Graham: Women's sexual desire: challenging nature of "dysfunction"

Question 1

this article critically examines the medicalization of female sexual desire and the dsm’s classification of sexual dysfunctions, challenging how society, media and pharmaceutical companies influence our understanding of ‘normal’ sexual desire in women. it discusses the creation of the female sexual interest/arousal disorder, the pharmaceutical treatment flibanserin and the role of advocacy campaigns like ‘even the score’.

Answer 1

oke

Question 2

dsm changes

Answer 2

merged female sexual arousal disorder and hypoactive sexual desire disorder -> female sexual interest/arousal disorder

Female Sexual Interest/Arousal Disorder was introduced in DSM-5, since there was no evidence for a distinction between subjective arousal and desire; FSIAD criteria include subjective, behavioural and physical aspects of desire/arousal

The DSM-5 definition is no longer based on the HSRC phases and has added specific duration and severity criteria, emphasising distress

Question 3

FSAID diagnosis requires symptoms to be…

Answer 3

• at least 6 months
• present in most sexual encounters
• cause significant distress

this is a more fluid and inclusive approach, the criteria are subjective, behavioural and physical, and emphasizes variability in how desire is experienced (therefore more representative of women’s diverse experiences).

Question 4

flibanserin/Addyi

Answer 4

for higher sexual desire. but limited effectiveness and significant side effects. origineel een ineffectieve antidepressiva. eerst afgekeurd door de FDA, maar daarna toch gegeven door pressure van lobbyisten die onder de naam van ‘feministen’ gingen. maar niet veiliger of efficienter.

Question 5

kritiek op de even the score campagne

Answer 5

oversimplifies complex issues around female sexual health, should offer alternatives to pharmaceuticals

Question 6

criticism on the medicalization of female sexuality

Answer 6

• framing of natural variations in sexual desires as disorders
• pharmaceutics dont address relational, cultural or psychological contributors of desire. (eg. education campaigns emphasize drugs over holistic solutions)
• risks pathologizing womens experiences, reinforcing an unrealistic standard that high sexual desire is normal or ideal

Question 7

waar leidt die emphasis on high sexual desire toe

Answer 7

often leads to women interpreting fluctuations in libido as signs of dysfunction.

Question 8

what relational and emotional factors play along with low sexual desire

Answer 8

often women have a desire for closeness, rather than just sexual activity. feelings of guilt for not desiring their partners and often engaging in duty sex.

Question 9

media’s role in shaping sexual health narratives

Answer 9

media often facors biological explanations and pharmaceuticals while neglecting psychological or relational factors.

Question 10

misrepresentation fo research

Answer 10

journalists may lack the training or time to critically assess clinical trial data, often relying on press releases rather than full studies. therefore public narratives are often incomplete or biased.

Question 11

limitations of clinical trials and research

Answer 11

• sample: trials for FSD drugs use strict criteria and WEIRD + heterosexual participants
• research uses narrow definitions of ‘sex’, excluding other pleasurable sexual experiences lke non-penetrative touch, role play or masturbation
• need for therapies like relationship therapies or education on sexual pleasure

Question 12

recommendations for researchers, clinicians and media

Answer 12

• research: more diverse participants and adopt broader definitions of desire. should combine treatment
• clinical practice: clinicians should validate fluctuations in sexual desire as normal, especially during life transitions and discuss non-pharmacological options for managing low libido
• media: should balance risks and benefits of pharmaceutical treatmetns and emphasizing the importance of alternative, non-drug options

Question 13

human sexual response cycle

Answer 13

linear series of sexual response: excitement, arousal, orgasm, resolution

real sexual experiences usually do not fit this one size fits all model

Question 14

circular model of sexual response

Answer 14

emphasises the role of responsive sexal desire rather than spontaneous desire

Question 15

wrong representations of sex:

Answer 15

• Desire is seen as strong and spontaneous, rather than reactive and responsive
• Orgasms are goals to be achieved
• Sex means PIV intercourse; other activities are just foreplay or simply inferior
• Good sex requires frequency and novelty
• Sex is vital to any relationship
• Male desire is simple, female desire is complicated
• Sexual problems always have physiological bases