ollege students were asked whether they had ever had a sexual experience in which they, or their partner, had trouble with sexual functioning. Many said they had experienced problems and had trouble talking to their partners about it. As you read the following accounts, notice how the women often feel responsible for their partner’s sexual problems. Why do you think this is? What about the men’s attitudes? How can women be taught to feel less responsible and guilty? How can men learn to feel less pressure to perform?
Female: Being in college, you find yourself stressed more than anything. Therefore, sex isn’t always the first thing on my list, but it is for my partner. It’s hard to get turned on when you are stressed out. The best sex we have is on the weekend after a relaxing night out with friends.
Female: My boyfriend has problems getting an erection after a long night of drinking. I was crying and all upset because I thought he was cheating on me and didn’t care about me or wasn’t attracted to me anymore.
Female: My boyfriend has trouble becoming aroused. We never really talked about it, but it really bothered him. At first I thought it was me, but I realized later that it was his problem, and it can’t be all my fault. He went on Viagra and that worked for him.
Female: My boyfriend has a tendency to orgasm after only a few minutes. This has gone on for quite a while, and we finally talked about it. He told me he just got too excited, and maybe we could slow down a bit.
Female: I have trouble reaching orgasm. It affects our relationship in a way that I get nervous when we reach that point, so it’s even harder to get the orgasm. Makes me feel like I have done something wrong.
Female: This happens all the time with my boyfriend. Sometimes I’m wet and he can’t get it up, or he can get it up and I can’t get wet. We talk about it all the
time, but it doesn’t really affect our relationship, because we still have sex, just not as often. We do other things to sexually stimulate each other.
Male: The first time I ever tried to have sex I was unable to have an erection. I was really embarrassed, but my partner was very understanding.
Male: I always feel so much pressure during sexual intercourse. Men are supposed to be able to provide orgasms for their partners, and I tend to focus so much on this that I lose my erection. This is both disappointing and frustrating for me. The more frustrated I get, the more likely the erection won’t come back.
Male: / have had a couple of times where I couldn’t get an erection or my partner couldn’t get turned on or sex hurt her. We have always had good communication skills so we can talk about it. It never hurt our relationship but probably made it stronger by talking about it. We still have a great sex life.
Male: I had too much to drink one time, and I didn’t feel much of anything during sex. She was really upset and felt like it was her fault, so I had to convince her it really wasn’t. I now know how to "read" the signs when sexual activity may be involved, so I drink much, much less. It helps because she sees I am making an effort to acknowledge how she feels, and we both end up happy with the result.
Male: My girlfriend was diagnosed with vulvar vestibulitis. Our sex life was great prior to the diagnosis but then she lost her sexual interest, and sex became really painful. I understood sex hurt, but she cut me off from everything, totally. Slowly our relationship disintegrated into a friendship with quite a bit of resentment and confusion.
Source: Author’s files.
tercourse. This implies that only heterosexuals experience sexual dysfunction because gay men and lesbian women do not engage in vaginal sexual intercourse. The truth is that we all—gay, straight, and bisexual—experience sexual dysfunctions. The definition of “penetration” may not always refer to penile-vaginal penetration—it can include anal, oral, or digital penetration. In this chapter, we will refer to an inclusive definition of sexual dysfunction.
A sex therapist’s first task in evaluating a new client is to ascertain whether a dysfunction exists, and if so, whether the dysfunction is psychological, physiological, or mixed. This is not always an easy task because psychological and physiological factors can overlap. Let’s take a look at some of these factors.