Midlife and Menopause
Female Sexual Dysfunction: A Feminist View
A New View of Women's Sexual Problems (continued)
Women's Sexual Problems: A New Classification
Sexual problems, which The Working Group on A New View of Women's Sexual Problems defines as discontent or dissatisfaction with any emotional, physical, or relational aspect of sexual experience, may arise in one or more of the following interrelated aspects of women's sexual lives.
I. SEXUAL PROBLEMS DUE TO SOCIO-CULTURAL, POLITICAL, OR ECONOMIC FACTORS
A. Ignorance and anxiety due to inadequate sex education, lack of access to health services, or other social constraints:
- Lack of vocabulary to describe subjective or physical experience.
- Lack of information about human sexual biology and life-stage changes.
- Lack of information about how gender roles influence men's and women's sexual expectations, beliefs, and behaviors.
- Inadequate access to information and services for contraception and abortion, STD prevention and treatment, sexual trauma, and domestic violence.
B. Sexual avoidance or distress due to perceived inability to meet cultural norms regarding correct or ideal sexuality, including:
- Anxiety or shame about one's body, sexual attractiveness, or sexual responses.
- Confusion or shame about one's sexual orientation or identity, or about sexual fantasies and desires.
C. Inhibitions due to conflict between the sexual norms of one's subculture or culture of origin and those of the dominant culture.
D. Lack of interest, fatigue, or lack of time due to family and work obligations.
II. SEXUAL PROBLEMS RELATING TO PARTNER AND RELATIONSHIP
A. Inhibition, avoidance, or distress arising from betrayal, dislike, or fear of partner, partner's abuse or couple's unequal power, or arising from partner's negative patterns of communication.
B. Discrepancies in desire for sexual activity or in preferences for various sexual activities.
C. Ignorance or inhibition about communicating preferences or initiating, pacing, or shaping sexual activities.
D. Loss of sexual interest and reciprocity as a result of conflicts over commonplace issues such as money, schedules, or relatives, or resulting from traumatic experiences, e.g., infertility or the death of a child.
E. Inhibitions in arousal or spontaneity due to partner's health status or sexual problems.
III. SEXUAL PROBLEMS DUE TO PSYCHOLOGICAL FACTORS
A. Sexual aversion, mistrust, or inhibition of sexual pleasure due to:
- Past experiences of physical, sexual, or emotional abuse.
- General personality problems with attachment, rejection, co-operation, or entitlement.
- Depression or anxiety.
B. Sexual inhibition due to fear of sexual acts or of their possible consequences, e.g., pain during intercourse, pregnancy, sexually transmitted disease, loss of partner, loss of reputation.
IV. SEXUAL PROBLEMS DUE TO MEDICAL FACTORS
Pain or lack of physical response during sexual activity despite a supportive and safe interpersonal situation, adequate sexual knowledge, and positive sexual attitudes. Such problems can arise from:
A. Numerous local or systemic medical conditions affecting neurological, neurovascular, circulatory, endocrine or other systems of the body;
B. Pregnancy, sexually transmitted diseases, or other sex-related conditions.
C. Side effects of many drugs, medications, or medical treatments.
D. Iatrogenic conditions.
Conclusion
This document is designed for researchers desiring to investigate women's sexual problems, for educators teaching about women and sexuality, for medical and nonmedical clinicians planning to help women with their sexual lives, and for a public that needs a framework for understanding a rapidly changing and centrally important area of life.
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For further information about the Campaign for "A New View of Women's Sexual Problems," to obtain additional copies of this document, or to make a financial contribution, please contact:
Dr. Leonore Tiefer, 163 Third Ave., PMB #183, New York, NY 10003, [email protected] or
Dr. Carol Tavris, 1847 Nichols Canyon Road, Los Angeles, CA 90046, [email protected]
ENDNOTES
1. Linda Alperstein, M.S.W., Assoc. Clin. Prof., Psychiatry, University of California at
San Francisco; Psychotherapy Practice, San Francisco, CA
Carol Ellison, Ph.D., Author; Psychotherapy Practice, Oakland, CA
Jennifer R. Fishman, B.A., Doctoral Candidate, Department of Social and Behavioral Science, UCSF, CA
Marny Hall, Ph.D., Author; Psychotherapy Practice, San Francisco, CA
Lisa Handwerker, Ph.D., M.P.H., Institute for the Study of Social Change, University of California at Berkeley, CA
Heather Hartley, Ph.D., Ass't Professor, Sociology, Portland State University, OR
Ellyn Kaschak, Ph.D., Professor, Psychology, San Jose State University, CA
Peggy J. Kleinplatz, Ph.D., School of Psychology, Univ. of Ottawa, Ontario, Canada
Meika Loe, M.A., Doctoral Candidate, Women's Studies Emphasis, Sociology, University of California at Santa Barbara, CA
Laura Mamo, B. A., Doctoral Candidate, Department of Soc. and Behav. Sci., UCSF, CA
Carol Tavris, Ph.D., Social Psychologist; Independent Scholar, Los Angeles, CA
Leonore Tiefer, Ph.D., Assoc. Clin. Professor, Psychiatry, New York University School of Medicine and Albert Einstein College of Medicine, NY
2. American Psychiatric Association (1980, 1987, 1994). Diagnostic and Statistical Manual of Mental Disorders, 3rd, 3rd-revised, and 4th editions. Washington, DC: APA.
3. Masters, W. H. & Johnson,V. E. (1966) Human Sexual Response. Boston: Little, Brown, and Co.; Masters, W.H. & Johnson, V. E. (1970) Human Sexual Inadeqacy. Boston: Little, Brown, and Co.
4. e.g., Tiefer, L. (1991) Historical, scientific, clinical and feminist criticisms of "the Human Sexual Response Cycle" model. Annual Review of Sex Research, 2, 1-23; Basson, R. (2000) The female sexual response revisited. J. Society Obstetrics and Gynaecology of Canada, 22, 383-387.
5. Frank, E., Anderson, C., & Rubinstein, D. (1978) Frequency of Sexual dysfunction in "Normal" couples. New England Journal of Medicine, 299, 111-115; Hite, S. (1976) The Hite Report: A nationwide study on female sexuality. NY: Macmillan; Ellison, C. (2000) Women's Sexualities: Generations of women share intimate secrets of sexual self-acceptance. Oakland, CA: New Harbinger.
6. WHO Technical Report, series Nr. 572, 1975.
7. Full text available here.
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