Free The Sex Myth: Why Everything We're Told Is Wrong by Brooke Magnanti Page A

‘women with HSDD exhibited
greater activation in the inferior frontal, primary motor, and insular cortices.’ But how each region of the brain relates to arousal in women is actually unknown. And as always, correlation
is not causation – proving that would take far, far more work than a short-term study of twenty-six people.
    As far as these things go, the amount of attention in the press seems out of proportion to what is clearly a small and prospective study. And as the only study to suggest this kind of aetiology
for lack of sexual desire, surely far more needs to be done before saying for certain whether the disorder is physiological in origin – or if it even exists at all.
    When it comes to diagnosing medical problems, everything we know starts with small observations. Over time, these are confirmed by larger studies, covering longer time periods, of more people.
Epidemiology goes hand in hand with experimental research to help a picture start to form. With a combination of approaches, over time,scientists can start to tease out the
potential causes of an identifiable problem. A single study that recruited twenty-six people? And the relationship between what was found and the criteria for subjects to be included? It’s
not enough.
    So, just what is HSDD, and how were the afflicted volunteers diagnosed? The disorder is listed under the Sexual and Gender Identity section of the DSM-IV and was known as inhibited sexual desire
disorder in earlier versions. Claims are made that it can be diagnosed using just five yes-or-no questions.
    The diagnostic questions include asking whether someone is receptive to their partner’s come-ons, ever loses interest in sex once it begins, and whether they feel sexual desire.
    As before, there are no time parameters given on any of the questions, and no measures of frequency or severity.
    If these questions seem vague, that’s because they are. The DSM estimated that about 20 per cent of the population had HSDD, and with such a blunt diagnostic tool, that high number is
unsurprising. And HSDD can be ‘acquired’, or in other words, a person might have felt desire before, but doesn’t any more. With such broad criteria, and a lack of wide-scale
study, it’s possible any number of claims could be made about the origin of a lack of sexual desire . . . but it doesn’t make them proven.
    Combine this with the extensive search for a ‘female Viagra’, and the utter failure of pharmaceutical companies to find one, and you start to wonder if HSDD even exists at all.
    HSDD fits into a history of attempts to give strict guidelines to what is ‘normal’. The diagnosis ignores the social factors that can influence expression of sexuality, not to
mention relationship context – I would consider myself highly interested in sex, but have definitely gone off it when having relationship problems. Is that really a good basis for diagnosing
a mental disorder?
    While nymphomania and hysteria have fallen by the wayside as medical diagnoses, it seems we are unwilling to let go of a tendency to define what is the ‘right’ amount of sex. With
more and more clinical interest in ‘sexual addiction’ and ‘hypoactive sexual desire’, it’s hard to see how exactly things have changed.
    Bermuda, 1961. At the nuclear arms summit, Prime Minister Harold Macmillan was mortified to discover an intern of President Kennedy’s tucked in the back of a
limousine, waiting to service JFK. Kennedy’s excuse? Withdrawal symptoms. ‘If I don’t have a woman for three days, I get terrible headaches.’ 42
    But do the rich and famous really have an illness, or is their behaviour more a result of opportunity?
    American feminist author Gloria Steinem called President Clinton a ‘sex addict’ after his affair with Monica Lewinsky. ‘He’s sick – he’s got an
addiction’, said former president Gerald Ford. ‘He needs treatment.’ 43
    This kind of judgement is pure speculation. Steinem