Sex Bias in the Diagnosis of Primary Orgasmic Dysfunction

Jerome C. Wakefield

    Research output: Contribution to journalArticle

    Abstract

    M. Kaplan proposed that some diagnostic categories are constructed with a built-in sex bias, making diagnosis of females more likely by the very way the disorder is defined. However, critics such as Williams and Spitzer have remained unpersuaded that such categories exist. After briefly analyzing the concept of sex bias, I argue that Masters and Johnson's widely used diagnostic criteria for primary orgasmic disorders are sex biased in several ways. First, the female dysfunction is defined as lack of orgasmic achievement, whereas the male dysfunction is defined as lack of orgasmic ability, a narrower category. Second, a man is diagnosed as orgasmically dysfunctional only if he has experienced full arousal without orgasm, whereas a woman can be diagnosed as orgasmically dysfunctional even if she has never experienced arousal. Third, it is known that fewer women than men masturbate and that masturbation is the easiest way to reach orgasm; therefore, women are more likely than men to report lack of orgasmic achievement for reasons independent of orgasmic pathology. Problematic consequences of such biases include inflated incidence estimates for women, the appearance of enormous gender differences in pathology, ill-founded ideas about female psychosexual vulnerability, and overconfidence in the efficacy of sex therapy. Finally, contrary to Kaplan's critical comments about DSM-III, I argue that DSM-III's diagnostic criteria for orgasmic dysfunction correct the sex biases in Masters and Johnson's approach and represent substantial progress in diagnostic logic.

    Original languageEnglish (US)
    Pages (from-to)464-471
    Number of pages8
    JournalAmerican Psychologist
    Volume42
    Issue number5
    DOIs
    StatePublished - May 1 1987

    Fingerprint

    Sexism
    Orgasm
    Arousal
    Diagnostic and Statistical Manual of Mental Disorders
    Psychological Sexual Dysfunctions
    Masturbation
    Pathology
    Aptitude
    Incidence
    Therapeutics

    ASJC Scopus subject areas

    • Psychology(all)

    Cite this

    Sex Bias in the Diagnosis of Primary Orgasmic Dysfunction. / Wakefield, Jerome C.

    In: American Psychologist, Vol. 42, No. 5, 01.05.1987, p. 464-471.

    Research output: Contribution to journalArticle

    Wakefield, Jerome C. / Sex Bias in the Diagnosis of Primary Orgasmic Dysfunction. In: American Psychologist. 1987 ; Vol. 42, No. 5. pp. 464-471.
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