Come as You Are (2 page)

For instance, it was just sort of assumed that since men have orgasms during penis-in-vagina sex (intercourse), women should have orgasms with intercourse too, and if they don’t, it’s because they’re broken.

In reality, about 30 percent of women orgasm reliably with intercourse. The other 70 percent sometimes, rarely, or
never
orgasm with intercourse, and they’re all healthy and normal. A woman might orgasm
lots of other ways—manual sex, oral sex, vibrators, breast stimulation, toe sucking, pretty much any way you can imagine—and still not orgasm during intercourse. That’s normal.

It was just assumed, too, that because a man’s genitals typically behave the way his mind is behaving—if his penis is erect, he’s feeling turned on—a woman’s genitals should also match her emotional experience.

And again, some women’s do, many don’t. A woman can be perfectly normal and healthy and experience “arousal nonconcordance,” where the behavior of her genitals (being wet or dry) may not match her mental experience (feeling turned on or not).

And it was also assumed that because men experience spontaneous, out-of-the-blue desire for sex, women should also want sex spontaneously.

Again it turns out that’s true sometimes, but not necessarily. A woman can be perfectly normal and healthy and never experience spontaneous sexual desire. Instead, she may experience “responsive” desire, in which her desire emerges only in a highly erotic context.

In reality, women and men are different.

But wait. Women and men both experience orgasm, desire, and arousal, and men, too, can experience responsive desire, arousal nonconcordance, and lack of orgasm with penetration. Women and men both can fall in love, fantasize, masturbate, feel puzzled about sex, and experience ecstatic pleasure. They both can ooze fluids, travel forbidden paths of sexual imagination, encounter the unexpected and startling ways that sex shows up in every domain of life—and confront the unexpected and startling ways that sex sometimes declines, politely or otherwise, to show up.

So . . . are women and men really that different?

The problem here is that we’ve been taught to think about sex in terms of behavior, rather than in terms of the biological, psychological, and social processes underlying the behavior. We think about our physiological behavior—blood flow and genital secretions and heart rate. We think about our social behavior—what we do in bed, whom
we do it with, and how often. A lot of books about sex focus on those things; they tell you how many times per week the average couple has sex or they offer instructions on how to have an orgasm, and they can be helpful.

But if you really want to
understand
human sexuality, behavior alone won’t get you there. Trying to understand sex by looking at behavior is like trying to understand love by looking at a couple’s wedding portrait . . . and their divorce papers. Being able to describe
what
happened—two people got married and then got divorced—doesn’t get us very far. What we want to know is
why
and
how
it came to be. Did our couple fall out of love after they got married, and that’s why they divorced? Or were they never in love but were forced to marry, and finally became free when they divorced? Without better evidence, we’re mostly guessing.

Until very recently, that’s how it’s been for sex—mostly guessing. But we’re at a pivotal moment in sex science because, after decades of research describing
what happens
in human sexual response, we’re finally figuring out the
why and how
—the process underlying the behavior.

In the last decade of the twentieth century, researchers Erick Janssen and John Bancroft at the Kinsey Institute for Research in Sex, Gender, and Reproduction developed a model of human sexual response that provides an organizing principle for understanding the true story of sex. According to their “dual control model,” the sexual response mechanism in our brains consists of a pair of universal components—a sexual accelerator and sexual brakes—and those components respond to broad categories of sexual stimuli—including genital sensations, visual stimulation, and emotional context. And the sensitivity of each component varies from person to person.

The result is that sexual arousal, desire, and orgasm are nearly universal experiences, but when and how we experience them depends largely on the sensitivities of our “brakes” and “accelerator” and on the kind of stimulation they’re given.

This is the mechanism underlying the behavior—the why and the how. And it’s the rule that governs the story I’ll be telling in this book:
We’re all made of the same parts, but in each of us, those parts are organized in a unique way that changes over our life span.

No organization is better or worse than any other, and no phase in our life span is better or worse than any other; they’re just different. An apple tree can be healthy no matter what variety of apple it is—though one variety may need constant direct sunlight and another might enjoy some shade. And an apple tree can be healthy when it’s a seed, when it’s a seedling, as it’s growing, and as it fades at the end of the season, as well as when, in late summer, it is laden with fruit. But it has different needs at each of those phases in its life.

You, too, are healthy and normal at the start of your sexual development, as you grow, and as you bear the fruits of living with confidence and joy inside your body. You are healthy when you need lots of sun, and you’re healthy when you enjoy some shade. That’s the true story. We are all the same. We are all different. We are all normal.

the organization of this book

The book is divided into four parts: (1) The (Not-So-Basic) Basics; (2) Sex in Context; (3) Sex in Action; and (4) Ecstasy for Everybody. The three chapters in the first part describe the basic hardware you were born with—a body, a brain, and a world. In chapter 1, I talk about genitals—their parts, the meaning we impose on those parts, and the science that proves definitively that yes, your genitals are perfectly healthy and beautiful just as they are. Chapter 2 details the sexual response mechanism in the brain—the dual control model of inhibition and excitation, or brakes and accelerator. Then in chapter 3, I introduce the ways that your sexual brakes and accelerator interact with the many other systems in your brain and environment, to shape whether a particular sensation or person turns you on, right now, in this moment.

In the second part of the book, “Sex in Context,” we think about how all the basic hardware functions within the context of your actual life—your emotions, your relationship, your feelings about your body,
and your attitudes toward sex. Chapter 4 focuses on two primary emotional systems, love and stress, and the surprising and contradictory ways they can influence your sexual responsiveness. Then chapter 5 describes the cultural forces that shape and constrain sexual functioning, and how you can maximize the good things about this process and overcome the destructive things. What we’ll learn is that
context
—your external circumstances and your present mental state—is as crucial to your sexual wellbeing as your body and brain. Master the content in these chapters and your sexual life will transform—along with, quite possibly, the rest of your life.

The third part of the book, “Sex in Action,” is about sexual response itself, and I bust two long-standing and dangerous myths. Chapter 6 lays out the evidence that sexual arousal may or may not have anything to do with what’s happening in your genitals. This is where we learn why arousal nonconcordance, which I mentioned earlier, is normal and healthy. And after you read chapter 7, you will never again hear someone say “sex drive” without thinking to yourself,
Ah, but sex is
not
a drive.
In this chapter I explain how “responsive desire” works. If you (or your partner) have ever experienced a change in your interest in sex—increase or decrease—this is an important chapter for you.

And the fourth part of the book, “Ecstasy for Everybody,” explains how to make sex entirely
yours
, which is how you create peak sexual ecstasy in your life. Chapter 8 is about orgasms—what they are, what they’re not, how to have them, and how to make them like the ones you read about, the ones that turn the stars into rainbows. And finally, in Chapter 9, I describe the single most important thing you can do to improve your sex life. But I’ll give it away right now: It turns out what matters most is not the parts you are made of or how they are organized, but
how you feel
about those parts. When you embrace your sexuality precisely as it is right now, that’s the context that creates the greatest potential for ecstatic pleasure.

Several chapters include worksheets or other interactive activities and exercises. A lot of these are fun—like in chapter 3, I ask you to think
about times when you’ve had great sex and identify what aspects of the context helped to make that sex great. All of them turn the science into something practical that can genuinely transform your sex life.

Throughout the book, you’ll follow the stories of four women—Olivia, Merritt, Camilla, and Laurie. These women don’t exist as individuals; they’re composites, integrating the real stories of the many women I’ve taught, talked with, emailed, and supported in my two decades as a sex educator. You can imagine each woman as a collage of snapshots—the face from one photograph, the arms from another, the feet from a third . . . each part represents someone real, and the collection hangs together meaningfully, but I’ve invented the relationships that the parts have to each other.

I’ve chosen to construct these composites rather than tell the stories of specific women for two reasons. First, people tell me their stories in confidence, and I want to protect their identities, so I’ve changed details in order to keep their story
their
story. And second, I believe I can describe the widest possible variety of women’s sexual experiences by focusing not on specific stories of one individual woman but on the larger narratives that contain the common themes I’ve seen in all these hundreds of women’s lives.

And finally, at the end of each chapter you’ll find a “tl;dr” list—“too long; didn’t read,” the blunt Internet abbreviation that means, “Just get to the point.” Each tl;dr list briefly summarizes the four most important messages in the chapter. If you find yourself thinking, “My friend Alice should totally read this chapter!” or “I really wish my partner knew this,” you might start by showing them the tl;dr list.
^I
Or, if you’re like me and get too excited about these ideas to keep them to yourself, you can follow your partner around the house, reading the tl;dr list out loud and saying, “See, honey, arousal nonconcordance is a thing!” or “It turns out I have responsive desire!” or “You give me great context, sweetie!”

a couple of caveats

First, most of the time when I say “women” in this book, I mean people who were born in female bodies, were raised as girls, and now have the social role and psychological identity of “woman.” There are plenty of women who don’t fit one or more of those characteristics, but there’s too little research on trans* and genderqueer sexual functioning for me to say with certainty whether what’s true about cisgender women’s sexual wellbeing is also true for trans* folks. I think it probably is, and as more research emerges over the coming decade we’ll find out, but in the meantime I want to acknowledge that this is basically a book about cisgender women.

And if you don’t know what any of that means, don’t worry about it.

Second, I am passionate about the role of science in promoting women’s sexual wellbeing, and I have worked hard in this book to encapsulate the research in the service of teaching women to live with confidence and joy inside their bodies. But I’ve been very intentional about the empirical details I’ve included or excluded. I asked myself, “Does this fact help women have better sex lives, or is it just a totally fascinating and important empirical puzzle?”

And I cut the puzzles.

I kept only the science that has the most immediate relevance in women’s everyday lives. So what you’ll find in these pages isn’t the whole story of women’s sexuality—I’m not sure the whole story would actually fit in one book. Instead, I’ve included the parts of the story that I’ve found most powerful in my work as a sex educator, promoting women’s sexual wellbeing, autonomy, and pleasure.

The purpose of this book is to offer a new, science-based way of thinking about women’s sexual wellbeing. Like all new ways of thinking, it opens up a lot of questions and challenges much preexisting knowledge. If you want to dive deeper, you’ll find references in the notes, along with details about my process for boiling down a complex and multifaceted body of research into something practical.

if you feel broken, or know someone who does

One more thing before we get into chapter 1. Remember how I said we’ve all been lied to, but it’s no one’s fault? I want to take a moment to recognize the damage done by that lie.

So many women come to my blog or to my class or to my public talks convinced that they are sexually broken. They feel dysfunctional. Abnormal. And on top of that, they feel anxious, frustrated, and hopeless about the lack of information and support they’ve received from medical professionals, therapists, partners, family, and friends.

“Just relax,” they’ve been told. “Have a glass of wine.”

Or, “Women just don’t want sex that much. Get over it.”

Or, “Sometimes sex hurts—can’t you just ignore it?”

I understand the frustration these women experience, and the despair—and in the second half of the book I talk about the neurological process that traps people in frustration and despair, shutting them off from hope and joy, and I describe science-based ways to get out of the trap.

Here’s what I need you to know right now: The information in this book will show you that whatever you’re experiencing in your sexuality—whether it’s challenges with arousal, desire, orgasm, pain, no sexual sensations—is the result of your sexual response mechanism functioning appropriately . . . in an inappropriate world.
You
are normal; it is the world around you that’s broken.