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New Directions in Sex Therapy Chapter 2 2 The “New View” Campaign A Feminist Critique of Sex Therapy and an Alternative Vision LEONORE TIEFER, Ph.D. Sex therapy is an area of psychotherapy that developed in the 1970s during the so-called sexual revolution. from a superficial perspective, it seemed simply to be a pragmatic approach that used education and behavioral interventions to help people with sexual performance problems. from a political and cultural perspective, however, sex therapy’s inattention to factors like social and cultural context, gender construction, and heteronormativity; its reliance on limited and intercourse-centered diagnoses; and its neglect of preventive sex education mark it as narrow and politically conservative (Irvine, 1990; Becker, 2005). many chapters in the first edition of this book, including mine on femi- nism and politics (Kleinplatz, 2001; tiefer, 2001b), were attempts to correct, or at least to challenge, the narrow, essentialist, and depoliticized aspects of sex therapy that dominated most texts. The continuing success of thefirst edition speaks to the frustration many progressive scholars and practitioners of sex therapy feel with the field’s unexamined assumptions and conservative spirit, and I can only hope that this second edition will excavate even more of those assumptions and help to redesign sex therapy’s boundaries. let us begin with what a feminist perspective is and why it is needed in sex therapy. Feminist Perspectives feminism is a social change movement of many phases, facets, components, and constituencies that advocates for the eradication of gender inequities Copyright © 2012. Routledge. All rights reserved. © 2012. Routledge. Copyright in a world of socially constructed and institutionalized gender differences (ferree & mueller, 2004). The academic wing of feminism, women’s studies (now often gender studies or gender and sexuality studies), puts women’s per- spectives and interests at the center of scholarship that utterly transforms Kleinplatz, P. J. (Ed.). (2012). New directions in sex therapy : Innovations and alternatives. Retrieved from http://ebookcentral.proquest.com21 Created from lewisclark on 2020-03-31 09:16:21. 22 • leonore tiefer, Ph.D. our views of culture , history, science, and social life. gender scholars have described at length and with great attention to local detail how sexualities are constructed within cultures, organizations, relationships, and individual lives (e.g., Corrêa, Petchesky, & Parker, 2008; Jackson & Scott, 1996). In the 1970s and 1980s, feminist therapists had many things to say about revising and expanding sex therapy (Cole & rothblum, 1988). They argued (e.g., Ellison, 2000; hare-mustin, 1991; Keystone & Carolan, 1998; tiefer, 1991a) that sex therapy • Was too genital and goal oriented • relied on sexist sex research, language, and theory • used a sexist nomenclature of sexual problems • neglected gender-related power differences • marginalized pleasure in favor of normative sexual performance • Was oblivious to subjective sexual meaning and ignorant of cultural variations • unintentionally (or not) reinforced patriarchal interests and sexual double standards • unintentionally (or not) supported compulsory heterosexuality • Ignored social causes and solutions of sexual problems feminist sex therapy reformers offered various suggestions to improve the field. tiefer (1996a), for example, suggested that a reformed and transformed sex therapy would include remedial and corrective psychoeducational ele- ments such as: • feminism 101 to raise awareness about sexism, i.e., emphasizing gender in political context—not just as an identity category • Deconstruction of the American Psychiatric Association’s (APA) Diagnostic and Statistical Manual of Mental Disorders (DSM) diag- nostic categories as part of the critique of medicalization • Positive genital education to counteract widespread and even institu- tionalized pudendal disgust • Assertiveness training to counteract internalized sexual censorship • Body-image reclamation to exorcize the effects ofsexual objectification • Physical and mental masturbation education to engender sexual entitlement, self-knowledge, and subjectivity • Extragenital and non-orgasmic pleasuring instruction to counter- act performance-oriented sexuality and encourage lifelong adaptive sexual learning • Political education of sex therapists and a commitment to social change Copyright © 2012. Routledge. All rights reserved. © 2012. Routledge. Copyright The commercial landscape changed in the 1980s and 1990s, and popular sex advice books became easily available in big chain bookstores and, then, through the Internet. They often included some of the suggestionsmade earlier Kleinplatz, P. J. (Ed.). (2012). New directions in sex therapy : Innovations and alternatives. Retrieved from http://ebookcentral.proquest.com Created from lewisclark on 2020-03-31 09:16:21. The “new View” Campaign • 23 by the feminist reformers. But by the 1990s and the new “post-feminist” era, political critiques of sex therapy and calls for problem prevention through gen- dered analysis and antisexism work were played down in favor of a narrower focus on personal, interpersonal, technical, and lifestyle changes (e.g., Becker, 2005; Cass, 2007; hall, 2004; Pertot, 2005). It was assumed that society had gotten enlightened and that gender equality had been won. Also, it became unfashionable to “politicize” professional activities. Political voices labeling sexology and sex therapy as conservative moved to interdisciplinary and criti- cal social studies while sex therapists focused on the good news about healing and women’s entitlement to pleasure and satisfaction (Albrecht, fitzpatrick, & Scrimshaw, 2000; morrow, 2007; Seidman, fischer, & meeks, 2007). It was rare to find a therapy text that offered both a strong critique of the field and practical approaches to people’s sexual insecurities. (for one exception to the rule, see tiefer & hall [2010].) Political interest in feminist sexual values and goals could still be found outside sex therapy, for example, in sex education curricula from various nonprofit groups.* In addition, feminist therapists (not usually sex therapists) continued to underscore political topics like sexual violence against women and media objectification of women’s and girls’ bodies and the need for therapists to be politically engaged. feminist values are also present in quali- tative and multimethod sex research that seeks complex, politically informed discussions about what women mean when they speak of sexual desire or satisfaction or complain about sexual problems (e.g., Bancroft, loftus, & long, 2003; goberna, francés, Paulí, Barluenga, & gascón, 2009; graham, Sanders, milhausen, & mcBride, 2004). Explicit feminist perspectives in sex therapy (e.g., women’s entitlement to pleasure; women’s right to refuse unwanted sex; the need for women to know their own bodies) have been absorbed without acknowledging that these are political gains that are still far from universal. Any discussion of the need for further political struggle has been sidelined in the current apolitical epis- temology (Becker, 2005). Thus sex therapy focuses on proper technique and communication, with interventions assumed to be scientific, professional, neutral, objective, and value free. But who does what to whom sexually is fundamentally a political matter rather than a scientific one, and “experts” are people who have been trained in and then promote culturally dominant paradigms. feminists repeatedly point out that experts are “political appointees” who represent a point of view rather * http://www.advocatesforyouth.org/index.php?option=com_content&task=view&id=948 Copyright © 2012. Routledge. All rights reserved. © 2012. Routledge. Copyright &Itemid=629 http://www.plannedparenthood.org/resources/implementing-sex-education-23516.htm http://www.siecus.org/index.cfm?fuseaction=Page.viewPage&pageId=514&parentID=477 http://www.uua.org/religiouseducation/curricula/ourwhole/ Kleinplatz, P. J. (Ed.). (2012). New directions in sex therapy : Innovations and alternatives. Retrieved from http://ebookcentral.proquest.com Created from lewisclark on 2020-03-31 09:16:21. 24 • leonore tiefer, Ph.D. than being neutral (rubinstein, Scrimshaw, & morrissey, 2000). feminists point out that “expertise” has hurt women in the past more times than can be counted when it comes to sex and reproduction, and that while it might be nice to believe that science is always neutral and health authorities are motivated only by the best interests of their patients, this is a fairy tale (Ehrenreich & English, 1978). The best practice acknowledges that everyone has special inter- ests and blind spots, and that informed patients and ethical providers must function in a complex and ambiguous world where plans and decisions are made on the basis of careful thought, but in the absence of truth or certainty. Current Limited Sexological Reforms The APA is in the process of revising and updating its classification system and list of mental disorders for the upcoming fifth edition of The Diagnostic and Statistical Manual of Mental Disorders (DSM-5) scheduled for publica- tion in may 2013 (c.f., www.dsm5.org). Some of the alterations planned for the sexual dysfunction section* have emerged in debates about sexual arousal and desire initiated by feminists (Brotto, 2010). for example, graham and Bancroft (2006) argue that clinicians need good community survey infor- mation that validly identifies current norms for a woman’s “ethnic,
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