Riba Rambles:
Musings of a Mental Magpie

About the author: Elisabeth in early 2007, photo by Todd Belf
Elisabeth "Lis" Riba is an infovore with an MLS. This is her place to share whatever's on her mind, on topics both personal and political. [more]
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Saturday, November 19, 2005
Final words on FSD (for now)
Posted by Lis Riba at 11:40 PM

So, as Saturday night is winding down, I think it's time to call an end to what I'm calling my FSD week. For easier access, I'm including a quick index of all my entries on FSD.

Keep in mind, I'm not a medical professional: just a well-informed patient who has been educating herself as best she can.
So here are a few resources for further information:

• I'll confess that I haven't personally read this work, but I have an extremely good feeling about For women only: a revolutionary guide to reclaiming your sex life by Jennifer and Laura Berman. The authors are a physician and psychologist, and together used to work in the BUMC Center for Sexual Medicine, before setting out to establish their own clinic.

Dr. Irwin Goldstein has his own site, with separate information sections geared towards patients and more technical information for doctors.

The Women's Sexual Health Foundation has several information pamphlets geared towards patients, including advice on talking to your doctor about sexual difficulties.

[If you know of other books/sites worth recommending, please share them in the comments.]

A certain amount of thanks to Pseudo-Adrienne whose posts at Alas, a blog and Our word inspired me to such heights of eloquence and depths of rantage this week.

Index of posts:

Finally, as I mentioned in an earlier post, all the top hits when Googling "feminist and FSD" or "feminist and sexual dysfunction" are from the anti-FSD contingent. This page of my blog is actually within the top 100, but fairly low on the page.

I don't normally ask this, but if a few more of you would be willing to link to this week's archive using those keywords... well, at least that way other sufferers searching for help can more easily get this point of view as well for a more balanced picture.

Just sign me:
     A feminist on female sexual dysfunction (FSD)

And thanks.

Further Firefly adventures
Posted by Lis Riba at 10:04 PM

Ages back, I posted a link to an unfilmed Firefly script, "Dead or Alive"

Well, now Tim Minear has spilled the beans on another story they were plotting that never even reached the script stage.

I'll warn you before you read it: this one is real grim, although it does possibly explain one unresolved question from the pilot.

So, without further ado, and courtesy of FireflyFans.net and [info]the_cortex,

Some people are having too much fun
Posted by Lis Riba at 9:40 PM

Sports Illustrated includes an advance look at the Quidditch World Cup.

...There were some eligibility issues surrounding Krum before the tournament started, however, as rumors circulated that he hired an agent before his final year at Durmstrang began. As a result, he lost out on a major six-figure endorsement deal with Thunderbolt brooms.

Krum didn't cause nearly as much of a stir, however, as his teammate, chaser Jakob Levski, who refused to suit up for Bulgaria's second-round match with Luxembourg in observance of Yom Kippur...


Movie sign
Posted by Lis Riba at 8:35 PM

Just saw Goblet of Fire.

They sold out for the afternoon showing we wanted, so we only just got out.

Many other people can write more cogent reviews, so I'm not going to bother.

I'll just say that between this and Doctor Who, David Tennant is earning himself hordes of squeeing fangirls.

Doctor who...
Posted by Lis Riba at 1:30 PM

So, last night for charity, a free eight-minute snippet of the new Doctor Who was made available on the Internet.

Oh my.

Since then, I've been watching various other video clips from the BBC's official Dr. Who site, both new material from this past year and older retrospectives of the older material.

Now I want to see the new series. Anybody locally have a copy I could borrow?

Friday, November 18, 2005
Friday funnies
Posted by Lis Riba at 8:25 PM

Taking a brief break from the rants to browse the blogosphere...

Beware the automatic audio, but get a load of this garment. [via Feministe]

Dominoes, sparrows, and shaggy dogs has to be read to be believed.

Also, following up to Monday's post on she-geeks, I can't believe I missed these but (a) further talk on female nerds, and (b) somebody's putting out a pin-up calendar, which Shelley offers critical comments upon.
[These latter two found via the Carnival of Feminists, Issue 3.]

Female Sexual Dysfunction: A Truly Feminist Viewpoint
Posted by Lis Riba at 7:10 PM

So, now I've publically attacked two major feminist institutions, Ms. Magazine and Our Bodies, Ourselves, over their incomplete and one-sided coverage of female sexual disorders.

I'm just going to take a step back for a moment and see if we can't build some consensus.

The World Health Organization has released a statement on sexual health:

“Since health is a fundamental human right,
so must sexual health also be a basic human right.”

I wonder if everyone reading this, if everyone who calls themselves a feminist, can at least support this statement, whether or not we agree over the role being played by the medical establishment or drug companies or societal pressures or anything else.

If we can at least come together to find agreement in this most basic statement of principle, that gives us a certain amount of reassurance that we're all on the same side, even if we disagree about the means of achieving it.

WHO provides further elaboration with some working definitions:

Sexual health is a state of physical, emotional, mental and social well-being related to sexuality; it is not merely the absence of disease, dysfunction or infirmity. Sexual health requires a positive and respectful approach to sexuality and sexual relationships, as well as the possibility of having pleasurable and safe sexual experiences, free of coercion, discrimination and violence. For sexual health to be attained and maintained, the sexual rights of all persons must be respected, protected and fulfilled.

Sexual rights embrace human rights that are already recognized in national laws, international human rights documents and other consensus documents. These include the right of all persons, free of coercion, discrimination and violence, to:

  • the highest attainable standard of health in relation to sexuality, including access to sexual and reproductive health care services;
  • seek, receive and impart information in relation to sexuality;
  • sexuality education;
  • respect for bodily integrity;
  • choice of partner;
  • decide to be sexually active or not;
  • consensual sexual relations;
  • consensual marriage;
  • decide whether or not, and when to have children; and
  • pursue a satisfying, safe and pleasurable sexual life.

The responsible exercise of human rights requires that all persons respect the rights of others.

All in favor?

Anyone opposed?

More feminists against FSD
Posted by Lis Riba at 7:05 PM

I've got to stop searching the web for further feminist commentary on female sexual dysfunction. Supportive messages are few and far between, while most of what I find renders me inarticulate with rage. [It took me a while to decide whether to actually link to these sites and give them further attention/GoogleRank.]

The central locus of much of the anti-FSD crusade appears to be Dr. Leonore Tiefer, who runs a website called FSD Alert (fsd-alert.org). Considering her website's subtitle is "A New Medical Myth," it's pretty obvious where she stands on the issue. She's quoted in most of the articles I find that are critical of FSD, and even when she's not named, many of the arguments that incite me to rant parrot her claims.

Given how much of her rhetoric is rooted in the notion that the definition and treatment of FSD is all about profits, I should point out that Dr. Tiefer a psychologist and sex therapist. In other words, if women can find cures through medical means, it directly hurts her pocketbook. So her motives are just as compromised as those she criticizes. [You see? Two can play that game. I'm just a patient. My primary goal is obtaining treatment by whatever method works.]

Going back to that FSD creation myth one more time, a Good Vibrations article provides some necessary context these critics are missing:

In October 1998, the city of Boston hosted the first international consensus development conference on female sexual dysfunction. This meeting was made up of physicians chosen by the American Foundation for Urologic Disease, and came to the conclusion that female sexual dysfunction was a legitimate, diagnosable psychiatric condition. The year 1998 just happens to be the year Viagra (sildenafil) was approved for treatment of erectile dysfunction in men.
According to Irwin Goldstein, MD, who chaired three later meetings in 1999 and 2000 to further define and establish appropriate treatment for FSD, putting it more or less in the same camp as the granddaddy of all male sexual problems -- erectile dysfunction. As Goldstein, a Professor of Urology and Gynecology at Boston University School of Medicine, told womensenews.com, "Erectile dysfunction is a medical condition. You need to have women's sex problems in some context." Goldstein believes that a number of factors have led to the explosion in female sexual dysfunction, including childbirth and hysterectomy procedures that damage sexual nerves.

Since the announcement that FSD is a psychiatric disorder, many feminist writers have criticized Goldstein and the pharmaceutical industry -- which had financial ties with the majority of physicians at the conference -- for trying to profit by creating a new disorder which can potentially be treated by expensive drugs -- á la Viagra.

The problem is that pharmaceutical and medical device companies are not able to begin clinical trials and seek approval from the FDA for treatment of disorders that don't exist. Until FSD was established as a psychiatric or medical condition, no treatment could be sought by these industries.

Got that last bit?

[Along similar lines and at the other end of the spectrum, having a name for the condition also seems to make insurers more amenable to reimbursing patients for our expenses.]

Although I don't agree with everything in the Good Vibes article (hey, they've got a business to protect, too), a few other good lines are worth quoting:

We live in a world profoundly changed by generations of female sexual explorers, who have made it safe for a woman to walk into her doctor's office and say "Damn it, Doc, I'm not having enough orgasms. Do something!" But those women aren't getting much of the credit. The good news is that women who want sexual pleasure are perceived as a strong enough market that the medical community would want to market products and services to them. That has to be a good thing, since not too long ago it was a widely held belief that women didn't want or enjoy sex. Clearly doctors, male and female, now understand that women do want sex, and in fact will go to great lengths to get it.

When a woman walks into a doctor's office and describes the symptoms of FSD, she has as much right to receive appropriate treatment as she would if she had the measles.

Assuming that enlightened physicians diagnose FSD based on the patient's appetite for a satisfying sex life, rather than some arbitrary 1970s-era list of how many orgasms Helen Gurley Brown thinks a girl ought to have, what FSD boils down to is a patient's self-reported lack of sexual satisfaction, caused by anything.

Now, that last quote isn't entirely accurate, given (a) the various subcategories of dysfunction which I listed in my previous post, and (b) that crucial clause in most of the definitions “which causes personal distress.” It's like the legal definitions of disability, in which the impairment must "substantially limit ... major life activities." My problem goes far beyond mere dissatisfaction.

Humor break!
Rocky: "We're supposed to help damsels in distress."
Bullwinkle: "Hey, lady, are you in distress?"
Natasha: "Dis dress, dat dress, who cares? I'm distraught."
Bullwinkle: "Do we help damsels in distraught?"

One last point I wish to make about the positive side to assigning labels.

Sexuality -- particularly one's own sex life -- is a tough subject to discuss. Blogging makes it easier, since I'm sitting here at my computer and we're not face to face. But since I've opened up, because I've outed myself, other women have come to me to talk about their own problems.

And having clinical terminology makes these conversations easier. We don't have to get into embarrassing specifics about our intimate lives unless we feel it's necessary for understanding. And so what if the same disorder may have different root causes and require different treatments? The shared experience of dealing with similar symptoms still gives us a commonality to bond over!

But I digress. I intended to write about anti-FSD rhetoric from otherwise feminist sources.

Sadly, the latest edition of Our Bodies, Ourselves appears to be a major offender, parrotting the usual spin that doctors and pharmaceutical companies are trying to profit by creating problems out of otherwise normal variations. [At least the new version mentions the Pill can induce desire problems. That was totally absent in previous editions, much to my detriment.]

You can see for yourself in their companion content to their chapter on Sexuality, which they have the nerve to call Female Sexual Dysfunction: A Feminist View.

Hell, I'll just quote 'em directly:

Female Sexual Dysfunction: A Feminist View

Many of us have strong ideas about how much desire we think we "should" have. Movies, television shows and magazines often portray women as highly sexual. Drug companies and the popular media capitalize on these images and bombard us with messages about how to increase our sexual appetites. While these portrayals are accurate for some of us, they represent only a narrow slice of the wide range of women's experiences. Paradoxically, while desire is supposed to be invisible in girls, pharmaceutical companies (and medical researchers often hired by those companies) have begun to define low sexual desire in women as a medical disorder deserving of medical treatment. Yet what they label a disorder may, in fact, be a variation in sexual desire.

We've posted several articles that explore the issue in-depth. A New View of Women's Sexual Problems explains the limitations of the medical women's sexual problems, while Feminists Fight Drug Companies Over Vision of Women's Sexuality explores one woman's attempt to understand how and why drug companies pathologize women's sexualiy. Also check out The Making of a Disease: Female Sexual Dysfunction an indepth article from the British Medical Journal. (2003-- free) and The Marketing of a Disease: Female Sexual Dysfunction (2005 -- available for a fee) and the website www.fsd-alert.org.

<sarcasm> Isn't that a helpful, balanced overview of the issue? Notice anything missing? Growl...

I've already sent the Boston Women's Health Book Collective an email complaining about their coverage and requesting they strongly consider posting something from an alternate viewpoint as a counterpoint.

Still, they're headquartered in Boston, which has been the Hub of the fucking Universe as far as FSD research is concerned! Dr. Goldstein, the Berman sisters, the Center for Sexual Medicine all got their start in the Boston area, and have never been shy about educating anyone interested in learning more. So how did OBOS manage to completely miss it all!?!

As I understand it, BWHBC and OBOS were founded out of a desire for women to take control of their health into their own hands and out of a patriarchal medical system that ignored women's needs.

And now they're trying to recast the history of female sexual disorder research into that same mold.

Well, guess what. The acknowledgement of FSD as a disorder is exactly the kind of thing that BWHBC was working towards. It's a victory by angry frustrated women demanding of doctors and drug companies that "this is a problem" so loudly that the industry was forced to respond. We've spent years agitating for recognition that therapy isn't always the answer, and fighting for equivalent options as have long been available for men.

And then along comes Our Bodies, Ourselves telling its readers to "resist the attempt to medicalize sexual desire." [Bottom of page 191; you can read it through Amazon's Search Inside feature. Look for the mention of "Tiefer."]

Once again, it leaves me speechless, because everything I want to say right now sounds gratuitously and unhelpfully nasty to women whom I'm sure meant well.

We're not living in 1955 any more, when Valium was apparently handed out like candy to unhappy housewives. This is 2005. I am nobody's victim and I really hate this kind of disempowered portrayal.

In the meantime, I feel extremely sorry (and worried) for any women with FSDs who rely upon OBOS for medical information, and hope for their readers' sakes the BWHBC will correct it quickly.

Friday Penguin Blogging
Posted by Lis Riba at 7:21 AM

Damn, even when I don't go looking for them, the stories find me:

Giant penguin holds up train

A train driver caused delays on a German rail line after mistaking a giant toy penguin for a dead man in a tuxedo.

Passengers were left stranded in Neuwied after Udo Vergens pulled the emergency stop when he saw what he thought was a man lying face down and wearing a black and white tuxedo.

Officials who came to investigate found only a man-size soft toy penguin lying on the tracks.

A Neuwied police spokesman said: "We are at a loss to explain the presence of this very large penguin.

"We would think you would notice if you lost something like this."

[Ananova via Shakespeare's Sister]

Thursday, November 17, 2005
I'm just can't help myself...
Posted by Lis Riba at 10:00 PM
Get your rant on
Posted by Lis Riba at 8:15 PM

This is a rant, full of anger and emotions and opinion. If you want solid facts about female sexual dysfunction (FSD), I suggest you jump to yesterday's post where I provide a few links on the current state of medical science.

For someone usually so... dispassionate, I find some of the rhetoric bandied about critical of FSDs infuriating. That's what rendered me incoherent last night. I'm going to try again to address some of the misinformation I'm seeing around the web.

What's most frustrating, is when I confront people in online discussions who claim that FSD is a myth by saying "I have FSD, I can show you the lab results to prove it, what are your questions?" they always seem to just disappear into the mists. Folks are perfectly happy making gross generalizations and spewing rumor, but when called on it by someone with personal experience, I feel like I'm addressing a roomful of crickets. No apologies, no justification of what they wrote before, no requests for further clarification. Just silence. Makes me wonder whether they're actually reading and learning from what I wrote, or if these same people will continue to spew the same tripe in the future. [Some comments may come from flyby's, but you'd think the person who blogged the original comment might have something to say.]

At any rate, to get some of this off my chest, here are a few of the myths and misconceptions I hear repeatedly in these discussions, with my response. To protect the guilty, I won't quote anybody directly, but I'll do my best to convey the tone in which these remarks are made.

“The definition of female sexual dysfunction is too vague. It's a catchall that will be used to stigmatize normal women.”

I suppose folks could get that perception if they only read the few sensational stories that reach the mainstream press. But the mainstream media in general does a pretty poor job reporting on complex medical issues, and sexuality is a particularly difficult topic. By the time it's been simplified for the lay-audience, accuracy gets sacrificed, so I would never take such reporting at face-value without checking against more scientific/technical publications.

Anyway, Female Sexual Dysfunction is an umbrella term encompassing several different disorders. Patients may experience only one of these or may suffer from multiple problems. Here are some brief definitions of the current subcategories:

 • Hypoactive Sexual Desire Disorder (HSDD):
Persistent or recurrent deficiency and/or absence of sexual fanatasies/thoughts, and/or desire for, or receptivity to, sexual activity, which causes personal distress.
 • Sexual Aversion Disorder:
Persistent or recurrent phobic aversion to and avoidance of sexual contact with a sexual partner, which causes personal distress.
 • Sexual Arousal Disorder (FSAD):
Persistent or recurrent inability to attain or maintain sufficient sexual excitement, causing personal distress. It may be expressed as a lack of subjective excitement, or a lack of genital lubrication, or swelling, or other somatic responses.
 • Persistent Sexual Arousal Syndrome (PSAS):
A subclassification of female sexual arousal disorder, PSAS is defined as feelings of spontaneous, persistent and intense genital arousal with or without orgasm, with or without genital engorgement, in the absence of sexual desire.
(Read more information about PSAS; Read personal experiences of women with PSAS)
 • Orgasmic Disorder:
Persistent or recurrent difficulty, delay in or absence of attaining orgasm following sufficient sexual stimulation and arousal, which causes personal distress.
 • Sexual Pain Disorders:
 • Dyspareunia:
Recurrent or consistent genital pain associated with genital intercourse.
 • Vaginismus:
Recurrent or persistent involuntary spasm of the musculature of the outer third of the vagina that interferes with vaginal penetration which causes personal distress.
 • Non-Coital Sexual Pain Disorder:
Recurrent of persistent genital pain induced by non-coital sexual stimulation.
(Read more information about pain disorders)
 • Female Androgen Insufficiency Syndrome:
A pattern of clinical symptoms in the presence of decreased bioavailable testosterone and normal estrogen status. Free testosterone values should be at or below the lowest quartile of the normal range. (clinical symptoms)

Is that more clear? Seem reasonable?

And notice that repeated phrase "causes personal distress." If the woman doesn't have a problem with her situation, then it's not FSD. Nobody's talking about drugging unwilling women into compliant Stepford wives.

“Drug companies are manufacturing problems to make money off women's insecurities”

In other words: Viagra's so profitable, they've turned their greedy eyes onto women as an untapped market.

Sounds plausible, but I was paying attention back then and saw the pressure coming from the other direction.

I was already experiencing problems when Viagra was released (yes, it really has been that long). I followed the news avidly looking for the slightest hint of something applicable to my situation, or even mentioning women as something other than the partner of someone in need of Viagra. [My "Impotence and Inequities" essay was written during that time.]

And apparently I wasn't alone. This 2004 news story recalls the response to Viagra's debut:

Suddenly women started asking, "If men can have their sex lives fixed, what about us?"

So women began calling the offices of Dr. Irwin Goldstein, an expert in male sexual health at Boston University School of Medicine.

The women, he says, were calling "in droves. It was amazing." And, as CBS News Medical Correspondent Elizabeth Kaledin reports, a new era was born.

"Viagra became this empowerment moment, so a woman would say, 'Well, perhaps this little pill could help me, cause this problem is killing me,'" says Goldstein.

So don't assume this is externally imposed, evil industry taking advantage of women. A lot of women have been frustrated for a long while and agitating for attention. What we're seeing now is long overdue.

“Most sexual problems are psychological (or cultural), not physiological, so focusing on physical causes will prevent people from getting much-needed therapy.”

Near the labia, there are teeny little tear-duct like pores. Sometimes, in some women, these can become inflamed and/or infected (possibly related to androgen deficiencies). Think of them like pimples. They're no bigger than pinpoints, but they hurt like the dickens when touched.

That condition is called vulvar vestibulitis.

After two-and-a-half years of therapy with the doctor who wrote the book on sexual pain, fifteen minutes in the stirrups with a knowledgable doctor diagnosed it more accurately. And a quick dose of topical anesthetic proved it correct. [Okay, that was midway through a four-hour intake appointment, after I already filled out assessment surveys and gave blood and narrated my sexual history to their office shrink, but still... he was able to identify the problem astonishingly fast.]

While self-actualization and self-awareness are admirable goals, that's not necessarily the best (and certainly not the quickest) way of treating FSD. We spent years trying solo therapy, group therapy, couples therapy, sex therapy, reading self-help books and so on. And none of that brought us one step closer to resolving the problem we were seeking help for. Therapists gave our relationship a clean bill of mental health -- we communicated well, respected one another, did everything right except we still had no sex life.

Dr. Goldstein was able to diagnose me during our initial visit, through gynecologic exam and bloodwork and other tests.

Yet even now, I hear of friends whose doctors suggest therapy as a first resort. And all I can think is that a one-time blood test would be so much more informative.

  • If the problem is at root hormonal, then supplements and medications will probably be necessary, whether or not they're supplemented by therapy.
  • In contrast, blood tests can also quickly rule out hormonal problems, which would point more confidently towards mental health providers.

It's so easy and so useful, you'd think it would be obvious.
So why do patients have to talk their doctors into taking this step?

‘Helpful’ advice...

The general mainstream folk-wisdom tips that people blithely offer can often make patients feel worse. I know the intent is well-meant, but the underlying message is often one of blame.

Too stressed? Overtired? That meant I wasn't relaxing enough. "You're thinking too much." How the hell do you respond to that!?

Often this advice boils down to a requirement one reexamine one's entire upbringing and make fundamental personality changes. Inhibited? Repressed? Shy? Gotta get over those...

Because my symptoms superficially resemble those of sexual abuse victims, I wracked my brain fruitlessly trying to think of any possible time I might've been abused as a child, in case I was subconsciously repressing trauma. I'm quite certain I wasn't, but in reaching that conclusion I put a lot of innocent people under suspicion.

Ian and I scrutinized every inch of our relationship to see whether I might be withholding sex as some kind of sublimated response to other dissatisfactions.

As for Ian... That leads into another common theme:

“Clearly, her guy's no good.”

You wouldn't believe how many times in discussion of FSD, I see snide remarks that the root of the problem is in the man's incompetence/insensitivity. He doesn't help around the house enough, he isn't supportive of her needs, or he's a lousy lay. You wouldn't believe the crude jokes and nasty insults that women crack about men when the subject of female sexual dysfunction comes up.

Let me speak from the heart: You're not helping the situation.

I will say openly, my husband has been a saint regarding this matter.

You won't believe the guilt and self-doubt he went through, wondering whether this meant he was a bad lover or unattractive or selfish or pushy...

Now, some of the advice may help in some situations. But it's repeated so incessantly, like a drumbeat, it's pervasive. It gets under your skin and festers.

We didn't even realize how much self-blame we were both carrying around until my hormone deficiency was diagnosed. What I remember most about that day was feeling like a tremendous weight had been lifted off our shoulders. We had spent years second-guessing every aspect of our lives, trying to find the cause, and it was invisible biochemistry. You can't imagine what a relief it was to finally know neither of us was at fault. We could finally relax and not only accept ourselves and our relationship, but feel good about it.

Or, as Ian put it:

“The fact that we have no sex life is not harming our relationship. But the fact that for years, we thought there must be something wrong with our relationship because we had no sex life -- that was causing damage. Discovering that there was a physical problem removed that stress from our relationship.”

And that's one reason I advocate so adamantly that FSD does exist and that it's real. Because I don't want to see others suffering the way we did.

There are more issues I'd like to cover, but that's enough for now.

What really burns my britches is how many of these objections to FSD come from self-proclaimed feminists.

I know FSD isn't the first medical condition that people have tried to dismiss or deny; some people don't believe in ADHD or PTSD. [I don't have a comprehensive list of frequently-challenged conditions, but I wonder whether this is more common among ailments predominently affecting women, such as fibromyalgia or chronic fatigue or postpartum depression.]

But I think those were cases where patients were challenging the medical establishment for recognition. Here, the medical establishment is trying to understand and come to grips with a long-overlooked problem and feminists are trying to stop it.

I mean, I can understand the objections of conservative Christians. It angers me, particularly when they try to block funding for necessary research, but I never expected their support when it comes to improving female sexuality. I'm not even terribly surprised that therapists are prominent in arguing against physiological treatment -- heck, it cuts into their business.

But the fact that I'm mostly arguing against other feminists? Disappointing, to say the least...

So how are you?

Wednesday, November 16, 2005
Posted by Lis Riba at 8:35 PM

Lots that I want to say tonight, but everything I try to write sounds incoherent once I've put it in words. :(

And, yay! This was an experiment, but it looks like Blogger fixed their problem with Opera. Since they never ever posted anything on it to their Status page or Known Issues, I have no idea when they did this.

Let's talk about sex(ual dysfunction)
Posted by Lis Riba at 12:00 PM

For folks dropping by seeking info on FSD, here are a few historical posts that may shed a little light on matters:

July, 2003, my husband blogged a lecture we attended on "Women without orgasm: now or not ever" presented by the Institute for Sexual Medicine at the Boston University Medical Center. This provides a good overview of the state of scientific knowledge at that time.

November 2003, the ISM held a free seminar on FSD, mostly geared towards doctors and therapists, but intended to educate anyone interested. Near the end, an invited panel of patients spoke about their personal experiences... and I was among them. Afterwards, I wrote up what I learned (not as much as I could've, perhaps, which is why I recommend Ian's earlier post) and shared early research on the risks of oral contraceptives.

June 2005, news about the Pill hit the fan, and I wrote it up here followed by my personal history showing why I find it so plausible.

Outside this site, The Women's Sexual Health Foundation remains an excellent all-around resource, particularly for laypeople. BUMC's Institute has closed up shop, but Dr. Goldstein's website also has good information.

These links mostly cover the medical and scientific aspects of FSD. Later I'll compile some of our comments on the political side of the fence.

And if there's anything else you want to know, feel free to ask. As long as I've outed myself about this, I want my knowledge and experiences to benefit others.

Posted by Lis Riba at 8:00 AM

I was out last night and didn't have much time for blogging new material (I want to gather links to all my previous posts on FSD in one place as a resource). But as long as I'm writing on the subject of FSD, some old news that I never posted to this journal because it happened while I was jobhunting and I really didn't want potential employers seeing this as their first impression of me.

In the Summer 2004 issue, Ms. Magazine published an article on female sexual dysfunction that I found particularly egregious. A few excerpts:

[W]omen are not like faucets that get jammed up and will not turn on. We're all naturally sexual -- the survival of humankind would otherwise be in jeopardy.

Clearly, by this logic, impotence or infertility must not exist either. We must eat to survive, so there must be no such thing as food allergies or acid reflux. We must breathe, so asthma is a fiction...

[Viagra] increases blood flow to the penis, and for 20 percent of women in Pfizer's study caused an increase in vaginal lubrication. What it doesn't do is create women's desire, arousal or orgasm.

Therefore, because this one medication doesn't treat all sexual dysfunctions, the entire notion of physical dysfunctions must be fallacious.

Let's be frank: Women are not sexually "dysfunctional."

The author consistently used quotemarks like these (or refers to "women's so-called dysfunction") throughout the article, to create a wholly dismissive tone.

So how did the author explain women's complaints? It all boils down to: Fatigue, troubling emotions (anger, anxiety & shame), and antidepressant medications.

Her concluding advice:

Make sex a habit. For those in long-term relationships, I suggest Rx sex once a week, minimum. No exceptions, no excuses.

Tell that to women suffering vaginismus or other sexual pain. Frankly, that sounds more like a prescription for abuse: you must have sex whether or not you want it. Ugh.

Not only did the article content itself appal me, but moreso to find something like that in Ms. of all places.

In response, I:

  • wrote an email to the author (she's a shrink, so I wanted her to have the correct info so she doesn't misinform her patients),
  • wrote Ms. a letter to the editor, and
  • sent Ms. a query letter and writing samples, offering an article from my POV or to be an interview subject for them.

I never heard back from them, but six months later Ms. published a heavily truncated version of my letter.

Here's the letter I sent the magazine; they only printed the portion highlighted in yellow:

Your recent article on women's sexual health ("Viagra or an Rx for Sex?" Summer 2004) made my blood boil. I am a woman with a physical sexual dysfunction. I do not have a "so-called" dysfunction, but a medical diagnosis supported by physical evidence.

Ms. Hankin's rationalizations boil down to "it's all in your head." That's an astonishingly patronizing message to see in your magazine. Men can suffer from physical equipment failures. Why is it so difficult to believe that women experience something similar?

Sexual dysfunctions include low desire, arousal difficulties, inability to orgasm, and painful intercourse -- and women often experience multiple symptoms in combination. These problems can come from injury or disability, hormonal imbalances, complications of pregnancy or hysterectomy, or any number of other factors that doctors are only now discovering.

All the therapy in the world won't cure a physical problem. I know. I've spent years of my life trying all kinds of therapy, with no luck. And yet, when I finally found the right doctors (the Institute of Sexual Medicine at Boston University), blood tests and a physical exam led to a speedy diagnosis.

Women with sexual dysfunctions need support and information. Sexual medicine is a new field. Doctors are unfamiliar and often uncomfortable with the subject, so patients often need to take the initiative with their own treatment.

Several women with sexual dysfunctions founded the Women's Sexual Health Foundation to share information [*] and resources on the subject. Their website, http://www.twshf.org/, contains brochures to educate women and health care providers, and I recommend them highly. For readers in the New England area, Boston University School of Medicine is one of the top institutions devoted to the field. They also provide information on their website (http://www.bumc.bu.edu/sexualmedicine) and hold regular information sessions that are free and open to the public.

The World Health Organization has stated that sexual health is a basic human right for both men and women. I would hope that Ms. Magazine could get behind that.

I do wish they had printed more of the factual material about what sexual dysfunctions entail, but hopefully that was enough to help readers with problems recognize themselves and their options.

And I hope the editorial staff read the uncut original (I meant what I said about "patronizing") and will think twice before writing so dismissively of women's health issues in the future...

And now y'all know some of the things I get up to that I don't blog.

Tuesday, November 15, 2005
If these delights thy mind may move
Posted by Lis Riba at 6:20 PM

Over in Elizabeth Bear's journal, a small subthread formed about how seldom Christopher Marlowe's plays are performed.

Would anybody else be interested in a community/list/blog listing of Marlowe Onstage? Offer worldwide coverage, with announcements of future productions as we find out, with links to reviews when they become available? After all, Marlowe performances are so few and far between that it's doubtful anyone can attend most of them, but it's nice to know they exist to have the possibility...

If I create such a group/listing, would it have an audience?

Alternately, is there some general Marlowe-centric news & discussion group I'm missing akin to TheGreatGlobe or Whedonesque or the Leaky Cauldron? [On Usenet, Marlowe is lumped in with the other Elizabethans in humanities.lit.authors.shakespeare.] If not, would people be more interested in something along those lines?

PS: Whether or not you're interested in such a group, if you've got a creative title suggestion, please share it.

Posted by Lis Riba at 5:55 PM

When Viagra first hit the market, I don't remember hearing anybody argue that medical science shouldn't be studying impotence, that impotent men would be better off seeking therapy, or that the problem lay in inconsiderate sexual partners rather than physiological problems.

There was some criticism and concern regarding healthy men taking Viagra as a lifestyle drug, but it was nothing like the overwhelming chorus I hear whenever the discussion turns to female sexual dysfunction.

Though that happened before I started blogging, "Impotence and Inequities" is an essay compiled from my Usenet posts during that period, pointing out the disparities in the treatment and coverage of sexual health for men and women. It's still worth a read, IMO, for a look at the underlying attitudes that influence our opinions.

Posted by Lis Riba at 7:59 AM

Female Sexual Dysfunction is in the news again, yet again questioning its existence as more than a marketing tool.

Pseudo-Adrienne over at Alas, a Blog provides the latest iteration of the spin:

When it comes to discussing Female Sexual Dysfunction (or perhaps Dissatisfaction), all the medical jargon and scientific theories as to why women "don't like sex and are therefore dysfunctional" come out. Some doctors and pharmacists think FSD can be easily solved with a pill or patch– no big deal. However does this "just give 'em a pill or a patch, and they'll start happily humpin' and climaxing" line of thinking conveniently gloss over the larger issue that some women are perhaps dissatisfied in their intimate relationships? What about stress from working, having to take care of children, and running errands all day? What about their past experiences with sex? Were some of them sexually abused or raped? What if the environment within their relationship and their partner make them feel uncomfortable about discussing their sexuality? What about society's stigmas around women being open and frank about their sexuality? Does a male-dominated medical and scientific field have anything to do with the lack of human-oriented (as in actually talking to women and getting them to be more open and frank) research of FSD? Don't these other concerns matter in the debate over FSD? Or are some women just doomed to remain sexually dissatisfied or dysfunctional for various reasons? Sigh– just keep on faking it, ladies (or visit your local sex-toy store). Well Planned Parenthood has recently put out an interesting article on FSD and the issues surrounding the "controversy" of women's sexuality and women being open and discussing their sexuality.

I'm here to say, “Yes, Virginia, there is FSD.”

Pardon my cynicism, but I've heard it all before. In fact, the issue comes up like clockwork every time the FDA makes another announcement. They're preserving male privilege with pills instead of dealing with women's real issues.

FSD is a real issue faced by women, too. It could be an equally valid feminist argument that actually studying women's physiology is an extremely overdue development...

I have to wait for their moderators to approve my comment on their site, but nothing prevents me from sharing it here with you:

I am a woman diagnosed with FSD.
I've experienced years of "let's throw therapy at it," reaching a point where my therapist (with permission) brought my case to a conference of sex therapists, before finally throwing in the towel and saying she couldn't help me further.

Unless you've been through it, it's hard to understand just how hard therapy can be. I scoured my background for any hint of possible repressed abuse (since my aversion is similar to that of abuse victims). My husband went through his own guilt that he was too pushy or not helpful enough or a lousy lover.

Why put people through that unnecessarily?

When a hormone test showed my hormones were off-the-scale low, it was such a relief for us both. It wasn't our fault.

If the physical aspects of FSD can be diagnosed with a hormone test, I don't see why there's such resistance to it. Perhaps in most cases, it will rule out the physical diagnosis and lead people to therapy anyway.
But therapy is expensive and timeconsuming and not always accurate. Knowing onesself better is a good thing, but when it can't solve the problem the patients want to resolve, it's a waste.

Physical bodies have flaws. We accept that with men, in part because the problem is so visibly one of hydraulics. But the notion that women should seek therapy first seems almost a throwback notion that "it's all in her head" and only if we can't get her head straightened out should we look at the rest.

I don't want to be accused of hijacking the discussion, but here's my personal history with FSD.
Feel free to ask me further questions on the subject.

I may post further on this here, since it's not hijacking when it's my own journal. Because if it's being discussed in one journal, it's probably all over the blogosphere, and I want this side of the story to get out as well.

PS: I know that coworkers and family members read my journal. If this is topic borders on TMI for your comfort level, you may wish to take a day or two off. I won't let you miss my London reports if you don't want to read about my (lack of) sex life...

Monday, November 14, 2005
She geeks
Posted by Lis Riba at 7:15 PM

Over on TV Squad, somebody's posted their list of The Five Nerdiest TV Characters.

Every single one is male.

So, where are the girl geeks?

  • Lisa Simpson, The Simpsons
  • Willow Rosenberg, when the character was in high school (the first three seasons of Buffy the Vampire Slayer — she got more cool in college)
  • Patty Greene, the lead in Square Pegs
  • Andrea Zuckerman, of Beverly Hills 90210 (again, primarily while the character was in high school)
  • Winifred "Fred" Burkle, on Angel
  • Kaywinnit Lee "Kaylee" Frye, from Firefly (“I'm not saying the eighty-oh-four's hard to repair, it just ain't worth it.”)
  • Gadget, from Chip 'n Dale Rescue Rangers

Many ensemble shows had minor supporting she-geek characters, such as Violet Bickerstaff in Saved by the Bell (though she mostly served as a love interest/girlfriend for Screech) or pretty much all the students in Head of the Class.

It's a bit more varied than stereotypical nerdboys with their pocket-protectors and high-water-pants, such as Urkel, Arvid, or Screech. That makes me wonder whether this is turning into more of a "brainy girl" list, rather than necessarily geeks. Or maybe I'm just hampered by the limited amount of TV I watch.

What do you think? Does Darlene Connor from Roseanne count (another Joss Whedon contribution!)? How about Daria Morgendorffer (Daria and Beavis and Butthead)? I vaguely remember an early-eighties series called Whiz Kids, but I have no recollection of whether the lead female was actually one of the hackers or just a girlfriend. But that reminded me of the Amanda Pays double-header: Theora Jones in Max Headroom and Tina McGee in The Flash...

But again, I wonder if I'm getting off-track.

If I expand media portrayals to include films, the prototypically perfect specimen is Jordan Cochran from Real Genius. But I can think of few other TV characters as vividly iconic.

Names, people. I need names!

Weekend review
Posted by Lis Riba at 9:15 AM

Spent much of the weekend happily immersed in Elizabethan England.

Saw the Theatre@First production of Merry Wives of Windsor. Ian wrote up his comments in detail, and my observations dovetail pretty closely with his, so don't expect much further review from me.

It's playing thru next weekend (just outside Davis Square), so if you haven't seen the play before, I recommend it.

For my own edification, I've started compiling a list of Shakespeare I've seen (on stage, film or video), which will eventually become a webpage on my site. So far, I've seen 28 productions of 17 plays, most within the last two years. Nearly half, though now I'm getting into some of the less-performed works, which may be more difficult. Fortunately, the entire season of Actors' Shakespeare Project is new to me, so that'll help.

Meanwhile, get a load of Elizabeth Bear's insightful look at Marlowe's "Passionate Shepherd". Layers upon layers, reminding me once again why I made a lousy literature student. I'm such a fast and surface reader that allegory escapes me.

Aside from that, I spent much of my time reading a most excellent manuscript. As yet unpublished, but it's blowing me away.

I concluded my weekend by catching the first half of The Virgin Queen last night on PBS. It's good.
Especially after reading history_spork's justifiedly brutal take on Shekhar Kapur's Elizabeth, I was worried about historical authenticity, but they generally seemed to get the characters right and events in the proper order, although with little to indicate how much time is passing. Robert Dudley was too pouty-faced for my tastes, and Phillip of Spain seemed too old compared to Mary, but nothing set off warning-bells in my head.

I still haven't written up my London trip report. It's odd (and annoying): When I start talking with someone, my excitement bubbles over so much that I can hardly shut up about it. But facing a blank page, I just freeze up, fearing (somehow) I won't do it (or y'all) justice. I know that's ludicrious, so I'm going to try to just talk to my page.



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