Aug 142011

I have talked on and on and on and, indeed, on about the medicalization of women’s sexual dysfunction.

I have also gone on and on and on about stuff that can actually help women increase their desire, most of which has to do with increasing understanding of how sex works and improving your relationship with your body. Medication isn’t the solution because there is no drug that can improve your relationship, which is the most common cause of “female sexual dysfunction.”

(All those links to other posts? They should be giving the impression that this here is a dead horse; you can’t medicate women’s sexuality because you can’t medicate the context in which sensations are perceived. Period.)

Okay, so The New View linked to this article about the development of The Subjective Sexual Arousal Scale for Men.

This seems to be to be a cynical and devilish (yet irritatingly clever) attempt to turn the arguments against pink viagra against themselves.

See, because low desire in women is not measurable in any objective way, pharmaceutical research has relied on subjective measures of a woman’s experience. When you study erectile dysfunction drugs, you study erections, which are nice and objectifiable and also fairly represent the man’s experience of desire, whereas a woman’s physiology just doesn’t necessarily match her experience of desire. So you measure experience. Technically, this is fair enough – your outcome measure should be something that pretty closely tracks the mechanism you’re trying to influence.

So yes, technically it’s fair enough, and that’s why it’s superficially reasonable to do the same with men. But in practice… how can you MEDICATE a person’s perception of a sexual experience, which boils down to their OPINION about whether or not it was satisfying?

Subjective experience – particularly subjective experience of distress and dysfunction – is shaped so much by culturally crafted expectations about how sex is supposed to work that people may (and often do!) believe they are broken when in fact they are fine.

And now they are applying the same logical-sounding but ultimately useless reasoning and assessment to men.

I’m all for expanding our understanding of men’s sexuality as a subjective experience, absolutely! But the idea of targeting subjective experience for medical intervention is the OPPOSITE of what we should be doing!

If we allow subjective experience to be medicalized, then the pharmaceutical with have a deep financial interest in making sure we all believe we are broken and that a medication will fix us, when in reality neither of those things is true.

So. That would be bad. In the quest for healthy, functional sexuality, asking how a person FEELS about their sexual experience is absolutely crucial to understanding their experience. But we can’t make feeling dissatisfied a diagnosis, or someone somewhere will make a giant profit making sure you always feel bad, so that you can pay them to make you feel better.