Feminist Sex Therapy

Feminist sex therapy has led the field in recognition of the costs of dismembering of sexuality from relational context. Tiefer identified the influences of the positivist approach and of biologically based explanations of human sexuality in the misdirection of sex therapy’s focus away from sex-role, relational, or psychological issues. Seidler-Feller ques-tioned the adequacy of sex therapy from a feminist perspective, citing the tendency to implicitly reinforce normative sex roles and the power differential between the sexes that underlies them. Tiefer also critiqued the DSM-III sexual dysfunction nomenclature as focusing exclusively on physical performance while omitting empirically based information on what women consider important in sexual life, including intimacy, negotiation, and communication. Tiefer adapted Reissman’s analysis regarding the negative consequences of medicalization for women’s sexuality, pointing out the processes of mystification, moral neutrality, and individualization of sexual problems inherent in the medicalized, traditional approach.

Mystification places definitions of “normal and healthy” sexual functioning in the hands of officially sanctioned experts rather than selfdefined enjoyment, more often reflecting these experts’ reality rather than women’s. When medical science alone defines the norms for sex, an objective reality is assumed, leading to a stance of moral neutrality in which “sex is no longer a human arena for negotiation, but an arena where there is an objective standard against which performance can be measured”. McCormick further identified the “nonconscious equation of sexual activity with reproductive potential” that influences clinicians to equate sexual dysfunction with “physical failures in the performance of intercourse”. In indhidualizniii sexuality and sexual problems, medicalization denies and obscures the effects of social contri-butions to people’s sexual complaints, including rigid sex roles, unrelenting standards of performance, relationships of unequal power, and histories of sexual victimization.

Tiefer recommended that feminist sex therapy include “corrective genital physiology education, assertiveness training, body image reclamation, and masturbation education.” McCormick also recommended that therapists treat individuals and couples for deficits in tenderness, poor communication, sexual selfishness, disinterest in oral sex, and unwillingness to cuddle, although she noted that deficits in these areas have not been assigned formal psychiatric diagnoses. A feminist approach to sex therapy uses existing scientific knowledge about biology, medical approaches, and empirically validated treatment techniques while adding the following ingredients:

  1. Recognition of social and cultural gender inequality;
  2. Recognition of the influence of this power differential in relationships, and a willingness to intervene at this level;
  3. Valuing equally the subjective and affective aspects of sexuality, relative to physical performance;
  4. Recognition of traditional sex roles as etiologic of many sexual problems, and a willingness to intervene at this level; and
  5. Recognition of the unique experiences of men and women regarding sexual socialization, experiences of sexual coercion, sexual decision making, and the influence of relational factors in sexual dysfunction.
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