The Female Orgasm Debate With Edward Clint at Skeptic Ink - My Response #2

Okay – So, this is the 4th part in a debate between myself and Ed Clint, a writer at Incredulous and Grad student of Evolutionary Psychology. I would like to thank Ed Clint for putting the time and energy into doing this. This is not his specific area of expertise, but he finds the topic interesting and has been a thoughtful partner in this. I have found this whole experience well worthwhile. I feel like it has pushed me and there have been some important and interesting topics brought into the discussion. Please check out the prior writing for context:

Ed's original post
Trisha's Reply
Ed's Reply

 That said, here we go.

He originally began by going through existing writing I had done and creating the following resolutions to debate:
The Statements to be Debated
1. Masters & Johnson’s (1966) book Human Sexual Response provides the best scientific description of the definition and nature of orgasm. 
2. Orgasm is caused by direct or indirect stimulation of the clitoral glans/vulvar area in women.
I signed off on them but at the same time added the following clarification to Resolution 2 through email which Ed also included:
Orgasm is caused by direct or indirect stimulation of the clitoral glans/vulvar area in women, in the same way that orgasm is caused by direct or indirect stimulation of the penis in men. There is no physical scientific evidence for stimulation on the inside of the vagina, by itself, causing orgasm in women. Although there is no reason to completely rule out the possibility of other physical and mental avenues for men and women (besides clitoral glans/vulvar area and penis stimulation) the lack of physical evidence for other avenues indicates these are at best quite rare indeed. As it is now, the word orgasm is often used in our culture for physical events that are not in fact orgasms, and this can cause confusion when discussing, teaching or learning about female orgasm.
The structure of this reply and last 

So, when I replied I began by outlining my support for these statements while keeping in mind his objections, and put the specific and detailed rebuttal of some particular objections into the appendices. He found it puzzling.
 "I find this odd as well, because the whole point of this debate is… the debate, and an appendix is usually where you put important, but secondary, material." 
Well, right or wrong, I felt it most important to my argument to detail out my support for the statements since most people hadn’t read my writing and my points had been boiled down to 2 resolutions, giving little room for nuance, BUT at the same time, I also wanted to incorporate and speak upon Ed’s points that I found intriguing and worthwhile for discussion – like M&J's own findings that seem to contradict resolution 2 and Ed's worries about psycho-social elements not being involved in the definition of orgasm. I actually spoke to all his objections in detail, but put the details about the objections that I felt seemed less interesting to the discussion in appendices. I thought that it made the whole thing a lot easier to read, while still having more specific arguments, background and detail available for those who were interested. This is a complex topic, full of nuance, and that is the way I discuss it, but it does get a bit long in the tooth.

In the end, I think we have both said our piece, and I think my arguments in my original reply are a generally good representation of my stance, although as you will see I have gladly made some concessions – particularly in regards to my language around defining orgasm. I very much appreciate this debate and Ed for a different perspective. So let me lay my reply out this way. First I’ll respond directly to Ed’s kinda big finale argument at the end. He believes important statements I make cannot live together. Then I’ll talk about where I stand on Resolution 1, cause I think Ed made a good argument in a particular aspect of this. Then I would like to finalize this with outlining areas of agreement and disagreement.

Ed’s big finale point - can these statement live together?

Under the topic of Resolution 2, Ed says the following:
"At this point, I must stop. There were other points I made that Trisha replied to, but it is not necessary to continue. Trisha must concede that this resolution is unsupportable. If her own source material can be ignored in lieu of an ad hoc story without any evidence, then there is no longer any tenable expectation to be bound by that source material. If the evidence is binding, then the resolution fails. If it is not, then both resolutions fail because that is a critical basis of both. Trisha has made these three statements:

Masters and Johnson’s description of the physical markers of orgasm are what I believe the scientific definition of the word orgasm should be based upon.  
Orgasm is caused by direct or indirect stimulation of the clitoral glans/vulvar area in women, in the same way that orgasm is caused by direct or indirect stimulation of the penis in men. 
The M&J accounts of both the intercourse and the breast induced orgasms were observed and recorded in the lab.  
It is logically impossible for these three statements to be simultaneously correct. One must be given up."
yeah, I think they can live together
I mean I get where he’s coming from because they seem to contradict each other, but I believe these 3 statements can live together. In fact, I took pains during my discussion of Resolution 2 in my last response to describe why those last two statements can and do live together. I’ll recap it all here though because I can’t help feeling that Ed didn’t really read what I had to say. For instance – he incorrectly remembered using an argument I actually gave him.
 “My first argument against this resolution was that M&J themselves recorded orgasms caused by penis-vagina intercourse and by breast-touching.” 
 Well, he did mention the penis-vagina intercourse, but he didn’t mention the breast-touching. I mentioned that.
“Like Ed mentioned about good ol’ Master’s and Johnson’s 1966 book Human Sexual Response, they did record orgasms in women during vaginal penetration with no additional stimulation. I would add that they also found 3 women (all of whom could additionally orgasm through clitoral glans area stimulation and through intercourse) who achieved orgasm through breast stimulation without additional clitoral manipulation.” 
So, I actually gave him what I believe to be the best argument for another stimulation trigger for orgasm besides the clitoral/vulva area. I did this because I talk about both those things all the time in my other writing, and because these things are true, and because I believe they need to be hashed out.

He also, I feel, mischaracterized how I speak about this – taking away all the nuance that I was so careful to include.
"Trisha has said that M&J is the definitive work and 'gold standard' on what constitutes female orgasm because of the use of objective, physiological measurements. However, she here claims we should disregard that same evidence and gives no reason why other than that it does not agree with her interpretation of what orgasm is."
 I certainly hope it didn’t seem like I claimed people should disregard M&J’s seemingly contrasting evidence with no reason. I mean, I gave reasons. He might not like them, but I gave reasons, and I was careful to discuss why this data was not as problematic as it appeared.

intercourse induced vs. vaginally induced orgasms
 Firstly, M&J themselves described the intercourse induced orgasm they observed as being caused by indirect clitoral stimulation - the penis pulling on the labia which pulled on the clitoral hood which gently rubbed against the clitoral glans. M&J said this, not me, and frankly, they were the ones with slow-mo cameras down there, so I’ll take their word for now since that’s the only physiological data we have on this so far. And let me be clear here – cause this gets confusing. Intercourse induced orgasms (that M&J verified) are different from vaginally induced orgasm (that have never been verified in any other study – even the one’s Ed tried to point to in this debate), and the distinction really does make a difference. It might be intricate and complicated, but it is not trivial.

The first is orgasm caused by indirect stimulation of the clitoral glans during intercourse. The other is orgasm caused by stimulation of something that is reached from inside the vagina, like the vaginal wall, the cervix, or the clitoral legs through the vaginal wall. You see, if orgasm is caused by glans area stimulation, then moving something in and out of the vagina can be seen as a pretty round-about way to go about lady-gasms, and would indicate that intercourse coupled with steady stimulation on the clitoral glans, attained however one can find to attain it, is the best way to go about orgasm during intercourse. If it were found that orgasm during intercourse happens due to the way the penis stimulates something in the vagina, then intercourse with no additional involvement of the clitoral glans might seem a really good way to go about achieving orgasm. Quite different modes of action during intercourse would seem to be needed to get that orgasm, and whether the clitoral glans is involved or not makes little difference.

This is important because lots of women want better information about how they can orgasm with another person, and these details are crucial. There is also the fact that people do surgery in that area, including general reproductive surgeries, FGM reconstruction surgeries and gender reassignment surgeries where understanding those seemingly minute details about where exactly is being stimulated when women orgasm during intercourse is not insignificant at all. So, M&J’s findings about intercourse orgasms make this complicated, but they don’t contradict that 2nd statement up there.

fantasy orgasms, M&J quotes and other contradictiness??
Ed continued his criticisms of my contradictiness and insistence that clitoral/vuvla area stimulation be required.
"M&J did not expect clitoral/vulvar stimulation to be required. While they did not observe it, they wrote, orgasm resulting from fantasy also would produce the same basic physiologic response patterns, and cited 8 other papers about fantasy-to-orgasm, no Rube-Goldberg effect required (p. 132-3). She suggested that the breast-stimulation orgasms might somehow be the clitoris being stimulated by some indirect movement of muscles or something. This is wild speculation from someone who repeatedly insisted that we must only use direct, objective, physiological measurements to reach conclusions about what causes orgasm."
First off M&J were just speculating that if fantasy-to-orgasm ever happened, then it would also include the physiologic markers we've been talking about here - because they were pointing out how integral those physiologic markers are to every orgasm they have ever seen in their research. The 8 other papers are just old papers talking about hearsay of these fantasy-to-orgasm things. Just like M&J, no other study then and up through today has recorded physiologic markers of orgasm in relation to non-physical fantasy. However, M&J did find that the physiologic response pattern (ie physiologic markers) they discovered were always a part of orgasms...so, as they postulated above, it should theoretically be part of a fantasy orgasm too.

But Ed's right, M&J never said outright that clitoral/vulvar stimulation must be required for orgasm. It's just that M&J found that it almost always was required. I was the one that took that general stance going from their data and subsequent physiologic orgasm research.

 But let's get back to the  clitoral/vulva stimulation almost always required thing.

breast stimulation
So, breast stimulation. M&J gave no explanation for the mechanism, and I did wildly speculate, but I didn't pretend it to be anything but speculation.
"As for the breast stimulation, this is up for debate and hopefully more study. I once put forth a thought on my blog that maybe, during the breast stimulation, some muscle tensing in the vulvar area, once the women had become highly aroused, moved everything around down there just enough to get a touch of clit stimulation and set off the orgasm. Who knows? It’s merely a guess that goes along with the pattern of really indirect stimulation giving less intense orgasms." 
 Hell, I’ll also throw out another wild speculation. Maybe, given that nipple stimulation is associated with uterine contractions (as I think many a new, nursing mother would know), that in a highly aroused state, the nipple stimulation could set off uterine contractions which kinda triggers the whole rhythmic release of pelvic muscle tension and blood congestion down there. Who knows? It too is just a guess.

I was clear in my conclusion that there was “some debatable evidence for a direct connection between breast stimulation and orgasm.”  I don’t think I was all disregard-y of M&J's evidence there, but I admit I was a bit snotty about it for joke sake, continuing with, “but those studies were done 50 years ago and reported in the M&J study that Ed thinks is not quite up to par, so take that as you will.” I think Ed might have taken that as disregard-y, so I apologize, but I didn’t mean it to be. Breasts are the only other area of stimulation besides the clitoral/vulvar area that seems to cause orgasm.

However, whereas there was tons of evidence in M&J and in studies after M&J corroborating that clitoral/vulva stimulation caused orgasms, this is far from true for breasts. There was only evidence from 3 women (.7% of the women in the study) who could orgasm through breast stimulation, and as of yet, no physical evidence in later studies to corroborate.

statements 2 & 3 existing together? sure.
I stand by calling it debatable evidence. I have always been quite clear, including in my original clarification for Resolution 2, that I am not saying that other trigger points for orgasm could not exist, but instead that if they do, they seem to be quite rare. The striking lack of evidence for other non-clitoral/vulva area routes to orgasm, as opposed to air tight proof of their non-existence, leads me to say what I say.

 So yes, even with the breast and intercourse data from M&J, I do assert that as much as we can say the penis needs to be stimulated for males to orgasm, we can also say the stimulation of the clitoral glans/vulvar area is needed for females to orgasm. These are both the heavily dominate way that orgasm has been observed in either sex, but there might be very rare exceptions for both. I mean, we cannot be positive that some men’s claims of things like anal and nipple stimulation orgasms or thought orgasms are patently false either.

what about the 1st statement?
The 1st statement up in that trio is as follows, "Masters and Johnson’s description of the physical markers of orgasm are what I believe the scientific definition of the word orgasm should be based upon.” I appreciate that Ed chose this statement. It is the line I crafted to begin my support for Resolution 1, and it reflects my sentiment better than Resolution 1 itself. I’m actually ready to admit defeat on the actual Resolution 1 because the wording created messiness I didn’t fully realize at first, but I'll get to that in the next section.

In the meantime, let me say that M&J did create a good description of the physical markers of orgasm, that are still respected, widely referred to, and haven't been debunked in the 60 years since they released it. Their data has been expanded upon; new tools for checking pelvic muscular activity and vasocongestion have been have been created, but physiologic data on arousal and orgasm attained since then has stood on M&J’s backs as opposed to crushing them, and the definition of orgasm, if not completely based on these markers, should certainly include them. I’ll get more into this later, but for now, I’m generally okay with this I don’t see this statement as being incompatible with the other 2.

with a little nuance this can work
So, again, I actually do believe all 3 of those statements can stand together, but only if we are willing to have nuanced discussions. With all honesty, if Ed chose to use Resolution 2, which is worded much more black and white, instead of a sentence from my clarification for that 2nd statement, then he’d definitely have a technical win. However, he didn’t do that. He listened to me and used my clarification, which I really appreciate. I don’t want this to be an either or. I want this to be a discussion that gets complex and tries to untangle this mess. All of those 3 statements above tell a truth, and together they begin to paint a more robust picture that can help to explain and understand female orgasm more clearly.

Resolution 1
1. Masters & Johnson’s (1966) book Human Sexual Response provides the best scientific description of the definition and nature of orgasm. 

So here is the concession. Resolution 1 is worded badly for what I wanted to support, and although I didn’t actually write it, I signed off on it and didn’t see the problems it brought with it – not really until I read Ed's last response. He called me on that, and I will gladly concede that statement. I actually appreciate the insight that Ed and this debate have given me into how I speak about Masters and Johnson and how I use words like definition, etc. in regards to orgasm. However, I continue to hold a slightly adjusted statement – that, I think, you will find makes sense if you read my original support of Resolution 1.

adjusted resolution 1
The physical markers of orgasm, specifically the rhythmic release of muscle tension and blood congestion, first discovered by Masters and Johnson, should be used as the marker of orgasm.

It’s similar, but without the insinuation that the book as a whole is the, like, only place to go for understanding the definition and nature of orgasm. I never intended that to be the case, and I think Ed and I talked past each other a bit because I didn’t at first see that insinuation in the resolution. First off, it’s the physiological discoveries in that book that are important, respected, and relatively stable as scientific insights - not every aspect of psycho-social discussion or insinuation in the book. And, although M&J discovered these physiologic qualities of arousal and orgasm, they are not the only ones who have done research on them. Further research has corroborated and also expanded and updated their findings and methods. This process of research building on research is clearly important and I never meant to disregard it. In fact, the fact that later studies were able to corroborate and expound upon M&J's physiologic studies is a major part of why I hold their work in high regard. I speak about these markers as M&J’s physiologic discoveries because their study was the first, the largest, and still remains fundamental, but I can see that invoking their names alongside the markers they first described brings baggage to the conversation that might not be useful.

Also, my adjusted Resolution 1 doesn’t get into wishy-washy words like 'nature' that encompass so, so much. I’m really by far most interested in digging through the physical part of the orgasm, which, if you read my writing at all, is probably pretty clear My intent with advocating about physical definition of orgasm has always been to create ways to discern what people actually mean when they say 'orgasm,' so that researchers, advisers, and experts are not saying things that mean something completely different depending on who is listening – which is largely the case with female (but not male) orgasm now.

why the physiologic markers matter so much
Whatever words and definitions are used, it’s simply true that having an ‘orgasm’ that includes that release of arousal induced muscle tension and blood congestion (the marker I put forth), is a different thing than an ‘orgasm’ that doesn’t include that release. Call the other one(s) not an orgasm or call them a different kind of orgasm – with yet to be found markers, but I would argue that we need to start making that distinction. In the end, I don’t care the words used, and I have no problem with orgasm defined as an “experience,” as Ed rightly points out that it often is. I just think that the physical markers of orgasm should be involved.

Otherwise, an ‘orgasm’ has no worthwhile meaning. Without these markers, if a person says she has had an 'orgasm' then she had one, no questions asked – even if the ‘experience’ is a feeling with no physical markers, an ejaculation, a nonphysical climax, or a heightened state of arousal. As always, I’m not knocking those experiences, but if they are all lumped into the same definition of ‘orgasm’ just because we refuse to limit the scope of the word using physical parameters, then it is a useless definition indeed.

but Ed was right, my definition was too limited
But back to what I was proposing as the definition - Ed was right that dictionary definitions of orgasm often say something about the whole experience of the thing. Although I took pains to be clear that I fully understood orgasm had all kinds of psycho-social elements along with the physical element, I was wrong to try and assert that the physical part is the definition of orgasm. And he is also right that Masters and Johnson would have defined the female orgasm (just as they did with the male orgasm) with the inclusion of the psycho-social elements of the experience.

but still, the physiological markers should be included
And speaking of M&J's definition of orgasm, Clint quotes quotes their definition with, “For the human female, orgasm is a psychophysiological experience…” and I will continue their quote, “occurring with and made meaningful by a context of psychosocial influence. Physiologically, it is a brief episode of physical release from vasocongestive and myotonic increment developed in response to sexual stimuli. Psychologically it is a subjective perception of a peak of physical reaction to sexual stimuli.”

So, using big-ass words, M&J defined orgasm both by the physical markers of orgasm (the release of blood congestion and muscular tension) and the psychological reactions to those physical events. So I was off from M&J definition by being too focused on the physical part of the definition, but the physical part was still a part. Other places do use very similar definitions to M&J, including the physiologic marker as part of the total experience. So when I said that the definition I first proposed is respected and widespread and Ed asks “where? by who?” These kinds of things are what I meant. I apologize that my meaning was muddied by my limited scope of the word ‘definition,’ but I think it’s at least somewhat fair to say that definitions that include these markers are widespread and respected.
"An Orgasm in the human female is a variable, transient peak sensation of intense pleasure, creating an altered state of consciousness, usually with an initiation accompanied by involuntary, rhythmic contractions of the pelvic striated circumvaginal musculature, often with concomitant uterine and anal contractions, and myotonia that resolves the sexually induced vasocongestion and myotonia, with an induction of well-being and contentment." -Women's Orgasm A Meston CM1, Levin RJ, Sipski ML, Hull EM, Heiman JR. nnu Rev Sex Res. 2004;15:173-257.
 "Orgasm is a subjective experience accompanied by involuntary muscle contractions."
-8-13 Hz fluctuations in rectal pressure are an objective marker of clitorally-induced orgasm in women. 2008 van Netten JJ1, Georgiadis JR, Nieuwenburg A, Kortekaas R. 
Arch Sex Behav. Apr;37(2):279-85. 
Even Wikipedia and dictionaries use the physiologic markers as part of the definition.
"Orgasm is the sudden discharge of accumulated sexual excitement during the sexual response cycle, resulting in rhythmic muscular contractions in the pelvic region characterized by sexual pleasure."  - Wikipedia
"The highest point of sexual excitement, characterized by strong feelings of pleasure and marked normally by ejaculation of semen by the male and by involuntary vaginal contractions in the female." -American Heritage 
So I hope my intention and meaning as I was talking about Resolution 1 are more clear now. As I said before, I appreciate this debate and how Ed pressed on this issue because it helped me see another perspective of my language that wasn't really clicking for me. I feel I can be more precise about what I want to say, and get my point across better.

Agreements and Disagreements

I’d like to just go through some of the topics discussed in our back and forth and see where we align.

Ed pulled these bits of agreement out in regards to female orgasm for his first post of this debate, and it's still true. "We agree that there is a long history of apathy, disregard, and politically-charged misinformation which continues to this day...We agree that miseducation on the facts has negative consequences for the mental and sexual health of women and men, and that these are therefore important issues to talk about and to educate about."

limitations of Masters and Johnson’s research
Ed and I both agree that, as he puts it,
“Masters and Johnson made major contributions to knowledge about sex”
 but he goes on to say.
“However, the idea that the scientific understanding of the clitoris, orgasm, and female sexual response crystallized 5 decades ago thanks to a non-refereed publication based on a few experiments with tiny, unrepresentative samples in artificial, ecologically non-valid circumstances is preposterous on the face of it”
So, I think we can also both agree that the scientific understanding of the clitoris, orgasm, and female sexual response did not crystallize 5 decades ago. I certainly never meant to assert that - only that their discoveries about how the body reacts during the sexual response cycle is fundamental and still quite relevant even though, but more appropriately because, later research has expanded on and corroborated their work. I’m all for even more physiological research. Bring it on, please.

I think it’s clear that we are actually not far off on this topic, but Ed listed out problems with their research including a tiny sample size, use of sex workers, sex in a laboratory, no replication, and WEIRD participants, and we talked about them a fair amount with some interesting things being said, so I’m going to go over them quickly. However, given his last reply, I will emphasize that I don’t want to insinuate that he disregards their study or their discovery of physiologic data because of this. He says,
"Trisha said that I object to aspects of the study 'in an attempt to discredit their findings about orgasm.' This is incorrect."
 He goes on to say all studies have issues, and he seems to be saying that he only has a problem with me asserting that this one study can be the end-all, be-all of sex research. If that is the problem then we are on the same page. Again, like I said above, I never mean to seem as though M&J is the only reigning authority on orgasm.

the flaws Ed described about M&J 1966

Tiny sample size: 
*(Ed has agreed through email correspondence to update mistakes made in his last reply on this subject, but at the time of posting it has not been changed)* (**update 10-30-2015 Ed has updated the post, but kept in something I thought he might change. He says, "In the case of intercourse, orgasm was, in every case, inferred from self report and physiological metrics Trisha has discarded as insufficient, such as blood pressure and heart rate." Actually every case of intercourse induced orgasm M&J reported on was induced through a a clear dildo with camera inside, and the women controlled the speed and depth of the in-out motion. There absolutely is data reported about vaginal activity and pelvic muscular activity during orgasm gathered from this method. Ed may be thinking about man on women intercourse - M&J could not get direct recording of the pelvic muscle activity during orgasm, and that's why they adjusted their camera techniques in their clear camera dildo to deal with the movement while still taking clear movies. This innovation was a hallmark element of their research.)**

Ed said in his original reply on this topic that pelvic muscular activity was only directly observed for
n=0 women during coitus and only n=6 women during masturbation out of the 382 active participants described by M&J. There is no basis for these numbers, and after email correspondence between us, Ed found that he had received inaccurate data and agreed to update that section (I think what I will do is rewrite this part and characterize the sample with the degree of specificity I am sure of, which is n = 70-382 or so in which some sort of measures of pelvic floor contraction were used, but the effective sample size is on the lower end because a comparative sample has to be controlled such that they are in some sense a random sample, given the same experimental treatments... - email correspondence by Ed Clint 10/27/2015).

The sample size in  this study is the largest of direct observation of the body during arousal and orgasm that yet exists. This is not really disputed (even with n=70, the low end of what Ed is proposing). Granted, as Ed points out, just because it is the largest study doesn't necessarily mean it has power to generalize, but this is an important fact none the less and nothing to sneeze at.

Neither of us actually knows the details about the actual raw data for that study, only what is described in the book. The raw data was by all reports destroyed many years later by Virginia Johnson. Just the fact that that there is no raw data is a mark against a study, but I think Ed would agree that there is no serious allegation that this data was made up or that M&J seriously misrepresented their data in any way.

Besides speculation about raw data we cannot get answers for, we don’t disagree in any serious way here. **(except that Ed seems to believe that there is no physiologic data recorded from intercourse induced orgasms. We'll have to agree to disagree on that because data about both timing and amount of pelvic muscle contractions at orgasm during intercourse,  as well as the changes in the vagina during arousal and orgasm caused by intercourse are clearly available in their book.)**

Use of sex workers
I don’t see any real problem here. Ed may or may not.

No replication
We both agree that later studies have substantiated M&J’s study. I believe Ed just wants it known that one study taken on its own is not enough, and I fully agree.

Participants are all of a Western, Educated, Industrialized, Rich, and Democratic (WEIRD) society
I said that WEIRD or not, ladies all over all have the same basic lady parts – Clits and dicks exist all over the world. Ed came back with some thoughtful points about things like possible hormone and microbial differences between groups, but I think Ed and I would agree that those considerations are important in terms of building on and understanding deeper complexity in the basic physiologic discoveries of M&J as opposed to negating the fundamental information we have gained from these discoveries.

I would like to also mention (because I think at first glance it might seem that this is in relation to all of M&J data) that the worries Ed pointed out from M&J themselves about the limitations of their sample population were specifically in relation to the surveys taken about the psycho-social elements of these people's sex lives. As M&J specifically pointed out, in comparison to Kinsey's survey data, theirs is meager at best. They were categorically not speaking about limitations of their physiologic evidence there.

We can both agree that although M&J did have the largest study of physiologic sex research, it does not mean that there isn't more knowledge to gain from physiologic research on more varieties of people.

Sex in a lab setting
We both agree that sex in a lab setting might be different than sex in private and that this is a bias all sexual studies must struggle with.

Robert King’s paper contradicting M&J’s physiologic data
I mean, we’re just going to have to agree to disagree about whether a study analyzing women’s descriptions of orgasms and using those description to create categories of orgasms is a study that is able to contradict the physiologic data M&J presented. I understand that Ed is not saying this paper is perfect in and of itself either, but he does still say it is contradictory to their work. I’ll add both of our full comments about this in Appendix A and let the reader decide for herself.

vaginal sensitivity
I agreed with him in my first response that bringing up the fact that there is less nerves in the vagina compared to the clit and vulva is not a useful argument against the possibility of a vaginally induced orgasm (I have used that in the past but no longer). However, I think he would agree that inversely, having sensitivity in the vagina is not proof for vaginally induced orgasms. To me we agree here, although he wrote in his last response that,
 “The internal anterior surface of the vagina has been documented to be more sensitive and important to female sexual response than the others (Komisaruk & Sansone,2003; Komisaruk et al.,2004). King et al. have suggested their methods may have prevented discovery of this fact because the Ulysses appliance and specula may have covered it in order to produce recordings (King et al., 2010). This, in turn, could bias their findings in favor of the supremacy of the clitoral glans.” 
It does certainly seem the lower anterior wall of the vagina is regularly regarded as the most sensitive part of the inner vagina in studies, but again, sensitivity on a body part does not mean stimulating it can produce orgasms. I imagine it’s possible that M&J methodology biased against fully investigating this area as a possible trigger point for orgasm, but plenty of other studies since have not. If this area has been neglected, it is no longer. Still, though, not one study has observed the physical markers of orgasm in relation to stimulating this area (although ejaculation has been observed).

So, I imagine here we can agree that the lower anterior wall of the vagina is clearly a sensitive area for many women and an interesting area for further investigation into female orgasm.

proof for vaginal orgasms?

As of yet Ed has not found a study that observed the physical markers of orgasm (rhythmic release of pelvic muscle tension and blood congestion attained during arousal) caused by stimulation of something inside the vagina; or from stimulation of any other body part besides the clitoral/vulva area; or through thought alone.

He hasn’t even found any other study (besides M&J) that have observed orgasm induced through intercourse (and stimulating the clitoral glans indirectly). The papers he put forth about infibulated women, women with spinal cord injuries and his pointing out that lesbians buy dildos have not had that kind of data in them, and they do not have any positive proof that vaginally induced orgasms exist. I’ll throw in my critique of a BBC article too since it includes even more studies that are often used to try to prove vaginally induced orgasms, yet do not have the data needed to do so. It’s not surprising to me that he hasn’t found one yet because I’ve been looking for those types of studies for years. (Please shout it out if you can find one).

He and I may differ on:
  • whether we believe that it is good methodology or not to accept a woman’s claim of orgasm without checking for physiologic markers of orgasm.
  •  whether an elevated heart rate or respiration can be considered useful enough to mark an orgasm (I certainly do not given that M&J and plenty of others have found that those two measurements spike during very high levels of arousal and so are not unique to orgasm).
  • whether certain brain activity can be a marker for orgasm (I do not given that there is no clear understanding about; 1. whether the brain activity found so far can be culminated into a single or even a few ‘orgasm identifier(s)’; 2. whether the brain activity recorded so far does actually happen whenever a certain climactic sexual experience takes place and if it can be discerned from other similar brain activity; 3. whether the brain activity recorded so far is reliable and identifiable in a variety of people; 4. if any of the brain activity correlates to orgasmic release of muscle tension and blood congestion in women; or 5. whether any of the orgasmic brain activity recorded so far can mark anything physical has happened at all).
Those are all points that could have a fair amount of useful discussion.

But I dare say we can agree that neither of us has found a study with observations of stimulation inside the vagina causing the rhythmic release of pelvic muscle tension and blood congestion attained during arousal; and also no other studies indicating stimulation of any other body part besides the clitoral/vulvar area or thought alone causing those physiologic markers of orgasm.

A Quick Conclusion

So, I have enjoyed this debate. I hope it gave readers something to chew on, and if Ed would like to make any more contribution, I would be more than happy to engage him, but if not, I think we have had a good run.

Appendix A

Ed's original point
Evolutionary psychologists have also investigated possible psychological mechanisms involved in sexual response—

 Men’s masculinity and attractiveness predict their female partners’ reported orgasm frequency and timing. [Link]
Are There Different Types of Female Orgasm? [Link]
Genetic influences on variation in female orgasmic function: a twin study [Link]

Sometimes producing findings that directly contradict M&J, such as Robert King et al. 2011:
Fundamentally, these data would seem to contradict the Masters and Johnson (1965) view that masturbatory orgasms are the same as those achieved through intercourse, especially in terms of pleasure and sensation. 
The full Robert King, et al 2001 quote added in here by me just for reader reference:
"Not only did it prove to be the case, as common sense would lead one to expect, that on average, orgasms achieved with partners scored more highly in terms of pleasure and sensation than orgasms without partners but, far more interesting, perhaps, was that this was not entirely the case. Recall that those two types of orgasms (I,II) that could be regarded as evidence of “good sex” consistently outscored solitary masturbatory orgasms on nine of ten composite measures of orgasm experience, clearly showing them to be more pleasurable. But, at the same time, orgasms type III and IV scored lower on nine of 10 adjective ratings than solitary masturbatory orgasms. Appearently, at least in terms of the orgasm experience itself, sometimes sex with oneself is more physically pleasurable than sex with a male partner, even when the latter provides sufficient sexual arousal to generate an orgasm. Fundamentally, these data would seem to contradict the Masters and Johnson (1965) view that the masturbatory orgasms are the same as those achieved through intercourse, especially in terms of pleasure and sensation."
My response
"Sometimes producing findings that directly contradict M&J, such as Robert King et al. 2011: 
Fundamentally, these data would seem to contradict the Masters and Johnson (1965) view that masturbatory orgasms are the same as those achieved through intercourse, especially in terms of pleasure and sensation." 
This quote boldly stood out to me, back when I read this particular article, as fully inaccurate, so it’s unfortunate that it was picked to prove there is data contradicting M&J’s work. “These data” that the quote is discussing are ones that show (they thought somewhat surprisingly) that a good number of orgasms with a partner were subjectively rated lower than masturbatory orgasms by women in their study (another group of partner orgasms were rated higher, but they found that less surprising).

Anyway, that’s not contradictory at all to M&J’s findings. Although M&J were clear through the study that the basic physiological elements such as spasmic release of muscle tension were universal to all orgasms, including masturbatory and those had during intercourse, they never held that they were the same in terms of pleasure or sensation. In fact, the surprising finding from the study above is specifically supported. M&J reported in terms of both the objective intensity of muscle spasms recorded and the subjective reporting of the woman, that masturbatory orgasms were ranked highest, followed by partner manipulation. The lowest rated orgasms were those achieved during intercourse (Masters 1966 p133).

M&J clearly claimed that the physical markers in orgasms during masturbation and intercourse were the same, but never claimed that any other element of these orgasms including intensity, length, meaning, or subjective pleasure were the same.

Ed's Response

1.6 Contradictory findings (e.g. King et al. 2010): Fundamentally, these data would seem to contradict the Masters and Johnson (1965) view that masturbatory orgasms are the same as those achieved through intercourse, especially in terms of pleasure and sensation.
This quote boldly stood out to me, back when I read this particular article, as fully inaccurate, so it’s unfortunate that it was picked to prove there is data contradicting M&J’s work. “These data” that the quote is discussing are ones that show (they thought somewhat surprisingly) that a good number of orgasms with a partner were subjectively rated lower than masturbatory orgasms by women in their study (another group of partner orgasms were rated higher, but they found that less surprising). Anyway, that’s not contradictory at all to M&J’s findings. Although M&J were clear through the study that the basic physiological elements such as spasmic release of muscle tension were universal to all orgasms, including masturbatory and those had during intercourse, they never held that they were the same in terms of pleasure or sensation. 
The quote is not inaccurate. M&J wrote, the maximum physiologic intensity of orgasmic response subjectively reported or objectively recorded has been achieved by self-regulated mechanical or automanipulative techniques. . . .The fundamental physiology of orgasmic response remains the same [whatever the mode of stimulation] (p. 132, emphasis mine).

 The authors collected data on subjectively reported physiological responses including muscle spasms and engorgement, but they found that the type of stimulation did matter and that, per the data, the orgasms may not be all physiologically identical. Not only is this contradictory of M&J, but the paper also expands in new, important areas that M&J didn’t really touch, such as reported emotional intimacy. This paper also published multivariate statistical analysis and used validation tools. Did M&J properly characterize their observations? We have no idea. They did not publish the data. The point I am making here is not that this one paper by King et al is the superior replacement for M&J, but to illustrate that many papers, like this one, do not necessarily accord with M&J, use a more sophisticated approach, and use modern tools and ethical standards permitting real investigation to happen. In many ways, these new sources of data are far superior and do not rely on M&J methodologically or theoretically.

1. Masters, W and Virginia Johnson. Human Sexual Response. Little, Brown and Co., Boston, 1966. 

2. Meston CM, Levin RJ, Sipski ML, Hull EM, Heiman JR (2004). Women's orgasm. Annual Review of Sex Research, 15, 173-257

3.Van Netten JJ1, Georgiadis JR, Nieuwenburg A, Kortekaas R. (2008)  8-13 Hz fluctuations in rectal pressure are an objective marker of clitorally-induced orgasm in women.  Arch Sex Behav. Apr;37(2):279-85.

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