"Return of Desire": Fighting Myths About Female Sexuality

The Return of Desire is the second of three books that Dr. Gina Ogden -- sex therapist, author and (disclosure) my admired colleague -- bases on her large survey of what women (and some men) really feel about sex. Following the highly respected The Heart and Soul of Sex, this time she fearlessly confronts head-on the profit-driven medicalization of women's sexuality, employing her unique holistic, positive approach to better understand the rich complexity of desire and sex.

Where do the frequently discussed claims of widespread women's sexual dysfunction come from? Many are based on the accepted performance model of sex research, which quantifies sexual function. Since acts of penetration and numbers of orgasm are fairly easy to count and compare, the arc from desire/arousal/orgasm/resolution has long been used to measure sexual function and dysfunction.

This quantitative approach is increasingly prominent. As Dr. Eleanor Roffman, psychologist and Lesley University professor, told me, "The push today, stimulated by managed care and pharmaceutical corporations, is towards evidence-based research -- and only that which is measurable by their instruments."

Feminism in the early 70s reclaimed the clitoris, challenged the myth of the vaginal orgasm and encouraged women to find their own routes to satisfaction. (So we all bought Magic Wand vibrators.) In reaction, the forces that make their living off sexual problems tried to keep control of the field. Ogden explains that in 1999 the Journal of the American Medical Association published an article declaring that "a whopping 43 percent of all American women just aren't interested in sex -- this based mainly on questions about how often 1,749 of them had intercourse." This one act -- some women may not like it, some men may be unable to perform, some couples may both be women -- is a starkly insufficient standard by which to judge sexual health or thrills.

In contrast, from the 3,810 completed surveys she received, Ogden gained a nuanced and enlightening picture -- one that reveals women's sexuality to be far more complex than the arithmetic of penile/vaginal penetration, one that embraces their physical, mental, emotional and, of particular interest to Ogden, spiritual lives.

Despite what women actually say about their own sexuality, the American Psychiatric Association's Diagnostic and Statistical Manual identifies "desire disorder" by "criteria for sexual dysfunction [that] are all physical, and they all relate specifically to problems with intercourse," Ogden writes. This despite decades of consistent research showing that "three-quarters of women are not actually satisfied by intercourse." It's the clit, stupid. And some lovin'.

Viagra et al has been a major contributor to the profits of the pharmaceuticals and now the push is on to "solve" the "problems" of women, especially older women. First they have to identify some problems and setting up narrow criteria with little relationship to what women really like is certainly one way. Already they offer us what Ogden calls "the so-called horny pills, creams and patches." Moreover, she reports, the same pharmaceuticals that market products for doctors to prescribe to pep up "sexless marriages" are the ones that fund most research into hormones and sexuality.

The quantity of material Ogden gained through the huge response to her survey is unprecedented and she is making excellent use of it. She calls The Return of Desire "A guide to rediscovering your sexual passion." Examining the impact of monogamy, affairs, childbirth and merging with your partner over time is just the beginning. There are other aspects of the kind of self-knowledge on which Ogden believes one builds sexual self-confidence, including an examination of "Living Curly in a Straight Culture: When Desire Meets Sexual Orientation."