“Sex is Not a Problem, but Lack of Pleasure Is”: Using a feminist and queer lens to critique the absence of pleasure in sexual science research and what this means for OT!

I have often thought about the lack of discussion around pleasure and conversely the prioritization of discussing sexual risk and pathology in sexual dialogues – to include academic dialogues, professional dialogues, and even familial or personal dialogues.   

Dr. Jones (2019) reviewed 300 articles from the Journal of Sex Research that were published between 2010-2015 and found disease and pathology were the main focuses of the articles. 

The articles had little discussion of the role pleasure plays in both enhancing quality of life and motivating high-risk behaviors. 

The researcher also highlighted the heteronormativity and lack of inclusivity pervasive in the articles.  They used a feminist and queer lens to challenge White Supremacy and heteronormative ideology pervasive in the articles which investigates very few social factors related to sex and sexuality.

For example, among many, the researcher found most of the articles related to female sexuality emphasized self-esteem, anxiety, assault, and victimization.  No wonder there is so much pain and anxiety prevalent in female sexual experiences.  The research highlights this and then healthcare providers focus on this – we expect this and reinforce this as normal and then NEVER ask about pleasure. 

I see this firsthand working with females referred to me for low desire. 

By the time they get to me, they’ve seen so many doctors who reinforced low desire as normal.  When I ask them “what they find pleasurable about sex,” many ask me to repeat the question, some look at me wide-eyed, and some start to cry saying “No one has ever asked me that,” or “I don’t know.” 

Another example was understanding condom practices among men who have sex with men (MSM).  The articles failed to discuss the motivating factors which lead to high risk behavior, for example, the role connection, pleasure, social status, and community plays in the sexual health decisions of MSM. 

The researcher argues that when research is conducted through a queer perspective a more holistic picture is reported on.

It also includes the decisions MSM may be more likely to make due to the discrimination they face on a daily basis and the lack of trust in a healthcare system, which historically has been harmful and misleading. 

Sometimes I don’t know whether OTs can really come to the plate and address what our clients need.  On one hand I know we are perfectly situated.  We understand meaningful activity and living life to the fullest.  We understand that what motivates people (pleasure) influences their occupational decisions and engagements.  We are taught to look holistically and consider the environmental context.  But we’re also products of our own environment and we have a ton of work to do to unlearn our own sexual biases. 

When the focus is so much on pathology to be fixed with medication, surgery, and an “it is what it is” from the medical community, do OTs really see their place working on promotion and sexual wellness? 

Talking about orgasms, pleasure, thriving as a sexual being instead of mechanically going through sexual motions to just survive as a sexual being.

Well of course I have hope, which keeps me sliding into your inbox (writing these blogs) to share the profound lessons I’m learning so we can unlearn our sexual biases and truly approach our clients with effective and compassionate interventions. 

So what can you do with this information? 

1. Well as always, start with self-reflection. Ask yourself, did you learn more about the negative consequences of sex or about the pleasurable and empowering outcomes?  What do you need to do to center pleasure in your own life?
2. Educate yourself and someone else: Read the article and then share this email with someone
3. Change where you work: Do you understand pleasure as a likely motivating factor in your clients lives?  Knowing this is a motivating factor and essential for quality of life, how can you advocate for this to be addressed more where you work?   What changes need to be made where you work to comprehensively and holistically address sex?

Reference 

Jones, A. (2019). Sex is not a problem: The erasure of pleasure in sexual science research. Sexualities, 22(4), 643-668.