Solving Desire

“Though Addyi is sometimes called the “pink” or “female” Viagra, how similar are the two drugs really? It turns out that the approaches the two drugs take to sexual dysfunction are entirely different, drawing on very different sets of assumptions about men’s and women’s sexuality.”

“Administering these drugs to patients also means administering a particular theory of sexuality and sexual difference, which has deep roots extending back to the earliest sexology texts of the Victorian era.”

“From sexology to psychoanalysis to our current biopsychiatric and neuroscience-based explanations and treatments, gender differences have been assumed and discursively reproduced.”

“Female sexuality has also consistently been characterized as complex, complicated, wayward, and peculiar—nothing like the straightforward, potent, goal-oriented, and virile sexuality of men.”

“Within contemporary sexual medicine and studies of pathology, men are perceived as disproportionately likely to suffer from physiological ailments such as erectile disorder, whereas women are understood as more likely to suffer from psychological blocks to optimal sexual enjoyment.”

“These perceived differences translate into drastically different framings and treatments of sexual dysfunction for men and for women, with broad consequences for both “dysfunctional” and “healthy” populations.”

“a woman’s desire to respond to her partner’s sexual advances becomes textually embedded in notions of what is considered “healthy” or “functional” female sexuality.”

“originally posited in 1966 by Masters and Johnson. The Human Sexual Response Cycle offered a linear model of sexual response: in sexually healthy or “normal” individuals, sexual stimulation ought to lead to orgasm.”

“As a response, in the 1990s, some psychologists began to challenge this model, arguing that it did not accurately fit “the female experience of sex.””

“Rather than question how well the linear Human Sexual Response Cycle describes sexual experience for everyone, these psychologists designed an alternative model of sexual response for women only, based on a categorically feminine framing of sexual health and pathology.”

“It draws on and perpetuates the notions that women are:

(1) less driven than men by spontaneous or internal sexual needs

(2) more likely than men to engage in cost-benefit analyses of sex, as they consider possible nonsexual rewards or incentives

(3) more likely than men to feel desire only or primarily when “triggered” by an initiating—and tacitly male—partner.”

“Addyi is not only the first sex drug marketed to women; it is the first drug ever to target desire or libido in humans.”

“Whereas Viagra affects physiology—increasing blood flow to the genital region—Addyi affects neurocircuitry. It goes right to the source of the so-called problem: the female brain.”

“Of the 26 treatments for men (really three primary drugs and 23 slight variations on them) none affect neurochemistry or attempt to influence sexual desire. They simply target men’s ability to maintain an erection. They are taken on an as-needed basis, when this very visible symbol of sexual readiness is absent.”

“Addyi, by contrast, targets women’s brain chemistry. But are chemical imbalances the real reason behind any given woman’s low desire? Desire—for all sexes and genders—is more complicated than something as easily detectible as an erection.”

“What if desire is actually so subjective and relational that it is impossible to isolate in the neurotransmitters of a single individual?”

“How we assess sexual problems and treatments — and how we know whether a treatment is working — depends on what kind of sex is regarded as optimal.”

“Sexual desire is not divorced from the domain of the political: how we have sex, with whom, and with what technologies (including drugs and other treatments) are all political choices.”

“Even more than women’s desire, it seems that women’s pleasure has been almost forcibly shut out of the clinic and the bedroom in too many times and places, or negated in lieu of someone’s else pleasure.”

“If we really cared about women, we’d focus more on their pleasure and try to dismantle some of the barriers to pleasure that women experience so regularly in our world—including gendered harassment and violence, low pay, and antiquated divisions of labor, including the disproportionate burdens of carework and emotional tending that women are expected to provide.”

“Maybe we’d stop thinking about how to make women more receptive and reassuring to men and more about how to put women’s desires and pleasures front and center.”

“There are many trajectories to that place of pleasure — if “sexual” pleasure is what we choose to pursue. If taking a drug will make women feel the desire that they desire to have, then, by all means, we should have it! But let’s not pretend we’ve come a long way, just because we now have a little pink pill to match his little blue pill.”