Travis Sky Ingersoll, PH.D., MSW, M.ED. - Social Work & Sexual Health Education/Consulting/Research
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Is frigidity for real?

Question: Is Frigidity Real?
A little background about the word “FRIGID”
Before I get into whether the condition of frigidity is real or not, it’s important to inform that the word “frigidity” is an outdated, sexist term.  There was a time in most world societies (not that long ago to be honest) that women were more likely to be seen as domestic livestock, as being voiceless, powerless and inherently inferior to men.  Their husbands and boyfriends expected them to demonstrate their appreciation for everything a man provided for them, by enthusiastically, passionately having sex with them whenever it was required.  Now, if for some unknown mysterious reason, women did not actually feel like providing their men with the sexual release those men felt entitled to, they would be labeled as FRIGID, a clinical diagnosis that equated a woman’s lack of sexual desire for her provider (her husband or boyfriend)  to a disorder of character. Calling a woman FRIGID was (and is) not a compliment;  it’s a pejorative term communicating that a woman is emotionally cold, has low libido, or simply does not respond “appropriately” to her partner’s sexual advances.
It is also important to understand that only women could be labeled “Frigid” since it was also believed that the nature of men made it impossible for them to NOT want to engage in sexual activity whenever they could.  This outdated and completely un-evolved social norm equates a couple’s relationship to that of a business transaction;  where one person makes the money and puts food on the table, while the other takes care of the children, domestic chores, and most importantly, provides sexual services regardless of sexual desire.  Unfortunately, such gender-role based beliefs are still commonplace throughout the world.  Not that I’m saying there doesn’t need to be a balance of contribution to a couple’s financial and domestic efforts; I’m just saying that sexual activity should never be an expected component of any romantic relationship’s accounting system (aka, the relationship LEDGER).
Hypoactive Sexual Desire Disorder
These days, a lack or absence of sexual desire and/or sexual fantasies, which causes marked distress or interpersonal difficulties (and cannot be better accounted for by another mental disorder, a drug, or some other medical condition) is called Hypoactive Sexual Desire Disorder (HSDD), not FRIGIDITY.  HSDD is listed in the DSM-IV under “Sexual and Gender Identity Disorders”.  HSDD can have a variety of emotional and physical causes for men, women and trans-identified individuals.  It is extremely important to understand that in order to be diagnosed with HSDD, your lack or absence of sexual desire and/or fantasies has to cause YOU significant personal distress and interpersonal difficulties. 
If your lack of sexual desire doesn’t bother you at all, maybe you’re simply Asexual.  Asexuality is a sexual orientation characterized by an overall lack of sexual desire and/or sexual fantasies.  And although Asexual individuals may be emotionally attracted to others, they simply have no desire to engage in sexual activity with them.  Let’s say that we’ve ruled out Asexuality as being the root of a person’s lack of sexual desire, as previously stated, HSDD can have a variety of emotional and physical roots. 
Examples of emotional causes of HSDD:
-        Low self-esteem, negative body image, lack of confidence
-        Fear of pregnancy or sexually transmitted diseases
-        Situational factors such as parents sleeping in the next room, an intoxicated partner,   
          or lack of adequate privacy
-        Emotions such as depression, guilt, anxiety, or boredom in the relationship
-        Physical/sexual intimacy inhibitions linked to religious or personal taboos
-        Communication problems, an argument or an unresolved emotional issue in the
-        Feeling emotionally distant from a partner
-        Past traumatic sexual experience such as rape, incest, or sexual assault
Examples of Physical Causes of HSDD:

-        Pain or discomfort during sexual intercourse (dyspareunia)
-        Vaginal dryness
-        Lack of adequate foreplay
-        Poor sexual performance from one’s partner
-        Fatigue or exhaustion
-        Insomnia
-        Side effects of prescription medications
-        Side effects of alcohol or substance abuse
-        Changes related to menopause or hormonal imbalance
-        Damage to nerves as a result of trauma or surgery (ex., hysterectomy, prostate
          surgery, etc.)
-        General infections, sexually transmitted infections
-        Gynecological problems and erection difficulties
In addition to the variety of emotional and physical causes of Hypoactive Sexual Desire Disorder listed above, a lack of sexual desire may also be linked to low levels of testosterone in males, females and trans-identified individuals.  Testosterone levels and one’s sex drive go hand in hand.  The more testosterone one has in one’s blood stream, the more likely they are to have a high sex drive (libido).  However, even high levels of testosterone can be negated if a person is dealing with one or more of the physical and/or emotional causes of HSDD.  This brings me to another important point to make; you don’t necessarily have HSDD simply because you are experiencing a lack of sexual desire.  Having a lack of sexual desire from time to time is completely normal, regardless of your gender.  Stress, painful skin conditions, lack of sleep, lack of reciprocity from your partner, and body image issues are all common reasons why people periodically have no interest in sex.  There is really no such thing as a “normal” sex drive.  Sex drives are as individually based as physical attraction templates; it’s all about what is “normal” for each individual.
How do you treat low libido or HSDD?
First off, it’s important to differentiate HSDD from normal, periodic decreases in libido, or a lack of sexual desire.  It’s really only a diagnosable problem if it’s causing serious and persistent personal and/or interpersonal distress.  Once you’ve ruled out any physical/medical cause (ex., pharmaceutical side effect, blood pressure/blood flow issues, etc.), it is important to investigate for possible emotional/relational roots to the problem.  This is typically achieved through individual and couples counseling and/or sexual therapy.  One of the initial areas of a person’s life that gets a lot of attention is their relationship, intimacy, and communication issues.  Healthy, honest, and open communication patterns are vital for any happy relationship, sexual or not. 
In a romantic relationship, non-sexual intimacy and sexuality education is almost always a primary component in the treatment for low sexual desire or HSDD.  Sometimes the problem is rooted in unrealistic perceptions of what defines a “normal” sexual experience, with people feeling that either their partner is not living up what they think is normal, or feeling that they, themselves, are unable to live up to their own expectations of what constitutes an ideal sexual performance.  This performance anxiety around sexual activity is often linked to something called “spectatoring,” in which the person isn’t completely within them-self experiencing the sexual act. Instead they are partly outside of themselves, critically judging their performance based upon internalized sexual norms; norms that often come from pornographic material such as videos and magazine articles.  The problem with judging one’s sexual “performance” based on porn has two major problems, 1) Porn sex is not realistic and often completely sexist and misogynistic, and 2) When you are outside of yourself, judging your performance, you are not in the present, actually enjoying the sex you are having!
If a clinician thinks that part of the problem is a result of stress, stress-reduction techniques will often be taught.   If it’s a self-esteem problem or a body image distortion, such issues will likely be addressed before tackling a person’s sexual dissatisfaction.  If however, as is often the case with heterosexual couples, the problem appears to be rooted in a sense of gender inequality, or due to the way each person in a couple attaches meaning to sexual activity, then couple’s counseling/therapy will need to focus on those issues.  Treating low sexual desire or HSDD can incorporate individual and/or couple therapy, hormonal testing and treatment, and/or addressing other medically based causes. 
I chose to equate Hypoactive Sexual Desire Disorder with the outdated concept of “Frigidity” for a couple of reasons.  Frigidity was almost always associated with a lack of sexual desire, and although it was primarily used to label women who did not want to have sex with the men they were in relationships with, HSDD addresses this lack of wanting for all genders.  I also chose HSDD because others “problems” of sexuality like premature ejaculation, erectile dysfunction, anorgasmia, dyspareunia, and sexual aversion disorder are sometimes the root of HSDD, but are also issues/conditions that can be unrelated to sexual desire and deserve their own time in the spotlight.
So, to answer the question posed by one of my students, “is frigidity real”, I’d have to say NO and YES.  No, frigidity is not real in that it is a value-laden sexist term that basically summarized the frustration of misogynistic men who felt entitled to their female partner’s body and sexuality whenever they wanted it.  And yes, low sexual drive is very real.   However, its origins can be rooted in a complex web of relational, physiological and emotional factors.  My advice to any man, or woman, or trans-identified individual who has a partner that doesn’t seem to be interested in having sex with them, is to communicate.  Ask them what is going on.  Let them know you are willing to do whatever it takes to be a part of the solution.  If that means couples therapy, do it!  If it means being there for your partner as they work through emotional/physical trauma, do it!  If it means widening your sexual repertoire to include new positions, new ways of communicating and/or expressing your sexuality, do it!  If it means honoring a request to brush your teeth or to take a shower before having sex, do it!  And most importantly, if it means redefining what you expect of your partner and yourself, regarding rigid, oversimplified and often sexist gender role ideologies, for goodness sakes, do it.  I guarantee that the more you are willing to care about your partner’s sexual and emotional health, the better your sex life will become:)
American Psychiatric Association. (2000). Diagnostic and statistical manual of mental disorders (4 ed., text revision). Washington, DC: Author.
Hall, K. (2004). Reclaiming your sexual self: How you can bring desire back into your life. Hoboken, NJ: Wiley.
Lazarus, A. A. (1963).  The treatment of chronic frigidity by systematic desensitization. The Journal of Nervous and Mental Disease, 136(3), 272-280.
Masters, W. H., & Johnson, V. E. (1966). Human sexual response. Boston: Little, Brown.
Masters, W. H., & Johnson, V. E. (1970). Human sexual inadequacy. Boston: Little, Brown.
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Masters, W. H., Johnson, V., & Kolodny, R. C. (1992). Human sexuality (3 ed.). New York: Harper Collins.
McCarthy, B., & McCarthy, E. (2003).  Rekindling desire: A step-by-step program to help low-sex and no-sex marriages. New York: Brunner/Routledge.
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