Barbara Raab

But then ask Leonore Tiefer about this gathering — indeed, ask her about this whole FSD movement. She’ll tell you this is bad news — very, very bad news — for women. Tiefer, a well-known clinical psychologist, professor and author (“Sex Is Not a Natural Act and Other Essays: Psychology, Gender and Theory”) who has specialized in sexuality and sex therapy for 30 years, will tell you she’s appalled by what she calls the “competitive commercial hunt for ‘the female Viagra.’”

She’ll tell you about the insidious inadequacy of the bible of the psychiatric profession, the Diagnostic and Statistical Manual of Mental Disorders (DSM), which divides all female sexual problems into four neat little categories: desire problems, arousal problems, problems having orgasms and pain. She’ll tell you she’s certain that dozens of lectures, slide shows and discussions about rabbit clitorises, rat vaginas and devices to measure blood flow are not going to help improve most women’s sexual lives.

Tiefer will tell you that, yes, she’ll be one of the hundreds of people converging on Boston to talk about sex. While locals and tourists spend this weekend enjoying the New England autumn — the crisp air, the foliage bursting with color, the festivals celebrating everything from Scottish culture to cranberries — Tiefer and a small group of other psychologists, sociologists and anthropologists who have formed the Working Group on a New View of Women’s Sexual Problems will be at the Marriott Copley Place fighting the good fight, trying to raise some consciousness about what they believe is “the urological/pharmaceutical co-option” of women’s sexual problems.

Salon spoke with Tiefer this week in New York, where she lives and works, just before she left for Boston, where her group was planning a press conference to unveil its blueprint, “A New View of Women’s Sexual Problems.”

You talk about the overmedicalization of the female sexual dysfunction movement. What do you mean by that?

Too much of the research about women’s sexual problems is funded by drug companies and narrowly conforms to their interests. There’s just too much emphasis on claiming things are physical and then selling products.

The pharmaceutical companies want products they can market, which I distinguish from products that will help women with their sexuality. Their criteria for many trials exclude women with so many real-world problems — they exclude women with psychological problems, or partner and relationship problems. They’re interested in studying women with purely physical problems. So they find drugs that work on these physical problems, but then their marketing strategy, as we’ve seen with Viagra, is to market romance. Their strategy is not to be specific and say something works with this kind of person who has this specific kind of problem. They just say, “Use the drug, start dancing!”

So do you feel this conference is dangerous?

I’m mostly feeling sad about it. I think it’s not doing what the doctors are coming to have done. Most come to help them learn more about women’s sexuality. Ironically, the FSD movement is bringing in a lot of women as patients who say, “I want some help.”

The doctors need some idea what to do. They learn little bits and pieces: Here’s something more to know about the vulva, here’s something more to know about cancer, here’s something more to know about hormone replacement therapy — but a comprehensive picture of women’s sexuality with heavy emphasis on the sociocultural, political and economic things that influence it? They won’t get that. The FSD movement is only able to make its claims because of the DSM’s overly genital, overly biologized, overly simple view of women’s sexual problems.

You say you want to present a “new view” of women’s sexual problems. What’s new about your view?

The new view is a new classification system for talking about women’s sexual problems. The DSM system that’s currently in use is very influential in the world, in research, in treatment and in the teaching of all kinds of professions. And it’s very influential in terms of how ordinary women view their own sexuality — whether they think they’re normal, whether they think they have a problem. I believe that classification system is profoundly flawed.

Aren’t you also classifying women’s sexual problems into four categories?

Yes, but it’s very important to recognize that fundamentally it’s a very different kind of list. The DSM is based on what constitutes “normal” sexuality, and then it offers four examples of symptoms that deviate from normal sexuality. We start off with a definition that has much less to do with any kind of universal biological norm. We define a sexual problem as discontent or dissatisfaction with any emotional, physical or psychological aspect of sexual experience. It’s a very subjective definition by a woman.

OK, so now explain how you can fit these subjective dissatisfactions into four “new” categories.

The first one is the social, cultural, political or economic category, which is completely missing from the way the DSM looks at sex. For example, is the woman having a problem because there is no sex education, so that she doesn’t even have a vocabulary to talk about her problem? Or is it a cultural problem because the norms that she was raised with are different than where she lives now? Or maybe she and her partner are from different cultures.

Then there is our second category: Is it a problem having to do with the relationship itself? Maybe there’s a lot of conflict, or distrust, or abuse, or negativity in the relationship. Or maybe the sexual compatibility is really low, so that what a woman likes or wants is a lot different than what her partner likes or wants. Or maybe her partner has a sexual problem that’s having a terribly inhibiting effect on this woman.

Talk about your third category, sexual problems due to psychological factors.

Psychological problems can cause sexual problems. It can be just general personality problems, or an attitude of fear or hostility or mistrust, or phobias that come from past abuse. There are quite a few women who are very afraid of becoming pregnant, or getting an STD, or losing something valuable, like their reputation or their self-esteem, if they were to become pregnant. So it’s something inside the woman, something psychological.

Your fourth and final category does seem to acknowledge a purely medical, or physiological, basis for some women’s sexual problems.

Yes. It could be a disease process, something circulatory, or it could be an STD that’s giving a woman pain, or it could be a side effect of medication or surgery. Situations where despite everything in the first three categories being OK — and that’s really crucial, and quite different than the way the field of women’s sexual problems is going now, which is to look at the body first — there’s something functionally wrong with her sexuality.

So you’re agreeing with many of those you otherwise disagree with, that a purely medical approach can sometimes be valuable?

I don’t think a purely medical approach can ever be valuable. I do think there are women whose sexual problems are medical in origin. But our medical category requires a ruling out of psychological, relational and sociocultural issues that are interfering before we conclude that this is a medical problem. I’d like doctors to have these ideas going through their mind, instead of first saying it must be hormonal or a blood flow problem or whatever.

Sure, the more subtle of the doctors can accept that people have minds and feelings as well as bodies. But it’s still as if whatever the problem is, it’s yours alone, it’s your individual problem, because either you had an unlucky life or an unlucky body. All of this energy is only going to help one woman at a time — at best. A lot of it won’t even do that. We’ve had 30 years of feminist research and writing that have shown that there are patterns of social reality that cause — dare I say it? — the majority of women to have certain kinds of sexual problems. Is that to be ignored? None of what’s going on in the FSD movement is addressing that.

You are one of the speakers at this conference. That’s a good sign, isn’t it?

The topic is “Beyond Dysfunction: A New View of Women’s Sexual Problems.” I get eight minutes.

It looks like the program also includes discussions of sexual abuse and other topics that are not just about the mechanics of a woman’s body.

Oh, yes. There will be some other speakers who will be talking about women’s sexuality in a way that’s not just, you know, how to fix the labia after cancer. There will be more attention to some of these larger contextual issues, or at least to women’s feelings and relationships, than last year. But is it because we’ve had a year more of doctors trying to treat women’s problems, and failing with their narrow approach? The fact is, the vast majority of presentations are not saying, “Maybe we don’t understand women’s sexuality correctly.” They’re saying, “These 12 things didn’t work, but mine, No. 13, is a winner! Mine is a cream instead of a pill, a gel instead of a cream!”

There are some women who will tell you they were given a pill, or a cream, and it did help them. Are you saying they’re deluded?

I’m certainly not going to say these women don’t know whether they feel better or not. But I am going to say it’s not the first and only way to go.

It was a modest little goal, for which I was happy to shell out $50, and sit in a cavernous arena with countless retired jerseys of New York Knickerbockers and Rangers hanging above my head, to listen to some of the most personal revelations about what happens “down there” — the kind of thing I’m more used to hearing about in groups of two.

Pardon me for quibbling about something so utterly, totally politically correct, but memo to Eve: three-and-a-half hours with no intermission? Even feminists have to pee. Especially when, even on this V-for-very special night, the Garden’s concession stands sold the usual V-for-vile hot dogs, nachos and supersize beers. And, you know, it’s not that I didn’t enjoy watching Glenn Close fall to her knees in her hot-pink pantsuit, shrieking “Cunnnnnttttt!!!” but it will really feel like we’ve come a long way (baby) when a big movie star can say the word “cunt” and not make thousands of women giggle and cheer.

Another thing, Eve: Are you aware of what your corporate sponsors (even vaginas, apparently, can get corporate sponsors these days) are doing? You heaped praise upon Lifetime, the cable television network, telling us it was proud to stand for stopping violence against women. But did you happen to catch, the night before V-day, Lifetime’s showing of that feel-good feminist classic “The Silence of the Lambs”?

And if those charitable folks at Tampax (nice synergy, Eve!) are serious about making the world safe for vaginas and the women who own them, why do they perpetuate the myth that there’s something, well, icky about tampons? When my supersize beer had taken up residence in my bladder and I just couldn’t wait any longer, I made a trip to the ladies room. On my way in, two nice young women offered me a freebie: a little box, wrapped prettily in shiny blue foil with yellow and white flowers and a sticker that said “Cool Gift Inside.”

At first I thought it was a Rice Krispies Treat. But it turned out to be a sample of Tampax Compak tampons, which, according to the ad copy inside, provide “Protection and Discretion in the Palm of Your Hand.” The two free tampons were inside a stylish jet-silver “Purse-Pak,” which was inside a cardboard box, which was inside the blue foil wrapping. In other words, at center stage in Madison Square Garden, members of a vulva choir were talking very loudly and very clearly about snatches, pussies, hoochies and every word you could possibly think of for “vaginas” while, at the same time, Tampax was handing out small, discreet, heavily concealed — shh! — tampons? Eve: tampon, TAMPON or, as Close might put it, “TAMMMPONNNNN!”

Inside the ladies room, the walls and stalls were papered with Tampax promotional posters saying, “Tampax: The Revolution Continues.” You want a tampon revolution? I’ll give you a tampon revolution: How about a box of supers for half the price I pay now? (I actually think I have a good idea for lowering the price of so-called feminine protection: Let’s designate a tampon- and napkin-free week during which every woman in America who is menstruating simply refuses to wear anything to catch the flow. The men that run the corporations that make these darn things will be giving ‘em away in no time.)

Shortly after V-day, two things happened as if by design, as if to remind me that it doesn’t have to be this way — with corporate sponsors promoting shame along with their products and multimillion-dollar movie stars gathering in a sports arena on a Saturday night, along with thousands of women, for a high-gloss event that links sex with violence instead of pleasure.

First, I read that Dr. William Masters had died. Here was a man — a churchgoing Episcopalian and a registered Republican — who, with Virginia Johnson, had devoted more than half a century to taking the mystery out of sex and making sex more pleasurable. Masters and Johnson were profoundly controversial, sometimes wrong, but always profoundly influential. Their goal was to bring sexual joy to the masses, and they did that, especially for women.

Second, shortly after V-day I discovered a new book whose approach is the antithesis of the coy and infuriating marketing campaign for the tampon that dare not speak its name. The book is “The Clitoral Truth: The Secret World at Your Fingertips” by Rebecca Chalker, a longtime women’s health activist, medical writer and sexologist. Women’s sexuality is not about the vagina, Chalker says. (So get over it, Eve.) Her book blows the lid off some of the biggest secrets being kept from women and their partners about women’s sexual pleasure and how to achieve it. The clitoris, Chalker tells us (and shows us, with drawings by Bay Area illustrator Fish), is the one part of the female body whose sole purpose is pleasure. It is, she explains, so much more than that pea-size, exquisitely sensitive bundle of nerves we think it is.

Drawing on her earlier work with the Federation of Feminist Women’s Health Centers and its groundbreaking 1981 book “A New View of a Woman’s Body,” Chalker shows that the clit really is a “system” of 18 distinct but interrelated parts. In the chapter “The Case of the Missing Clitoris,” Chalker details just how it came to be that, after 2,500 years in which the clitoris and the penis were considered coequals, so much information and knowledge about the clit just happened to get lost.

Chalker devotes an entire chapter to sorting out the facts, fiction and fantasy about so-called female ejaculation. She also details how women can expand their repertoire of sexual experiences and satisfaction by going beyond “the intercourse model,” and includes her own and others’ firsthand accounts of full-body pleasure workshops with names like “Body Electric” and “Sluts and Goddesses.”

“The Clitoral Truth” is “Our Bodies, Ourselves,” your favorite history textbook, a Nancy Drew mystery and the Good Vibrations erotica catalog rolled into one small volume (with a knockout cover). The book is personal as well as political — pro-masturbation but not anti-partner, pro-woman but not anti-man (although one can only imagine how most men would react to her statement that “men must be willing to learn some degree of ejaculatory control”).

Salon spoke with Chalker at her fifth-floor walk-up apartment in Manhattan.

Why don’t you do “The Clitoris Monologues”?

I just might.

If your clit could talk, what would it say?

I guess it would say, “Get me out of here! Get me out of this obscurity that I’ve lived in for millennia! I’m alive!”

Sounds like you want to take the clit out of the closet.

Yes. It’s been closeted, and denigrated. It’s pretty obvious that people still have a very hard time saying the C-word. I wrote this book to reclaim the clitoris. I wrote it to reveal the unknown extent and power of the clitoris, to raise it from this obscure, pea-size organ that we think of it as, to make the world safe for women’s sexuality.

When I’ve mentioned the title of your book, the first thing several people have said is, “Is that a book about masturbation?”

No. Not exclusively, anyway. The focus of this book is to help women understand, explore and expand their sexual response. Certainly masturbation is a bedrock of that. But the book is not about how to masturbate.

So what is the clitoral truth?

The clitoral truth is that women’s sexuality is more powerful and compelling and complex and unknown than has been acknowledged. The clitoris is as extensive as the penis. In fact, the clitoris and the penis are almost identical in their parts. They’re just arranged differently. Up until about eight weeks of gestation, all fetuses appear to be female. Then, in fetuses with X-Y chromosomes, which designates them as male, testosterone kicks in and the parts are rearranged. In females the parts continue to grow into what is really an extensive clitoral system. So literally, the penis is a derivation of the clitoris, not the other way around, and they’re equal. It’s just that the penis is outside, and can be easily seen.

So the clitoris is a lot more than what meets the eye?

Absolutely! Or the hand. It’s an organ system. There are parts that can be seen and felt, and there are parts that cannot be seen. There’s erectile tissue, for example, that fills with blood during sexual response. There are two parts that look like the wishbone of a chicken. And there are two large bodies of erectile tissue called bulbs, directly under the inner lips. There’s the urethral sponge, the spongy erectile tissue that surrounds the female urethra, just as it does in the penis. This is the location of the so-called G spot. There are also three layers of muscle underneath it all, and the muscles are critical in causing the spasm of orgasm. There are blood vessels, which bring the greater blood flow to the clitoris, and there are nerves, which carry the sensory signals between the clitoris and the brain and back.

Why is it that so many women, who are, after all, the owners of the clitoris, don’t know this?

It’s not just that women know so little about the clit — the medical profession knows little about it also. The reason is that women’s sexuality has been devalued in various ways over time. The ancient Greeks knew precisely that women’s and men’s genital anatomy was similar. Aristotle wrote about it, and Claudius Galen, the most famous physician of the Greek era, said that women are just men turned inside out. Galen’s works were the gold standard of medical understanding up to and throughout the Renaissance. In fact, in the 17th century, midwives recommended that women have orgasms to help them get pregnant, for general health and well-being and to keep their relationships healthy.

Ah, this is where you have unraveled a whodunit.

Yes. In the 18th century, around the time of the French Revolution, when women began to demand some measure of social and economic equality, we suddenly see women’s sexual response and anatomy and orgasm begin to be downplayed. For the first time, the leading philosophers and physicians of the day classified women’s sexuality, and their ability to menstruate and become pregnant, as a disability. From then on we see parts of the clitoris being left out of medical illustrations — literally erased — or being ascribed to the reproductive or urinary tract. All except for the little pea-size glans.

It sounds like a clit conspiracy, or maybe a coverup.

Yup. In the Victorian era, we see the first debate about whether orgasm for women is even necessary. And then Freud came along and said that the clitoris is a child’s plaything, and the vagina is the focus of mature women’s sexuality. Freudianism gripped the view of women’s sexuality almost throughout the 20th century.

You want women to understand that the clitoris is really the key player in women’s sexual pleasure. So is the vagina dead? Is it irrelevant, over?

As I say in my book, sex is not about the vagina. But no, we can’t just forget about the vagina. It provides this nice, tight, warm little pocket that is designed to promote male orgasm, and therefore pregnancy, and therefore the carrying on of the species. But the vagina does not work that well for women in terms of giving the clitoris the kind of stimulation that it needs.

When it comes to clits, does size matter?

No, the size of the clitoris doesn’t matter in being able to experience sexual response.

Are lesbians closer to the clitoral truth than heterosexual women are?

I think so. Because sex has been totally defined through male standards, lesbians have slipped under the radar, and they’ve been able to teach themselves and discover for themselves what feels good and what works in sex. Throughout history, lesbians have been ignored — or their existence has been denied. So they’ve existed in a secret world where they developed their own standards and sexuality.

In your book, you dive right into the controversy over female ejaculation.

The world is divided into two camps: those who believe it happens, probably because they’ve experienced it themselves or they’ve seen it occur in their partners, and those who don’t believe it happens. I’ve found references to female ejaculation in the first sexual advice books that were written in China, in 500 B.C. The phrase is “Her vulva floods.” You see these metaphors throughout history. So I thought, “This is ridiculous. We have this long history of references to female ejaculation. We have a lot of research that was initiated in the 1980s.” I just put it all together into a single chapter. Some women produce gushes of fluid; others produce little dribbles or drops; some produce none. I do not want to hold up female ejaculation as another performance standard for women, or say that it’s something men have to elicit in order to be successful. I just want the subject cleared up.

Why do you say that people should stop focusing so much on orgasm?

Orgasm is one of the possible outcomes of sexual activity. It is not the only successful outcome.

Isn’t that going to be a hard sell?

It is. Look, sexuality in our society has been defined entirely through the male standard: stimulation, erection, ejaculation. But there’s another way to do it, and it’s the oldest way in the world. Sexuality is the foundation of tantra and Taoism, which [are among] the world’s first religions. The focus was extended sexual sessions that were seen as leading to enlightenment. Women’s sexual response was highly valued, and men had to learn ejaculatory control so that women had a chance to have as many orgasms as they wanted. A man failed if he did not provide a woman with the opportunity to have the sexual pleasure she wanted. There are other ways to practice sex that benefit everybody, women and men.

You say in your book that men today need to learn some form of ejaculatory control. I read that and I thought, “Yeah, this is going to go over really big.”

I totally agree that it’s the toughest sell on the planet, and I don’t really know what we’re going to do about it. But men are really missing out on great pleasure. For women and men, learning full-body sexual response can be mind-blowing, orgasm or not. And it often results in a knockout orgasm for men and multiple orgasms for women, not to mention deeper intimacy.

But what about the good old-fashioned quickie?

There’s definitely a place for that, too. You might call those “maintenance orgasms.” It’s really like junk food or fast food. I guess they’re OK. I mean, you gotta eat, right?

Ashcroft, a professor of physiology at Oxford University in England, combines personal narrative, tales of derring-do and, most of all, accessible scientific explanations to describe what happens when human beings push themselves to their limits — when they succumb to the overpowering urge to climb high, dive deep, run fast, immerse themselves in unbearable heat or cold and venture into the mysterious and dangerous realm of space.

She writes of men and women who have succeeded, and of those who have failed. She answers the questions that have plagued you for years, like: Why don’t sperm whales get the bends when human divers do? Why can some human beings climb Mount Everest without extra oxygen while passengers in a plane that depressurizes at the same altitude stand no chance of survival? And what is the Vomit Comet?

And she writes of scientists and researchers who sometimes put their lives on the line (usually because they couldn’t convince anybody else to do so) to solve some of the riddles of human survival. There was, for example, Sir Charles Bladgeon, who, in the 18th century, walked into a room heated to 105 degrees C (221 F) with some eggs, raw steak and a dog. Within 15 minutes, the steak and eggs were cooked to perfection; Bladgeon and the dog, fortunately, were not.

Ashcroft herself is no stick-in-the-mud. She has experienced some of the extremes she documents, including immersion in superhot Japanese baths, altitude sickness climbing Mount Kilimanjaro and the terror of her first deep-sea dive. Talking with Salon by telephone from London must have seemed like child’s play by comparison.

The book’s cover has a sort of eerie photo of diving women. What’s that about?

Ah, yes, the Ama women of Japan. They’ve been around for 2,000 years. It’s such an onerous profession. They’re diving for abalone and shellfish and for the mother-of-pearl shells. The highly trained ones, the funado, dive to about 20 meters [66 feet] deep. They have a large weight attached that enables them to go down to the bottom. They dive down with a rope tied around their waist, and they have a small basket that they fill with the prime delicacies of Japan. And then a male assistant hauls up the basket, and the woman may fill more baskets, depending how long she can hold her breath. Then she’s pulled up to the top by the assistant. At that depth, you do need someone to help you up, because as you dive, the air in your lungs compresses and you tend to sink.

One lady-in-waiting at the court of the Japanese empress a thousand years ago described the fact that the women are the ones doing all the work. They are diving down into the cold, having to hold their breath, and then come up sputtering and choking. Meanwhile, the men who are their partners sit in their little boats on the surface of the water, drinking and telling jokes and laughing and talking to all the other men, and generally having a good time.

Why do some of us prefer the comfortable middle, and others seem to have a real thirst for life at the extremes?

I think that there are two different sorts of people — those who do it for the kicks, the adrenaline thrill, and those who do it because they find it interesting and fascinating. I’m one of the latter. The challenge of going up a mountain or looking at landscapes you’ve never seen before, is just exhilarating. I’d love to go into space and look down on Earth and space, wouldn’t you?

No, I think it would be quite frightening! Talk about some of the extremes that you have gone to.

Personally speaking, I’m a wimp. I do things I think are interesting and exciting, but I have never really put myself in any danger. I have climbed to the top of Kilimanjaro. I have done a little scuba diving. I have been in very cold and very hot environments. But we all put ourselves in conditions where there are physical challenges to us; it’s just that we don’t necessarily notice them. All of us fly in airplanes, and if the plane depressurized, we would have a big problem. There are many things that we need to do, and we have engineered our environment so that we can survive without difficulty.

Without meaning any disrespect, what’s exhilarating about feeling, on the top of Kilimanjaro, like your head’s going to blow off from altitude sickness, as you describe in the book? To be honest, when you are in an extreme situation, you’re not really thinking of the scientific explanations, are you? Aren’t you just thinking, Get me out of here?

If you’re a scientist, you see things on many different levels. I do think, I don’t want to be here; let’s get out of here. But at the same time, my brain is saying, What’s going on, what’s working, what can I do to make this better, how can I behave? And at the top of Kilimanjaro, the view is wonderful! There you are, and you have ice fields on the equator!

Is there an extreme you wouldn’t go to?

The people I admire most of all are firefighters. I’m afraid of fire. The whole idea of walking into a firestorm — that to me is so scary I just couldn’t bear to do it. My recurrent nightmare is running down a road engulfed in flames.

Back to airplanes for a minute. I’m a fearful flier, and your explanation of sudden depressurization made me wonder whether those oxygen masks would really do the trick.

These things are very dramatic, but they happen very rarely. There’s a reason you’re told to put on your oxygen mask before you put it on your child — if the cabin really depressurizes, you’ll be rather woozy before you’re even able to put it on your child. Once there was a blowout on a British Airways plane, where the window actually blew straight out, and the captain was actually sucked out. The reason he got sucked out, of course, is because he wasn’t wearing his safety harness.

So it all comes down to wearing your seat belt?

Absolutely.

You’re saying, if you were in a passenger plane at 35,000 feet, and the window blew out right next to you, and you had your seat belt on, you wouldn’t be sucked out of the plane?

You probably wouldn’t be. But all the things sitting on your lap would be.

That seems like a small sacrifice.

The other thing, of course, is that the windows on an aircraft are deliberately small. There is a trade-off between passengers who want to see what’s outside and stopping things and people from being sucked out if there is a blowout.

I don’t think I can talk about this anymore. Let’s switch gears. Life at the extremes seems to run in your family. In your chapter about life in the extreme cold, you tell the story of how your own grandfather, who was sick and wounded, survived quite an ordeal during World War I. After his ship was torpedoed, he somehow survived many hours, semiconscious, in freezing cold water. How do you explain his not succumbing to hypothermia?

First of all, he was quite a fat man. The fatter you are, the more insulated you are and the better you do. Second of all, the thing you shouldn’t do when you are in cold water is splash around and make a lot of movements. All those movements dissipate the water that is next to your body, which is warmed up by your body, so you do best if you just try to float. My grandfather was strapped to a stretcher, so he couldn’t move at all. And the third thing was, he was running a severe fever, so he was generating a lot of heat, which kept him warm, I think.

I think we’re developing a theme here. If you are fat and strapped in, you have a better chance of surviving air and sea emergencies.

Yes.

It’s fascinating that so many scientists and researchers have gone to real extremes themselves to answer questions about just how much human beings can endure. My personal favorite in the book is the British scientist who purposely put himself into convulsions to test the effects of gases on the human body at pressure. His work transformed modern underwater-diving practices.

Oh, yes, J.B.S. Haldane. One of the things that happened to him in his pressure chamber is that he got nosebleeds, and he wasn’t very tidy, so he sort of dripped along the corridor. Yes, he was quite extraordinary. You have to remember that some of these experiments were carried out during the Second World War, and during war, people are much less concerned about taking risks because other people are dying all around them. So, for example, there were scientists who actually went down underwater, having calculated the safe distance from an underwater explosion, and had somebody detonate the explosion and then check that they were safe. That’s what you have to do. You can’t expect volunteers to do things you haven’t done yourself.

Do you know what you’re going to put your own body through next?

What I’d really love to do — the one real extreme I’d like to try — is fly in the Vomit Comet.

The what?

The Vomit Comet. It’s used for training astronauts. It flies a parabola. It alternately dives and climbs in the sky. When it dives, you become weightless. And when it climbs, you get two times the force of gravity on you. A lot of people say it makes them sick.

OK, you’ve explained what happens when man goes into space, when man dives under the sea; you’ve explained how people can withstand incredible heat and cold. So now tell me this: How come nobody can make a decent cup of decaf coffee?

[Laughs] Scientifically, if you think about it, the question is how to get out the caffeine without ruining the flavor. I think it’s actually not a trivial question. It’s tricky. Some problems are just really difficult.

What a difference a century makes. In 1899, a sexually enthusiastic woman
would likely have been pathologized as a “nymphomaniac,” and hospitalized for insanity, clitoridectomy or both, and a woman who didn’t achieve a “vaginal orgasm” would be labeled psychosexually immature. In 1999, as our century reaches its climax, we have an international medical and scientific effort to encourage female sexuality, to help the more than 40 percent of American women who report one sexual complaint or another, be it lack of desire, difficulty achieving orgasm or excruciating pain instead of pleasure.

And so, for three glorious autumn days last week I sat in a ballroom with heavy drapes and crystal chandeliers and eavesdropped as people with M.D., Ph.D., M.P.H., R.N., FDA and NIH after their names exchanged data, hypotheses, ideas, beliefs, questions, answers, “Grand Master” lectures, podium presentations, poster displays, prize-winning essays and countless PowerPoint presentations, all on the subject of female sexual dysfunction, or “FSD.”

It was three days of immersion in the desire/arousal/orgasm/resolution cycle, vasocongestion (“that heavy feeling”), hormones and neurotransmitters; vaginas, lubrication and the clitoris (doesn’t rhyme with the name of a Seinfeld date), but none of it was nearly as sexy as five minutes of Barry White.

More than one meeting attendee was heard speculating that if Viagra and its
potential for tapping the other half of the gender market did not exist,
this meeting probably wouldn’t have either. And in fact, several large
pharmaceutical companies provided “unrestricted educational grants” for this meeting. One of the largest, at the “Diamond Level,” came from Pfizer
Pharmaceuticals Inc., the maker of Viagra. As one speaker put it, “Sex
sells. If you didn’t know that before Viagra, you know it now.”

I listened to a stunning blond Swedish researcher describe her
experiments with Seldenafil (Viagra’s real name) on “rat vaginal smooth
muscle.” Another researcher described her Viagra work on the “vaginal
tissue strips” of New Zealand white rabbits; the cute little critters are
“euthanized,” their vaginal tissue is removed and cut into small strips,
hung in chambers and bathed in drug solutions. The point, apparently, is
to understand the mechanism that causes an actual woman’s vagina to “relax” and “dilate,” which is what occurs in sexual arousal, and to determine
whether Viagra and other potential new drugs can help “enhance” that.

I saw pictures of turbocharged vibrators, gizmos for measuring and probing, and women lying on exam tables wearing weird 3-D sense-surround glasses watching Candida Royale erotic videos while a researcher sat at a computer five feet away measuring “pre-stim” and “post-stim” responses.

I saw charts and graphs and color duplex ultrasonograms of blood flow to the clitoris. I saw slides of vaginas turned literally inside-out, hanging
outside the body between the patient’s thighs, in a frightening example of
“uterine prolapse.”

I got a demonstration (on my inner wrist, alas) of a new device called the
EROS-CTD, a battery-powered vacuum device that looks like a computer mouse with a small, clear, plastic suction cup at the end. The device is turned on and the suction cup is applied directly to the clitoris to “cause clitoral
engorgement.” Ah, I thought, finally! A penis pump women can call their
own.

I even heard a few good jokes: (Quick, what’s the difference between a golf
ball and a G-spot?)

By far the oddest thing I saw was a French urologist’s black-and-white
images of a 30-year-old man and a 27-year-old woman who volunteered to have sexual intercourse in an MRI machine. This doctor admitted he had no
“therapeutic goals” for this project; he had simply become inspired by a
15th century DaVinci drawing of sexual intercourse and felt compelled to
create his own “actual anatomical images” of same. He could find only one
radiologist in all of France willing to join him in this endeavor. If
you’ve ever been subjected to an MRI, surely you can understand his report
that the male subject’s “erection was difficult to maintain during the
required imaging period.”

There were, to be sure, some take-home headlines from this meeting,
including a new, more woman-friendly way of defining FSD. It includes, for
the first time, the requirement that a woman’s sexuality be considered
“dysfunctional” only if it causes her “personal distress.” In other words,
these sexologists are now willing to concede that it is up to the woman
herself — not her partner, not her doctor — to determine whether her lack of desire, lack of arousal, degree of pain or difficulty with orgasm is
sufficiently troublesome to warrant diagnosis and/or treatment. You’ve
come a long way, baby?

There was also a “buzz” about the various Viagra studies on rats, rabbits
and even real women that, while small and preliminary, did seem to suggest some real promise in treating some women with arousal difficulties.
However, FDA approval for Viagra for women seems several placebo-controlled, double-blind studies away.

In a provocative lecture titled “The Sexual Pain Disorders: Is the Pain
Sexual or Is the Sex Painful?” a prominent researcher advocated that pain
and discomfort associated with sexual activities be reconceptualized,
treated not as sexual disorders, but as pain disorders, with the focus on
the pain, not the sex. As he explained, when a back injury keeps a worker
off the job, it’s not treated as a work problem, it’s treated as a pain
problem. Why should pain during sex be any different?

Anthropologist Helen Fisher spoke of the three brain systems for love:
lust, attraction and attachment. There were important presentations as
well about sexuality for women after a breast cancer diagnosis, diabetes or
hypertension; sexuality for women with spinal cord injuries; sex during
pregnancy; sex after menopause; and new ways to think about a woman’s cycle of desire, arousal and satisfaction.

Lesbians and lesbian sexuality were almost invisible at this conference,
with the exception of one presentation about treating “Inhibited and
Discrepant Desire in Lesbian Couples” (aka Lesbian Bed Death), and some
scattered efforts to eliminate the emphasis on sexual intercourse when
talking about what real women actually do. However, for the most part, this
conference placed the heterosexual woman who has intercourse in a stable
partnership front and center.

There was also a good old-fashioned feminist controversy, made all the more
poignant because Boston is hallowed ground: home base for the collective
that publishes the groundbreaking 1970s self-help book for women, “Our
Bodies, Ourselves.”

Even before the conference began, a New York psychologist and sex therapist, Dr. Leonore Tiefer, got scared. She firmly believes this
conference represents a watershed event in the history of women and the
history of sex. She sees only danger in a medical approach to women’s
sexuality, and accuses the medical establishment and pharmaceutical
companies of aggressively trying to define, control and profit from women’s
sexual satisfaction. “We are watching the calculated invention of a new disorder [for women] that serves many financial and professional constituencies — but not necessarily the interests of women,” she says.

Tiefer was outraged that the organizers recruited hundreds of people from
many health-care disciplines to this event, most of whom she says are
“oblivious to the politics of gender,” but invited almost no one who studies
sexuality from a social, cultural or psychological perspective.

From the podium, Tiefer accused her colleagues of “careerism uninformed by
women’s larger social predicaments,” and challenged them to resist “the
temptation to promote simplistic models and solutions for women’s complex
sexuality.” She reminded them that eroticism, personal longings, fear and
the need for intimacy and power are not found in any lab. She implored them not to try to measure and standardize that which is spontaneous.

It was a brave thing Tiefer did — “I would have felt like complete and
total shit if I hadn’t done it,” she says — especially to this crowd, so
giddy in its echo chamber of professional success and stature. Her talk was
politely applauded, but her politics predictably rejected and denounced by
many at this conference, including two angry women who took to the
microphones and called her “reactionary,” “archaic,” “intense,” even (gasp)
“anti-feminist” for wanting to preserve a lower-tech, non-medical approach
to women’s sex lives.

“Women should have choices. Not every woman wants psychotherapy, not every couple wants couples therapy,” was the reaction from Dr. Sandra Leiblum, a leading authority in the field of sex therapy. “Pharmacological options are a choice women should have. It would be like saying women can only have vaginal deliveries without any kind of sedative or epidural for pain.”

I couldn’t help but notice that this meeting was a managed-care efficiency
expert’s wet dream. The program book listed precise times for each event –
for example, “2:01-2:11 p.m.: Decreased Testosterone in Regularly
Menstruating Women With Decreased Libido: A Clinical Observation.” The
longest anybody got to speak, even though he or she may have come thousands of miles to do it, was 20 minutes, and these were the so-called “Grand Master” lectures — so authoritative, apparently, that no questions were allowed afterwards.

There was also a rat-a-tat-tat procession of six-minute presentations with
precisely four minutes of questions no longer than 30 seconds apiece. At one
point, as yet another researcher raced through his latest laboratory
triumph, the woman next to me muttered, “Leave it to men to rush through
sex.”

Here’s what I want to know: How come doctors, who, in my experience, are
constitutionally incapable of ever seeing any patient on time, can run their
conferences like clockwork? I propose a placebo-controlled double-blind
study on that.

But let it not be said that the world’s greatest sexologists are all work
and no play. On Saturday night, those willing to pay $85 apiece (on top of
the $495 registration fee) were treated to a clambake and lobster dinner
aboard a yacht circling Boston Harbor in the moonlight. They told
(preferably dirty) jokes for drink tickets; they chose “You Make Me Feel
Like a Natural Woman” as the FSD theme song; and, through a chain of events that nobody seemed quite able to recall the next morning, about 20 of these high-powered medical men stripped off their shirts, danced bare-chested to Motown oldies and posed for a team photo in a kick line.

Oh, and, in case you were wondering, the answer is: A man will spend 20
minutes looking for his golf ball.