A Modern Look at the Sexual Issues of Women
The recent publicity regarding medication for men’s sexual problems has also brought into attention the many sexual problems that women have and thus, a similar need for ‘female Viagra’. However, this ‘clamor’ has not taken into consideration the basic ways in which women’s sexual issues are different from that of men.
We strongly believe that the barrier in comprehending female sexuality is basically due to the way medical classification is done in its current use, one that was developed for the Diagnostic and Statistical Manual of Disorder (DSM) way back in 1980 by the American Psychiatric Association (APA). This divides the sexual problems of males and females into four basic categories problems in sexual function.
1. Problems of sexual desire.
2. Problems of sexual arousal.
3. Problems of getting an orgasm.
4. Problems of sexual pain.
These are conflict in what has been assumed to be a physiologically significant sexual response pattern that is universal, also called the “normal function” and described originally by Johnson and Masters back in the 60s. The common pattern begins, theoretically with sexual drive, proceeding sequentially to the stage of desire, followed by arousal and finally orgasm.
Recent decades have amply documented the shortcomings that this framework has in its application to women. The framework downgrades sexual issues to mere disorders like those of other physiological functions like breathing and digestive disorders and introduces three very serious distortions as outlined below.
1) Male and female sexual profiles are the same.
Early studies focused on the similarities in the physiological responses of males and females during sexual actions and this made them conclude that the sexual disorders of the two sexes also must be the similar. Women were asked by few investigators to describe experiences as perceived by them. When these researches were accomplished later, it became clear that males and females were different in many ways that are crucial.
The accounts of women do not fall quite as snugly into the Johnson and Masters model; as an example, “desire” is not separated from “arousal” by women. They also care more about particular arousal as opposed to physical arousal.
Further, the emphasis based only on physiological and genital similarities between males and females ignored any insinuations of inequalities created due to factors like gender, ethnicity, social class, sexual orientation, etc. Women cannot access proper sexual health, satisfaction and pleasure in many parts around the world is limited due to social, economic and political conditions, which also included extensive sexual violence. The social environments also prevent to a large extent the display of their biological capacities which was totally ignored by in the strict physiological way that sexual dysfunctions were framed.
2) Relational contexts do not exist in sexuality.
Relational aspects behind women’s sexuality are bypassed by the DSM approach of The APA’s. These often are the roots of sexual dissatisfaction and other problems, which include the need for sexual contact, a wish to please one’s partner, or in many cases a wish to avoid losing, angering or offending a partner. The approach taken by The DSM which is an individual one, assumes that the working of the sexual parts mean no problems; and problems lie only where the parts do not work. Women, however, do not see sexual difficulties in this way. By reducing “normal sexual function” only to physiology, the DSM incorrectly implies that it is possible to calculate and treat physical and genital difficulties without any regard given to the relation in which the sexual activity took place.
3) The sexual profiles of women are generally the same.
Women have different sexual needs, sexual satisfaction levels, and sexual problems and they cannot be fitted into classifications of just desire, orgasm, arousal, or pain. They are different in their value system, cultural and social backgrounds, approach to sexuality and are under different present situations, and it is not possible to smoothen these differences over into identical notions of “disorders”–or using an identical treatment assuming that one size fits everyone.
As there is no elixir for the political, socio-cultural, social, psychological, or relational base of the sexual problems of women pharmaceutical companies are eager to support research and have come up with public relations programs that focus on just fixing the body, the genitals in special. Infusion of funds from the industry into sexual research and an incessant media publicity of the many ‘breakthrough treatments’ help in bringing the physical problems into the spotlight and isolating them from other broader contexts.
This downplays and dismisses the factors that are often a far more important source of women sexual complaints like cultural and relational conflicts, sexual ignorance and fear. These are just put into a single category titled “psychogenic causes,” and go without a study or being addressed in any way. The drugs that will later advertised aggressively for all sexual dissatisfactions of women are not being tested with women who have these problems and they are being kept away from all clinical trials with new drugs.
This needs a new, corrective approach very fast. We think this might be possible with a newer and more appropriate classification of female’s sexual issues, one that lends precedence to individual inhibitions and distress arising within the wider framework of relational and cultural factors. It is time to start challenging cultural assumptions which are part of the DSM and with it eliminate the marketing programs of the medical industry which are only reductionist. Let’s all demand services and research studies that are driven by the specific sexual realities of women.
The International Views on Sexual Rights and Sexual Health
We attempt to shift from just the DSM’s mechanical and genital blueprint for women’s sexual tribulations by looking at international documents on the subject matter. A meeting on the needs for training of sexual aid workers was held by the WHO in 1974. The report presented here noted that “Human sexuality problems are widespread and important to the health and well-being of individuals in more cultures than was recognized previously.” Emphasis was given to taking a positive approach of human sexuality and of relationship enhancement. The definitions of “sexual health” offered here was “the integration of emotional, somatic, social and intellectual aspect of sexual well-being”.
The Declaration of Sexual Rights (1999) states that to ensure that people and the society develop a healthy sexuality certain civil liberties must be observed.
- Entitlement to sexual liberty, which excludes all forms of coercion, abuse and exploitation;
- Entitlement to safety and autonomy of the human sexual body;
- Entitlement to sexual enjoyment;
- Entitlement to sexual data;
- Entitlement to comprehensive sex education; and the
- Entitlement to sexual healthcare, to prevent and treat all sexual problems and diseases.
A New Outlook on Women’s Sexual Issues
We preview sexual problems as dissatisfaction or discontent with all physical, emotional and relational aspects of sexual experience. This discontent may come from any of the following interconnected factors of the sexual lives of females.
Sexual Problems Due to Economic, Socio-Cultural or Political Issues
A. Anxiety and ignorance may be due to inadequacy in sex education, inaccessibility to health services, and other social inhibitions:
- Lack of a vocabulary describing physical and subjective experiences.
- Lack of proper information on how gender influences sexual expectation, belief, and behavior of males and females.
- Lack of adequate information about life-stage alterations and human sexual biology.
- Inaccessibility to correct data and proper services for domestic violence, abortion, contraception, sexual disease avoidance and treatment and sexual trauma.
B. Sexual distress and avoidance due to perceived inabilities to live up to certain sexual cultural standards that include:
- Shame or anxiety arising about one’s body, attractiveness or responses.
- Shame or confusion about one’s sexual identity or orientation, fantasies and needs.
C. Self-consciousness due to conflicts between the sexual customs of the leading culture and one’s original norms or subculture.
D. Absence of interest or time, or tiredness due to work and family obligation.
Sexual Problems Concerning One’s Partner
A. Self-consciousness or avoidance and stress due to hatred or fear for one’s sexual partner, betrayal, abuse due to a couple’s uneven power and negative pattern of communication from the partner.
B. Losing sexual appetite and no reciprocity due to conflicts over daily matters such as schedule, finances, relatives or due to traumatic experiences like death of children or infertility.
C. Inhibitions or ignorance about relating sexual preferences during the start and natural build-up of sexual actions.
D. Discrepancies in the desire for participating in sexual actions or in personal preferences.
E. Self-consciousness in spontaneity or arousal due to the partner’s health or other sexual problems.
Psychological Factors Contributing to Sexual Tribulations
A. Inhibition of sexual pleasures, aversion or mistrust due to:
1. Abuse in the past involving of physical, emotional or sexual factors.
2. Personality problems with co-operation, rejection, attachment or entitlement.
3. Anxiety or depression.
B. Sexual self-consciousness arising from the fear of the sexual act itself or consequences of sex (e.g., soreness during sexual intercourse, STDs, pregnancy, losing one’s reputation, etc.).
Sexual Problems Due to Medical Factors
Sexual activity resulting in pain and diminished physical response despite safe and supportive interpersonal situations, good sexual outlook and sufficient sexual knowledge. Such problems may come from:
A. Various systemic or local medical conditions that affect the neurological, circulatory, neurovascular, endocrine and other bodily functions.
B. STDs, pregnancy or other sexual conditions.
C. Many drugs, medical treatments or medications that cause side effects.
D. Many Iatrogenic conditions.
All of the above is meant to help you if you desire to learn more about female sexuality and any problems associated with it. It is our hope that you come away with more knowledge about how to address – or at least understand – such problems.
