Come As You Are - A Book You Should Read

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This Book, Ya'll
Come As You Are: The Surprising New Science That Will Transform Your Sex Life  by Emily Nagoski

I've heard people talking about this book for a good while, and it's been on my list to read, but honestly, from the things people have said to me about it, I had a bit of a bad taste in my mouth. I was wrong though. Barring her, I would say problematic and scientifically incorrect, take on what orgasms are, all the worries I had were thoughtfully and much more subtly and complexly dealt with in the book. Actually reading it was way better than randos giving you their take on it - which is not actually that surprising, I guess.

In fact, it's an important book about sexual desire and how it works in an individual. It focuses on women, but much of the points are universal, and it's a truly useful read for men as well. But I think the issues of desire tends to feels more critical for the ladies. Many, many women (I would venture to say all women) feel like they struggle in serious ways with their desire at least at some points in their lives, and this book quite rightly points out many of the ways that these struggles are not related to personal 'brokenness' but to the very real context of our lives and our culture. This is so important because so many women feel they are broken when in fact we are all quite normal and sane. It is the stories we hear about how things should be and the expectations from our sexual culture that are broken. Nagoski does a fantastic job of step by step showing how one can become more conscious of their relationship to sex, desire, and arousal in order to heal in their own individual way where they need to heal. I recommended it almost immediately to one of my best friends and to many others since.

Points That Deserve To Be Shared From The Book
I'm going to quickly impart a couple of the main messages in this book. They are important and Nagoski wants us to share these messages with each other because, well frankly, we all deserve that knowledge and I appreciate Nagoski's activism on this front. Respect. Then, however, I will go ahead and talk about the improper way I thought the book treated orgasm...because I think that's important too.

1 Your sexuality, your desire, your arousal - it's all normal, even if it doesn't feel that way right now. Yeah, it sounds a little optimistic and naive - maybe even a little hippie-dippie, but she's right, and we women need desperately to really know that. We so often feel damaged or abnormal when it comes to these things, but truth is whatever your body or your desire is doing (or not doing) is really just a fairly sensible reaction to the situation at hand given your particular circumstance and experience. There's a great garden metaphor and a lot of talk about context and it's good, helpful stuff; stuff you need to hear, stuff you might otherwise have to work through with a good therapist. What I have here is a simplistic explanation. There's a lot to unpack on this topic, and it's worth reading the book and doing some of that unpacking because it can bring back a level of control and contenedtness with one's desire and sex life that may have previously felt impossible.

2 When it comes to arousal, we all have 'breaks' and also an 'accelerator.' Some things hit our breaks, others the accelerator, and we all have different levels of brake/accelerator sensitivities. You can encounter all the turn-ons in the world (which engage your 'accelerator'), but if something else is hitting your 'brakes,' arousal ain't gonna happen like you might expect - or at all. Noticing what is a brake for you, what is an accelerator, and how sensitive you are to each type of thing is key to understanding what's going on with your desire and why it actually makes way more sense given the context of your past experiences and your current situation than one might think. Maybe you get turned on really easily, but also turned off really easily...or maybe turned on really slowly and break really easily - you get the point. She speaks about this well.

*Okay, I'm gonna start my criticism a bit early. I love her discussion surrounding this. It's grounded in reality and helps visualize and unpack complicated feelings and scenarios of arousal. My gripe, though, is that it's missing what I see as the most glaring piece of context surrounding female desire. The book never specifically calls out how lack of consistent orgasm in previous and/or current sexual encounters over time could cause a person to code sexual scenarios drastically different than a person that has consistently orgasmed during sexual experiences in the past and present. Sadly, women more often than not fall into the first category and men the second - due to a shit culture for the clit and a fab one for the penis, but I digress.

Let me give an example for context: your partner rubs their pelvis against you as you get in bed ready for a good night's sleep, and it clearly means they want to fuck. For a person that has and continues to have consistent orgasms during their sexual encounters, that pelvis rubbing starts the 'accelerator,' bringing to mind a lot of arousing memories and expectations of an orgasmically satisfying adventure. However, for a person that hasn't been orgasming during fucks on the reg, well, that might easily trigger their 'breaks' because they don't like the frustration of not coming or maybe it doesn't really hit the break, but it does nothing for the 'accelerator.' It brings to mind memories of a fair amount of meh sex and expectations of not orgasming. Frankly, in this situation, something non-sexual like sitting down together with Netflix with a bowl of ice cream is sensibly more exciting. I think this is a desperately important part of how women's and men's desire and arousal can and often do diverge over time. Considering that penis owners (due to situational not biological differences mind you) tend to come almost every partnered sex act and clit-owners often don't is a fucking important thing to note when discussing the context surrounding how a person might experience desire.

3 Responsive and spontaneous desire - Some of the first things I heard about this book were people telling me that I should read it because it uses science to prove that some people have 'Responsive Desire' and some people have 'Spontaneous Desire' - like as in desire just pops up spontaneously for some people (i.e. mostly men) and for others (i.e. mostly women) desire is more likely to arise as a response to being physically aroused. That kind of annoyed me because it sounded to me like whoever wrote the book was just making up biological stories to ignore/paint over the much more complex and toxic problem of unequal damage our sexual culture spills upon women as opposed to men - damage that lowers sexual desire (see my above rant about how lack of orgasm during sexual encounters quite sensibly leads to a lesser interest in pursuing sexual encounters).

That annoyance still persists a bit after reading the book, but it is clear that Nagoski's points about responsive and spontaneous desire were much more complicated and thoughtful than the reader points I had been seeing. Firstly, I was happy to see that she was very clear in saying that no desire is actually 'spontaneous.' There is always a catalyst. It's just that for some people many, many more things are a catalyst, and she does admit that mostly men are in that category.  She was also very clear that this was not simply an innate biological difference - culture, experiences etc. have plenty to do with this. I appreciated that, but as you might expect, I think it's a real oversight to identify this thing that is obviously divided largely by gender without acknowledging that another known gender difference - the rate of orgasm during partnered sex - may have a strong relationship to this. I get it though. There is a time and a place for everything and maybe this book wasn't the time or place.

Although coming at it from a larger cultural perspective I find it problematic categorizing desire in this way, I think in a practical (maybe personally therapeutic) perspective, I can see this categorization as being quite helpful to an individual (i.e. tons of women and certainly many men as well) whose desire does not fit cultural expectations and are in need of some ideological scaffolding from which to build their understanding of themselves. So, from the aim and perspective of this book as, I think, largely self help, I understand why Nagoski categorized this way, and I see that it is useful in this context.

4 Non-concordance - This is simple and important. People can and often do experience non-concordance between their body and their mind when it comes to arousal/desire. So for instance, one's body may become aroused (get wet or hard) but there is no real desire felt. There also may be desire, but the body does not react with physical arousal. It's normal and very common, and trying to make sense of your desire only by how physically aroused your body becomes (and vice versa), is problematic. There are relationship, personal, moral even legal implications to truly understanding this.

My Criticism of How Orgasm is Discussed
So, do go read the book, but know that I disagree with how she discussed orgasm in the ways I map out below, and I ask to just keep it in mind as you absorb.

Lady-gasm and desire
First off, I'll just reiterate what I said above about lack of consistent partnered orgasm being an important element of desire loss in women. I think it was an unfortunate oversight in the book.  Everything else Nagoski said about what kinds of things might affect desire and how one might work to adjust those things is completely valid and important, but I think it's incomplete without really diving into lack of orgasm's affect on desire.

Lack of definition for orgasm - aka orgasm is whatever you say it is
The problem, though, and I imagine part of the reason she doesn't get into the orgasm/desire issue, is that Nagoski basically cuts off any nuanced discussion by saying an orgasm is anything and everything. One cannot give any practically helpful advise about what affect lack of orgasm may have or how to include more orgasms in partnered sex if one cannot even pinpoint what an orgasm is. I mean - might as well say getting a clown to do balloon shows in front of you while getting railed could work for some people, because why not? Anything is possible with orgasms, right? And, the clown example may seem extreme, but it's not too far off from what she actually does say about orgasm.

Here's a small sample of the highly pleasurable orgasms women have described to me: orgasm from clitoral stimulation, orgasm from vaginal stimulation, orgasm just from breast stimulation, orgasm from having her toes sucked, orgasm when her partner penetrated her well lubricated anus with a finger while pinning her to the bed with her hair (the most erotic sensation, she specified, was his warm palm resting gently on her butt cheeks), orgasm when her partner slowly and gently stroked fingertips on her outer labia again and again and again (she said what started out as an appetizer turned into the main course), orgasm without any genital stimulation while she was giving her partner oral sex (she was so closely attuned to his arousal that when he came, she did too).

Really? She came from having her toes sucked? She sucked dick to orgasm? Tell me she found it highly pleasurable. Tell me she felt a sudden climactic high from it. Tell me it's her favorite ending to sex. Who am I to judge? But, calling it an orgasm and categorizing it in with the rhythmic physical release of pelvic muscle tension that is universally understood as orgasm, is deeply problematic. It's also the contemporary way to talk about orgasm - in the sex education crowd - to take a 'if you like it and say it's an orgasm, I can't disagree stance,' so I understand why Nagoski refuses to put fences around the word, but that doesn't make it less problematic. Her only attempt at definition is 'sudden involuntary release of sexual tension' but then she takes great pains to make it clear that means anything you want it to mean.

When you strip it down to the universal essentials, here's what you get. Orgasm is the sudden involuntary release of sexual tension. Notice how much is missing from that definition; genitals, muscle contractions, sexual behavior, pleasure, or indeed anything that mentions what it feels like or how it happened. They can happen from clitoral stimulation, vaginal stimulation, thigh stimulation, anal stimulation, breast stimulation, earlobe stimulation, or mental stimulation with no physical contact at all.

She goes on to say a variety of places they happen and how they feel. I will wholeheartedly agree that it is not sensible to define orgasm using pleasure or what it feels like - who can ever say what something feels like to someone else. I'm even completely behind not defining orgasm by what sexual behavior is happening during it or what is being stimulated.

There is a good marker for orgasm, though
The involuntary muscle contractions, however, I think we must use as a marker for orgasm. Nagoski admits that "Those rhythmic involuntary contraction are perhaps the most nearly universal physiological marker of orgasm," but she goes on to say "even that can't be relied on all the time." To back that up she sites a study where 11 women masturbated to orgasm. I reviewed this article in 2016 if you'd like more information, but here's the basics. The female subjects masturbated and each had a probe in their anus to collect the involuntary muscle contractions of orgasm. They pushed a button to tell the researchers when exactly they orgasmsed so the researchers could see what was happening with their pelvic muscles at that time. 2 of the 11 women said they orgasmed but did not exhibit the involuntary muscle contractions.  Nagoski asserts that this means that orgasms cannot be defined by muscle contraction alone. Maybe. It also might mean that the tools for recording those orgasms were not sufficient. It could also mean that those women did not have an orgasm. The authors of this study struggled with the meaning and did not come to such a clear conclusion of their research as Nagoski. In the article's conclusion, they wrote:

"Two of the subjects did not demonstrate the distinct muscular evidence of orgasm that the other nine did. During none of their orgasms did the initial series of regular contractions occur. Were these subjects interpreting some less pronounced change as orgasm? Should orgasm be defined by what is perceived or reported, or by physiological criteria? At this early stage in recording pelvic muscular activity, we are not yet prepared to conclude that physiological characteristics are more valid than self-reported perceptions for identifying orgasm. At least until more data are collected, especially of the ontogeny of contraction patterns, we will continue our analysis of physiological changed based on subjects' self-defined orgasm."

In other words they made the executive decision for the purposes of this 1982 scientific article to call an orgasm whatever their subjects said was an orgasm because they were not yet prepared to say a woman might say she's having an orgasm when she is not.

Definitions matter
But, does it really seem so crazy in this confusing sexual culture that a woman might say, even believe, she is orgasming when physically she is not? We can't account for this not so absurd possibility if we are unwilling to define what an orgasm is. Yeah, it seems nice and women-empowering to believe all women about their orgasms, but to do that we must accept that anything any woman says is an orgasm is in fact an orgasm.

That might seem cool because, like, who am I to yuck someone's yum (that's super hip for sex positive sexperts to say btw)? It's not cool, though. It's not helpful. It's not kind. It's not sex positive. It's not feminist, and it's not even very nice in my opinion. BECAUSE DEFINITIONS MATTER - for education, for understanding, for clarity, for practicality, and for goddamn sure - for scientific inquiry. An orgasm is not an orgasm just because you say it is and an old coke can is not a rock just because it's on the ground with rocks. Sure, we can decide to call everything that's laying on the ground in that size range 'rocks,' but if you want to study rocks, how they're formed, how they get where they are, what they tell us about our earth - then adding old coke cans into the mix will really throw off the study results. Same with studying orgasms.

Involuntary rhythmic pelvic muscle contractions are no joke
Most things we call and understand as orgasms include the involuntary rhythmic muscular contractions that Masters and Johnson identified as markers of orgasm in the late 60's. Certainly this is true for male orgasms (which also include a usually simultaneous ejaculation as well), but also for females. Unfortunately there seems to be a deep urge to act as though there are lots of 'orgasm types' women (but not so much for men) have even though the evidence points to women's orgasms largely being the same as males - stimulated by the penis/clit area, preceded by physical arousal, and marked by the involuntary rhythmic pelvic muscle contractions. And guess what? Contrary to popular belief and even with decades of research trying to prove that things like 'vaginal orgasms exist; most of the things Nagoski listed up there have never in all of scientific literature been shown to cause those pelvic muscle contractions -  not cervical stimulation, not g-spot or urovaginal space pounding, not stimulation of the vaginal barrel, not penile stimulation of 'clitoral legs' through the vagina during intercourse, not thinking oneself into orgasm / non physical, not toe sucking, nor sucking dick. Women have had orgasms plenty of times in a lab, just as men have, but only clitoral/vulva stimulation and nipple stimulation (for 3 women in the original M&J study, but it should be noted all had weak contractions compared to their vulva/clit stimulated orgasms) caused the muscle contractions we know and love. You might have heard about studies that say otherwise, but that's because people act like a few famous studies prove things they actually do not...I summarized some of these studies for your reading enjoyment: one supposedly about cervical orgasms, one supposedly about clitoral leg orgasms, one supposedly about thicker urovaginal tissue causing 'vaginal orgasms. Oh and also, since Nagoski incorrectly asserts that the distance from the vagina to the clit is the reason some women 'vaginally orgasm' and some don't, here's 2 articles that supposedly prove that, but do not. HERE and HERE

Definition doesn't mean exclusion, though
So, yeah, I guess it comes down to words. If you want to call anything and everything orgasms, go for it, but please at least discern between orgasms that cause the involuntary rhythmic muscle contraction marker (let's call them marker orgasms) and ones that do not. One is not the same as the other. Let's go back to the 'coke can / rock', 'marker orgasm / other orgasm' analogy for scientific inquiry. If one is trying to understand how and why orgasms happen in order to understand better how to advise for achieving them, how to therapeutically help lack of orgasm, or even to understand what is common and what is not, then willy nilly including other orgasms in with marker orgasms quickly creates a confusing heap of messy, shit data. Similar to data about rock formation that is forced to include printed pressed aluminium cans in the analysis, data about marker orgasms that is forced to include other orgasm will throw off connections that should be made if the research was willing to call a spade a spade. I'm not saying that non-marker orgasms are not valuable or pleasurable, but they are different than marker orgasms. They should be studied differently, discussed differently, advised about differently, and women should know that one is not the other. We as a whole are not aware of that though, and frankly that is exactly why it currently seems like the data is unclear about female orgasm, but again, I digress.

Here's a truth. People don't always know what's actually happening in their body. Women don't get taught that much about their pleasure organ (clit) or their orgasms. We see more faked ones in the media than real ones. It's not crazy to think we might say and even think we marker orgasm when we have not, and the advise and information out there is so confusing that we may not know for years that there is a difference and that we haven't been having the type of physical orgasms that the men around us have probably been regularly having their whole sex life.

So, yeah, maybe whatever non-marker orgasm sensation a person has been having is pleasurable in some way, but again, it's not a marker orgasm, so it's physically different. Think about this. You have a pain in your chest. Are you having a heart attack or a panic attack? They might feel similar from what you understand about them, but the actual physical things happening and the results are drastically different. This is the same with an 'orgasm' that does not include the rhythmic muscle contractions that quickly rid the body of most of the built up sexual tension from arousal and an orgasm that does. When sex advisers, like Nagoski, so casually ignore the difference between a marker orgasm and other climactic experiences, they are robbing women of an incredibly important piece of sexual information.

Women deserve better information than we've been getting 
I truly believe that to act as though, for women, orgasm is just whatever you want to call orgasm is a disservice (men, lucky for them, don't seem to get this idea that lots of other things besides the rhythmic muscle contractions are orgasm forced upon them like women do, so take that as you will).

Women are not idiots. You can tell us that pleasure can come from anywhere, that a feeling of climax, even if it is not physical is a lovely thing to pursue if that's what you want. You can also tell us that when involuntary muscle contractions release the physical, sexual arousal that has built up, it's called an orgasm - or if you prefer marker orgasm. You don't need to place any value on it. It doesn't have to be the most pleasurable aspect of any sex act. It doesn't even have to be included in a sex act for it to be worthwhile. But we deserve to know what that physical experience is, that it is not something known in scientific literature to accompany vaginal canal, earlobe, thigh, or cervix stimulation, and that it is by far most likely to happen (and I mean almost exclusively - truly don't expect it to happen any other way) from clitoral glans/vulva stimulation - either direct or indirect. We can make our decisions about how to go about our pleasure from there, but without that information, it seems like porn is correct. It seems like an "orgasm" - the kinds men have way the hell more than we do in partner situations - can happen from just about anything (especially from intercourse), and that is categorically not true.

Thanks Dr. Nagoski - I loved the book despite my criticism
So, that's my hot take on Emily Nagoski's Come As You Are: The Surprising New Science That Will Transform Your Sex Life. I hope I sufficiently portrayed my deep respect and gratitude for the important things Nagoski is saying alongside my criticism of how she treated orgasm. My hope is never to hate on other people doing the hard work to improve the sexual lives of women. I have great respect for that and understand there are many avenues to get there. I do want to open the eyes of already thoughtful, smart people to a different perspective, to give resources and back up my statements so that maybe these smart, thoughtful people might adjust their work ever so slightly to incorporate the new perspective - because I think we get to orgasm equality and a better sexual culture faster if we all take the best from each other. It's a fine line, though. So, Dr. Nagoski, I hope I didn't offend.

I'll leave you with some of Nagoski's final words in the book because I think they sum up the spirit of sexual activism work, and I very much identify with it.

Why I wrote this book: Like many of you, I was taught all the wrong things as I was growing up. Then as I reached adulthood, I made all the mistakes, and I spent many years stumbling with unspeakably good fortune into settings where I could learn to get it right. Settings like the Kinsey Institute and one of only a handful of PhD programs with a formal concentration in human sexuality. I wrote this book to share what I learned, what has helped me and what I've seen help other women. I wrote it for my sister and my mother and for my sister's young adult step daughters, for my niece who is just approaching adolescence and most of all, for my students. I wrote it to share the science that taught me that I and my sister and my mother and my friends are all normal and healthy. I wrote it to grant us all permission to be different from one another. I wrote it because I am done living in a world where women are lied to about their bodies, where women are objects of sexual desire but not subjects of sexual pleasure, where sex is used as a weapon against women and where women believe their bodies are broken simply because those bodies are not male, and I am done living in a world where women are trained from birth to treat their bodies as the enemy. I wrote this book to teach women to live with confidence and joy. If you can remember even one of the ideas in this book; no two alike, brakes and accelerator, context, non-concordant arousal, responsive desire, any of them - and use it to improve you relationship with your own sexuality, you'll be helping me with that goal.