Are people experiencing more sexual problems?

Numbers of people reporting sexual problems appear to be high. For example, the 2000 UK national survey of sexual attitudes and lifestyles (NATSAL) found that 35% of men and 54% of women reported some kind of sexual ‘dysfunction’[97]. In the most recent NATSAL survey 42% of men and 51% of women reported some kind of sexual difficulty lasting more than three months in the past year and 10% of men and 11% of women reported feeling distressed or worried about their sex lives[98]. However it is important to remember that this is – at least partially – to do with the way that sexual problems or ‘dysfunctions’ are currently understood. The American Psychiatric Association Diagnostic and Statistical Manual (DSMV) lists disorders relating to desire, arousal, and orgasm. This influences how sex therapists and popular media understand sexual problems. The model this is based on assumes that it is normal to experience sexual desire, to become aroused (gaining erections, for men), and to reach orgasm through penetrative sex (hence the disorders of premature ejaculation for men who orgasm quickly or prior to penetration, and vaginismus for women whose vaginas cannot easily be penetrated)[99]. However, there are many asexual people who do not experience desire and who are not disordered[100]. Also, for many people and practices, sex does not require erections, penetration, or orgasm.

Understandings of what counts as a sexual problem are also related to ideas about appropriate gender roles and behaviour. For example some late 19th century writings claimed that respectable women naturally had no sexual desire, but today sexual function is often presented as essential to a satisfactory intimate relationship for women and men[101] .

Anxieties about sex are very common[102]. Boys and men tend to worry most about erectile dysfunction and premature ejaculation, penis size and shape, sexual techniques, physical attractiveness, as well as dating and relationship problems. Girls and women also often express worries about physical appearance and fear that failing to be sexual in certain ways will mean failing to develop and maintain a romantic relationship[103]. This is often bound up with wider pressures on women to define themselves around relationships with other people and to be viewed as desirable[104]. All of these kinds of anxieties can themselves be detrimental to sexual and psychological wellbeing. It has been argued that the global pharmaceutical industry has played a role in generating anxiety as well as promoting drugs that are expensive, can have unpleasant side effects, and can be ineffective[105].

There is disagreement about the cause of sexual problems. The use of drugs like Viagra initially appeared to challenge earlier psychological theories about impotence. Many doctors, scientists, and journalists suggested that the success of the drug showed that sexual problems were primarily physical. However it is not clear that Viagra has been as successful as has been claimed. Many prescriptions for Viagra are not reissued, suggesting that many patients do not persist with it, and that it is not quite addressing their difficulties in the right way[106]. The popularity of Viagra may reinforce notions that men should always be ready for (a certain kind of) sex, increasing the kind of pressure and anxiety that is related to sexual problems, and perpetuating the link between masculinity and erections.

Women report low desire much more frequently than men; for example in one survey 40.6% of women aged 16-44 reported low desire of one month’s duration over the previous year, in contrast to 17.1% of men[107]. Again, we need to think about how ‘normal’ levels of desire are defined, and also address the fact that relatively rigid ideas about what constitutes ‘proper’ sex often discourage people from exploring and tuning into their sexual desires. This may be particularly the case for women due to the sexual double standard which requires them to police a fine line between being regarded as a ‘slut’ or ‘tight'[108].

Since the release of Viagra, interest in ‘Female Sexual Dysfunction’ has also grown. But a focus on ‘dysfunction’ obscures the complex social aspects of sexuality and the role of issues such as fatigue, stress, inequalities in child-rearing and housework, lack of communication between partners, violence, body image and self-esteem problems, and misunderstandings of anatomy and function in people’s sexual experience[109]. For example, the continued lack of education about the need for clitoral stimulation for orgasm in the majority of women means that some women believe they require physical or pharmaceutical treatment for lack of orgasm when education in anatomy would suffice[110].

Can be people be addicted to sex and pornography?

97. Macdowall, W., Wellings, K., Nanchahal, K., Mercer, C. H., Erens, B., Fenton, K. A. & Johnson, A. M. (2002). Learning about sex: Results from Natsal 2000. Journal of Epidemiology and Community Health, 56(Supplement 2), A1-A26.
98. NATSAL (2013). Sexual attitudes and lifestyles in Britain: Highlights from Natsal-3, http://www.natsal.ac.uk/media/823260/natsal_findings_final.pdf?utm_source=2013%20Findings&utm_medium=Download&utm_campaign=Infographic%20findings%202013; see also http://www.natsal.ac.uk/
99. Barker, M. (2011). Existential Sex Therapy. Sexual and Relationship Therapy, 26(1), 33-47.
100. Brotto, L. A., Knudson, G., Inskip, J., Rhodes, K. & Erskine, Y. (2010). Asexuality: A Mixed Methods Approach. Archives of Sexual Behavior, 39(3), 599-618.
101. Richards, C. & Barker, M. (2013). Sexuality and gender for mental health professionals: A practical guide. London: Sage.
102. Boynton, P. (2009). Whatever Happened to Cathy and Claire?: Sex, Advice and the Role of the Agony Aunt in Attwood, F. (Ed.) Mainstreaming Sex: The Sexualization of Western Culture. London: I.B. Tauris, 94-111.
103. Barker, M. (2011). De Beauvoir, Bridget Jones’ Pants and Vaginismus. Existential Analysis, 22(2), 203-216.
104. Gill, R. (2008). Empowerment/Sexism: Figuring Female Sexual Agency in Contemporary Advertising. Feminism & Psychology, 18, 35-60; Harvey, L. & Gill, R. (2011). The Sex Inspectors: Self-help, Makeover and Mediated Sex in Ross, K. (Ed). Handbook on Gender, Sexualities and Media. Oxford: Wiley-Blackwell, 487-501.
105. Irvine, J. M. (2005). Disorders of Desire: sexuality and gender in modern American sexology. Philadelphia: Temple University Press; Tiefer, L. (2004). Sex is not a natural act, and other essays. 2nd ed. Boulder, CO: Westview Press; see also http://www.newviewcampaign.org/
106. Grace, V., Potts, A., Gavey, N. & Vares, T. (2006). The Discursive Condition of Viagra. Sexualities, 9(3), 295-314; Marshall, B. L. (2002). ‘Hard Science’: Gendered Constructions of Sexual Dysfunction in the ‘Viagra’ age. Sexualities, 5(2), 131-158.
107. Macdowall, W., Wellings, K., Nanchahal, K., Mercer, C. H., Erens, B., Fenton, K. A. & Johnson, A. M. (2002). Learning about Sex: Results from Natsal 2000. Journal of Epidemiology and Community Health, 56(Supplement 2), A1-A26.
108. Barker, M. (2013). Consent is a grey area? A Comparison of Understandings of Consent in 50 Shades of Grey and on the BDSM Blogosphere. Sexualities, 16(8), 896-914.
109. Tiefer, L. (1995). Sex is Not a Natural Act. Boulder, CO: Westview Press; Fishman, J. R. (2004). Manufacturing Desire: The Commodification of Female Sexual Dysfunction. Social Studies of Science, 34(2), 187-218.
110. Kleinplatz, P.J. (Ed.) (2013). New Directions in Sex Therapy. Philadelphia: Brunner-Routledge.

Can be people be addicted to sex and pornography?