According to Science, Your Sex Drive Is Real

It becomes very clear that opponents of HSDD medical treatment options who are holding up "responsive desire" as a rationalization for blocking FDA approval of a first-ever drug for this condition are either being disingenuous, or they have no idea what they are talking about.
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Every seven seconds. That's how often men supposedly think about sex, according to conventional wisdom. And women, you ask? Well, if you believe that same conventional wisdom, not nearly as much. In fact, one sensational claim out there in the media right now takes that a step further by arguing that women, in fact, have no sex drive at all.

This claim comes at a flash point in the debate surrounding the Food and Drug Administration's (FDA) potential approval of what would be the first-ever medical treatment option for women's most common sexual dysfunction. With the FDA's decision expected this summer, silly season is definitely upon us as opponents of medical treatments for Hypoactive Sexual Desire Disorder (HSDD) -- which impacts 1 in 10 American women and is characterized by a distressing lack of sexual desire -- pull out all the stops in their efforts to marginalize and discredit women living with a condition that has been recognized by the medical community for more than 30 years.

Here's the crux of the crazy: Those in the "no sex drive" camp say that sex drive is defined as "spontaneous desire" -- meaning that a person is interested in and motivated to have sex BEFORE sexual activity has started. For example, fantasizing about a steamy moment with Bradley Cooper when you see him on TV. They say that this type of "spontaneous desire" doesn't happen for women, and argue that women instead experience "responsive desire" -- meaning a woman is motivated to have sex ONLY AFTER sexual activity has been initiated or her partner begins to touch her sexually.

First, as a clinician, as a woman and as a feminist, I think it's important that we stop here for a moment and really break down what they're saying with this "responsive desire" theory. Because when we do, it's even more disturbing than at first glance. What these people are REALLY saying is that a "no" from a woman when it comes to sex might not really mean "no" if her desire is going to kick in anyway. Think about that for a second.

As a theory, "responsive desire" is about as far from the mainstream as it could get. So while it makes for an eye-catching headline -- "Sex Drive Doesn't Exist!" "There's No Such Thing as Sex Drive!" -- it doesn't have a scientific leg to stand on.

That's the good news. Here's the bad: The real danger of these headlines is that contrary to the personal experience of women, especially those who previously HAD SPONTANEOUS DESIRE, and lost it, such claims hurt women who are already struggling with often personally devastating issues of libido. Women who have been diagnosed with HSDD have NO desire of any kind -- spontaneous or responsive. In fact, the very definition of HSDD, as I mentioned earlier, is a distressing lack or absence of sexual desire. And feeling obligated to have sex isn't sexual desire either.

Understanding that, it becomes very clear that opponents of HSDD medical treatment options who are holding up "responsive desire" as a rationalization for blocking FDA approval of a first-ever drug for this condition are either being disingenuous, or they have no idea what they are talking about. Frankly, either option is scary on its face, considering the massive disservice they are doing to the very women they're claiming to represent.

FDA approval of a first-ever treatment option for HSDD would be a historic moment for the millions of couples who are currently living with HSDD without a medical treatment option. It would also be a game-changer for women's sexual health on an even bigger scale, as it would open up the pipeline and field of research for a variety of treatment options to come.

As the FDA approaches the finish line in its consideration of this first-ever drug for HSDD, instead of insulting women by telling them their desire to hunger for their partner again is abnormal, we should be listening to them. These are women in healthy and stable relationships. They love their partner. They don't understand why they have no interest in sex and they want to feel differently. Women have waited long enough. We must empower them to take ownership of their sexual desire and do what it takes to regain their desire if they want it.

Dr. Clayton is interim chair of the department of psychiatry & neurobehavioral sciences, David C. Wilson professor of psychiatry and professor of clinical obstetrics and gynecology at the University of Virginia School of Medicine in Charlottesville. She is distinguished fellow of the American Psychiatric Association and certified by the American Board of Psychiatry and Neurology. Dr. Clayton is consulting editor for the Journal of Sex & Marital Therapy and received the Columnist of the Year award in 2005 for her bi-monthly column in Primary Psychiatry, "Considerations in Women's Mental Health." In 2007, her book, Satisfaction: Women, Sex and the Quest for Intimacy, was published for the general public.

Disclosure: Dr. Clayton is a consultant to or on the advisory boards of Apricus Biosciences, Inc., Euthymics, Forest Research Institute, Inc., Lundbeck, Palatin Technologies, Pfizer, Inc., S1 Biopharmaceuticals, Inc., Sprout Pharmaceuticals, Takeda Global Research & Development and Trimel Pharmaceuticals; and receives grant support from Forest Research Institute, Inc., Palatin Technologies; Pfizer, Inc., Takeda and Trimel Pharmaceuticals.

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