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Models of Desire

Models of Desire

by Dr. Barb DePree

Women are not men. No surprise, right? In many parts of our lives, we know that.

When it comes to sex, though, many of our expectations—and those of the experts who advise us—are still based on expecting that men and women are more alike than not. And women are not men.

There’s an important implication from the model for women’s sexuality I’ve shared before, the one developed by Rosemary Basson, of the University of British Columbia. Women are not men: While men quite predictably experience desire and then arousal, women don’t. Sometimes, actually, women don’t experience desire until midway into lovemaking.

No big deal, you’re thinking? I wish.

Unfortunately, the messages we’ve internalized affect the way we behave and what we believe about ourselves. I’ve talked about hypoactive sexual desire disorder (HSDD) before, and it’s something I regularly talk about with women in my practice. There are hormonal changes, reactions to prescriptions, and other factors that can lead to HSDD, which is real and deserves attention from researchers and pharmaceutical companies.

But sometimes what we wish we could fix with a pill is actually the fact that we’re women, not men. If we, as women, expect to respond sexually as men respond, we’re more likely to misread our reality as “lack of libido.”

Which leads to the other reason I think understanding Rosemary’s model is a big deal. I talk to women who are at some point in a vicious cycle: They don’t experience interest as they used to; some physical changes have made intimacy uncomfortable or even painful; they begin to avoid sex; the physical changes continue; and intimacy becomes even more uncomfortable. How do we reverse this sequence? Or avoid the slide into it?

We can start with the reasons—beyond the hormones that drove us at 27—that we might want to be sexually intimate with a partner: to please him, to experience closeness, to cement our relationship, as an apology, a thank-you—or because we want to feel our own liveliness, sensuality, and power!

Kama Sutra Massage OilsAnd then we can trust that desire will come into the picture, if we’re having the kind of sex that arouses us. Michael Castle wrote about this in Psychology Today: “Sex that fuels desire is leisurely, playful, sensual…. based on whole-body massage that includes the genitals but is not limited to them.” Castle says women often complain that men are “too rushed, and too focused on the breasts, genitals, and a quick plunge into intercourse.” That kind of lovemaking doesn’t allow space for women to experience desire.

He points out, too, that leisurely, sensual sex is also recommended by sex therapists to men dealing with premature ejaculation or erectile dysfunction. Happily, the kind of sex that fuels women’s desire is also good for their partners.

Women are not men. We can recognize, internalize, and celebrate our difference. We can be sure we’ve communicated with our partners what we like when we make love. We can let go of any expectations except our own. We are women.


  • There is no question that desire primarily depends on who you are with, and a new relationship is rarely plagued with HSDD. It is 5 years into a relationship (or thereabouts the studies suggest) that the ‘newness’ is no longer a driver of desire. Keeping things interesting is a must in long term relationships. I certainly don’t advocate that patients find a new relationship, and even if they do, a few years later they are often back in the same situation.

    Dr. Barb on

  • Wonder if I am some kind of anomaly. I have often, and mostly, experienced desire, then arousal. Doesn’t it also have something to do with who you are with? Or want to be with, or rather be with? So many married couples bored, uninterested in one another sexually/erotically and just let it go into the sunset. And then they think they’ve ‘lost interest’ on account of HSDD, when in fact, if a certain man shows up she just may start breathing hard. A lot of denial about this. It would simply destroy too many marriages.

    Margaret on

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