Why medicalization? Introduction to the special issue on the medicalization of sex

This special issue grows out of the need to bring into focus the historical and sociocultural contextualization of sex to the sexological community. The specific focus is on analyzing how medicalization is affecting many areas of sexual life and discourse, but the larger goal is to help situate sexuality studies in its broadest perspective. Articles will be of general interest to those interested in interdisciplinary scholarship; the specific articles address HIV politics, sex therapy, women's sexual health, sex and aging, the popularization of weak science, and the media's view that sexual exuberance is a central marker of recovery from cancer. Medicalization is a current trend that illuminates the importance of a broader view of sexology.     

Letters to the editor

Relatively little attention has been paid to the use and importance of labels used by men who have sex with men to describe insertive or receptive sexual behavior during intercourse. This study examines sexual self‐labels, sexual behavior, HIV transmission risk, and psychological functioning among 205 HIV‐seropositive men who have sex with men. The majority of participants (88%) identified as a “top, “ a “bottom, “ or “versatile. “ Tops were more likely to engage in insertive anal intercourse than bottoms, and bottoms were more likely to engage in receptive anal intercourse than tops, with versatiles reporting intermediate rates of both behaviors. Although the results suggest preliminary evidence regarding the predictive utility of self‐labels, sexual behaviors of self‐label groups were greatly overlapping. Differences were found among self‐label groups in gay self‐identification, internalized homophobia, sexual sensation seeking, and anxiety. Results suggest an added value in assessing self‐labels in addition to asking about sexual behavior.     

Medicalizations and demedicalizations of sexuality therapies

This article complicates recent discussions about the expanding zones and influences of medicalization and biomedicalization on sexuality and sex therapy by contextualizing them with competing nonmedicalizing trends. These latter developments include an escalating nonexpert commercial sexuality sector on the Internet, as well as a long history of anarchic and democratizing social politics, such as "the counterculture" and "free love movements." What these nonmedicalizing trends have in common is the view of sexual problems and solutions as far broader than sexual dysfunctions and sex therapies, a belief in the social determinants of individuals' sexual experiences, and a deep concern regarding the socially harmful consequences of medicalization. With the quantity of sexuality information and advice available to the public through the Internet only likely to expand, a long era of clashing claims about relations between sexuality and health and about the role of expertise in sexual life can be foreseen.     

Missed Opportunities in the Patient-Focused Drug Development Public Meeting and Scientific Workshop on Female Sexual Dysfunction Held at the FDA,October 2014

There were numerous missed opportunities at the October 2014 U.S. Food and Drug Administration (FDA) meeting on female sexual dysfunction (FSD). They included opportunities to hear from a diverse range of patients and to engage in evidence-based discussions of unmet medical needs, diagnostic instruments, trial end points, and inclusion criteria for clinical trials. Contributions of the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) nomenclature, based on extensive research, were dismissed in favor of language favoring a seemingly clear but scientifically unsupportable distinction between women's sexual desire and arousal. Numerous participants, including patients recruited by their physicians, acknowledged travel expenses paid for by interested pharmaceutical companies. Conflicts of interest were manifold. The meeting did not advance the FDA's understanding of women's sexual distress and represents a setback for our field.     

The concept of chastity in biblical society

A distinction is made between two different but closely related syndromes—“cross gender identification” and “gender behavior disturbance”—in male children. Based on assessment data and systematic clinical observations of a group of 47 such children in a longitudinal research study, a set of factors are identified as relevant to the diagnostic task. Specific diagnostic procedures were developed for the clinical evaluation and psychological testing of male children referred for potential gender dysphoric problems, and these procedures are presented in detail with accompanying rationale.     

New perspectives in sexology: From rigor (mortis) to richness 1

“Rigor” is a term which has been used in sexology to imply that there is a hierarchy of methodologies and approaches to sex research. This paper argues that “rigor” is actually a term used rhetorically in an attempt to achieve professional legitimacy in a field perennially threatened because of its politically relevant subject matter. Rather than worry about a seat at the table, we need to look more towards the postmodern richness of diverse and even contradictory standards and approaches to sex research to reveal the range and depth of our subject matter. Recent issues of JSR introducing feminist perspectives offer examples of the range of work which should be acceptable to those interested more in intellectual challenge and quality than traditional respectability.