A Fucking Mess: Pills, Partners and Desire

If Emily Nagoski could have explained responsive desire to my now ex-husband, our marriage might have had a shot (or at least been more fun while it lasted). I tried to explain my desire to him, but I guess I made a mess of it.

In her New York Times op-ed piece (see below), Ms. Nagoski discusses Sprout Pharmaceuticals’ resubmission to the Food and Drug Administration of its drug, Flibanserin, to treat low sexual desire in women. In that context, she explains two different models of sexual desire: spontaneous desire and responsive desire.

The theory of spontaneous desire, the old-school model, places desire first in the desire/arousal linear progression with a desire for sex motivating the individual to seek satisfaction, which then results in arousal. The desire for sex in this model just happens — it’s a spontaneous (or perhaps ever-present) urge.

By contrast, under the theory of responsive desire, desire for sex does not show up until it is invited to the party by erotic stimulation — arousal first, then desire.

The difference between these two models of desire and, perhaps more importantly, the difference between experiencing one or the other versus experience little to no desire at all, is what leads to criticisms when it comes to “treating” sexual desire in women. So what type of desire is Flibanserin really trying to fix?

If Flibanserin purports to and actually does treat across-the-board low desire in women (that is, women who experience neither spontaneous nor responsive desire), then fantastic. But if it’s purporting to treat low desire while sneakily setting out to treat (and is marketed to treat) responsive desire as if it were low desire, that’s where critics like Ms. Nagoski (and myself) see a problem.

But why would a drug company make a pill to “treat” responsive desire? Where’s the market?

In her article, Ms. Nagoski notes that she has met with numerous women who assume that, because their desire is responsive rather than spontaneous, they have low desire. And those women feel bad about this (mistakenly labeled) low desire because they don’t feel a “persistent urge” for their partner. But Ms. Nagoski never explicitly says who (other than Sprout Pharmaceuticals) is doing the judging and desire-shaming. I know who. The partner.

From about day 300 of our relationship (and we were together for almost 18 years), my ex-husband and I were on different pages of the sexual manual. He wanted to have sex with me almost all the time, even as the years wore on. He didn’t need an arousal trigger. His desire for me was just there (spontaneous).

But I couldn’t return the same kind of desire for him. I needed arousal — a trigger, a spark to ignite the fire (responsive). It was hurtful to him that I did not have a persistent urge to have sex with him. But to me, needing a trigger seemed totally normal, and his no-trigger desire seemed weird and unnatural. What a mess.

We never learned how to talk through all this stuff and understand (and accept and work with) each other’s brand of desire. He wouldn’t let go of the idea that it was my problem (I was “frigid”), and I needed to be fixed. For awhile I bought into that theory, and it made me feel horrible and helpless because you can’t fix what is not broken. Even worse, it became a self-fulfilling prophecy because I shut down my desire for him — how can you desire someone who claims you are frigid?

But I finally realized that his theory was shit — if I actually suffered from low desire, I would rarely feel desire at all. Yet my desire was triggered often and intensely by outside erotic stimulation. He was plain wrong, but I couldn’t figure out a way to explain my desire that didn’t hurt his ego and put him on the defensive. It was a vicious, draining cycle of blame and hurt. A fucking mess.

So back to the drug — if in fact Flibanserin is setting out to treat that pesky, trouble-making responsive desire, to whom is this magic “skip the arousal” desire pill going to be marketed? I’m guessing to female partners in long-term relationships — or more likely, their male partners who don’t understand how to tap into that responsive desire. A pill to make you settle for less.

But the spontaneous vs. responsive desire isn’t a medical issue — it’s a relationship issue. And if you can’t talk about it, because everyone goes on the defensive and feelings get hurt, you have a relationship problem, and there’s no effective pill for that (believe me).

And anyway, should you have to take a pill to want to fuck your partner? If you experience desire when exposed to erotic stimulation, then you probably don’t have a low desire problem that needs treatment. If your partner is convinced that that the way in which you experience desire is so troublesome that you need to be “fixed,” then you have a partner problem. Or if the erotic stimulation you need is stuff that he’s not comfortable with — that’s a compatibility issue, not a medical issue. Maybe you can find compromise. Maybe you can try watching porn together or find other outside erotic stimulation to bridge the gap. I don’t know. But if he’s convinced it’s all you, my non-professional advice: find a new partner.