Who desires female desire? The history of female hypoactive sexual desire disorder and its opponents
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2018-07
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Abstract
After the great success of Viagra, pharmaceutical companies had a new goal: the "female Viagra", i.e. a pill for hypoactive sexual desire disorder (HSDD), the most commonly diagnosed female sexual dysfunction. Each subsequent proposal for the treatment of low desire showed the process of disease mongering in all its glory and simultaneous attempts to strengthen the hypotheses about its biological basis: when trying to introduce sildenafil for female use, the experts talked about the dysfunction of pelvic blood circulation, when testosterone patches joined the race, HSDD was supposed to be androgen deficiency, when finally flibanserin was introduced, HSDD began to be presented as a disorder of neurotransmitters in the brain. These various concepts of the genesis of HSDD showed the first problem with the female Viagra: the highly problematic definition of HSDD and the promotion of reductionistic hypotheses, despite strong empirical evidence of their inadequacy to describe female sexual desire. On the other hand, psychological studies show that female desire substantially lowers with the duration of the relationship, while at the same sexual reactivity to new sexual stimuli increases. These effects are stronger for women than for men, creating a tension within heterosexual relationship. Therefore it is not a coincidence that HSDD is reported most often by married women in long-term relationships, and that women decide to present their low desire as a problem due to the partner's reaction or pressure. Thus, there is a doubt whether lowered desire (as a symptom that is not an indicator for other disorders, eg depression) should be treated as a medical phenomenon - perhaps it should be rather viewed as a spectacular example of pathologization of a completely normal state. In such case, a "treatment" for HSDD would be in fact equal to regulating the female nature to the partner’s expectation or/and to the certain cultural vision of the relationship. I will back up this hypothesis against the background of research on female desire and contrasting it with the changes in the justification of the pathology of HSDD over time (from psychoanalysis to modern biological theories), where the silent assumption about the desired level of female sexual interest has indeed nothing in common with the statistical and health standards.
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Grunt-Mejer, K., Chańska, W. (2018). "Who desires female desire? The history of female hypoactive sexual desire disorder and its opponents". International Academy of Sex Research Annual Meeting, Madryt 17-20.07.2018