I recently embarked on a PhD at Edinburgh University where I'll be spending the next three years or so studying female sexuality - specifically, what happens when it goes wrong and becomes dysfunctional.
There are a number of issues surrounding the emergence of female sexual dysfunction (FSD) and the rush by pharmaceutical companies to find a treatment. Right now, I feel a little like the kids in The Cat in the Hat, looking around and saying "this mess is so big and so deep and so tall, we cannot clean it up, there is no way at all". However, I have to start somewhere so I thought I'd do so by immersing myself in what all the women diagnosed with the condition are thought to be lacking: desire.
Scientists in the sexual health field studying female desire attempt to determine what arouses women. They study physical responses to visual and audio stimuli, their professed desires, and their fantasies. When they examine their results they look for correlations and discrepancies between what women say turns them on and what their bodies respond to. Dr Meredith Chivers is one such scientist who carried out a study in which participants were shown clips of heterosexual, gay, and lesbian pornography, a naked woman exercising, bonobos mating, and a naked man with a flaccid penis walking along a beach. They were given a keypad on which to rate their arousal and a plethysmograph, a small plastic probe to measure blood flow to the vaginal walls, was inserted into their vagina. What Chivers found was remarkable: regardless of what they registered on their keypad, women's genitals responded with varying degrees of arousal to all the images.
The findings of such studies as Chivers' complicate attempts to find a treatment for FSD. Or they should. The extent to which pharmaceutical companies, looking to find an easy fix for a huge market would have any intention of exploring the complexity of women's sexual desire is debatable. Women diagnosed with Hypoactive Sexual Desire Disorder (HSDD), the most common disorder, are said to have deficient fantasies and desire - for there to be a deficiency, there first needs to be a standard of expectancy or normalcy. This is problematic because there is no way of measuring sexual normalcy that isn't influenced by societal factors. Yet normalcy is what every pharmaceutical company searching for a treatment is promising women.
Women seeking treatment speak to drug trial organisers about how often they have sex; to analysts about their longing to feel desire and desired; to researchers about what turns them on; and to clinicians about the vaginal pain that stops them having sex. They feel sexually faulty and believe that, however it is they're supposed to feel about sex, whatever standards they're supposed to be reaching, they're failing to do so.
I'm intrigued to know just what this normal female sexuality entails. The marketing for erectile dysfunction treatments promote the manly man - capable, strong, spontaneous, and monogamous.
What figures and scenarios will be used to promote an FSD treatment to women? If Chivers is right, it should be a panoply. Possibly not bonobos, but all manner of sexual arrangements appeal to women: one-night stands; same sex dalliances, flings and relationships; polygamous relationships; monogamous relationships; relationships across ages. Will there be groups of women out on the town looking to get laid or will they be padding off to bed in soft focus with a sole male partner? Treatments for erectile dysfunction have never been marketed at gay men so will the companies avoid lesbians in their marketing?
During the clinical trials and in consultations for erectile dysfunction treatment, men are asked about their penises, but not about their thoughts. For women, a key component in the diagnosis is the presence or absence of sexual fantasy in their lives. If drug companies are prescriptive about the sort of sexual behaviour they encourage through their marketing, will they encourage clinicians to behave in a similar manner during diagnosis? Perhaps certain sorts of fantasy or desires will be discouraged or will disqualify women from treatment. Fantasies of rape, for example. Women are asked about their fantasies, but why not men? What would happen if men were, too? Would a man who admitted to fantasies of rape still be prescribed Viagra?
Corralling desires into fields of normal and abnormal is not new. It would a pity, indeed, if treatments for FSD were no more than the latest means by which to do so.Suggest a correction