The Changing View of Normal Female Sexuality

Perfectly Normal: Living and Loving with Low Libido
by Sandra Pertot, Ph.D

Feel like you wouldn't care if you never had sex again? You're not alone. By far the largest group of people seeking sex therapy is women who feel there must be something wrong with them because they don't have the urgent sex drive that they believe everybody is supposed to have. In Perfectly Normal, Dr. Sandra Pertot dismisses that theory. She believes that there are many ordinary and logical reasons why you might not want to have sex--and provides practical solutions to everyday sexual problems. She doesn't offer a cure for low libido but rather an approach for making your sex life the best it can be with what you've got. In Perfectly Normal, you'll find specific tips on discovering your sexual potential, including how to:

• Explore your ability to have orgasms
• Stay focused during sex
• Practice fantasizing
• Appreciate your body
• Identify what gets you interested in sex-and what turns you off

Dr. Pertot also offers advice for you and your partner on developing your sexual relationship. She shows you how to take advantage of sensory, emotional, and environmental triggers that make it possible for you to develop a sex life that works for both of you-and will sustain you and your partner into old age.

Chapter 1

"I never feel like [having] sex," says Julia. "What's wrong with me?
When I know Tom wants sex, I usually feel that I just can't be
bothered. He's upset because I always seem to be saying no,
and I never come on to him."

There is nothing obvious to distinguish Julia from other women. She could be a businesswoman or a housewife, twenty-something or in her midlife, in a caring relationship or one that is emotionally barren. She is just as likely to be fit and healthy as she is to be overweight and rundown. She may once have felt very strong sexual desire or have always had little energy for sex. There are many women who feel like Julia does, and they may have only one thing in common: They sometimes think that they wouldn't care if they never had sex again.

In TODAY'S WORLD, young women expect to want sex with passion and enjoy it with abandon. A good sex life is regarded as a right that is taken for granted. With increasing recognition of women's rights in both the personal and public domains, women are no longer expected to play a subservient role to men in their personal relationships, and positive images of female sexuality are the norm. Lead characters in books and movies are routinely portrayed as sexually confident women, and numerous books and magazine articles are dedicated to helping the average real-life woman discover her sexual potential.

Of course, female sexuality hasn't always been viewed so positively. During the past century, female sexuality was variously denied, trivialized, repressed, and subjugated. To understand our current view of female sexuality, we have to start by looking to the past.

FEMALE SEXUALITY IN THE 20TH CENTURY

Medical and religious writers in the early decades of the 20th century viewed sex as a necessary evil that should be controlled at all times. They thought that masturbation, for example, could lead to mental or physical illness and even early death. Men were unfortunately more susceptible to the evils of sex, but women, mercifully, were often spared. Influential writers such as Dr. William Acton believed that normal women lacked sexual feelings of any kind and had sex only to please their husbands or to become pregnant.

Not everyone shared this view. The famous Viennese psychiatrist Dr. Sigmund Freud believed that sexual pleasure was a basic need for both men and women. However, he wasn't at all confident that women could mature enough to reach their sexual potential. Writing in the early part of the century, Dr. Freud had a powerful negative influence on the understanding of the sexual nature of women. He characterized them as mutilated males, biologically inferior because they lacked penises. And he insisted that an essential phase in the psychosexual development of women was acquiring the ability to achieve orgasm from penile thrusting alone. Although he recognized that the clitoris was highly sensitive and the vagina relatively insensitive, he stated that the inability of a woman to achieve orgasm with only the stimulation of intercourse was an indication of severe personality disorder.

The legacy of writers such as Acton and Freud continued into the second half of the century. In 1972, British sex educator Clare Raynor echoed Acton by declaring that though men have strong sex drives, women want sex only for babymaking. Many experts continued to support Freud's view that it might be difficult for women to mature sufficiently enough to come to orgasm during intercourse, and writers such as Canadian gynecologist Marion Hilliard, M.D., advised women not to be selfish and to consider their partner's feelings. This meant that sometimes they should fake arousal and orgasm so that their partner could feel proud and confident as a man.

Maxine Davis, a popular author in the 1950s whose books were still highly regarded and read decades later, gave women some conflicting advice. She advised young wives that it was their responsibility to adapt themselves to their husband's needs in order to have a successful marriage, because their own sexual pleasure wasn't an essential part of love-making. Like Raynor, she advised women to sometimes fake orgasm, but she also recommended that they come to climax during intercourse at least some of the time, because this was the only true path to sexual ecstasy. At the same time, Davis felt that they should never take charge, because she believed that men don't like bossy women.

In the early 1960s, popular psychologist Joyce Brothers, Ph.D., advised women who did indeed desire sex to not make it too obvious. She felt that for a marriage to be good, the husband had to dominate both sexually and financially. Wives could certainly work outside the home, provided they didn't have a more-responsible and more-financially successful job than their husband did, and they could want and even enjoy sex as long as they weren't too aggressive about it and allowed their husband to set the sexual pace.

It's no wonder that many women found the whole notion of sex confusing. Premaritally, it was the woman's responsibility to control any sexual behavior to avoid pregnancy, and within marriage, she should not be too keen on having sex but certainly be prepared to do her conjugal duty. If she was doing her marital duty, maybe she could or should enjoy it and perhaps even have an orgasm but only if she could do it in the normal way (that is, through intercourse). Even then, because of the absence of realistic sex education, there was a good chance that a woman wouldn't know what intercourse actually was—the wedding night was something of a shock to many a virgin bride. And if she did know what was expected of her, how did she know? Was she "that kind of girl"?

While there were some writers throughout the century who questioned the notion that sex was inherently sinful and tried to bring some enlightenment into the lives of married couples, overall, society remained essentially conservative. Married couples had limited access to information on sexual matters, and girls were typically denied even basic information about menstruation, so the onset of menarche was often terrifying.

All that was about to change.

The Cultural Shift

When world-renowned sex researchers William Masters, M.D., and Virginia Johnson published their groundbreaking work Human Sexual Inadequacy in 1970, they estimated that as many as 50 percent of couples led unsatisfying sex lives. At that time, they believed that the most significant causes of sexual problems were conservative cultural attitudes about sex, and ignorance about basic sexual functioning.

As difficult as it may be to believe now, the extent of sexual ignorance at that time was such that most people were unaware of the existence of the clitoris; many young brides had no idea that men had erections; and even into the 1970s, there were some couples whose apparent infertility was due to the fact the wife was still a virgin—neither partner knew where to put the penis!

It was assumed that a man knew more about sex and had to be patient with his virgin partner, guiding her through the mysteries of sex. It isn't clear how men were supposed to acquire this greater sexual knowledge and understanding, because sex education seems to have consisted of furtive schoolyard discussions, awkward "talks" from parents, and what was learned by self-discovery. If sex education in any formal sense did occur, it concentrated on reproduction and the immorality of premarital sex and masturbation; techniques for sexual pleasure were certainly not on the agenda.

There were many influences that combined in the 1960s to help shape a significant shift in our attitudes toward sex over the subsequent decades. These changes provided a climate for Masters and Johnson's work that had not existed before (although their ideas still met with considerable hostility from the conservative sections of society).

One of the most significant of these changes was the development of the contraceptive pill. Effective contraception meant that couples could explore sex for pleasure without fear of unwanted pregnancy. Still, no one, not even the sex researchers, asked the obvious question: What makes sex pleasurable? Instead, it was assumed that sexual pleasure was inevitable with certain sexual behaviors and that appropriate sex education would give couples all the information they needed.

Improved contraception led to a new phase in the women's movement. Control of fertility meant the opportunity to explore other life choices and redefine relationships with men. Women began to question the traditional view of sex as a wifely duty. The view of women as sexually naive and uninterested was seriously challenged during the 1960s, and for many women, being expected to endure male caresses without consideration for their own enjoyment was no longer acceptable. More and more women wanted a part of the "sex for pleasure" movement, and they developed the confidence to seek it. Not only that, many women felt strongly that they should participate in sex only when they felt like it. Saying no to your partner was becoming accepted as a fundamental right.

This change in focus away from reproduction and marital duty drew attention to the problems of people who did not automatically find sex an enjoyable pastime. The time was right for serious researchers to explore the sexual difficulties many people reported, and Masters and Johnson took up the challenge.

One of their major starting points was to discredit the long-held view that sexual problems are always a symptom of deep, underlying psychiatric illness that can be cured only by long-term psychotherapy. Instead, they claimed an impressive cure rate with their treatment program, which combined sex education, a series of couples exercises called Sensate Focus, and specific behavioral strategies for each of the sexual dysfunctions. This approach came to be known as sex therapy.

Sex therapy challenged old beliefs and lack of knowledge. It came as a surprise to many that women were capable of orgasm and that it was most likely achieved by clitoral rather than vaginal stimulation. Couples learned that what happened prior to intercourse (foreplay) was as important as the act itself. Men learned that they could delay ejaculation to enhance the satisfaction of both partners and that they didn't have to endure impotence in painful, embarrassed silence.

One of Masters and Johnson's most fundamental aims was to abolish goal-oriented performance. They believed that if people stopped being anxious about their performance and were willing to put into practice some basic techniques, good sex would happen naturally, making sexual pleasure within easy reach of everyone. (Interestingly, early sex therapy did not address the problem of sex drive: It was assumed that once a couple stopped being anxious about sex and learned how to achieve sexual pleasure, sex drive would automatically increase.)

As a young sex therapist in the early 1970s, I remember embracing all this exciting knowledge and the associated treatment protocols with an almost evangelical zeal. It seemed, back then, that sexual liberation was about to be realized—and my colleagues and I often joked that we'd be working ourselves out of a job, because there would be no need for sex therapists in the new millennium.

THE IRONY OF IT ALL

Despite 30 years of access to sex therapy and an increasing openness about sex during that time, the reported rates of sexual problems have not changed significantly—making for an interesting paradox. There's more sexual content in books and films than ever before, and there are hundreds of books and magazine articles dedicated to exploring and offering solutions for all kinds of sexual difficulties. In spite of this, a large population survey conducted in 1994 by University of Chicago sociologist Edward Laumann, Ph.D., and his associates estimated that 43 percent of women and 31 percent of men in the United States have sexual problems. One in three women rated themselves as lacking interest in sex, which was double the reported rate for men. (The major concern for men was worry that they climaxed too quickly.)

These results were astounding, particularly the figures on low sex drive in women. Although other more recent studies haven't found the same high rates, they still report that 20 percent of women, or one in five, complain of low libido. These numbers don't come as a surprise to sex therapists. Our offices are busy with women of all ages who worry because they don't feel like having sex as often as they believe they should, or as often as their partners would like.

Think about it. Sit in a mall and watch the crowds go by, and consider that at least one of every five women walking past you is likely to not be too keen on sex. That's an awful lot of worried or dissatisfied women and stressed relationships.

How did this happen? In an age of sexual sophistication and celebration of sexuality, when one of the best-selling books in the late 20th century was called The Joy of Sex, what went wrong? Why has the optimism we sex therapists had in the 1970s failed to be vindicated? Why, in particular, do so many women not want sex?

These are the questions the first part of this book seeks to answer. (And although I am focusing specifically on women's lack of sexual interest, this isn't to say that men don't have their own problems. Indeed, one in six men in Dr. Laumann's 1994 study rated themselves as having little or no interest in sex, but in my clinical experience, the issues affecting male libido are different from those of concern to women, and they would justify a book of their own.)

This book is not about a mystical philosophy to put your sex life on a higher plane. It's not a guide to sexual positions and a variety of sexual techniques nor a manual of behavior programs to help you learn to be orgasmic or deal with painful intercourse. There are hundreds of books already available on these topics. Rather, it's a book for women—and their partners—who often feel irritated at the thought of sex or simply can't be bothered, then worry that there must be something wrong with them or their relationship. You'll be relieved to learn that this isn't necessarily the case.

To solve the problem, though, we have to start trying to see through a well-constructed illusion, which is the focus of the next chapter.

© 2005 by Sandra Pertot

About the Author

Sandra Pertot, Ph.D., is a clinical psychologist and sex therapist in private practice. She has been published in Woman's Day, Penthouse, and many publications in Australia where she lives.