criteria – someone who enjoys masturbation & who has had a wide range of sexual experiences – you are not representative of women. I think I’m supposed to give Tiefer the benefit of the doubt here and interpret that statement to mean, it would have worked better to include women who met Master’s & Johnson’s original criteria, plus women who did not, in the HSRC study.

Whew. I could probably go on with the first section of Sex is Not a Natural Act, but I’ve already broken 3,000 words for this one post, and I’m only 24% finished with the book.

That said, there are a couple of phrases & key words Tiefer’s used that piqued my curiousity… symbolism… Tell me now, you tell me, person reading this blog post, if you’ve made it this far, I could use some feedback here: Would you consider myths & fairy tales to be symbolic? Do myths count as anthropology studies material? Something in this book made me remember something I read about vaginismus and certain women in fairy tales… and it ain’t pretty. There’s more too… DSM-III… disability… wait, you’re not looking at it from the other end.
And I haven’t talked much about using the Kindle itself – it’s undeniably a different expeirence from using a regular paperback book, and it’s got some positives and negatives. So maybe next time we talk about Sex is Not a Natural Act, we can also talk a little more about the Kindle itself.
But until then – that’s all I’ve got to offer you for now.

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