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The US Food and Drug Administration (FDA) has approved two drugs for ‘hypoactive sexual desire disorder’ in women, flibanserin (Addyi) in 2015 and bremelanotide (Vyleesi) in 2019. In this paper we examine the outcome measures and clinical trial data upon which regulatory approval was based. In clinical trials, flibanserin led to an average of only one additional enjoyable sexual experience every two months, bremelanotide to none. Trials for both drugs feature shifts in primary outcomes and a contested indication. A politicised industry-sponsored advocacy campaign and conflicted patient and expert testimony likely influenced flibanserin’s approval at its third attempt. Bremelanotide, with even weaker efficacy, capitalised on the regulatory precedent set by the approval of flibanserin. Reconsideration of regulatory decisions to approve these drugs is in order, as well as a broader examination of how future regulatory decisions can better address conflicts of interest and clinically meaningful benefit.

Is there anything new to say about love potions, aphrodisiacs, sex drugs? Sometimes it seems every food, spice, and chemical combo has already been loudly promoted and, later, quietly debunked. Yet...

In 1980 I was invited to write a weekly 200-word column for the New York. Daily News, which advertises itself as the largest-circulation daily in the country. I knew they wanted something popular and a little titillating, not academic or political, but I thought I would see if I could find some way to present the ideas I was interested in anyway. The News called the column "Your Sexual Self," exactly the sort of privatized perspective I planned to preach against! I had to repeatedly resist the editors' request that I answer readers' questions in the column. I got lots of mail, but none of it ever commented on the columns; it all wanted advice. The News called it quits after six months; I have selected a few of those columns to include here.

A feminist analysis of the patriarchal bias in sexology could do worse than begin with one of the fundamental elements of the new sex therapy: "sensate focus." The quotes from people for who emotional and not sensory focus are the centerpiece of sexual experience; it is no surprise that the quotes are from women. Shere Hite's entire volume is dedicated to a "redefinition" of sexual relations wherein routine scripts of foreplay-to-intercourse-to-orgasm would be replaced or at least enhanced by more spontaneity, variety, verbal communication, fun, and tenderness. Such a redefinition requires appreciating the deep gender differences in sexual socialization in our society and rejecting the notion that sex-as-usual represents the interests of all men and women. Therapists' commitment to a sensate view of sexuality not only represents a choice about what sort of sexual experience is "real" or "best" but also assumes that all partners are already sensually adept or would be able to learn how to focus on sensation.

Suppressing pornography will harm women struggling to develop their own sexualities: History teaches us that any crackdown on sexually explicit material always falls the hardest on experimental presses, alternative artists, small theaters, and the like. Accusations that pornography harms women amount to a powerful form of backlash against new sexual forms. The consequence is a blanket of inhibition. The antiporn feminists argue that pornography is to be interpreted in a literal way—if it's a picture of a woman being fucked while lying across three tall stools in a coffee shop, it's a picture of an embarrassed, uncomfortable, and unhappy woman. Opponents of pornography often argue that women in pornography are seriously harmed while doing the work and that eliminating pornography would help these women escape from abominable conditions. Finally, and perhaps most important, suppressing explicit sexual materials will harm women by strengthening the power of the conservative religious lobbies.

The conference, from October 22 to 24, is entitled "New Perspectives in the Management of Female Sexual Dysfunction." A business meeting will be held to discuss and vote on creating a new organization to address this supposed dysfunction, and the whole ball of wax has been underwritten by "unrestricted educational grants" from several pharmaceutical companies. It seems clear that the purpose of this conference on "New Perspectives in the Management of Female Sexual Dysfunction" is to promote the medicalization of women's sexuality—a process of establishing universal norms, and then declaring all variations disordered and in need of treatment. The "female sexual dysfunction" is being invented at this very moment and that it represents a serious challenge for feminists. Absent were women's medicine, gay and lesbian medicine, adolescent medicine, women's studies, lesbian studies, bisexual and transgender studies, social science, sociology, medical sociology, anthropology, medical anthropology, and history, history of medicine, cultural studies, film studies and ethnic studies.

The modern view of sexuality as a fundamental drive that is very individualized, deeply gendered, central to personality and intimate relationships, separate from reproduction, and lifelong would be quite unrecognizable to people living in different civilizations. Kenneth Plummer contrasted the popular drive-based view of human sexuality with the social constructionist dramaturgic metaphor of sexual script. Histories and anthropologies of sexuality are being revolutionized by the new constructionism. The major obstacle to a social constructionist approach to sexuality is the domination of theory and research by the biomedical model. Historical studies are dear to social constructionists because they can point the way to analyses of cultural meanings and changing personal experiences. The ideological support for medicalization is essentialist, naturalist, biological thinking. The privileged position of biology in sexual discourse is based on the assumption that the body dictates action, experience, and meaning. As sexual interest and adequacy gain in social importance, weaknesses in one's preparation become more significant.

Physicians are not well prepared to address patients' concerns about their sexual behavior or to diagnose sexual dysfunction, owing to their limited personal and clinical experience and education on the topic.

A narrative of my first months as a breast cancer patient offers insight into how a feminist meets a biomedical crisis. Instead of consulting other women and feminist texts, I initially immersed myself in scientific information-gathering, only realizing later that decision-making is best done with feminist resources as well as medical experts. The new cancer centers are staffed with enthusiastic young women professionals who practice an autonomy-celebrating feminism that resulted in consumeristic pressure towards body normalcy through unnecessary (cosmetic) surgeries. I resisted this pressure, but learned that sexist assumptions and prescriptions flourish in the cancer-industrial complex—be prepared!

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.

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.

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.

In 2002, Sexual and Relationship Therapy published my leading comment, “Beyond the medical model of women's sexual problems: A campaign to resist the promotion of ‘female sexual dysfunction’”. I wr...

The New View Campaign is a grassroots initiative begun in 1999 to challenge the over-medicalization of sex in the wake of publicity following the release of Viagra. This paper describes the history of the campaign and its activities, which started with analysing the construction of female sexual dysfunction, and moved on to develop a critical understanding of sexuality as a market for the pharmaceutical industry to exploit. The campaign has also had much to say about a positive model for sexuality, sex education, treatment of sex problems, and sex research. From 2006, we began to look at the new female cosmetic genital surgery industry. In 2008, we wrote letters to many government and medical professional groups expressing our concerns about female cosmetic genital surgery and asking for support. We also organised a demonstration outside the office of a New York surgeon who was doing this surgery and developed a webpage as a resource for students, scholars, journalists and activists. In 2009, we held an event in an art gallery that celebrated artists who support and encourage female sexual diversity. Supporters and colleagues of the campaign have published books and articles, and created visual and training materials, including a project called Vulvagraphics.

Female genital cosmetic surgery (FGCS) refers to new treatment/enhancement technologies that have engendered much controversy. Examining FGCS through the lenses of bioethics, feminist theory and medical marketing situates it within makeover culture and deregulatory politics, and links it to feminist debates about making choices within constrained contexts. This article points out numerous analogies between the creation of FGCS and the new sexuality pharmaceuticals, and shows the relevance of the New View Campaign's analysis for this new domain.

This special issue of Feminism & Psychology presents a sampling of the type of work stimulated by The New View Campaign against the medicalization of sex, c. 2008. In this introduction, I offer a brief history of the New View Campaign (1999—2008) and show how the articles in this special issue illustrate many of its major themes. In closing, I suggest future directions for New View-inspired research and theory.

My presidential address to the International Academy of Sex Research in 1993, 5 years before Viagra was released to the world, was entitled “Three Crises Facing Sexology” (Tiefer, 1994). One of the...