To Ms. B and the NYT

The New York Times Science section has an article about medical interventions for women’s sexuality

In the VERY FIRST PARAGRAPH, journalist Abby Ellin describes three phenomena that are regular topics on this blog:

Since Ms. B. entered her mid-40s, she says, sex has been more about smoke and mirrors than thunder and lightning. She is rarely if ever interested enough to initiate it with her partner of 10 years, and she does not reach climax during the act.

She wishes it were otherwise.

Regular readers will be bouncing in their seats, waving their hands, going “Oooh! Oooh! I know! That’s responsive desire and normal anorgasmia with intercourse – more than 23 of women are not reliably orgasmic from intercourse – and negative meta-feelings!”

And that answer would earn you a gold star. Well done you!

I have talked at length about the medicalization of women’s sexuality, including some thoughts on the misunderstandings prevalent among pro-medicalization feminists.

This article quotes a number of people making those mistakes. For example it seems to me that Dr Michael Krychman makes Mistake #2 (mistakenly dichotomize “organic” or “biological” and “mental”) when he says, “These sexual complaints are real; they’re not imagined.” (He sits on drug company boards.)

And I think Dr Bat Sheva Marcus makes Mistake #3 (“women clearly understand their own sexuality”) when she says, “To say that women are complaining about their sex lives because pharmaceutical companies told them to is really insulting to women.”

For the record, I’m pretty sure that women aren’t complaining about their sex lives “because pharmaceutical companies told them to;” they’re complaining because they’re dissatisfied with their sexuality as it is, and they’re dissatisfied because they feel broken and inadequate because they think their sexuality is SUPPOSED to be something else. However, women are seeking PHARMACEUTICAL remediation for their dissatisfaction because the pharmaceutical industry told them to – told them they could and should.

And the whole article makes Mistake #1: not clarifying exactly what we’re talking about. Is it lack of orgasm? Desire? Arousal? Pleasure? Satisfaction? All of the above? If it’s all of the above, it’s not a disorder it’s a SYNDROME, and without specifying what’s wrong, you can’t begin to describe a causal mechanism.

Okay, but anyway, let’s get back to Ms. B, from the first paragraph. I’m worried about her, because se says that she feels “sexually dead,” which is definitely not a feeling I would wish on anyone.

But readers, we can help! I think we can.

Dear Ms B:

Your lack of initiation of sex is probably due to your having responsive desire instead of spontaneous desire. It’s normal and healthy and totally fine; it just means you need sexy things to start happening before you’re actively interested in pursuing sex. Solution? Your body and brain need more deliberate creation of sexy moments, paying more attention to what things your partner does that make you feel affectionate, trusting, intimate, and cuddly, and maybe a less emphasis on the idea of “spontaneous” sex. You might also consider the joys of lemonade sex.

And your lack of orgasm with penetration puts you in the majority. Only 1 in 3 women is reliably orgasmic from vaginal penetration alone; the rest of women need clitoral (or some other) stimulation in order to come. You’re normal. Orgasm with penetration are ALSO normal, and if you’re interested in practicing having orgasms from intercourse, there are lots of options to try, but it’s neither necessary nor typical to have orgasms with intercourse.

Finally, the feeling “sexually dead.” This is agony, I understand the hollowness and feeling of inadequacy, abnormality, or brokenness that can come with that feeling. And I think there’s a cognitive-behavioral practice that can help with it, known generally as “reframing” or “emotional reappraisal.”

Feeling “sexually dead” is actually a “meta-feeling” – it’s how you feel about how you feel. Your sexual feelings are (1) responsive rather than spontaneous desire and (2) non-penetrative orgasms (the sex researchers who trained me consider sexual motivation to be an emotional state, if that helps to translate). How you feel about how you feel is “sexually dead.”

Reframing involves recognizing how you feel – responsive desire and non-penetrative orgasm – and trying on neutral or even positive feelings about those feelings.

“I feel responsive desire,” you think to yourself, “And I’m okay with responsive desire!” You work on reshaping your environment to work WITH your style of sexual desire, rather than fighting against it, resenting it, and, thus further decreasing your desire.

“I don’t have orgasms from penetration,” you say, “And I’m TOTALLY NORMAL AND HEALTHY! And here are the things that DO make me come:” and you make a list.

This isn’t an easy shift. Most people feel resistance; people are certain, at first, that feeling okay about their sexuality as it is is, like, “giving up.” It’s not. It’s reeducating yourself and shifting your attitude to one that both is more scientifically accurate AND makes sex better rather than worse.

There’s so much more, Ms. B, we could say about this. I’m writing a book about it this summer – it’s going slowly, but I hope you and all the women who feel as you do will read it and that it will bring a spark of hope, confidence, and joy to your sexuality.

Love n kisses,

Emily and the Dirty Normal crew