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Gina Ogden remembers trying to cheer up a woman in her sex therapy practice with some Woody Allen.

"Don't knock masturbation," Alvy Singer had famously sniped at Annie Hall. "It's sex with someone I love."

Dr. Ogden's patient was not amused: "She said, her eyes filling with tears, 'Well, I don't like myself very much.' "

"If you don't like yourself," said Dr. Ogden, the Cambridge, Mass.-based author of The Return of Desire, "you don't get to go to bed with someone you like. In other words, you probably aren't going to masturbate."

It goes beyond the double standard: Largely ignored by sex education and almost entirely unrepresented in pop culture, female masturbation – solo, not witnessed by a man – may very well be the last remaining sexual taboo.

The reasons are plentiful and range from basic anatomy to the shockingly archaic: Think a lingering hyper-awareness of feminine hygiene and a feeling that orgasms are most authentic when they happen with a man.

A recent study involving 800 American adolescents aged 14 to 17 found that 74 per cent of the young men surveyed had gratified themselves, versus just 48 per cent of the women. By age 17, an estimated 46 per cent of girls reported masturbating just a few times a year, according to the joint study by the Indiana University School of Medicine and the Kinsey Institute for Research in Sex, Gender and Reproduction. Although the gender disparity narrows with age, studies consistently find men outpacing women in every age group.

"Young women are not encouraged to take ownership of their bodies or of sexual pleasure," says Peggy Kleinplatz, a professor in the faculty of medicine at the University of Ottawa.

"The imagery that they've seen, whether in pornography or in mainstream movies, such as American Pie, makes reference to adolescent male masturbation as a normative part of male sexual development. Female sexual exploration, by and for themselves, is discovered – if at all – in silence," says Dr. Kleinplatz.

While female masturbation was famously acknowledged with a cameo by the Rabbit Pearl vibrator in Sex and the City, ultimately it seemed like product placement, Dr. Kleinplatz says. More recently, photo book giant Taschen's La Petite Mort featured women masturbating, albeit screaming and posed in lingerie and heels for Toronto photographer Will Santillo.

Going truly solo is another story: "Socially, it's understood that boys need to do that. That's a part of who they are. Whereas girls, it's not ladylike and we're supposed to rely on our partners," says Carlyle Jansen, founder of Good for Her, a Toronto sex shop.

An Australian study in the current issue of the Canadian Journal of Human Sexuality surveyed 40 women aged 20 to 61 on the topic and found that the women's sexual desire peaked most often with a partner, not alone. It was "responsive," not "spontaneous."

"Men may have a more spontaneous pattern of sexual response and that may prompt them to masturbate more frequently, whereas women need something to react to, and often that's interaction with a partner," Alex McKay, the journal's associate editor, said in commenting on the Australian research.

Mr. McKay thinks the divide is less about anatomical knowledge and more about "differences in sex drive."

There has always been the suggestion of a superior male sex drive, as well the argument of biological necessity: Men, as well as primates, require regular masturbation to maintain sperm quality. And then there's basic anatomy.

"Boys touch their penis – it's easy to find. They touch it when they start using toilets. Girls, they don't find it the same way. Physiologically it's harder so women aren't going to do it as much or discover it as easily," says Ms. Jansen, who runs "Learning to Orgasm" – courses that are always sold out and populated by women from their 20s to their 60s.

Another stigma revolves around hygiene: "We still have a lot of hang-ups," says Ms. Jansen.

Exhibit A: the recent, controversial ad campaigns for vaginal washes and wipes on offer from Summer's Eve.

For many of the young women Dr. Kleinplatz works with, squeamishness arises around the NuvaRing contraception device and the DivaCup menstruation cup: "I have heard so many women say, 'Yeah I don't want to stick my fingers in there.' But it's okay for your partner to stick his penis in there? 'Oh yeah, but I wouldn't want to stick my fingers up there.'"

Pointing to the rising popularity of labiaplasty and "designer vaginas," Dr. Ogden thinks the problem is worsening: "We're supposed to look a certain way, smell a certain way, feel a certain way. It's not about self-pleasure. It's all about the other."

Beyond anatomy, Ms. Jansen says another hurdle to orgasm is expectation, mostly the women's own.

"Often women will tell me that they're bored after two or three minutes of pleasuring themselves. Their minds start to drift, they start wondering if their partner's going to be disappointed if they don't orgasm, or they think about things they have to do later."

She adds: "Men can generally orgasm more quickly so there's less time for the attention to leave and go somewhere else."

So what are the effects on a sex life for the non-masturbating gal? Experts are mixed.

Mr. McKay argues that "it's a big leap" to assume young women less inclined to self-stimulate will have less satisfying romantic and sexual relationships in adulthood.

Others aren't so sure: "If you're counting on your partner to know more about your body than you do, that's going to add unnecessary awkwardness to the mix and make it more likely that your sexual experiences will be less than satisfying," says Dr. Kleinplatz.

"Rather than approaching sex with anticipation, you eventually begin to approach it with dread."