Last Mother’s Day, news had just broken that then-Congressional Representative Anthony Weiner had tweeted a picture of his erect penis to a woman, thinking the tweet was private. The blogosphere immediately erupted in debates over the relative merits of women over men, the moral weight of adultery (Weiner is married), and the need for public officials to stop thinking they understand new media.
For me, however, a central question raised by the event was never fully addressed: what is it with men and photos of their erect penises?
In the 12 months that have passed since the Weiner incident, I have received unsolicited penis pictures from several men I wasn’t dating, didn’t plan on dating, and in some cases didn’t even really know.
And I am not alone. Only just this week, a friend of mine received an erect-penis picture via text from a coworker who had intended it for his girlfriend but then thumbed in the wrong number.
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In fact, a quick poll of those of my (male and female) friends who cared to answer the question shows that un-solicited penis pictures are not all that uncommon. Interestingly, the women I asked all said they had never sent photos of their genitalia to anyone. Absent more representative polling (and somehow I don’t think this question has ever made it into a survey), let’s just say for now that men are more likely to take and send photos of their genitalia than women.
The question is why? And… so what?
Here’s my theory.
Men and women are taught to deal with social situations differently. Men and boys are overwhelmingly taught to depend on themselves, to be direct, and to celebrate their physical strength. Women and girls, on the other hand, are taught the value of social coherence and politeness, and are often not encouraged to celebrate their bodies at all. Whether these are innate sex differences or acquired characteristics is an open question, but socially, for most people, and in varying degrees, the sciences agree that gender (i.e. learned norms), if not sex (i.e. biological distinctions), makes a difference.
This is the framework that makes a man more likely than a woman to think a photo of an erect penis is a good way to communicate something positive about a man’s body. And it is the same framework that makes a woman more likely than a man to worry if she is overweight or unattractive (which according to prevailing norms often is seen as synonymous).
Like most internalized behavioural patterns, the difference is the starkest when the individual feels threatened.
In the context of an inter-personal relationship this means — to be slightly clichéd about it— that men are more likely to react to insecurity by reasserting their physical superiority (“You have never seen a bigger dick than mine!”) and women are more likely to react by begging for approval (“Does this dress make my ass look big?”). Both proclamations get old fast, not least because anyone who’s ever been on the receiving end of either knows there is only one appropriate answer, regardless the truth: “Of course not.”
But even if you transplant this dynamic to a professional or other public arena, these somewhat primitive reactions are problematic. Men are more likely to assert their superiority — despite and often because of any insecurity they might feel — whereas women are more likely to phrase statements as declarations of submission — despite being experts in their field and sometimes precisely because they are.
This very real gender difference is at least partially at fault when it comes to companies and society more generally valuing women’s work less than men’s: women, themselves, tend to play down their own value.
To be sure, there is no research on the relation between penis pictures, gendered social cues, and how it relates to job performance and pay rates. Moreover, I am certainly not trying to blame women for the discrimination they suffer. And I don’t believe any of these tendencies are universal, absolute, or inevitable.
However, there is more than enough science to support the existence of gendered reactions to threats and insecurity, and to point out the different ways in which boys and girls are taught to think about and enjoy their bodies, even today.
Perhaps more to the point, male (sexual) aggression — even when solicited, welcomed, and enjoyed — is part of a gendered framework that, if imposed in a general and mechanical manner, hurts us all. In fact, research shows that gendered norms make men much less likely than women to seek medical or other help for physical and mental health issues, with very real consequences for their health and happiness.
So, gals, next time you put on your favourite dress, ask yourself how you feel, not how someone else might think you look. And guys: if you find yourself about to snap a picture of your junk, ask yourself if that really is your best side, and if you wouldn’t rather be known for who you are.
Some advocates are calling the Food and Drug Administration's historical hesitation to approve a drug that would treat low sex drive in women sexist; others are saying the development of the medication itself is sexist. Who's in the right?
Last week, Sprout Pharmaceutical resubmitted its New Drug Application to the Food and Drug Administration (FDA) for the approval of flibanserin, a medication designed to increase sex drive in women suffering from what has been called hypoactive sexual desire disorder (HSDD). The FDA has rejected the drug twice before, asking for more research on its safety. This has prompted some people—many of whom identify as feminists—to call the agency sexist and to argue that if the medication were for men, it would have been on pharmacy shelves already. Other advocates, however, think drugs like flibanserin should never make it to market at all, because they believe that HSDD was made up by companies trying to profit off of women’s sexual insecurities. So, what is this pill, why are so many people fighting about it, and is there a happy medium here?
Flibanserin, which will likely have a sexier name if or when it is available for sale, was originally developed as an anti-depressant. As such, it works on neurotransmitters in the brain—increasing levels of dopamine and norepinephrine and decreasing levels of serotonin. In trials, this rebalancing of brain chemistry seems to also increase women’s desire for sex. “Cara,” a woman who has become a bit of a spokesperson (albeit one going by a pseudonym) on behalf of the company’s efforts with the FDA, explained to Marie Claire that she and her husband had wonderful sexual chemistry before kids, but that all but disappeared once she became a mother: “That broke [my husband’s] heart. He’d be lying next to me and I could just feel his anger and sadness in the air.” After she joined the drug trial, she says, her libido returned. As she noted, “Flibanserin helped me remember that person I used to be.”
But, like other antidepressants, flibanserin has side effects—most notably nausea and sleepiness—which were reported by 10 percent of the women, some of whom said their drowsiness was intense enough to interfere with their ability to drive. The FDA cited side effects like these as the main reason for rejecting the drug the first time it was up for review in 2010. At the time, a panel of experts unanimously voted against it because they believed the benefits did not outweigh the risks. The drug’s initial developer, Boehringer Ingelheim, then sold the drug to Sprout, which conducted additional efficacy and safety studies before resubmitting an application for approval. This second application was rejected in 2013; after a formal dispute of the decision, the FDA asked the company to provide more data on flibanserin’s interactions with other medications.
One particular concern is how the drug will combine with a class of antidepressants known as selective serotonin reuptake inhibitors (SSRIs). These medications increase serotonin in the brain, which is the opposite of what flibanserin does. Interestingly, and perhaps significantly, doctors consider SSRI use to be linked to many women’s low sex drives. The application Sprout filed last week included more information on drug interactions like these.
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Ahead of the filing, Sprout and supporters have been lobbying hard for the drug’s approval and gone so far as to call the FDA’s rejection of the earlier applications sexist. Several prominent women’s rights groups, as well as some lawmakers, have joined with a group of drug companies all working on this issue to create the Even the Score campaign. Those behind the campaign argue that men have 26 drugs to address sexual dysfunction, while women have none; they say, “Treatments for women’s sexual dysfunction seem to be held to a different standard for approval at the FDA, and women suffer the consequences due to lack of access to safe and effective treatments.”
As Coco Jervis of the Women’s Health Network explains in a recent piece for Rewire, however, these arguments don’t hold up to scrutiny very well. First, she points out that men only have 26 drugs if you count every duplicate drug (a brand name and all of its copies)—in reality, men have about six solutions for sexual dysfunction. And while this is six solutions more than women have, this doesn’t mean sexism is at play.
On a biological level, men and women function very differently when it comes to sexual arousal and performance. Viagra—and medication like it—is all about the plumbing. Men who get aroused but fail to get erections take the pill when they want to have sex, and it increases blood flow to the penis. That is far simpler and more direct than a treatment like flibanserin, which is trying to change how women’s brains are wired and must be taken every day. In a statement made last year, the FDA said, “We do not believe there has been any gender bias with regard to our review of this drug.”
Jervis brings up another important point about the “score” that the campaign is trying to even. She notes that it is unfair to directly compare women’s sexual dysfunction—which is a wide-ranging and not well-defined concept—with men’s impotence. She writes:
The word “dysfunction”—medical jargon for anything that doesn’t work the way it should—suggests that there is an acknowledged norm for female sexual function. That norm has never been established. Although male sexuality is more complex than sheer physical arousal, erections are quantifiable events that scientists can measure in objective terms. By contrast, cis women’s sexual response is, by and large, qualitative, and difficult to subject to clinical trials. Furthermore, as we all already know, sexual desire differs over time and between people for a range of reasons largely related to relationships, life situations, past experiences, and individual and social expectations—and “normality” can vary widely from person to person.
In fact, there is not widespread agreement about whether HSDD, the disorder filbaserin is designed to treat, even exists. In an op-ed for theNew York Times, sex educator and author Emily Nagoski points out that HSDD was removed from the Diagnostic and Statistical Manual of Mental Disorders in 2013 and replaced with female sexual interest/arousal disorder (FSIAD). The reason, she explains, is that women often follow a different pattern of sexual desire than expected. Rather than experiencing sexual desire as a spontaneous, frequent occurrence, Nagoski says, many women need to be aroused first. Then, she says, desire will follow. Sexual desire, in this case, is reactive. FSIAD is intended to describe women who have neither spontaneous or reactive desire, many of whom, according to Nagoski, can be helped with non-pharmaceutical treatments like therapy.
Which brings us to those sexual health experts who believe the drug would do a disservice to women. Leonore Tiefer, a clinical professor of psychiatry at NYU School of Medicine, has been an outspoken critic of efforts to create drugs to treat women’s sexual health. She told NPR, “The misrepresentation that everybody should be having it—needs to have it, wants to have it, has a problem if they don’t have it—is to change, really, what sexuality is into more of a medical thing.” And, as she added in Marie Claire, “The pharmaceutical industry wants people to think that sexual problems are simple medical matters, and it offers drugs as expensive magic fixes.”
Those who take this view would often prefer to see a concentration on the emotional and relationship components of sexuality, which may very well be at the core of women’s lack of sexual desire. They also point out, again, that all women are different and there is no “right” amount of sexual desire to be “fixed” with medication. Adriane Fugh-Berman, who studies drug companies at Georgetown University, told NPR, “There’s really been a move toward medicalizing normal human experience. And while there are certainly some women who have very troublesome symptoms of low libido, it’s not at all clear that medication is a good answer for them.”
Drug companies indeed stand to profit off women—that is an unmistakable consequence of the availability of a “Viagra for women” on the market. But caught in the fight between them and the scholars who think this medicalization of sexuality is the wrong direction for society are the women themselves. And many of them, like Cara, just want to see their sex drive—which is often buried under kids, laundry, and a full-time job—return to what it used to be.
To me, there seems to be a pretty clear middle ground here (though I realize those on each side of the issue will likely disagree). If a drug can help a woman want and enjoy sex again, that is not in of itself a bad thing. It seems almost cruel to deny her pharmaceutical relief on the grounds that she’s a victim of society’s unrealistic expectations about female sexual desire. It’s dismissive to suggest that her feelings on the issue are not at all her own. And it is demeaning to suggest that a woman didn’t notice her lack of sexual desire until drug companies came along with a solution.
Of course, at the same time, the FDA needs to be extremely cautious (as it has been) before approving any drug that is working on something as important and complicated as brain chemistry. And, if it takes a lot longer to get it right and effective than it did for drugs that make men hard, that’s not sexism—that’s just reality. If it does hit the market, health-care providers should help women carefully decide if this is the right choice.
Women deserve sexual desire and pleasure. For some, it will come easily. For others it may take therapy, relationship counseling, or finding a better partner. And, someday, for others it may come in an easy-to-swallow pill. It’s time to stop bickering and slinging accusations and instead let women find their sexual satisfaction through whatever means works best for them.
This week, Virginia Johnson, half of the pioneering sex research team Masters and Johnson, died; it was reported that HPV vaccination rates have stalled; and new research said smoking during pregnancy causes behavioral issues in kids.
This Week in Sex is a weekly summary of news and research related to sexual behavior, sexuality education, contraception, STIs, and more.
Sex Researcher Virginia Johnson Dies
Virginia Johnson, best known as half of the sex research team Masters and Johnson, died Thursday at the age of 88. Johnson became a household name in 1966 when she and her partner, gynecologist William Masters, published Human Sexual Response. The book, considered groundbreaking in the field of sex research, presented the results of laboratory studies of men and women actively engaging in sexual behavior either together or alone. Using their observations, the authors described the sexual response cycle in both genders as having four stages: excitement (in which the penis and clitoris become erect and the vagina lubricates), plateau (in which individuals maintain a stable level of arousal), orgasm (in which individuals experience a rush of pleasurable sensations), and resolution (in which the body returns to its unexcited state). They also argued that Freud’s theory of vaginal orgasms being superior to clitoral orgasms was false, saying, essentially, “An orgasm is an orgasm.”
Though she became a researcher and sex therapist in her own right, Johnson joined Masters in 1957 as his administrative assistant after having been a country singer and a newspaper writer. At the time, Johnson had also been married and divorced three times and was the mother of two small children.
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Masters and Johnson went on to work together for over 35 years, during which they ran the Reproductive Biology Research Foundation in St. Louis (which was later named after them) and wrote more than five additional books. Though they are pioneers in the field of sex research, they have received a fair share of criticism over the years. Some researchers have argued that what they observed in a laboratory setting was not necessarily what happens in bedrooms across the United States. Moreover, their 1988 book about AIDS, Crisis: Heterosexual Behavior in the Age of AIDS, which was not peer reviewed, included some glaring inaccuracies about the disease, such as the assertion that it could be transmitted by eating food prepared by an infected restaurant worker.
The pair married in 1971 and divorced amicably in 1993. Their relationship and work was the subject of a 2010 book, Thomas Maier’s Masters of Sex, which has been turned into a series for Showtime, premiering this fall.
HPV Vaccination Rates Stall
Earlier this week, Rewire reported on two new studies representing good news and bad news about human papillomavirus (HPV). First, researchers concluded that certain strains of HPV cause about one-third of cancers of the neck and throat. On the flip side, another study found that one of the available vaccines designed to prevent HPV infection and cervical cancer can also prevent these cancers of the neck and throat. Unfortunately, now news has come out that there was a slowdown in the number of vaccines given in 2012.
The Centers for Disease Control and Prevention (CDC) released an article this week showing that HPV vaccination had increased over the first five years the vaccine was available, and that by 2011, 53 percent of girls had gotten at least one dose. In 2012, however, that number barely budged, with only 53.8 percent of girls having received the shot. According to USA Today, CDC Director Tom Frieden told reporters in a telephone briefing on Thursday that this is very disappointing news. “Coverage for girls getting this anti-cancer vaccine has not increased at all from one year to the next. Zero,” said Frieden. “We’re dropping the ball. We’re missing opportunities to give the HPV vaccine. That needs to change to protect girls from cervical cancer.”
The CDC recommends that girls receive the three-dose vaccination as part of their regular preventative care beginning at age 11. The goal is to make sure that all young women are protected from HPV before they become sexually active. This is clearly not happening. According to the paper, if every girl 11 and up who saw a health-care worker since 2007 had been encouraged to get the HPV vaccine, coverage could have reached 92 percent.
A study earlier this year suggested that some parents still fear that the HPV vaccine will encourage sexual activity in young people. Frieden pointed out that this is not the case, saying simply, “HPV vaccine does not open the door to sex. HPV vaccine closes the door to cancer.”
Parents also have been swayed by false reports of the vaccine being unsafe. The truth is that the vaccine is quite safe. More than 56 million doses of the HPV vaccine have been distributed since 2006, and only 21,194 adverse events have been reported. Most of these are limited to pain at the site of the shot, redness, and swelling. As Frieden put it, “We’ve been doing a systematic review of medical records in managed care systems for any adverse events that occur after vaccination with the HPV vaccine and we haven’t seen anything other than fainting.”
Fainting is not uncommon after any vaccine, especially for adolescents.
HPV is very common, with about 79 million Americans becoming infected each year. Moreover, about 17,400 women in the United States get cancer caused by the virus—cervical cancer being the most common type. And about 8,800 men get cancers of the neck, throat, and penis from HPV.
Smoking During Pregnancy May Lead to “Conduct Disorders” in Kids
There is a picture in one of the old photo albums on my parents’ bookshelf of my mother visibly pregnant with my sister unabashedly smoking a cigarette at a party. It was 1970; no one had told her or anyone else that it was a bad idea. By the time she got pregnant with me two years later, doctors were recommending that women quit smoking at least for those all-important nine months. In the decades since, it has become clear that smoking during pregnancy can lead to a host of problems, including miscarriage, placental abruption (when the placenta separates from the uterus too early), premature babies, babies with low birth weight, sudden infant death syndrome, and certain birth defects, such as cleft palates. New research, published in JAMA Psychiatry, now adds behavior problems to the list of health issues smoking during pregnancy can cause.
Researchers looked at data from three studies of parents and children: one that includes biological and adopted children, one that includes children adopted at birth, and a third that includes children who are “adopted at conception” and are raised either by parents who are genetically related to them or ones who are not.
Mothers were asked if they smoked during pregnancy and how many cigarettes they smoked per day. The researchers then asked both parents and teachers about any behavioral problems the children displayed between the ages of 4 and 10. Children were given a behavior score based on these reports with 100 being the average. The researchers determined that children born to biological mothers who did not smoke scored 99 on average, while those born to mothers who smoked ten or more cigarettes per day scored 104 on average. These results did not change based on whether a child was raised by the birth mother or not, suggesting the issues are biological rather than social.
Theodore A. Slotkin, a professor of pharmacology and cancer biology at the Duke University School of Medicine in Durham, North Carolina, published an editorial that accompanied the study. He writes, “Thus, the conclusion is incontrovertible: Prenatal tobacco smoke exposure contributes significantly to subsequent conduct disorder in the offspring.”
Of course, if I try to hold this over my sister in any way, she will undoubtedly point out that mom’s doctors ordered her to have a glass of vodka every day to “quiet the baby” during the last six weeks of her pregnancy with me. But that’s for another article.