Come as You Are (30 page)

Thank you.

•  •  •

If you’re ever in doubt that genital response is about
expecting
, without necessarily any connection to
enjoying
or
eagerness
, just remember this: Lubrication Error #2 wants to claim that we can know what women really are turned on by when we measure what their genitals respond to. That would mean that women whose genitals respond to images of bonobos copulating really are, deep down, almost as interested in watching nonhuman primates copulating as they are in watching porn.

Really? Come on.

Even in the face of such absurdities, it’s an incredibly persistent myth. Alain de Botton, in
How to Think More about Sex
, goes so far as to describe lubricating vaginas and tumescent penises as “unambiguous agents of sincerity,” because they are automatic rather than intentional, which means they can’t be “faked.”

If that’s true, then when your doctor taps your knee’s patellar tendon and your leg kicks out, that must mean you actually want to kick your doctor.

Or when you have an allergic reaction to pollen, you must hate flowers.

Or when your mouth waters around a mouthful of moldy, bruised peach, you must find it delicious.

Don’t get me wrong—you might want to kick your doctor and you might hate flowers and you might enjoy moldy, bruised peaches. But your automatic physiological processes are not how we would know that. No. Automatic physiological processes are, ya know,
automatic
, not sincere.

But it gets worse—it gets less funny and more dangerous.

If we persist in the false belief that women’s genital response reflects what they “really” want or like, then we have to conclude that if their genitals respond during sexual assault, it means they “really” wanted or liked the assault.

Which isn’t just nuts, it’s dangerous.

“You said no but your body said yes” is an idea that shows up both in the lyrics of pop songs and in the images at Project Unbreakable, an online gallery of sexual assault survivors holding signs with phrases said by their rapists, their families, or even police responders.
¹⁸
But you know by now that bodies don’t say yes or no, they only say, “That’s sexually relevant,” without any comment on whether it’s appealing, much less whether it’s
wanted.
A penis in a vagina is sexually relevant, though it may be unappealing, unwanted, and unwelcome. There is no wanting necessary for genital response. It’s just, “This is a restaurant,” with no comment on whether it might be a good place to have dinner.

•  •  •

It’s an ancient fallacy, this notion that physiology can prove whether someone likes something sexual. Until the 1700s, people believed that conception was the pleasurable part of sex for a woman, so if a woman got pregnant, she must have experienced pleasure, and if she experienced pleasure, then the sex could not have been unwanted.
¹⁹
Because, “She said no but her ovaries said yes.”

This myth has its own degree of traction, showing up in the public discourse as recently as the 2012 Senate race in Missouri, when Republican candidate Todd Akin said, “If it’s a legitimate rape, the female body has ways to try to shut the whole thing down,” which even Mormon presidential candidate Mitt Romney described as, “insulting, inexcusable and, frankly, wrong.”
²⁰

Sex researcher Meredith Chivers often says, “Genital response is not consent.” Let’s add to that, “And neither is pregnancy.”

Genital response is no more an expression of pleasure, desire, or consent than the fertilization of an egg is. I hope that is totally obvious to you by now.

•  •  •

We metaphorize our bodies; we use descriptions of our physiology to stand in for descriptions of our states of mind. “I’m so wet” and “I’m so hard” are intended to say, “I’m into this.” These metaphors are so entrenched that people believe they’re literal. Indeed, some people actually want us to believe that women are lying—whether deliberately or because we’ve been culturally oppressed out of the capacity to recognize our own desires—when we say we’re not turned on but our genitals are responding.

I hope that by now, six chapters into this book, you know better. You know that male and female sexualities are made of the same parts, just organized in different ways, and you know that no two people are alike. You know that what activates your accelerator or hits your brake is context dependent. You know that women’s sexuality is even more context sensitive than men’s, that developmental, cultural, and life history factors
all profoundly shape how and when our bodies respond. You know that sexually relevant and sexually appealing are not the same thing.

Women are not liars, in denial, or otherwise broken. They are
women
, rather than men.

lubrication error #3: nonconcordance is a problem

The third way to be dangerously wrong about nonconcordance is to decide that it’s a symptom of something.

Suppose you recognize that nonconcordance exists, you acknowledge that it’s
expecting
without necessarily indicating
enjoying
or
eagerness
, and then you read the research that shows there is a correlation between nonconcordance and sexual dysfunctions related to desire and arousal.
²¹
And so you decide that, because nonconcordance is associated with dysfunction, nonconcordance must be a problem.

Which brings me to a sentence every undergraduate who takes a research methods class will memorize: “Correlation does not imply causation.” It refers to the
cum hoc ergo propter hoc
fallacy—“with this, therefore because of this”—which means that just because two things happen together doesn’t mean that one thing caused the other thing.

The quintessential example in the twenty-first century is the relationship between pirates and global warming.
²²
This is a joke made by Bobby Henderson, as part of the belief system of the Church of the Flying Spaghetti Monster. Henderson wanted to make a point about the difference between causation and correlation, so he drew a graph that apparently plotted increase in global temperature with the precipitous drop in the number of seafaring pirates.

Did the loss of pirates cause global climate change?

Of course not. It’s absurd, right? That’s the point.

Actually, we can hypothesize a third variable that influenced both the reduction in pirates and the change in global climate: the Industrial Revolution.

Like this putative correlation between pirates and global temperature, there’s also a correlation between nonconcordance and sexual dysfunction. The correlation makes it easy to think that the nonconcordance is
causing
the sexual dysfunction, or that the dysfunction is
causing
the nonconcordance.

Turns out, no. Just as pirates and global temperature can be linked together by the Industrial Revolution, nonconcordance and sexual dysfunction are linked together by a third variable: context.

How does context link sexual functioning and concordance?

Sexually functional women have brakes that are sensitive to context, turning off the offs when they’re in the right context—which, remember, means both external circumstances and internal mental state. Sexually dysfunctional women’s brakes stay on, even in contexts where you would expect them to turn off.

I’ll illustrate this with an extraordinarily clever study published in 2010. Dutch researchers built an “ambulatory laboratory”—a take-home kit of plethysmograph, laptop computer, and handheld control unit.
²³
Participants completed tests in the lab similar to other nonconcordance research—viewing erotic stimuli and testing various automatic and conscious responses—and they took the ambulatory lab home with them and tested themselves there, too. This way researchers could measure how being in the lab influenced the results, compared to being at home. In other words, they measured the effect of
context.
They studied two groups: eight women with healthy sexual functioning (the control group) and eight women who met the diagnostic criteria for “hypoactive sexual desire disorder” (the “low-desire” group).

Result: The control group’s genital response
and
subjective arousal more than doubled when tested at home, compared to in the lab. Plus they reported feeling “less inhibited” and “more at ease” at home. The low-desire group’s genital response also doubled at home . . . but their subjective arousal did not, nor did they report feeling less inhibited or more at ease. Which is to say, they were less concordant because their
brakes didn’t turn off. Just being at home wasn’t enough to turn off the low-desire women’s brakes.

The sexually satisfied women were more sensitive than women with low desire to the change in context from the lab to home. Which is exactly the result you’d expect if you assumed that women’s sexual satisfaction is more dependent on sensitivity to context than on sensitivity to genital response.
²⁴

Let me make that extra clear: The big difference between women in the control group and women in the low-desire group was
not
what their genitals were doing or even how aware the women were of what their genitals were doing. The big difference was how sensitive their brakes were to context.

Context sensitivity causes both the low desire and the nonconcordance. Nonconcordance is not the problem. Context hitting the brakes is the problem.

Context—external circumstances and internal brain state—is fundamental to most women’s sexual wellbeing; increasing sensitivity to context, rather than to genital response, is what makes the difference.

Context is the crux and the key. Context is the cause.

medicating away the brakes

I’ve spent my career teaching people how to change their external circumstances and heal their central nervous systems in order to maximize their sexual potential. In other words: how to change their contexts. And this kind of education is effective at improving people’s sexual wellbeing.
²⁵

But boy, it would be easier to just take a pill, right? A pill that temporarily turns off your brake—the elusive “pink Viagra.”

One of the authors of that ambulatory lab paper is aiming to make just such a pill. Adriaan Tuiten is a lead investigator in developing new drugs for “female sexual dysfunction,” one of which is intended to turn off the brakes.
²⁶

It’s a really smart idea, targeting medications to the brakes and to women whose brakes are most prone to getting stuck.

So can you turn off the offs with a drug? Research is under way and has been published, including a series of three papers in 2013.
²⁷

The regimen for the brake-targeted intervention is described in the research this way: Four hours before having sex—or a “sexual event,” as the researchers call it—drop a testosterone solution under your tongue and swish it around for about a minute. Two and a half hours later, take a pill. Then, an hour and a half after that, have some sex. Voilà!

Did it work? You decide:

The women in the study rated their “sexual satisfaction” with “sexual events” both with a placebo and with the drug. Half of the women experienced no significant change. But half the women (the “high inhibitors” group) experienced a statistically significant difference in sexual satisfaction. With the placebo, they reported being 50.2 percent satisfied, on average, with a given sexual event. With the drug, 59.6 percent satisfied.

Would you schedule sex for a specific time, drop testosterone under your tongue four hours beforehand, and then take a pill two and a half hours after that in order to increase your satisfaction that night from 50 to 60 percent?
²⁸

And what else might increase your satisfaction with a “sexual event” that much?

How about if you felt really beautiful?

Or if you felt profoundly, deeply trusting of your partner?

Or if you felt like you had 100 percent permission to take as long as you wanted to become fully aroused and your partner would love every second of it?

Or, if you have a history of trauma, as so many women do, if you felt you could more completely release that trauma and fully engage with pleasure in the present moment?

Would that increase your satisfaction by 10 percentage points? More than 10?

•  •  •

The drug is designed to turn off your brakes by changing your brain, rather than by changing the context to which the brakes are responding. As the researchers write: “Ideally, sexual dysfunction in human subjects should be described in terms of a constellation of interacting mechanisms, both biological and psychological, which at the same time should provide an adequate indication for treatment.”

This is an excellent example of medical model thinking, since it pays attention to biology and even psychology but ignores relationship and social factors—in other words, it ignores women’s actual lives. You can’t medically treat a whole life or a relationship, so why bother taking them into account when trying to figure out how to treat sexual problems?

The reason to bother is that life factors like relationship satisfaction and trauma history significantly impact sexual wellbeing—I’m thinking way more than 10 percent—and they can be changed. Kids can be baby-sat and parenting can be shared by multiple adults; relationships can be strengthened; trauma can be healed.
²⁹

We don’t need to reduce nonconcordance. We need to improve the contexts—external circumstances and internal states such as stress, attachment, self-criticism, and disgust. It doesn’t take a pill to do that.