The widespread attention that the issue of men’s erectile dysfunction has received recently has generated interest in the sexuality of women. It has further created a competitive environment centered on the search for a female version of that magic blue pill called Viagra.
However, the sexual problems that women contend with vary fundamentally from men’s and this factor is not being researched or critically looked into.
It is our belief that a basic obstacle that stands in the way of comprehending female sexuality is the medical categorization scheme that is currently being used. It was a development of the American Psychiatric Association, or APA, intended for the association’s Diagnostic and Statistical Manual of Disorders (DSM). This was undertaken in 1980 and the revised versions were published in 1987 and 1994. This particular scheme classifies the sexual problems of men and women into four sections in terms of sexual problems.
o Disorders of sexual desire.
o Disorders of sexual arousal.
o Disorders related to orgasms.
o Disorders of sexual pain.
These disorders are an instability experienced in an unspoken response of sexual nature in the physical form, which is described as normal. This was initially outlined by Masters and Johnson in the late period of the 1960s. This widespread pattern theoretically starts with sexual desire and follows a sequence from desire to arousal and finally, orgasm.
Recently, the weakness of this framework in relation to women has been adequately acknowledged. Three of the gravest misrepresentations produced by this outline, which in essence diminishes sexual tribulations to that of physical functions, are the following.
1) An alleged concept of sexual equality between men and women.
As a result of the emphasis placed on similarities regarding the physiological responses of men and women to sex, the conclusion made was that the sexual disorders would naturally be the same. A small number of investigators took the time to enquire from women about the types of sexual disorders they were experiencing. These studies revealed that there are crucial differences between males and females.
The accounts of women cannot be accommodated by the Masters and Johnson standard. An example is that women do not make a distinction between arousal and desire. Women are less concerned with physical arousal in comparison to subjective arousal. The sexual complaints that women have emphasize on problems that are not included in the DSM.
Subsequently, the importance the physiological and genital similarities that males and females share leaves out the connotations of the inequalities presented by issues of gender, ethnicity, social class and sexual orientation among others. Economic, social and political situations, which include rampant sexually oriented violence, stand in the way of the access of women to reproductive health, sexual pleasure and fulfillment across the world. The social environments that women live in can adversely affect the indication of biological ability; this is a glaring reality that has been completely disregarded by the restrictive physiological idea of sexual dysfunctions.
2) The removal of the sexuality relational context.
The approach of the American Psychiatric Association’s DSM circumvents the relational factors regarding the sexuality of women. These factors are usually the cause of sexual dissatisfaction and other sexually related problems such as the need for intimacy; desire to submit to partners, avoiding offence, loss or anger of partners. The DSM uses an individualistic approach that presumes functioning sexual organs indicate that everything is fine while dysfunctional organs are an indication of a problem. However, most women cannot apply this to the definition of their sexual problems. The DSM reduces the issue of regular sexual function to a physiological level erroneously suggests that genital and physical disorders can be dealt with without considering the type of relationship where the sexual activity is carried out.
3) The ranking of dissimilarities among women.
Not all females are similar. Their sexual desires, satisfaction levels and difficulties cannot be conventionally classified in groups of yearning, stimulation, orgasm and discomfort. The dissimilarities among women are reflected in their sexual attitudes, societal upbringing, cultural environment and present circumstances. These are differences that should not be packaged as a common concept of dysfunction that regards all women as one entity.
The lack of tangible aspects in terms of socio-cultural, physiological, political, interactive and social foundations of female concerns has generated the interest of pharmaceutical companies. These companies are in support of studies and public relations systems, which will concentrate on resolving the problems that are related to the genital area of women’s bodies. The financial support of industries in the research of sexual issues and constant media coverage on advances in treatment have served to place these physical difficulties in the public eye and given them a forum for expanded discourse.
The aspects that form the basis of the sexual concerns women contend with such as relationship and cultural grievances or lack of sexual knowledge or fear are typically ignored and disregarded. They are ‘conveniently’ grouped together as psychogenic causes. These aspects are not researched on or addressed. The women who have these difficulties to contend with
A solution to this glaring discrepancy is required as a matter of urgency. Our suggestion is that a clear and beneficial categorization of the sexual problems that women face is devised. This should give an accurate report that is centered on individual pain and reservation, which comes as a result of a far reaching structure of relationship and cultural aspects. We pose a challenge to the presumptions that are deeply entrenched in the DSM and the derogatory facets of studies and marketing endeavors that are evident in the pharmacy field. We call on the key stakeholders to carry out studies and services that are not inspired by commercially driven ambitions but by the needs of women and their actual sexual situations.
Sexual Health and Rights: Views from Around the World
As a bid to veer from the DSM’s genital and emotionless outline of the sexual problems that afflict women, we shifted our focus to documents from an international scope. The World Health Organization convened a special conference about the training requirements for sexual aid workers in 1974. In the report, it was noted that: “A progressive amount of knowledge is an indication of the persistent nature of human sexuality problems. They are more crucial to the health and well being of people in numerous cultures than previously realized”. The report placed emphasis on the significance of tackling sexuality and the improvement of relationships. It provided an expansive explanation of sexual health as “the incorporation of the somatic, expressive, rational and collective aspects of a sexual being”.
The 1999 World Association of Sexology Hong Kong meeting took on the Declaration of Sexual Rights. As an effort to establish the sexual health of human beings and their societies, the Declaration affirmed that “these sexual rights must be acknowledged, upheld, valued and protected”.
o Entitlement to sexual free will, exclusive of all sexual cruelty, mistreatment and exploitation;
o Entitlement to sexual liberation and wellbeing of the sexual being;
o Entitlement to sexual gratification, which is a basis of bodily, emotional, cerebral and spiritual health;
o Entitlement to sexual knowledge, created by unfettered but scientifically acceptable analysis;
o Entitlement to widespread education on sexuality;
o Entitlement to sexual well being and care, which should be accessible for the prevention and management of sexual problems, concerns and disorders.
The Sexual Problems of Women: A Novel Categorization
For our purposes, let’s define sexual problems as dissatisfaction or discontent with any physical, emotional or relative element of a sexual incident. These problems may come up in a number of these interconnected factors of the sexual lives of women.
Sexual Problems As a Result of Socio-Cultural, Economic or Political Dynamics
A. Lack of knowledge and apprehension owing to insufficient sex education, unavailable health care, or other sexual limitations:
o Deficient vocabulary to explain individual or physical occurrences.
o Insufficient information about the sexual biology of people and the changes experienced in various stages of one’s life.
o Lack of data regarding the roles of males and females in terms of sexual needs, viewpoints and attitudes.
o Limited access to services and information for contraceptive provision, abortion, prevention and care of STDs, sexual distress and violence against women.
B. Avoidance of sex or sexual frustration caused by a professed incapability to conform to cultural standards of sexual ideals and these include:
o Apprehension or disgrace about a person’s body, sexual appeal or sexual reactions.
o Uncertainty or disgrace about a person’s sexual preferences, character or sexual desires and fantasies.
C. Reservations owing to differences concerning one’s sexual standards, sexual background, culture and the norms of the prevailing culture.
D. Disinterest, exhaustion or limited tome because of obligations at home and work.
Partner and Relationship Sexual Issues
A. Reservations, evasion or frustration that is caused by infidelity, hate, fear, abuse by a partner or inequality between couples or as a result of an unconstructive form of communication between partners.
B. Differences in sexual desire or dissimilarities in inclination towards certain types of sexual actions.
C. Unawareness or reservations about means of communication or initiation, monitoring or molding activities of a sexual nature.
D. Diminished interest in sex and sexual reciprocation because of differences regarding common matters such as finances, time, and family members or as a result of harrowing experiences, for example, inability to bear children or infant death.
E. Difficulty in achieving arousal or impulsiveness owing to the state of a partner’s health or sexual disorders.
Psychologically-Based Sexual Issues
A. Dislike of sex, suspicion or an apprehension in enjoying sex because:
o Experiences form the past that involved sexual, emotional and physical abuse.
o Personality issues that constitute attachment, negative response, support and entitlement problems.
o Dejection or stress.
B. Sexual reluctance owing to a phobia of performing sexual activities or the possible consequences of sex e.g. painful intercourse, pregnancy, STDs, loss of a partner, reputation loss.
Sexual Problems as a Result of Medical Factors
Distress or negative response during acts of sex regardless of an accommodating and secure interactive atmosphere, ample knowledge about sex and positive attitudes towards sex can be brought about by:
A. A large number of local or universal medical conditions, which affect neurovascular, neurological, endocrine, circulatory and other components of the body.
B. STDs, pregnancies, or other conditions related to sex.
C. Adverse aftermath of numerous drugs, medication or treatment.
D. Ailing conditions.
This article is intended for researchers who want to examine the sexual problems that women have, for educators who teach about female sexuality, for both medical and non-medical personnel that plan to transform women’s sexuality, and for the general public that requires a structure to understand this diverse and essential aspect of life.