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Meredith Chivers earned fame in 2009 for her “bonobo porn” studies, which revealed just how stunningly little we know about the mechanics of women’s desire. Now she is working on the forefront alongside other Canadian scientists to fill in the sizable gaps in our understanding. (Michelle Siu For The Globe and Mail)
Meredith Chivers earned fame in 2009 for her “bonobo porn” studies, which revealed just how stunningly little we know about the mechanics of women’s desire. Now she is working on the forefront alongside other Canadian scientists to fill in the sizable gaps in our understanding. (Michelle Siu For The Globe and Mail)

‘Arousal-first’ desire may be more typical for women, and it doesn’t need a cure Add to ...

The vanguard of this country’s sex research involves a La-Z-Boy chair sitting opposite a flat-screen TV, inside a cinder block room in Kingston.

Decorated sparsely with a poster of Claude Monet’s Water Lillies, this is the decidedly unsexy “participant room” of the sexuality and gender lab at Queen’s University. Here, psychologist Meredith Chivers mines the depths of female desire in hopes of improving women’s sex lives.

Participants sit in the maroon recliner, covering themselves discreetly with a bedsheet. Laminated instructions tell them how to attach the vaginal and clitoral plethysmographs – tools for measuring genital arousal in the lab. Once they get settled in, the human guinea pigs watch porn, subjectively rating how turned on they feel using a keypad strapped to the chair. Under the sheet, the plethysmographs keep tabs on the other story.

Chivers earned fame in 2009 for her “bonobo porn” studies in which women responded physiologically to a startlingly wide swath of pornographic material, from heterosexual, homosexual and solo masturbatory human sex to bonobo apes mating – this despite saying they felt little for the visuals.

The provocative research revealed just how stunningly little we know about the mechanics of women’s desire. Now, working on the forefront alongside other Canadian scientists to fill in the sizable gaps in our understanding, Chivers is homing in on arousal and desire – specifically which one comes first in women.

While the traditional view has been that people are seized by spontaneous pangs of desire and then get aroused for sex, a newer school of thought proposes that we might have it backward, at least as far as women are concerned. Some sex researchers now believe this “arousal-first” mode of desire may be more typical for women – and that it doesn’t require a cure.

It’s a paradigm shift that leapfrogs over the hype this month of a “pink Viagra,” after an expert panel of the U.S. Food and Drug Administration cautiously approved flibanserin, a drug marketed to spark spontaneous desire in women by tweaking the brain’s levels of dopamine and serotonin. Flibanserin has been rejected twice already for its troubling side effects and poor efficacy (the drug resulted in a meagre 0.7 more “sexually satisfying events” per month in trials).

Rather than pathologizing women who don’t spontaneously crave sex and prescribing dubious pink pills to fix what might not be broken, some therapists are focusing instead on heightening arousal among couples – some with eyebrow-raising methods, from mindfulness therapy and prescriptions for porn to scheduling appointments in bed. This is not exactly date night, but it’s a potential therapeutic game changer, especially for women struggling with low libido in long-term, committed relationships.

“For so many women, it’s such a relief to hear this,” says Chivers, who punctuates her rapid-fire science-speak with bursts of laughter and deft one-liners about sex. She sits in her office, where a Joy Division poster (“Love Will Tear Us Apart”) hangs on the wall. “Instead of this idea that there’s something wrong with women because they aren’t having spontaneous urges driving them to seek out sex, they’re hearing that being responsive to their partner and environment is desire as well,” says Chivers, adding, “It offers a whole other way of interpreting their sexuality.”

The current thinking builds on decades of research about the human sexual response cycle. In 2000, Rosemary Basson, a clinical professor in sexual medicine at the University of British Columbia, nudged the science away from a strictly linear desire-arousal-sex-orgasm model, pioneering a cyclical model instead. The latest edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), released in 2013 also reflects this shift, collapsing women’s sexual desire and arousal disorders into a new diagnosis of “sexual interest/arousal disorder” (SIAD), after clinicians reported female patients often had difficulties differentiating between desire and arousal. Today, some researchers and clinicians believe a more common experience for women might be “responsive desire”: desire that arises in response to something pleasurable, not in anticipation of it.

Emily Nagoski, a women’s sexuality lecturer at Smith College and author of the new book Come As You Are: The Surprising New Science That Will Transform Your Sex Life, explains it this way: “Responsive desire happens when you’re not really looking for it but something sexy like your partner comes along and starts kissing your neck. You’re in a good state of mind, your body lights up and you go, ‘Oh right, sex! That’s a good idea! We should do that.’”

But if spontaneous desire isn’t the norm for women, what starts the arousal process, if not a touchy-feely spouse? What does it take to turn women on? In laboratories across the country, sex researchers are trying to tease out some answers.

In her Kingston lab, Chivers is manufacturing arousal to map out the aftershocks on female desire. She’s currently recruiting women with and without sexual difficulties to find out whether watching porn in that La-Z-Boy will leave them feeling more lusty later at home. Three days after the lab sessions, the women will complete questionnaires about their sexual thoughts, feelings and behaviours, repeating the process three times over three months. A 2004 Dutch study has already shown that porn-induced arousal can spur on desire and real-life sex for women, even many hours later. A group that watched pornographic videos in the lab reported more having more sex (both solo and partnered) in the 24 hours that followed than a group that took in neutral material.

“The knowledge that doing something pleasant or arousing may lead to feelings of sexual desire, it’s going to be tremendously helpful in therapy settings,” Chivers says. “Are we going to recommend that people start using erotica? Maybe, if that’s what they want to do as part of their sexual repertoire. This could be a way to help women amplify their desire.”

Lori Brotto, director of the University of British Columbia Sexual Health Laboratory, is already experimenting with pornography in her clinical practice. But first, her clients have to master mindfulness and actually start paying attention to pleasure.

Brotto, who helped steer the revision on the new diagnosis of SIAD in the DSM-5, runs an eight-week mindfulness therapy program for women suffering from low arousal and desire. Combining a regular meditation practice with sex education and some enlightened porn viewing, the sessions are intended to get women who complain of feeling “disconnected” during their sexual encounters to focus on physical sensations and turn off their multitasking brains. The goal is to get women to let go of the nagging thoughts that inhibit sex – the piles of dishes, the unexercised body, assumptions about a partner’s expectations – and zoom in on their own arousal, all in the name of triggering desire where it is wanting.

Although Brotto’s technique may not increase spontaneous desire, it has been shown to jump-start sexual satisfaction among women. Claire, a 57-year-old insurance estimator in Vancouver, completed the therapy in 2013 and said she feels better equipped to let negative thoughts “flow downstream” so she can tune into sensations (and desire) instead. “Normally, I’d be like, ‘Did I shave my legs today? I should have shaved my legs. Well I did them yesterday, maybe it’s not so bad. I don’t think he’ll notice. Now he’s getting to my stomach. Oh my god, I’ve gained 10 pounds, it’s all squishy.’”

Claire says the thought process now runs more like this: “Okay, yup. You didn’t shave your legs today. Just let go. Okay, well that feels really nice.”

For the women Brotto coaches, being in the moment allows them tap to into arousal and subsequent desire. For Nagoski, the path to arousal is largely contextual. She describes the “brakes” and “gas” of female desire: Sexual accelerators can include things such as running a bath, putting on lingerie or spending some time with an erotic novel or porn. And then there are the brakes, the nagging thoughts Brotto also warns against: daily life stressors, poor body image or simply worrying that the kids will walk in. “Turning on the ons and turning off the offs, both are equally important,” Nagoski says.

What much of this new science of desire points to is a cold, hard reality: good sex takes effort, not popping pink pills. That’s especially true for partners in long-term committed relationships who have exited the honeymoon phase and can barely remember the spontaneous fits of desire that marked the early years.

Research by John Gottman, psychologist and author of The Science of Trust, has found that spouses who sustain a strong sexual connection over multiple decades have two things in common: they have a strong friendship and cultivate their sex life, literally setting time aside time for it. Says Nagoski: “You have to make a date and prioritize sex: ‘Saturday at 2 in the afternoon, you, me and the red underwear. We’re going to put our bodies in the bed and touch each other and see what happens.’”

Think of it as sex homework. In the Netherlands, Stephanie Both, an assistant psychology professor and senior therapist in the department of psychosomatic gynecology and sexology at Leiden University Medical Centre gives women assignments such as reading erotic literature, watching pornographic films and masturbating “to find out what is pleasurable.” For spouses she goes back to Masters and Johnson, who prescribed “sensate focusing” touching exercises for couples.

“You have to work to get that feeling,” Both said. “The therapist doesn’t have a magic wand to give you those feelings. And at least at this time, there’s no pill to give to you.”

Yet even as science reveals that arousal manufactured this way can jump-start desire, many couples recoil at the thought of “working” at better sex. There’s a reluctance to give up the myth of lifelong, spontaneous desire: we believe that if it doesn’t happen automatically, someone is being disingenuous. Instead of working toward arousal – or risking talking about what they actually like in bed – many spouses would rather contend with marital bed death.

“We have grown up in a culture that has the wanting and the craving at the centre of our definition of sexual well-being. What responsive desire tells is that’s wrong. What we ought to have at the centre is pleasure,” Nagoski says.

“It seems like such a simple message: pleasure. But it turns out it’s a pretty radical shift for a lot of people.”

***

“Pink Viagra”

Having being rejected twice before, flibanserin, a drug dubbed the “pink Viagra,” inched closer to market this month, thanks largely to a shrewd marketing strategy. Sprout Pharmaceuticals, developers of the drug, politicized its pink pills with a media campaign called “Even the Score.” The movement promised to “give women a voice,” accusing the Food and Drug Administration of sexism for backing many pills for ailing male libido but none for women.

The campaign divided feminists: While some urged that women struggling with low desire and desperately trying to salvage their relationships deserve options, others argued that women deserve better than a pill with marginal benefits and troubling side effects.

As part of the pharmaceutical company’s push, women suffering from low sexual desire gave emotional testimony at the FDA hearing in Washington earlier this month. Amanda Blackie Parrish, a Tennessee mother of four and one of the most vocal participants in Sprout’s drug trials, had described her sexual problems (before flibanserin) as such: “Once I started, it wasn’t an issue. It was getting me started.”

To experts such as Emily Nagoski, director of wellness education at Smith College, that didn’t ring like sexual dysfunction. It sounded more like a woman with responsive desire, a woman who might not initiate sex in spades but responds perfectly well to arousal. “Responsive desire is not a disease that requires treatment. It’s healthy, normal sexual functioning,” said Nagoski, who attended the hearings and believes women with responsive desire need education, not medication.

Still, on June 4, Sprout won a surprise success: approval from an expert panel of the FDA (the final decision comes in August). Despite flibanserin’s moderate benefits for women’s sexual desire, a committee voted that the drug be given the go-ahead, but with both label warnings and strict conditions: Side effects include fainting, nausea, dizziness, sleepiness and low blood pressure.

***

Inside Meredith Chivers's laboratory

What’s it like to run through psychologist Meredith Chivers’s tests as she tries to better understand female desire?

My visit to her world-renowned laboratory at Queen’s University in Kingston, begins with the strict mechanics. A light sensitive plethysmograph measures “genital vasal congestion,” or the blood flow that causes bodily tissues to swell up and is believed to be linked to lubrication. Men get a penile gauge filled with mercury: shaped like a rubber band, it comes in different sizes and stretches during erection. Women get two plethysmographs: a tampon-like one for the vagina and another gauge that rests atop the clitoris, this one resembling Mr. Potato Head’s nose.

Kelly Suschinsky, a postdoctoral fellow in psychology who works in Chivers’s lab explains how it all works, leading me into the participant room. I crack some bad, nervous jokes but Suschinsky, a seasoned researcher, is all business.

When Suschinsky leaves the room, I hook myself up to the gauges, move to the La-Z-Boy chair and recline. The lights dim and a film rolls on the flatscreen TV across the room. First comes a neutral video intended to bring people to baseline; during my visit it’s David Attenborough expounding on the majesty of the snow-capped Rockies. After that, the abrupt switch into porn: a heterosexual couple in an apartment filled with vases, a man and woman masturbating solo, two gay men and a lesbian pair with a vibrator. Then the weird stuff: a woman doing calisthenics in the nude and a male bodybuilder sauntering naked and unaroused on a rocky beach.

Using a computer keyboard affixed to the arm of the La-Z-Boy, I record my “subjective arousal” in real time by clicking up and down on arrows. These correspond with a green bar on the screen; it rises and falls from 0 to 100 for “maximum arousal.” Everything is wired to a control room across the hall where Chivers’s team reads the data. On one computer screen, red lines undulate into peaks and valleys on a graph, each wave form representing the amount of blood circulating within the vaginal wall with each heartbeat. Bigger waves mean there is more blood flow in the region; more blood flow is linked with sexual stimuli.

My waves swell highest for the vibrator-wielding lesbians, followed closely by the passionate hetero lovers in the vase-filled room. Like other women who’ve run through the test, I’m unstirred by the naked gym rat strolling the beach. (Here, the researchers posit that women’s near-universal thumbs down might have to do with the man’s flaccid penis; Chivers conducted research recently that found women respond more favourably to closeups of erect penises.)

Unlike many women, I show “very high agreement” between my self-reports and my physiological arousal – between what I say turns me on and what my body actually responds to. (This is not entirely surprising: after reporting on sex for a decade, I’ve become both forthright and blasé about it.) In science-speak, I’m “concordant” rather than “discordant.” Discordance is a mostly female phenomenon researchers have been exploring since the 1970s, with women’s bodies often not aligning with their words. Chivers is constantly having to correct those curious about her work who assume that what happens in a woman’s body reveals what she really wants – that the vaginal plethysmograph is a lie detector test. By that logic, we’d all be hankering for bonobo sex.

My contribution to science is over in about 30 minutes, but Chivers has more work to do.

“I have all this data showing people getting sexually aroused by all kinds of stuff. Does that have any implications for their desire, who they want to be with or what they want to do?” says Chivers, an associate professor of psychology at Queen’s. “I really want to try to understand what makes something sexual. It’s a really, really big question.”

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