Deconstructing Women's Sexualities:
A Qualitative Study on the Experiences of Women with Low Sexual Desire
Deconstructing Women's Sexualities:
A Qualitative Study on the Experiences of Women with Low
Sexual Desire
Melissa Singh
Student number: 12082651
First Supervisor: Dr. M.D. (Marci) Cottingham Second Supervisor: Dr. Marie-Louise Jansson
Program: Sociology: Gender, Sexuality, and Society
Word and page count: 16202 words (excl. cover pages, acknowledgements, abstract, bibliography, and appendices)
June 2019
Cover Page Picture Credits: Kristen Singh, Product Designer and illustrator from Toronto, Ontario.
Acknowledgements
I want to give a special thanks to all of the participants who dedicated their time and effort providing narratives regarding their experiences with low sexual desire. I recognize that talking about sexuality is often taboo and sometimes challenging to discuss. I appreciate their willingness, openness, and trustworthiness with their sensitive information.
I want to thank Kristen Singh, a product designer and illustrator from Toronto, for creating the cover photo, particularly tailored for this thesis. As per my request, she made the picture come together exceptionally well, and the graphic showcases the topic of low sexual desire by accentuating the idea of sexual desire/lack thereof in a exclusionary and non-pathologizing fashion.
I also want to thank Kat Kova, a Sex Therapist from Toronto, for sharing her knowledge about sex therapy in Ontario, different therapeutic strategies for women with low sexual desire, and for providing some insights regarding the main themes found in my data. Her expertise regarding communication between partners, the effects of medication on sexual desire, and how people can seek guidance if they want it provided the application of the thesis topic of low desire within everyday life.
Finally, I thank my thesis supervisors Dr. Marci Cottingham and Dr. Marie-Louise Jansson for guiding me, challenging me throughout my research by providing extensive feedback, and helping me to explore the topic of women’s low sexual desire further.
Summary
The intended purpose of this master’s thesis is to figure out how medical and social notions relating to sexuality affects the perceptions and experiences of women who self-identify with having a low sexual desire for approximately six months or more. By using the theoretical approaches about asexuality, the mind/body dualism debate, and the naturalistic/social body debate, there is an emphasis on how the internalizations and externalizations of social and medical aspects contributing to low sexual desire are prevalent within women’s lives. The theorization of this thesis demonstrates diversity amongst theories because it aims to integrate academic knowledge from different fields such as Sociology, Biology, and Psychology. However, the aim of the paper is not to come off as one of the hard sciences, rather, the take is more on philosophical and sociological outlooks of the hard sciences, such as biology, and how they help, or further problematize, with the topic at hand. Furthermore, the research intends to include branches of sociology, including Sociology of the Body and Sociology of Emotions. By taking an interdisciplinary approach, one of the aims is to combine social phenomena, such as social pressures, expectations, and perceived normalizations, with biological aspects. As a result, I explore the social without neglecting physiological circumstances; for example, I discuss hormones and Hypoactive Sexual Desire Disorders (HSDD).
I analyzed the narratives of the experiences of 15 women from the Greater Toronto Area and the Netherlands primarily by using Bourdieu’s concepts of reflexivity and habitus (Bourdieu, 1978; Bourdieu, 1984; Bourdieu,1988; Bourdieu, 1990). In addition to Bourdieu’s ideas, I used Shilling’s (2012) analysis both to accentuate and be critical of biomedical renditions of low sexual desire. The paper begins with a brief background about what low sexual desire is, its theoretical importance, and a more detailed description of my specific aims. The theoretical section includes low sexual desire in connection with asexuality because the framework is
integral to research done on low libido. The part about the mind/body dualism debate begins with the inspiration of Bourdieu’s concepts of reflexivity and habitus, then introduces the basics about the debate, and finally, how the mind/body dualism debate applies specifically to low sexual desire. In discussing the natural/social body debate in the theoretical section, it shows the importance of considering both biological implications, such as hormones, medical conditions, medications, and social impacts, such as social interactions, relationships, institutions.
Throughout the methods, I started with how I started data collection, how I structured and coded the data, the demographics, an additional interview with Kat Kova (MSc, RP), the ethics, and self-reflexivity as a researcher. The findings include the context of sex therapy in Ontario and the Netherlands. Furthermore, it focused on themes such as medications, medical conditions,
mental/physical trauma, pain/discomfort during sex, sexual orientation, religiosity, and
education. The discussion section is an overview analysis of the findings concerning asexuality and the mind/body dualism debate, and it also includes the limitations of this paper. Finally, the conclusion provides some idea of how the current research is essential for theorists in the sociology of the body/emotion and how future research should continue with the topic of low sexual desire.
Table of Contents
1. Introduction 7
1.1. What is Low Sexual Desire? 7
1.2. Theoretical Importance 8
1.3. Aims 8
2. Theoretical Framework 10
2.1. Asexuality 10
2.2. Mind/Body Dualism 11
2.3. Linking the Natural Body to the Social Body 13
3. Methods 17
3.1. Data collection 17
3.2. Structure and Coding 18
3.3. Demographics (Refer to Table 1 in Appendix) 19
3.4. Additional interview 20
3.5. Ethics 21
3.6. Self-Reflexivity as a Researcher 21
4. Findings 23
4.1. Background of Sex Therapy in the Context of Ontario 23
4.2. Background of Sex Therapy in the Context of the Netherlands 23
4.3. Medications/Drugs/Alcohol Use and Low Sexual Desire 24
4.4. Medical Conditions and Low Sexual Desire 26
4.5. Mental/Physical Trauma and Low Sexual Desire 27
4.6. Pain/Discomfort During Sex 30
4.7. Sexual Orientation 32 4.8. Relationships/Coupled Partnerships 33 4.9. Social Relationships/Friendships 36 4.10. Religiosity 37 4.11. Education 39 5. Discussion 41
5.1. The Relevance of Asexuality in the Findings 41
5.2. The Relevance of Mind/Body Dualism in the Findings 42
5.3. Self-reflecting on the Theoretical Analysis of the Findings 43
5.4. Limitations 44
6. Conclusion 45
6.1. Final Summation 45
6.2. What Can Future Research Do? 46
Appendix 1 52
Appendix 2 53
1. Introduction
1.1. What is Low Sexual Desire?
Low sexual desire or low libido occurs when someone has little to no desire to engage in sexual activity, and this can fluctuate over time, depending on the individual’s life scenarios. There might be short-term periods in which a person has a low libido; however, I focus on women who have prolonged experiences of not desiring sexual activity. Low sexual desire is a broad term which relates to literature about Hypoactive Sexual Desire Disorders (HSDD), Female Sexual Interest/Arousal Disorder, asexuality, and more. The DSM-5 recognizes Female Sexual Interest/Arousal Disorder as a diagnosis for women who have a reduced or absent interest in sexual pleasure, and the symptoms must be ongoing for six months minimum (Spurgas, 2013, p. 191). Heiman, Rupp, Janssen, Newhouse, Brauer, and Laan (2011) differentiate low sexual desire from HSDD by indicating that the lack of sexual desire persists over time, or is recurrent, and if it causes distress or interpersonal problems, this might be enough for a diagnosis of HSDD (Heiman, Rupp, Janssen, Newhouse, Brauer, and Laan, 2011, p. 772). Helen Singer Kaplan (1977), an Australian-American sex therapist, said that desire is an appetite that has its locus in the brain, but it is not possible to come up with a definite definition of the inhibition of desire because a “normal sexual desire” is unknown (Kaplan, 1977, p. 4). Furthermore, she describes low libido as when an individual has little or decreased sexual appetite but who may still retain their capacity for orgasm (Kaplan, 1977, p. 5). According to Rosemary Basson (2002), a Clinical Professor and Director of the University of British Columbia Sexual Medicine Program, 33-39 percent of North American women self-diagnose themselves with low sexual desire, and it is one of the most common issues women talk about during sex therapy and gynecological visits
(Basson, 2002, p. 357). Hormonal changes caused by different types of medications including birth control, anti-depressants, and psychotropic drugs may affect people’s libido and physical arousal, and the findings in the present study illustrate this through the analysis of the narratives
of the participants. All of these variations of low libido are essential to the discussion because there are many biological and social factors which influence how individuals experience sexual desire. Thus, the thesis project aims to explore these various factors and consider the blurred lines between the social and biological dualisms that often underlie considerations of sexual desire and libido.
1.2. Theoretical Importance
This study is essential because it aims to explore respondents’ perceptions of their experiences of low sex drive and connect it sexual and bodily practices that blur the mind versus body dualism. The research provides general ideas about the cause and effect of medical and social scenarios that influence perceptions and experiences with low desire. It is also essential to indicate that there are women who identify as having a low desire but do not find it a problem in need of fixing. Furthermore, by considering that some individuals might feel content with their lack of sexual desire (and might identify as asexual), I want to fill in the gaps within current research that neglect to critique the idea that having a low sexual desire is a problem in need of fixing. I aim to explore different attitudes towards low sexual desire (e.g. asexuality), different non-medicinal methods of treatment/therapy, and how people who do see it as a problem cope with low sexual desire. Religiosity, age, health, gender, education, and socio-economic
circumstances may impact asexuality, which is the label and sexual orientation for individuals who do not feel attraction to any gender (Bogaert, 2004, pp. 279-281). I propose to investigate the effect of social and medical notions about women’s sexuality on their perceptions and experiences with low sexual desire. This study is socially and theoretically essential because it will problematize the pathologization of low sexual desire while building on the perceptions, practices, and experiences of the respondents to gain an idea of how social and medical notions of sexuality further create or dismantle the relationship between the mind and body.
1.3. Aims
The purpose of this thesis is to investigate how social and medical notions about sexuality affects how some women experience low sexual desire; furthermore, I aim to figure out how these different social and medical notions, including the internalizations and externalizations attached to them, further influence the relationship, or lack thereof, between the mind and the
body. Interrogating low sexual desire in connection with the mind/body dualism fills in the gaps of current research because many sexological studies including the Hite Report (1977) and the G Spot (1983) focus more on bodily practices rather than the connection between pleasure and the mind. Hite does not mention much about the role of the mind in connection with bodily pleasure. Furthermore, these studies primarily focus on pleasure as opposed to desire, and although they interconnect and sometimes depend on each other, they can also be independent of one another. For example, one might feel sexual pleasure without having a sexual desire and vice versa. There is considerable work on asexuality, which emphasizes the voices and experiences of individuals who do have a low desire, while also critiquing the medical field for doing that very thing (Betchen, 2014, Bogaert, 2004; Bogaert, 2006; Bogaert, 2015a; Bogaert, 2015b). Some prior literature primarily focuses on the biomedical deficiencies relating to low sexual desire with some consideration of women’s experiences (Basson, 2002; Basson, 2006; Heiman et al., 2011). Building on prior empirical studies which focused on women’s cultural and social positions in addition to their experiences with pleasure and desire (Hite, 1997; Kahn et al., 1983), I want to propose research that further investigates the mind/body dualism debate by looking at the cause and effect between normative medical and social ideas about low desire. The social justice aim is to provide a non-pathological understanding of low libido, but also providing insight into how the medical system might benefit people dissatisfied with their amount of low sexual desire. This social justice aim appears through a mixture of interdisciplinary theoretical frameworks,
including those from the sociology of the body and sociology of emotion. The empirical aims of this master’s thesis are to situate women’s life experiences with low sexual desire. I achieve this by viewing the common trends with medications, medical conditions, mental/physical trauma, pain/discomfort during sex, sexual orientation, religiosity, and education and the impact these themes have on the participants’ low sexual desires. These aims are reachable through the
theorization of how asexuality, the mind/body dualism debate, and the natural/social body debate contribute to the discussion of low sexual desire.
2. Theoretical Framework
2.1. Asexuality
In biology, asexuality refers to animals who reproduce without sexual intercourse; however, researchers find that there are sexually reproducing organisms that have no sexual interest or attracted to potential partners, and thus rendered asexual (Bogaert, 2006, p. 241; Bogaert, 2015a, pp. 1-2). Similarly with humans, asexuality is when individuals do not have sexual attraction towards people of any gender; however, asexuality is more complex than this one idea, which the current research aims to consider when using the framework to theorize low sexual desire. Asexuality, as it relates to humans, is relevant to the study of women’s perceptions and experiences of low sexual desire because it is an identity category and sexual orientation in which includes individuals who have a low attraction for individuals of all sexes and genders (Bogaert, 2006, p. 241). The criteria for HSDD often overlaps with asexuality; for example, those with life long HSDD and asexual individuals are likely not to experience sexual attraction to others (Bogaert, 2006, p. 243). However, in HSDD and sexual aversion disorder, there usually is or was a sexual orientation to either one or both genders, but there is either an aversion for genital contact or low sexual desire for these partners (Bogaert, 2004, p. 279). There are different pathologizations of asexuality, including that individuals might have different physical abilities, mental health issues, and interpersonal functioning/relations (Bogaert, 2006, pp. 247-248). However, it is insufficient to pathologize all individuals who do not have a sexual desire without the consideration of their morals, values, and, beliefs including individuals who are a part of certain cultures and religions that do not promote sexuality (Bogaert, 2006, p. 248). There are myths that asexual people do not masturbate, but some do masturbate for purposes such as exploration (Bogaert, 2015b, p. 58). Some individuals masturbate to nothing in particular; however, undirected masturbation does not necessarily mean that all asexual individuals lack sexual fantasies, although it is unknown whether their fantasies co-occur with masturbation (Bogaert, 2015b, p. 61). There is a continuum of how much desire individuals have; as a result, asexuality does not only refer to individuals who lack sexuality entirely. While acknowledging the vast biomedically-based literature on low sexual desire, this project aims to explore the social as well as biological factors that shape such experiences and take an agnostic approach to the
issue of pathology. Some women may see such low desire as a problem (biomedically defined in terms of pathology) while others may not. Framing low sexual desire as a biological pathology may be one way in which dominant biomedical discourse maintains a dualism between the mind and body.
2.2. Mind/Body Dualism
Social structures shape individuals’ interpretations, which helps them construct their identities; however, this depends on their cultural, political, and social capital (Singh, 2018a, p. 2; Shilling, 2012, p. 93). People’s bodies are never fully complete but affected continuously by social, cultural, and economic processes (Shilling, 2012, p. 96). The process of reflexivity is circular in that individuals continuously alter their identities relative to their interpretations of numerous social interactions and factors including relationships, friendships, school, seeking medical attention, etc. (Bottero and Crossley, 2011, p. 102; Shilling, 2012, p. 105; Singh, 2018a, p. 2). This thesis aims to use Bourdieu’s concept of reflexivity in two ways: one – to be reflexive as a researcher/interviewer, and two – to understand how the respondents display self-reflexivity within their specific narratives (Bottero and Crossley, 2011, p. 102; Bourdieu, 1990, p. 386; Shilling, 2012, p. 105; Singh, 2018a, p. 1). In addition to social context, individuals’ different social identities such as their religious involvement and culture might deem it
inappropriate to act upon sexual bodily queues or fantasies and desires (Bogaert, 2015b, p. 18; Bogaert, 2004, p. 286). Individuals might respond to these queues without having any desire for sexual contact with others simply because masturbation and self-exploration feel good and has health benefits (Bogaert, 2015b, pp. 55, 57). The habitus is located within and affects every aspect of the body, and how people treat their bodies ‘reveals the deepest dispositions of the habitus’(Bourdieu, 1984, p. 90; Shilling, 2012, p. 94). Individuals may change social realities that shape them through habitus, behaviours, and interactions within those realities. Society forms individuals and individuals formulate society (Singh, 2018a, p. 2). Habitus can form through repetition and imitation; in other words, habitus can come out of various body techniques (Singh, 2018c, p. 60).
Descartes views the mind and body as two distinct opposites, wherein the mind and body are two substances that causally interact in a mechanistic fashion because the mind uses choice and is the cause while the body uses motion and is the effect (Skirry, 2019, para. 23-43).
Furthermore, he argued that the mind is entirely and truly distinct from the body and may exist without it (Shilling, 2012, p. 138). The mind/body dualism and its criticisms are a significant part of the sociology of the body and emotions the subfields because many scholars and philosophers look into the interconnection and relation between the mind and the body. Shilling (2012) argues that classical sociology produced this dualism by following the philosophical idea that the mind defines humans as social beings (Shilling, 2012, p. 12). On the contrary, William James, an American philosopher, looks at how physiological feelings can cause individuals to feel
emotions, as opposed to the reverse, wherein emotions cause the physiological effects like heart palpitations, crying, and so on (Myers, 1969, pp. 67-68). Overcoming the mind/body dualism is essential to past approaches to low sexual desire because the interconnection between the body and mind influence one and another, and the findings in the current research exemplifies this through the particular narratives of the respondents. Biomedical framings often assumed a disconnect between the mind’s choices and the body’s actions. Investigating this topic in the current project, we must overcome this dualism to show the link between social, cultural, medical, and historical ideas as well as biological and physiological responses.
The debates of the mind/body dualism connect to queer theory because queer theorists (and feminists) argue that scholars must transcend this dualism if we are to fully account for the lived experiences of women as well as sexual minorities (gay, lesbian, bisexual, and asexual). Attractions of the mind do not necessarily always match pleasures felt in the body (Bogaert, 2006, p. 244). The empirical findings of the current study look at the co-occurring connections and disconnections between desire and pleasure through the lens of the interconnected links and detachments between the mind and the bodies through the participants’ narratives. We must look at the fluidity between sexual desire and pleasure rather than seeing them as mutually exclusive or contained within a body that is only causally affected by the mind. Shilling (2012) argues, “Body theorists were struggling against the dominant philosophical approach in Western thought that had for centuries revolved around a dualism that prized the mind above the flesh.
Descartes’s Cogito ergo sum (‘I think, therefore I am’) involved at one level a dismissal of all the body’s senses” (Shilling, 2012, p. 138). Thus, it is essential not to overlook the interconnectivity the mind and the body, as both generate feelings that may affect one and another either directly or indirectly. As mentioned previously, pleasure and desire are interconnected; however, they can exist without each other, and current research tends to focus on one or the other. Freund
argues that individuals must have a sufficient degree of control over the close integration that exists between the body and mind. Although this research does not exclusively follow all of Freund’s perspectives, some of these ideas relate to the findings because of how the respondents connected their sexuality to their life experiences. This control, which Freund theorizes about, requires the awareness of the linked nature of the mind/body relationship, a capacity to monitor and interpret messages that come from within, and the ability to mobilize the body’s resources in a manner that allows it to deal with such messages (Shilling, 2012, p. 101). Also, when
discussing Freund’s perspectives, Shilling uses the example of pain as the messages that come from within (Shilling, 2012, p. 101). However, this may extend to pleasure, although, historically speaking — no theorist, in particular, there were ideas that pain and pleasure are opposite
feelings. Furthermore, Shilling further exemplifies this by illustrating how people’s bodies signal when they are hungry, and their interpretations of those messages either helps them work to ignore or satisfy hunger. Similarly, this can be said for low sexual desire because individuals might have bodily queues in which their bodies seek pleasure (for example, muscle
relaxation/tension, vaginal stimulation), and it is up to their responses to their interpretations of those messages to either react not react to those sensations. However, as discussed earlier, pleasure and desire are not always synonymous nor simultaneous. An individual might or might not choose to satisfy those body signals depending on the time and place they are in, meaning that the reactions to these messages are contextual. Thus, taking into account social context is critical for understanding how some women come to experience low sexual desire and if/how they label it as pathological or normal.
2.3. Linking the Natural Body to the Social Body
A common theme in the existing literature about asexuality includes its comparison to Hypoactive Sexual Desire Disorders (Bogaert, 2006, p. 248; Bogaert, 2015a, p. 7). The asexual community aims to distance itself from the medicalization and pathologization of low sexual desire (Bogaert, 2004, p. 279). The distinction between medicalized conditions and asexuality highlights the dualism between naturalist and social constructivist approaches to sexuality. On the one hand, and there are many biological factors which contribute to low sexual desire – including, certain medications, medical conditions, hormone levels, and so on (Basson, 2002, p. 358; Basson, 2006, p. 1504; Gianotten, Bolle, and Hengeveld, 2004, pp. 569-570; Heiman et al.,
2011, p. 773). However, there are also many social factors such as relationships and friendships and how individuals internalize and externalize them through a reflexive process (which the findings of the current study cover) that contribute to low sexual desire (Bogaert, 2015a, p. 4; Fahs, Swank, 2016, p. 61; Singh, 2017b, p. 11; Singh, 2018a, p. 2). Depending on individual bodies, different methods of birth control may increase or decrease sexual desire. Many anti-depressants and psychotropic medications include side effects that may decrease sexual desire, although this differs from each individual and their bodies. Other medications also might have an impact on one’ libido depending on their individual situations. The mind has a great impact on how these bodily changes become regulated. Deepak Chopra, an American author argues that the mind comes before matter, the body is fluid and dynamic, and the mind and body go through an infinite feedback loop (Chopra, 1990, p. 14). However, quantum healing sometimes comes off as pseudo-science, for example, Pennycook, Cheyne, Barr, Koehler, Fugelsang, go as far as using some of Chopra’s statements as an example of “pseudo-profound bullshit,” although they primarily looked at some of Chopra’s tweets as a part of their study (Pennycook, Cheyne, Barr, Koehler, and Fugelsang, 2015, p. 561). Although some of Chopra’s arguments, including how the mind/and body connect to one and another, relate to the mind/body dualism approach, I will avoid the perspectives of quantum healing because of the substantial arguments that it is pseudo-scientific. Regardless, it is important to remember that both mental and physical components related to health and sexuality are essential to the discussion of low sexual desire because experiences, perceptions, and biology become integrated into what a person internalizes and externalizes throughout their life span. This particular importance links to the mind/body dualism debate because mental and physical impulses and sensations correlate with one and another. Furthermore, by identifying with certain biological or bodily characteristics, such as how much sexual desire an individual has, enables people to build communities with people who have similar traits (Bogaert, 2015b, p. 85). Sociology distanced itself from naturalist, biologist, psychologist perspectives until it started to critique the very lines between nature and nurture. Shilling (2012) discusses how naturalistic views of the body form a basis for, and contribute to social relationships, and sociology needs to recognize the contribution that bodies, such as their biological and physiological properties, make to social identities and relations (Shilling, 2012, p. 41). For example, various hormonal changes in the body may cause different levels of libido, which becomes internalized and externalized by the individual depending on their particular
social and mental situations. There is an alternative perspective which recognizes the properties of the body, yet understanding that social processes influence the body (Shilling, 2012, p. 75). It is essential to look at the interrelations between biological and social phenomena (Shilling, 2012, p. 76). This connection between biological and social phenomena relating to the body correlates to the discussion about low sexual desire because things like hormone levels and effects from medication are just as relevant as social factors that come into play. The body consists of higher levels of organization involving feelings, beliefs and a reflexive consciousness that enables embodied subjects to exercise agency, in addition to the inevitable biological properties which make up the body (Shilling, 2012, p. 75). It is essential to inquire how people’s biological condition relates to their social interactions because there are certain social attachments to things like low sexual desire. These attachments may include negative interactions such as social stigma, shame, pathologization; however, they might include positive ones, including compassion, empathy, and support.
2.4. Previous Empirical Approaches to Studies about Sexual Desire
In her foundational work on low sexual desire, Shere Hite (1977) focused on women from the ages 14-78 and with different levels of education (Hite, 1977, pp. 23-43); however, she did not collect data on race and religious background. Katz and Marshall indicate the connection between ageing women and low sexual desire, and by suggesting that acceptance of low desire as a consequence of becoming older is a part of the supposed ageing process (Katz and Marshall, 2003, p. 7). The medical system, media, and society often impose that elders are usually categorized as asexual, mainly because ageing individuals are often attributed with a disability that renders them non-sexual (Chaya and Bernert, 2014, p. 100). White (2016) analyzes scholarly journals and how fatness often becomes correlated to low desire (White, 2016, p. 2). Mainstream discussions about sexual bodies render fat people as either asexual or perverse (LeBesco, 2004, p. 40). Furthermore, in regards to the possible correlation between religiosity and low sexual desire, Woo, Morshedian, Brotto, and Gorzalka (2012) state, “The finding that the relationship between various domains of religiosity and sexual desire is mediated by sex guilt may have implications for understanding the etiology and the treatment of low sexual desire in women” (Woo, Morshedian, Brotto, and Gorzalka, 2012, p. 1492). The sample provided by Woo et al. included college and university educated women, but their analysis made no correlation between
their education level and low sexual desire. Heiman et al. sampled 93 premenopausal women either from the Netherlands and the United States and who are with or without low sexual desire; however, this study focuses on a demographic of a different age group, with their mean age being 31 years old (SD: 8.0), and they excluded women who take anti-depressants (Heiman et al., 2011, p. 773). The current study aims to situate low sexual desire within the Netherlands and in the Greater Toronto Area, which past studies have not.
Building on this past research, this project will consider the role of age, sexual
orientation, relationship status, medicine, mental states, and national contexts outside the US to understand low sex drive among women better. Past research on low sex drive has either been fully within the biomedical establishment or fully within the social sciences; thus, the aim in the present study is to integrate both by analyzing the participants’ narratives based on the common themes. For example, the biomedical model helps to discuss the participants’ experiences with medical conditions and medicine; however, there still remains criticism about the extent of how much society relies upon medicine to the point where social circumstances such as interactions, relationships, and communicating become less prevalent. The current research attempts to blur the lines between the natural/social body debate by integrating the biomedical establishment with social sciences within the analysis of the participants’ experiences. Additionally, in transcending the mind/body dualism, the current study aims to consider the social, cultural, religious, and physiological factors that shape women’s experience of low sexual desire.
3. Methods
3.1. Data collection
In this qualitative study, I conducted in-depth semi-structured interviews with 15
respondents via video chats, voice calls, and in-person, individually depending on what made the respondents most comfortable. The video chats and phone calls took place on either Skype, FaceTime, or Whatsapp, depending on what the participant wanted. I recorded the videos via the Recorder app on an Apple iPhone. I used Bookeo for scheduling participants, which enabled the respondents to choose their preference for the date and time. A qualitative approach helped with retaining in-depth information in connection to the topic by starting with demographic
information, followed by more details of the respondents’ experiences and perceptions of low sexual desire. The theories depended on the findings of the data collected because the analysis depended on some of the prevailing trends, key phrases, and answers from the interview. As a result, the study began inductively by researching existing theoretical frameworks about low sexual desire. However, the research ended up more abductive through the implementation of the production of theories based on the surprising evidence found in the data, thus, by moving back and forth with data and theory iteratively (Timmermans and Tavory, 2012, p. 168). The focus is on 15 women of the ages between 18-30 from the Greater Toronto Area (GTA) and in the Netherlands who have had a low sexual desire for approximately six months or more, including those who received a medical diagnosis in addition to those who self-identify. The target did not necessarily consist of asexual people or people with Hypoactive Sexual Desire Disorders
(HSDD); however, current literature focuses on the similarities and differences between the two (Bogaert, 2015a, p. 12). Consequently, not all respondents have experiences with consulting doctors, especially those who self-identify as having a low sexual desire; however, I probed more questions about their experiences with doctors if the respondents indicated that they consulted one. The aim was to focus on women in the Greater Toronto Area because of my accessibility to educators, acquaintances, and people working with the field of sexuality. After roughly a month of finding participants in the Greater Toronto Area, some participants started dropping out of the study, so I opened the demographics to women living in the Netherlands. This expansion
interview in person, which made some people feel more comfortable than if I interviewed them through video chat. I used a snowball sample to gain access to willing participants by having my friends, family, colleagues, tell their peers about my research in addition to having them share it on Facebook. In addition to contacting my acquaintances to find participants, I recruited
participants by advertising the study on social media and online bulletins, including Kijiji,
Craigslist, Facebook, and Instagram, and also by contacting the Gender, Sexuality, and Women’s studies administration at York University in Toronto to distribute emails to its students. The Canadian organizations Re: searching for LGBTQ Health and Re: searching for LGBTQ Health shared my participant request on their social media platforms. The Centre for Feminist Research, a group, affiliated with York University, also shared the study on their Facebook page. I paid for an advertisement promotion on Kijiji and Craigslist, which only attracted one participant. On Instagram, I paid for an advertisement promotion in which 5431 people saw the advertisement over six days, all of whom are women and live in Ontario. About 73 percent of the people
reached were between the ages of 18-24, and 27 percent were between the ages of 25-34. In total, according to the promotion insights of the post, users viewed the Instagram advertisement 7612 times. I achieved this post promotion with a budget of five euros a day for six days. The
advertisement on Instagram and posts on various Facebook groups attracted the majority of the participants. In addition to the use of social media and online classifieds, I sent the participation request via email to Gender and Sexuality Studies students at York University, which helped me recruit a couple of respondents.
3.2. Structure and Coding
The semi-structured interview included a set of 34 questions (see appendix 2). Depending on the specific experiences from some of the respondents, some of these questions were not necessary, while some of their responses enabled me to tailor new questions to go more in-depth on essential information found in their narratives. After the interviews and transcriptions, I recorded similar trends via Google Docs by making comments on the similarities and differences between the experiences of each respondent. From converting the data into analysis, I transcribed most of the interviews right after the interviews and five of the interviews when I finished
collecting all of the data by using transcribe.wreally.com. Documenting the similar and different trends directly after the completing the transcriptions enabled me to narrow down the data I
found necessary to the topic and how I chose to connect the final findings to the theorization of asexuality, the mind/body dualism debate, and the natural\social body debate. I coded the recorded interviews by comparing similar experiences and responses found throughout all 15 interviews, which included subjects such as sexual harassment/abuse, anxiety, depression, post-traumatic stress disorder, birth control, anti-depressants, and so forth. Before narrowing it down to 8 categories, in Google Docs, I used the Control+ F key to find the keywords, such as sexual assault/harassment, anxiety, depression, medication, stress, pain/discomfort, shame, and so on. Then I used the comment tool on Google Docs to highlight the trends. After this, I wrote in bullet points at the end of the document, bringing together all of the common issues. For the
demographics, I recorded their information on a table to organize that portion. The first draft of the table included more details pertaining to their demographics until I made them more general to be easier for people to read. Lastly, I grouped all of the answers to each question of every interview to make it easier to compare and contrast the participants’ narratives. It is not easy to find prior resources that look at all of these different subjects into one study, so it was essential to indicate how sexual harassment/abuse, anxiety, depression, post-traumatic stress disorder, birth control, anti-depressants affect sexual desire. After making connections between these subjects, I combined some of them into bigger categories such as medications, medical
conditions, mental/physical trauma, pain/discomfort during sex, sexual orientation, religiosity, and education. Medical conditions and mental/physical trauma relate to one another, but the separation of the categories represents the respondents’ experiences with the conditions, and on the other hand, what particular scenarios contributed to their acquired mental condition. This particular method is how I decided to include and separate certain data under different categories in the final findings.
3.3. Demographics (Refer to Table 1 in Appendix)
Nine of the respondents living in the Greater Toronto Area and six are living in the Netherlands. All of the participants are cisgender women. The sample of women from the Greater Toronto Area included women of various nationalities. Of the nine respondents from Toronto, five are Caucasian, three are East Indian, and one is Afro-Caribbean. The diverse sample collected from the Netherlands primarily consisted of English-speaking expats of different nationalities and ethnic backgrounds. All six respondents from the Netherlands are
Caucasian, but one respondent is from the United States, another is from Australia, one is Canadian, and the rest come from different countries in Europe. In total, the sample consisted of eleven Caucasian and four non-white women. The median age is 24 years old, while the mean age is slightly higher at 24.9 years of age (SD: 3,28). All of the respondents completed or are currently completing post-secondary education. Eleven respondents are either currently working on or completed a Bachelor’s degree, two finished or in the middle of completing a Master’s degree, while two completed a college program. Eleven of fifteen women identify as
heterosexual, one respondent identifies as pansexual, one respondent is heteroflexible, while the remaining two are bi-curious or questioning. Eight women are single, six are in a relationship, and one has a complicated relationship status. Seven women indicated that they have some mental or physical disability, while the remaining eight said that they do not have any. Nine individuals reported being irreligious; however, two of those respondents identified as spiritual. Five respondents are either Catholic or Christian, and of those five, only one person identifies as devout, and two identify as more spiritual than religious. The one remaining participant identifies as Hindu but is not devoted.
3.4. Additional interview
In addition to the 15 interviews with women who currently experience low sexual desire, I interviewed Kat Kova, a registered psychologist (MSc, RP) from Toronto, Ontario, who specializes in sex therapy, relationship issues, and trauma (Psychology Today, 2019, n.p.). Kat graduated in 2018 with a Master’s of Science degree in Couple & Family Therapy from the University of Guelph and has a private practice in Toronto (Psychology Today, 2019, n.p.). Her expertise gave insight into the different themes found throughout my data collection, including the effect of medications, mental/physical trauma, medical conditions, asexuality, and
relationships on low libido. In this one hour long interview, we discussed some of the common themes found in the qualitative interviews, how seeking sex therapy works in Ontario and more general information that she had to say about low sexual desire. During this conversation, I ensured the anonymity of all of the research participants by omitting all of the demographics, their names, and any descriptors that could identify them in any manner, including their detailed narratives.
3.5. Ethics
I provided the respondents with a consent form with the details of what the thesis regards, answered all of their questions to the best of my ability, and supplied a general spiel of what the research covers at the beginning of each interview. During and after the interviews, I ensured the confidentiality of the participants’ identities by leaving their names out of the voice recordings, transcriptions, and final analysis; reducing their location to either the Greater Toronto Area or the Netherlands, thus leaving out their specific cities; excluding their occupations; and so forth. Furthermore, in the transcriptions, excerpts, and analysis of this thesis, I omitted the particular names and identities of their peers, including their partners, friends, and family, in which some participants discussed during the conversation. The participation was completely voluntary and unpaid. Moreover, I made it clear to the respondents that they could refuse to answer any or all of the questions if it made them uncomfortable. At the end of each interview, with the best of my ability at the time, I offered respondents some of my recommendations such as books,
communities, events, and a sex therapist in Toronto if the respondent wanted more resources about low sexual desire. I also offered to send the participants my final research after
completion.
3.6. Self-Reflexivity as a Researcher
A significant part of the ethical practices of the current study includes situating myself as a researcher throughout the practices of the interviews, meaning, making the participants
comfortable and understanding the sensitivity of their information. This self-reflexive process is also essential when analyzing their narratives because it can easily distort people’s realities into something it is not. Bourdieu critiques the scholastic point of view through what he calls the “scholastic fallacy” wherein the academics change individuals’ interpretations of social life and makes them critical of things, which may not be relative to social reality (Bourdieu, 1990, p. 384; Singh, 2018a, p. 1). In the present study, the aim is to showcase the participants’ experiences without misconstruing their narratives. I attempt this by using direct excerpts from the interviews and merely analyzing them in connection with concepts including asexuality, mind/body
dualism, naturalistic/social body debate, and low sexual desire itself (Basson, 2002, p. 358; Basson, 2006, p. 1504; Bogaert, 2006, p. 243; Bottero and Crossley, 2011, p. 102; Heiman et al.,
2011, p. 773; Shilling, 2012, p. 105). Bourdieu argues that academic individuals are privileged because they can think about situations in abstract ways by creating conceptual frameworks rather than identifying a particular phenomenon for what it is (Bourdieu, 1990, p. 384; Singh, 2018a, p. 1). For Bourdieu, the academic understanding of the world might not be relative to how the world is (Bourdieu, 1990, p. 386; Singh, 2018a, p. 1). Thus, it is essential to avoid
misconstruing people’s stories through scholastic bias. Bourdieu suggests questioning the questionnaire and its designer, who should raise questions by separating from common beliefs. Researchers should critique intellectual bias within intellectual work (Singh, 2018a, p. 3). The scholastic view happens when academics, scholarship, and knowledge permeate in a person’s unconscious thoughts (Bourdieu, 1990, p. 386; Singh, 2018a, p. 1). Individuals should recognize intellectual bias by acknowledging their significance with the historicization of the scholastic fallacy (Singh, 2018a, p. 3). Academics project knowledge of the world onto others, which can be irrelevant to reality (Singh, 2018a, p. 1). It is essential to note the contexts of where the participants currently reside; as a result, I attempt to provide a background of how sex therapy works in Ontario and in the Netherlands. This attempt offers ideas of how the medical contexts in these locations provide therapy for low sexual desire, of course when individuals want to seek therapy, although the findings indicate that not all the participants particularly want to seek medical aid for their low libido.
4. Findings
4.1. Background of Sex Therapy in the Context of Ontario
Kat Kova indicated that if an individual wants to go to a sex therapist in Ontario for any reason, their insurance if they have any, might cover the costs. She works under the wing of a psychologist; therefore, insurance covers some of her services. Psychologists are a part of the healthcare wing, but psychotherapists are not. Sex therapy is not a protected title so
psychologists, therapists, and councillors can identify as sex therapists, so sex therapy is not always covered. The individual has to pay full price if they do not have insurance that covers it. Additionally, due to some regulations, some sex therapists who work in private practice
sometimes cannot accept insurance. Additionally, there is a whole process for a professional’s recognition as a sex therapist. However, there are psychologists, like Kat Kova, who specializes in sex therapy. People seeking sex therapy in Ontario can search for it on Psychology Today and the Society for Sex Therapy and Research (SSTAR) network. There are substantial differences between the healthcare systems in Canada and in the Netherlands, for example, health care systems in Canada vary by province, especially Quebec, which has its own healthcare system. The Ontario healthcare system also varies from the Netherlands.
4.2. Background of Sex Therapy in the Context of the Netherlands
Health insurance is mandatory for people living and working in the Netherlands (Ministerie van Algemene Zaken, 2019, n.p). In the Netherlands, people report their sexual problems to sexologists; however, there is overlap with psychiatry and sexology because sexual changes can affect the mood of the individual (Gianotten et al., 2004, p. 561). Seeking a
sexologist in the Netherlands depends on the individual’s insurance package, whether the service is covered or not, and whether the practitioner has a contract with insurance or not. Insurance does not cover patient services if the practitioner does not have a contract. Insurance does not cover undiagnosed conditions, relationship counselling, and those without a referral from a general practitioner (Zorgwijzer, 2019, n.p.). However, insurance sometimes does not cover services, even when an individual has a referral from a physician.
4.3. Medications/Drugs/Alcohol Use and Low Sexual Desire
Given my interest in transcending the mind/body and natural/social body dualisms that underlines past approaches to low sexual desire, I was interested in the medical history of participants and wanted to understand how physiological symptoms might converge with social factors in shaping their experiences of low sexual desire. To that end, I asked participants about the use of medications and substances that might impact libido. Ten of the fifteen respondents in my study use medications such as birth control and anti-depressants, which affects hormone levels. Seven respondents have taken or currently take different types of birth control, including the patch, pill, NuvaRing and Depo-Provera. The hormonal changes caused by these various medications inevitably impact people’s libido and physical arousal. However, not all birth controls and psychotropic medications distinctly include low sexual desire as a side effect. Hormone balances and the reactions from particular medications differ for every person. Some psychotropic drugs may cause pain in the genitalia or a reduced feeling, and substances with anticholinergic and anti-adrenergic effects may cause reduced lubrication and erection (Gianotten et al., 2004, p. 569). Dopamine activates sexual need, and anti-serotonin activates sexual behaviour and promotes orgasm, while anti-dopamine and serotonin hinder senses, sexual activity, and orgasms. (Gianotten et al., 2004, pp. 569-570). Prosexual neurotransmitters,
including dopamine, oxytocin, noradrenaline, and serotonin via the 5HT1A receptor, decreases with androgen deficiency (Basson, 2002, p. 358). Higher testosterone levels may increase sexual arousal, activity, and desire (Heiman et al., 2011, p. 773). However, testosterone levels alone may not increase sexual desire alone. It is unclear whether estrogen deficiencies contribute to low sexual desire (Basson, 2006, p. 1504). Many of the women taking medications noticed a drop in their sexual desire, and some of them expressed that it is one of the reasons why they want to get off of their prescribed drugs; however, this is not always possible, because some of them indicated that they still need their medication. One of the respondents stated,
I had three concussions in my life, suffered from anxiety and depression. I’m taking a baby dosage for the depression. A year ago we thought I had a polycystic ovarian syndrome, I had lost my period for over a year, and it turned out I had no estrogen, normally in that situation testosterone takes over, which you’d think would help my sexual life, but it didn’t. I’m getting my period now, which is great. I haven’t checked my
blood in a while, and I don’t know if that has to do with my low desire. I’m on a
NuvaRing because its a more centralized hormone, you’d think it help with sex, but I was off the NuvaRing when we were figuring out why I wasn’t getting my period. My doctor was saying that I would have to be off the NuvaRing for a long time before I can get pregnant.
Kat Kova indicated that certain birth controls contain both progesterone and estrogen, so they help with stabilizing hormone levels without diminishing sexual desire. She mentions that how people perceive things affects their sexual desire and that how our mind works also affects hormone levels. She recommends to weigh options of different types of birth control, figure out the reasons why someone is on birth control, and see if any other options can help manage their situation. For depression, anxiety, and PTSD, she recommends that people should try natural solutions to aid them so they can evaluate if they still need medications, for example, talking about their issues, seeing a therapist, doing therapeutic strategies. This way, such medications such as anti-depressants are not primarily used as a cure although they are just bandaids. This perspective is a balance between naturalistic and social conceptions of the body because
medication might be essential for an individual to use medications for their well being; however, treatment other than through medications might be helped with less of a biomedical treatment, such as through talk therapy, social interactions, writing, and as Rothschild explains, body psychotherapy (Staunton, 2014, p. 3). Kat mentioned that exercise and talk therapy work exceptionally well to help people with their self-esteem and to improve sexual desire. Under consultation and supervision of the person’s prescribing doctor, they can request to switch another medication that does not have a low desire as a side effect; however, changing
medications should happen gradually or with a wash-out period (Gianotten et al., 2004, pp. 573-574). Some of the respondents use marijuana for medical, mental, and physical purposes, but only one particularly receives prescriptions for it.
Users of marijuana often report relaxation, openness to the environment, increase of sexual pleasure, and decrease of aggression; however, dosage matters because, generally, sexual sense and pleasure increases after one joint, but after two joints it decreases as sedation starts (Gianotten et al., 2004, p. 612). Most of the respondents only drink alcohol occasionally; however, some indicated that similar to marijuana, it helps them mentally and physically relax.
At a low alcohol level, the alcohol raises the testosterone level in the blood, which increases the sense; however, on the contrary, alcohol consumption also suppresses the functioning of the central nervous system, whereby the sexual functioning decreases (Gianotten, 2004, p. 610). Four respondents report that they consume marijuana, and two of them indicated that it helps them relax mentally and physically; however, one of these women expressed how depending on drugs to function may lead to issues, so she keeps that into consideration as well. A participant also receives prescriptions for marijuana for pain relief. When asked if cannabis helps, one respondent, said,
I need some kind of outside influence to help me relax. I can’t allow my mind to relax enough for my body to enjoy it.
This narrative demonstrates the importance of the connection between the mind and body because the respondent expressed how her physical pleasure depends on whether her mind enables her to relax or not. This excerpt helps to dispute the cartesian idea of “I think, therefore I am,” which assumes that the mind superior to and separate from the body (Shilling, 2012, p. 138). This example highlights something complex – the mind cannot simply control the body – but through the introduction of chemicals, it tries to alter the mind and body externally. As a result, the motivations of the consumption of outside sources, such as marijuana and alcohol, also disputes the mind over matter idea mentioned earlier when discussing Chopra’s arguments because it shows that the mind cannot overcome matter, so it uses sedation, numbing, or clearing of the mind to let the body relax.
4.4. Medical Conditions and Low Sexual Desire
A handful of the women reported that they have disorders relating to menstruation, hormones, and issues with ovaries. One respondent has artificial hips, which sometimes hurts during daily activities and sexual intercourse. She revealed that her sexual desire became low when she started having pains in her hip, which persisted after the hip replacement. Another respondent had endometriosis, and she expressed that the incision still hurts her. Some of the conditions respondents reported having included Premenstrual Dysphoric Disorder, cysts in ovaries, Polycystic Ovarian Syndrome. Kat Kova mentioned that low sexual desire often
correlates to other medical conditions and sexual dysfunctions. A diagnosis of HSDD excludes circumstances of which low desire results from other conditions, for example, Major Depressive Disorder; however, if another condition results in HSDD, it is subject to a separate diagnosis, for example, HSDD due to major depressive disorder (Bogaert, 2006, p. 243). Seven of fifteen women indicated that they have some mental illness, and of these seven women, six respondents indicated that they have anxiety, two have post-traumatic stress disorder (PTSD), five have depression, and many of these women reported that they have a combination of the three conditions. Three of these respondents taken or currently take medications to treat these conditions.
4.5. Mental/Physical Trauma and Low Sexual Desire
Seven of fifteen participants reported mental, emotional, sexual, and or physical trauma in their lifetimes resulting from different reasons. However, five of fifteen (one third) of the participants specifically indicated that their experiences with sexual abuse and sexual harassment by men affect how they perceive and experience their sexual desire. Some of these women expressed their concern of being abused and harassed by men again, so it affects their dating lives and the connection between their minds and bodies because of the reminder of what happened to them and the fear that it will happen again. Often, participants reported having flashbacks of these traumas—memories which overwhelm the mind and body and make it difficult for them to become in the right mental state to enjoy sexual activities. A participant stated,
I have a little bit of depression. For me, it was two years ago when something bad happened. I was sexually assaulted, so it still sticks on my mind. I think its these two big things that happened to me. I really just started hating men and starting seeing them as people who only want sex. My boyfriend is good, but from my past where people were not responsible for what they did to me, or my ex-boyfriends who’d sleep around, these are big turn-offs.
Sticking in mind means that the body can feel it too. The body might feel particular sensations while having a flashback. Similarly, certain bodily sensations may trigger a certain
memory, and it can remember traumatic events (Staunton, 2014, p. 106). The autonomic nervous system (ANS) sometimes prepares the body for flight/flight/freeze as if the memory currently happens; moreover, these traumatic flashbacks can either happen through visual, auditory, behavioural or tactile senses (Staunton, 2014, p. 103). The associations that an individual consciously or unconsciously gives to the feelings felt in the body, which trigger certain flashbacks or memories that trigger bodily reactions may become positive or negative. When describing emotion throughout their theoretical frameworks, Cottingham and Fisher (2016) describe that it “is a body’s processing of social conditions, of its context” rather than an outcome of rational and conscious considerations of costs and benefits (Cottingham and Fisher, 2016, p. 4; Gould, 2009, p. 31).
Traumatic memories and flashbacks might not only affect an individual in the present but also how they think about the near or far future. Risk is not separate from emotion theoretically or meaningfully because socially situated constructions of risk occur simultaneously with feelings (and the management) of fear and anxiety surrounding future-oriented projections of harm (Cottingham and Fisher, 2016, p. 3). This idea relates back to the process of reflexivity and how individuals continuously alter their identities relative to their interpretations of numerous social interactions because some may unconsciously or unconsciously alter their actions
depending on their fear of arising situations (Bottero and Crossley, 2011, p. 102; Shilling, 2012, p. 105; Singh, 2018a, p. 2). One woman said that she is afraid of using dating applications because of the fear that she may experience a sexual assault again. She said,
I suffered violence from my family, male toxicity, slut-shaming, rumours, sexual assault. Like when I wanted to hang out with guys and just talk and then I would end up being sexually assaulted. It’s definitely traumatizing. With my ex, he helped me decondition myself from that trauma because we were friends for a while before dating. But this is why I don’t like meeting guys on dating apps because I don’t know if this will happen again. I’m trying to get myself out there again though.
One of the respondents described many of the trauma she endured, including suffering a miscarriage and being sexually assaulted and harassed by men. The respondent expressed how she changed her lifestyle because of the trauma she endured. However, she also explained how
her body, particularly her nipples and vagina, had stimulation, but she was unable to have the right headspace to focus and enjoy the intimate moments with her ex-boyfriend.
She stated,
I did experience sexual violence. The women around me experienced sexual violence. I just figured that men are so violent, and they just take from women sexually. It just makes me feel like men don’t deserve it. As a heterosexual woman, if he does not meet the standard of who gets to have me, I don’t care to waste my time or desire to give myself to him. Especially after all the mental work and therapy I did, I don’t want to go through that again. I got sexually assaulted when I was 16, and for the first two years, I couldn’t have sex because it would remind me of that, but following that, I had done enough work mentally that freed enough space for me to have sex, and then I turned to sex as a coping mechanism. I was very vocal about my situation, and I did enough mental work for me to be sexually liberated. As soon as the mental wasn’t there, I didn’t want it anymore. But if you are not earning it, not measuring up to my ex, not meeting the standard, then you aren’t worth it.
I just got really tired. When you’re having sex, you’re genuinely giving a performance unless you just lay there. Now I definitely just lay there, but it is just about my mental. Sometimes you can see that I am getting wet and my body is responding, but my mind is not there yet. Like children who get abused feel guilty because they get hard/wet, but there’s a huge disconnect when your mind is not there.
I had the miscarriage and tried to have six months later, and I couldn’t do it. I told him to get off of me. I got up and left. After that, he did not talk to me because I didn’t really explain why. He was expecting a certain experience, and I didn’t deliver.
As mentioned previously in this thesis, pleasure and desire are not always synonymous nor simultaneous. Women’s subjective sexual attraction patterns often do not match their genital arousal patterns (Bogaert, 2006, p. 244). Hence, fantasies and desire are not always consistent with physical stimulation and pleasure. Other respondents reported that they also had bodily
sexual sensations at times where their minds could not act upon those physical stimulations. For example, one reported that she had these bodily feelings while she was busy cooking dinner and could not act on it. However, in the excerpt, this particular woman’s experience is an example of the complexities of the identifications, internalizations, and externalizations of sexual touch because she identifies how she associates sex with different life events, and her mind cannot focus on sex despite having bodily stimulation. The meanings that individuals attach to certain sensations and touches may reflect how they experienced it in the past. Certain scents, touches, noises, and tastes might trigger certain emotions, help people overcome trauma, and help them cope; however, these senses may also trigger traumatic memories and cause pain. Sometimes individuals have dysphoric reactions to any physical arousal that takes place, including when there has been past abuse (Basson, 2002, p. 358). Kat Kova talked about how certain life events and trauma can alter brain chemistry, and by trying to figure out and work through the root cause can help people stabilize their mentality.
4.6. Pain/Discomfort During Sex
Eight of fifteen women stated that they do not have any additional sexual problems such as pain and discomfort. However, the other seven women indicated that they experience pain or discomfort during sexual intercourse. Some of the reasons for the pain and discomfort related to medical conditions they endure. A respondent indicated that she had pain during sexual
intercourse because of an undiagnosed yeast infection. One woman mentioned that her vagina had a hard time lubricating, resulting in discomfort and pain. Women can use hormone therapy or, more naturally, exercise their pubococcygeus muscle (PC) because a healthy muscle is more sensitive to physical stimulation in opposition to a “flabby” one (Kahn et al., 1983, pp. 95, 101-102). Another one of the women reported having pain while engaging in sexual intercourse because of a hip condition; therefore, the pain she endures during sex does not have to do with her vagina itself. Due to her hip condition, she is careful with the partners she chooses because she needs to be able to trust that they will consider her hip issues. Previous studies show that arthritis caused sexual difficulties in people’s lives, most commonly because of hip pain and immobility rather than loss of libido (Stern, Fuchs, Ganz, Classi, Sculco, and Salvati, 1991, p. 228). Another one of the respondents indicated that she had vaginismus, which affected her sex life negatively because of the pain she endured. She discussed that throughout her life span, there
were times when her body did not cope when she was mentally ready for sex, and when her body started to cooperate, then her mind was not ready.
The 23-year-old woman stated,
I first had sex last summer, and before that, I tried and was a really bad experience. Have you heard of vaginismus? I think I had that, and it made me more frustrated and
everything. My boyfriend tried his best, but he was still frustrated. My body wasn’t ready, and I had to work for months to get over it. I used to have a little pain having sex. When I lost my virginity it was like a murder scene because there was blood everywhere, but I read blogs and stuff online and realized it was normal, so I don’t think it was that bad. Things are not as bad as when I had vaginismus.
One woman indicated that too much stimulation in the clitoris makes her uncomfortable. She said,
Yeah, sometimes I find it too overwhelming, the sensation is like too much, and I don’t know how to deal with it, so I say stop. Particularly clitoral stimulation, if it goes too long, it feels uncomfortable and sometimes painful. When something is put in the wrong way, it hurts a little, like I bled a little bit once. But the stimulation of the clitoris is the big one. There needs to be a mix of other things going on or else its too much.
The first example relates back to the section about medical conditions, in which they affect people’s desires and access to pleasure. As mentioned previously, certain medications may lead to a lack of lubrication (Gianotten et al., 2004, p. 569). Additionally, without close regulation of pH levels, medications such as certain antibiotics may kill good bacteria, and some doctors, at least in the Greater Toronto Area, recommend taking probiotics while taking antibiotics to balance this out and to avoid yeast infections. Vaginismus is more complicated because there is no direct cause of it; however, psychological, traumatic, and societal factors (such as in contexts where sex is taboo) might come into play (Crowley, Goldmeier, and Hiller, 2009, p. 225).
Hiller, 2009, p. 225; Kahn et al., 1983, pp. 95, 101-102). Perhaps through enough habituation of these exercises, a woman’s vaginal practices change over time. It is also common for women feeling overwhelmed or uncomfortable with a certain amount of clitoral stimulation (Kahn, 1983, pp. 148-149).
4.7. Sexual Orientation
As mentioned previously, Eleven of the fifteen women identify as heterosexual; one identifies as pansexual, one is heteroflexible, while the remaining two women are bicurious or questioning. Although many of the respondents indicated characteristics of asexuality throughout their perceptions of their low sexual desire, none of them presently specifically self-identified as asexual. Two respondents briefly considered themselves as asexual in the past, but one reported that it was because her ex-partner was lacklustre, and the other reported that she did not find anyone she was attracted to at the time. One thought about how she might be asexual throughout this span of her life because she did not want kids and was not attracted to her partner at the time. The respondent described that this particular ex-partner was emotionally abusive, and she
suffered certain kinds of pressure from him. She stated,
At one point, I convinced myself that I was asexual, and I didn’t want kids because I wasn’t attracted to him. He definitely blamed me for things. That definitely took a toll.
The other respondent also explained how she briefly thought she was asexual. She said,
I haven’t dated that much. I guess I thought in high school I was asexual, but I just never found people I was attracted to. In university, I opened up more, but I don’t like random hookups. I’m very selective with partners.
Identity categories are non-static and unstable. Notions of pleasure, desire, and preference are changeable throughout time and experience. Sexuality and desire can be fluid and change over time; as a result, labels can be problematic, for example even if someone is attracted to women only, the word “lesbian” can be restrictive because an individual’s sexuality can change
