Retro Post: Skeptic Ink Article Critique and the History of The Debate It Led To

Share

Tweet

Retro Post Intro
This is a retro article. I originally wrote this in June of 2014. I re-read it recently and still feel strongly about what I've said here, and think it's worth a re-issue. 

Plus, this article actually sparked a pretty long blog-to-blog discussion, which I think is also worth going over and linking to here (which I will do below).

The history of the debate that this post led to
You see, after I let commented on the author's (Edward Clint's) original post that I had done some critiquing. He, to my surprise, graciously agreed to further debate.on this topic. He replied to my critique I'm re-posting on his own blog HERE. I replied back HERE. 

At that point he didn't respond back and about 4 months later, I emailed him seeing if he was still interested in the debate. We had a very cordial relationship, and I told him I hoped I hadn't been too harsh and offended him. He was very nice in his reply, and let me know he 
I am not offended by your style saying, "By internet standards, you're practically Ned Flanders." He went on with a bit of a gripe though. "However, you do appear to have taken a swipe at me in order to pick a fight on the topic you prefer while ignoring the fact that I was not speaking to that topic. I find that borders on disrespectful, not that I believe you intended any offense. You sense that we disagree on that topic, and I think you are straining to find a way to see that disagreement in what I have written, but it is not there. You had, and have, a much better option if you want to have that other discussion: you could have just asked what my position was and if we could discuss that. There's no reason that couldn't happen without us endlessly dissecting whether or not my essay about bad io9 reporting was sufficiently deferential to your sense of history and fact."   

So, I took a little issue to that and emailed him back a long-winded email describing how I thought maybe he wasn't actually reading my arguments because he is speaking on the topics I'm critiquing him on and that we do, in fact, disagree. He, as you might expect, took a bit of issue to that, then wrote me back the following after writing some nice small talk that we'd been engaging on:

Let me clarify some things for you. I am not ignoring or failing to understand what you have said. I am asserting the autonomy and rules of engagement as they apply to your actions. There are two arguments I am perfectly inclined to have and one that I will refuse you. I will call those A, B, and C

A) What is the factually correct definition, description, and nature of orgasm as it relates to stimulation of the clitoris and vagina?
 B) How defensible was my post on clitoral anatomy and bad science reporting?
 C) Whether or not my resolution of A caused my resolution of B.  

I am not wiling to engage with you on C. My reasons for this are that it strikes as not entirely appropriate (as I wrote before, it seems like picking a fight). You don't think that you are, and I take you at your word, so I will give you two other reasons why I will not engage with C. One, we will never get past the "B" component, ever. You are mistaken about your belief here. I am sure you believe your interpretation, but I have access to my own beliefs, intentions, and memories and you are not correct. I simply did not ever intend to say VIO is real and true and should be taken as the truth. I knew it was contentious territory when I wrote about it, and so I tried to stay out of that particular debate, deliberately, knowingly. I've read your arguments to the contrary and they will not succeed. But whatever your beliefs, know that we will never get past "B" and to "A". I will simply not allow a false point criticizing my writing to stand.I will counter every one of your points, and we can go around and around doing that if you wish, as I said I am fine with "B". Reason number two: "A" is a very big debate. It should stand alone, and not be muddied by blog politics about whether I was right in some tangentially related earlier writing or not. It deserves to have its own debate where one side, mine, is not instantly set to the defensive and put in a pit of assumed wrongness. It must begin on clean, neutral terms, or not at all, just like any formal debate.  

 These reasons are why I could not just take you up on your offer, you prefaced it with a C argument against me, forcing me to defend B and preventing me from ever getting to A, because I will not permit this water to be muddied, even if you believe that it already is. I do not, and I will not agree to that as a term.  

 So pick one, A or B, or none of the above. But whichever you pick, you must let the other one go, and if you choose A, then the exchange must be reset and not a direct continuation of the discussion up to now (though of course it can be justly called a consequence of it). Those are my terms. 

 
I wrote him back a quick email letting him know that if those were his boundaries, I'd be happy to debate A. So, that is the explanation for why we shifted focus, and at that point we started a new and separate debate. He started it HERE. Then I responded HERE . Ed responded back HERE. And I responded a 2nd time HERE. 

I really enjoyed the chance to debate. I think responding to him and thinking about all this from a different perspective helped clarify a lot of things for me and I'm grateful to that. I'll let you go through all these as you will and get what you get from this debate...it's only like a thousand million trillion hours of reading, so super easy spare time reading - yay!  


...And Now the Original post from June 2014

Charlie sent this article to me (The Clitoris Revealed and How io9 Got It Wrong) from Skeptic Ink. The author (Edward Clint) was lambasting a recent i09 article on its terrible coverage of a 2009 study that used a sonogram to look at the full clitoral complex (there's a lot of erectile clitoral tissue below the skin). The study linked an area where part of the clitoral complex got cozy against the vagina during penetration to an area the 5 women in the study felt was a pleasurable one in the vagina. The researchers suggested this may be the "g-spot" (as in the "g-spot" may actually just be the area where the root of the clitoral complex butts up against the vagina during penetration and not be some piece of anatomy within the vagina). There is a suggestion that this "g-spot" is linked to the "vaginal orgasm" the 5 women in the study claim to have, but there is no specific causal connection asserted in the study's conclusion. 

Edward Clint rightly details how the io9 article covering the study is characteristically silly in the way media interpretations of scientific studies always seem to be, and I appreciated that he pointed that out. In fact, I loved that this article pointed out a lot of things about scientific reporting that annoy me (not telling the full story, over exaggeration, only picking out the parts that seem exciting), but then at the end of the article, there is a section called "The vaginal orgasm and the G-spot debate: We can all stop caring now," and that's where it all goes wrong. 

Frankly, I don't think that Clint (and he's not alone - honestly his tone and arguments are very much the status quo) has a good handle on some important aspects of this subject, Let me tackle the larger issue first.

An orgasm caused by stimulation of something inside the vagina (a Vaginally Induced Orgasm or VIO),  has never actually been recorded. I know it sounds crazy, but it's true. It doesn't exist in scientific record. (I explain that further HERE and HERE if you are interested).  Most people writing about g-spot/vaginal orgasms don't know or completely ignore this. They, quite wrongly, take for granted that VIO's exist, and I think it twists the entire picture of female sexual response into a confused mess that is not helpful to anyone. Take for instance Clint's discussion about the "vaginal vs. clitoral orgasm debate." 

In the first half of the 20th century, notions of vaginal vs. clitoral orgasm took hold (thank Freud, who coined the term vaginal orgasm), along with the ignorant and sexist notions that women incapable of the “vaginal” orgasm were “frigid” and that penis-vagina sex was the only source of orgasms that counted. This lead some feminists to adopt the opposite and politically-valenced position that the vagina was irrelevant to pleasure, and that the vaginal orgasm was a lie. Just in case you think I am overstating, feminist Anne Koedt wrote in 1970, It has also been known that women need no anesthesia inside the vagina during surgery, thus pointing to the fact that the vagina is in fact not a highly sensitive area. (This quote was repeated to me in a 2012 gender studies classroom by a professor, quite seriously) This is why it’s good to remember the opposite of wrong is not necessarily right and that it’s a bad idea to confuse facts with moral values: facts can change. 

He seems to play Anne Koedt as some crazy ideologue, but she is not. Koedt was part of a larger feminist campaign that emerged from the then recent Master's and Johnson physiology of orgasm research. M&J's research described how there was no evidence of VIOs and showed how stimulation of the clitoral glans caused female orgasm. That research is, to this day, still relevant and foundational. Let me be clear. Orgasms caused by stimulation of the clitoral glans have been described, documented, and there is a clear understanding of what is needed to get them and who is capable of having them. Orgasms from vaginal stimulation have not been documented or described and there is no clear understanding of what is needed to have them or who is capable of having them. 

Koedt's statement that the vagina has very little sensitivity to touch and that the vaginal orgasm is a lie is not just a willy-nilly opposing reaction to Freud. It is what the science says (this was true in 1970 and still today). Freud's theories, including the "vaginal orgasm" that he so kindly birthed into this world, are just some completely untested ideas a famous dude had that really, really caught on - that's all. To pose Freud's bullshit against Anne Koedt's article, an article that is backed up by good science, is just plain silly.

Even after the G-spot was "discovered" and brought into the public eye in 1982, there still has been no causal connection documented in a lab between something in the vag being stimulated and an orgasm. From the G-spot's 1982 "coming-out,", we did learn that there are prostate-like ducts surrounding the urethra that protrude out from the vaginal wall when excited (this is what I would define as the g-spot), and that when there is sufficient pressure and stimulation of that area, some women ejaculate (which is different from orgasm) through their urethra. That is the only type of sexual release caused by vaginal stimulation that has been documented, and yet strangely this article and almost all like it ignore this very real and concrete quality of the g-spot. Instead the focus is on its possible part in a type of orgasm, that frankly, may not even exist. 

Another issue I have is that Clint confuses two different " clit vs. vag debates." There is a debate about whether a vaginal orgasm exists at all. This is the debate I'd like to have and the debate that was in question with Anne Koedt and similar feminists of the time. Then there is the debate about whether VIOs are caused by something actually in the vaginal structure  vs. the idea that VIOs are caused by indirect stimulation of the deep clitoral roots through the walls of the vagina. Clint sort of lumps these two together as the clit vs. vag debate, but they are actually quite different. The first follows what is scientifically known and simply sees no evidence for a VIO. The second assumes that VIOs obviously exist and is simply asking whether the clitoral legs stimulated through vaginal penetration is the cause or the vag itself. 

The modern research tells us that everyone is right! Or, everyone is wrong, however you’d like to parse it, because all of the parts are important. And right on cue, both “sides” of the G-spot debate have claimed immediate victory with the anti side saying “See, it’s just clitoral!” and the pro side saying “see! it is real, and just where we said!”. The correct answer is, researchers aside, who cares? 
What if the orgasm some women experience during vaginal intercourse is caused by the internal clitoris? Does changing the mere label and invisible mechanism for the event from “vaginal” to “internal clitoral” change a thing about the event for anybody involved? Does it somehow change moral arguments about the political equality of women? I don’t think that it does. Isn’t it cool if it’s a fact that the G-spot that some women report actually is the spot where the clitoris contacts the anterior vaginal wall?

This is annoying to me because the very important debate about whether vaginal orgasms even exist, the debate he unfairly poo-pooed as just a feminist reaction to Freud's nonsense, is further being pushed into irrelevant obscurity because he's incorrectly lumping it with a debate about which undefined mechanism causes an undocumented, not understood, orgasm that may not even exist. "Is it the thing in the vag we can't find?" vag side says, "or the penis pushing against the wall of the vagina - which then pushes on the surrounding tissue - which then pushes on the clitoral leg that causes VIO?" clit side asks. Framed this way, Clint's right, who cares? It probably doesn't exist anyway. (and P.S. when it's said that the clit has more nerve endings than the entire penis, it is meant that the clitoral glans, the part on the outside, has that many nerves, not the whole clitoral structure. I can't find anything that says how nervy the inner clit legs are, but I think it's fair to say it's a hell of a lot less nervy than the glans. The inner legs engorge with blood when aroused, that seems to be their claim to fame - not intense nerviness). 

My other major problem with Clint's last 3 paragraphs is a little more complicated. You see, although I've already pointed out that a VIO is neither understood nor documented, and that wondering which part (the inner clit or the vag) causes these VIOs is kinda useless since we can't even describe the thing they supposedly cause, the idea of a VIO is still incredibly important to tons of women and their partners. Women and men hear it exists, and the details of what exactly may cause it are a matter of great interest. A quick scan through advice columns, magazine articles, books and the internet would easily show how interested people are in this. It shouldn't be taken lightly that women are in search of better information about these types of orgasms, and I was bothered by the flippant way Clint speaks about the level of actual interest non-research people might have in the specific details of how a VIO might be achieved. 

Frankly, I think Clint underestimates the amount of worry, confusion and frustration women (and men) carry about VIOs. Just think about it. These VIOs are over-abundantly depicted in porn, romance novels, and everywhere else sex is depicted. They result from the most common of sex acts - vaginal-penile intercourse. They are low maintenance (just get banged!), supposedly wildly amazing orgasms, yet only 20 to 30% of women say they can experience these elusive trophies of female sexuality. Why wouldn't people hang on every tidbit of information about them? People are not stupid, and they know that understanding these detailed mechanisms are the key to both learning and teaching how to achieve VIOs.(Does the inner clitoral leg really butt up against the vagina to cause these wildly elusive VIO's or is there another stand-alone piece of anatomy some women have that makes them unique and lucky vag-gasm princesses?!? Are all women's bodies capable of VIOs, or just some? What is the anatomy difference among the haves and have nots? Is it the sex position or the dude's junk size that makes it possible?). Just telling people that it's a vague area that can be reached through the vagina is not enough. People certainly want more. I think it's ridiculous, given how much of an importance our culture puts on VIOs to say, who cares? 

So, again, my larger issue with this article and the g-spot/vaginal orgasm debate in general is that the discussion begins from the assumption that there is something that causes these vaginal orgasms, but no one (even quite skeptical people) thinks to say, "hey, wait....what exactly is a VIO? Oh, there is no real definition? It's never actually been physically documented? Why is that? Hmmm, maybe it's kinda problematic to be looking for the cause of something that is not actually defined." 

Having straight-faced discussions about which possible anatomical configuration causes vaginally induced orgasms is as gross to me as discussing what causes women's intuition. Yeah, people talk about it as if it exists, and women will even tell you that they have it, but it is not defined. It may not even exist, and there is no way someone can identify the cause of something when no one knows what exactly that something is. This is pretty basic stuff, and critical people should be looking at and talking about this debate differently. In the future, I would love to see skeptics be as thorough and skeptical about female orgasm as they are with evolution, religion, and global warming.

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

Share

Tweet

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.

ladygasms
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.

Cited
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.

The Female Orgasm Debate With Edward Clint at Skeptic Ink - My Response #1

Share 

Tweet   

I have to say, I’m excited to be having this debate, and I want to thank Edward Clint for agreeing to do this. Ed co-produces Skeptic Blogs and writes on a variety of topics there. He is currently a graduate student at UCLA studying Evolutionary Psychology. He has proven to be quite considerate to me and thoughtful about this topic. As Ed said, this is a new debate. It is not building from our original back and forth.

I have written extensively on my stance about female orgasm and  made a movie on the topic. So, since my view is already out there, Ed and I agreed that he would begin our discussion with a response to my stance (taken from my movie and my blog – particularly THIS POST explaining  why I say that vaginal stimulation has not been shown to cause orgasm). Please check out Ed’s post HERE. We are specifically taking opposite sides of the following statements. I’m on the pro side, of course. *(You can now find Ed's response HERE and My response back HERE).

for the record, I wouldn't define this as orgasm

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’m going to go about this by first outlining my support for these statements. I will keep in mind the objections Ed has outlined, and do my best to touch on those. After that, I will respond specifically and in more detail to each of his objections in the appendices. Hopefully, this can allow those who want to read just the gist to drop off before it gets more detailed.  

Support for Statement 1

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

Masters and Johnson’s (M&J’s) description of the physical markers of orgasm are what I believe the scientific definition of the word orgasm should be based upon. Very basically, the main physical marker is a rhythmic release of the pelvic muscle tension and blood congestion that has developed during sexual arousal. It’s measurable, well known, possible in both men and women and in people all across the world, and relies on the well known and heavily agreed upon physical markers of sexual arousal in order to come about. No other commonly used definition of orgasm is that verifiable, that universal, or that directly linked to the physical elements of sexual arousal.

This definition of orgasm makes sense even given the immense variation in psycho-social elements that affect people’s ability to attain orgasm and the meaning and subjective pleasure they find in it. This physiological event exists as a human event that can and does occur in direct relation to human sexual arousal. Plus, although the psycho-social elements are absolutely integral in understanding things like who has orgasms, why people don’t have them, and what significance orgasm has to a population, the event still exists on its own and stands as a good definition of orgasm. Let me elaborate on why this physiologic definition of orgasm seems most sensible to me.

1 The orgasmic muscle contractions described by M&J are not under dispute as a marker for sexual climax. Although the word orgasm and its meaning are contentious, this marker for sexual climax is not, and it is already part of any sensible and knowledgeable definition out there for orgasm (Meston et al p174).  It is known to exist in both men and women and is a thing that the majority of women and almost all men experience (even if they have wildly different ways of getting to it and diverse feelings about it).  So, there is agreement that this exists and about how it behaves and is measured. It is already a respected and widespread definition of orgasm. I am merely proposing it be the definition. There is a universal element to this definition particularly because it is a physiologic one.

Ed objects to aspects of the 1966 M&J study in an attempt to discredit their findings about orgasm. The objections are sometimes blatantly wrong and other times simply not a good argument for disregarding or discrediting it. I have specific responses to his full list of objections and also a  response to Ed’s citation that claims to directly dispute M&J’s finding (it absolutely does not ) in appendix A below. M&J is a 50 year old study, and things have changed. Their work has been expanded on. More work has gone into things like hormonal activity during arousal and orgasm, and modern ways to record the physical markers of arousal and orgasm have been developed (M&J used to actually get down there and measure parts by hand to check for vasocongestion. Photoplethysmographs are now often used to do that), but these markers M&J identified are still understood as important markers. Their work in Human Sexual Response is by far the largest and most comprehensive physiological study of arousal and orgasm that exists. It is fundamental and has not been rejected or seriously debased over the last 50 years (Meston et al p180).

2 There, of course, are other experiences some would put forward as being orgasms; ejaculation, tantric/spiritual/mental experiences,  or a type of inner/vaginal/uterine/g-spot/anal climax that specifically does not involve the recordable muscular activity described by M&J. That’s not a complete list, but it’s some of the usual suspects, and I think it's problematic to call or insinuate that any of these things are orgasm.

Ejaculation is a sexual response but is a different physiologic event than orgasm. This is true for both men and women...and although men almost always experience it, since it is linked to orgasm in males, it may not be common among women. The rest of the above options have no set of physical markers that could let a scientist know that these events are occurring. The respondent must be taken at their word that there is a climactic sexual experience happening. The only exception to this would be some studies showing mental activity during a time when the respondent claims to orgasm. This is a recordable response, but as of yet there is no clear understanding of whether the brain activity seen is a reliable marker to indicate any particular kind of climactic sexual experience, much less the muscle contractions identified by M&J’s work. There is also no understanding of what that brain activity correlates to physically, or if it correlates to anything physical at all.  Brain activity may be an interesting avenue of research to pursue, but to be convincing as a marker for orgasm, that mental activity should  also correlated with a culmination of or climax to physical sexual arousal.  

3 Which brings me to my major reason for calling the muscle activity described by M&J orgasm (and biggest qualm with calling these other things orgasm).  The M&J described orgasm has a physiologic quality that is quite specifically the physical climax of changes in the body that happen during human sexual arousal, and those other things in the list are not. To be clear here, I’m not arguing that those other things have no value, are not pleasurable, or don’t feel climactic. I’m not even arguing that orgasm is the most pleasurable thing a person can experience regarding sex. I’m arguing that these other things are something different and not events that rely on and relieve the muscle tension and blood congestion in the pelvic region induced by sexual arousal. I believe that makes this event more than just one of many possible experiences that people find pleasurable or climactic during sex. It makes this event an orgasm.

Before I move on, let’s get back to sexual arousal because I think it is often hard to separate the ideas of arousal and orgasm, and I’ve found over and over through the years that discussing the two as separate seems to cause major confusion about what I am arguing. So...Yes, sexual arousal can be “turned on” in humans in an infinite number of ways. It’s got everything to do with psycho-social and circumstantial variables. The thing is though, however one gets it started, sustains it, or increases it (and that process really is as unique as people are), when it happens, the body reacts largely the same in all humans. The basic markers of sexual arousal that M&J noted  (such as penile erection, vaginal lubrication, testes being pulled up against the body, and repositioning of the uterus/elongation of the vagina - all due to pelvic vasocongestion and muscle tension), have certainly been expanded upon over the last 50 years, but they are basically the same things researchers still today use to denote arousal. Increased heart rate, raised blood pressure, increased pain theshold and pupil dilation are also used but are indicators of regular ol’ non-sexual arousal as well. So, how one gets aroused, how he/she feels about it, and expectations surrounding arousal are incredibly complicated and variable, but how the body responds to that arousal seems to be quite universal.  

The orgasm is absolutely dependent on that physical arousal because there needs to be sexual muscle tension and blood congestion present for there to be an event (the orgasm) that releases that tension. It’s clear that orgasms don’t happen without arousal and arousal doesn’t happen without activities that are steeped heavily in psycho-social elements, so a complete study of orgasms among humans is naturally tied to the psycho-social. However, the definition of orgasm, doesn’t need to be.

Why it's important to make this distinction

I really do understand that the feelings around a word like orgasm are complicated. I really do know that although I have no intention of telling women that there is only one way to enjoy sex (for instance - experiencing the orgasm defined by Masters and Johnson), that none the less, my simply saying that there should be a standardized definition of the word orgasm, is enough to make some people feel slighted, misunderstood, or inadequate. I don’t love that, but I think that advocating for clarity in the discussion of female sexual response is worth the trouble it digs up.

There is confusion about the word orgasm. Researchers, doctors, therapists, sexual advisers, and random people who want to speak about orgasm from a place of even limited authority could continue to use that word loosely, to make statements about orgasm without being specific about what is meant, but I think it only leads to spinning our wheels on the topic. Saying that situation A causes an orgasm in one study and that situation B causes an orgasm in another study, is most helpful when the word orgasm means the same thing in both. Right now, it does not - way too often. It seems to me like people involved in this discussion are talking around each other and there needs to be clarity of language…to help women understand their situation and to help researchers build from each other's work more easily.

As I described above, I think orgasm should be used to describe the M&J definition of orgasm. I also think ejaculation should be used to describe ejaculation, and a climactic experience should be used to describe a climactic experience sans orgasm. Other more specific words could come to light to categorize these other mental or physical climactic experiences as researchers hopefully gain clear understanding of what these are and how to identify them. Also, I think scientists should be cognizant of the mixed use of the word "orgasm."   If talking about reported cases of orgasm, there should be an understanding that a claim of “orgasm” could mean a wildly large amount of different events, and data should be assessed with that in mind. I believe that clarity of language is absolutely necessary for the discussion about female orgasm to move forward (instead of in confusing circles like it seems to be doing now).

Statement 1 Conclusion

I do also get where Ed is coming from when he says that orgasm is “a mental event, an experience.” He’s right, it is both of those things, but so is every other thing we humans do. It’s not useful as a definition. It's also not a reason to disregard the M&J characterization as insufficient. The physical characterization of orgasm proposed is an undisputed reaction that can happen to both men and women all across the world at the climax of a person’s physical sexual arousal. The contractions can be weak or strong, have a somewhat variable rhythm, last for a somewhat variable amount of time, but the basic description set forth by M&J is a sensible definition for orgasm. The fact that there is infinite variation in how people get from no arousal to orgasm, or in how people subjectively experience this event does not mean that we don’t or can’t have a good definition of orgasm. Similarly the infinite subjective experience of a heart attack, and the many discussions existing about what causes them and what prevents them, does not negate that it is a blockage of oxygen-rich blood to the heart muscle. Both a heart attack and orgasm exist as a thing that can be defined, and all the psycho-social things around us can inhibit them, help them, affect the framework in which they are practiced, and bring different meanings to them. However, it is difficult to really discuss those psycho-social aspects in any meaningful way unless there is a clear definition of what it is they are affecting, and that clear definition is exactly what I propose.

Support for Statement 2

Orgasm is caused by direct or indirect stimulation of the clitoral glans/vulvar area in women.

I think my support of statement 1 stands on pretty firm ground, but I willingly admit this second statement is slightly mushier. However, it doesn’t have to do with the arguments about Female Genital Mutilation (FGM), cervical stimulation in women with spinal injuries, culture considerations or dildos as Ed suggests. It does have something to do with his point about M&J’s findings regarding orgasms during intercourse though. I actually think some of M&J's findings are the best arguments against this second statement. So, let me tell you why I think there’s mushiness in this argument, and then I’ll tell you why, even with the mushiness, it’s still the most sensible one. 

The reasons for this mushiness in Statement 2

1 My assertion is not based on undeniable proof. It’s based on an overwhelming amount of evidence that stimulation of the clitoral glans/vulva area can induce orgasm and an overwhelming lack of evidence that any-other-thing-stimulated can induce orgasm. That’s why I make that assertion. It’s about the evidence as is. However, although there has been about 50 years since M&J first came out, and so far there still isn’t much to go on for the “any-other-thing-stimulated can induce orgasm” statement, it's possible there could be in the future.

2 It is all very close together down there. It doesn’t seem impossible for the clitoral glans area, without being directly touched, to be stimulated just enough to orgasm from movement in areas close by such as; 

the in-out movement of a phallus in the vagina, 

or strong vibration on a close-by area, 

or specific muscular movement that might shift things slightly in the vulvar area. 

I think it’s incredibly important in science and in sexual advice to parse out as clear and detailed an understanding about what is and is not known to induce orgasm as we possibly can be. That means really trying to figure out the specifics of what touches what. I will continue to argue that this is meaningful and incredibly important, but I get that it can get a little nuanced for some people’s taste.

3 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.

Yet Statement 2 is still the best bet 

Those 3 points all kinda go together so let me just explain a little. The M&J accounts of both the intercourse and the breast induced orgasms were observed and recorded in the lab. They documented both subjective accounts of the orgasms and objective recording of the orgasmic pelvic muscular activity. There are no other studies that document an objective recording of orgasmic pelvic muscular activity for orgasms stimulated from anything but the clitoral/vulva area – not stimulation of the breasts (besides M&J), not anuses, not G-spots, V-spots, C-spots nor other spots, not from the inner clitoral legs being pushed on or "crushed" through the vaginal wall, not the vaginal wall itself, and not even any other intercourse induced orgasms like the M&J documented ones above (I’ll get back to these in a minute). 

Those studies just don’t exist. There’s plenty of claims in surveys and even in labs studies that these other types of stimulation do cause women to orgasm, but the physical evidence just has not been taken; or the physical evidence taken was things like heart rate, blood pressure, pupil dilation, or pain tolerance – all things that are certainly markers of arousal (both general arousal and sexual arousal) but not necessarily of orgasm; or it’s a brain scan that might suggest an orgasm, but there is no recording of the pelvic muscle activity to go along with it, and no certainty that the brain activity seen means anything about a physiologic response in the body – much less orgasmic muscular activity. These other studies and surveys that suggest female orgasm caused by something other than clitoral/vulva area stimulation exists, simply don’t give any actual evidence that this is the case.

Okay, so there is a striking lack of evidence for non clitoral/vulva area induced orgasms, except for M&J’s work. It might seem problematic to my statement, but it’s less than you’d think. M&J asserted that the orgasms through intercourse, the ones with no other clitoral/vulva area stimulation, were actually stimulated through the clitoral glans indirectly. They asserted that the clit was rubbed through a Rube-Goldberg-like situation in which the labia pulled on the clitoral hood which rubbed against the clitoral glans – so it was quite indirect. 

They give no explanation about the mechanism for which the breast orgasms happened, but they say that the timing of the physiologic markers during arousal and orgasm in both the intercourse and breast orgasm were quite similar. Both were also the weakest type of orgasms that the women had. All the physiologic markers and muscular activity for orgasm were recorded, but they were just objectively recorded as weaker and subjectively reported by the women as weaker. In fact, for the entire study, M&J report that in terms of both the objective intensity of muscle spasms recorded and the subjective reporting of the woman, the masturbatory orgasms were ranked highest, followed by partner manipulation and the lowest intensity reported and recorded was achieved through intercourse (and breast stimulation) (Masters 1966 p133). So, given that the low intensity of the orgasm correlated with more indirectness of the stimulation, it might be just as likely, if not more likely, evidence for the importance of clitoral glans area stimulation for female orgasm, rather than being evidence for inner vaginal induced orgasms. 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.

Ed's Objections

As I said before, Ed's point about intercourse related orgasms in the M&J study was valid, but his other objections relating to cervical stimulation in women with spinal injury, orgasm in women with FMG, or lesbians buying dildos, aren't useful. They're interesting, but they simply don't contradict Statement 2. The truth is there simply are not studies (the one's Ed cites included) that document a situation where stimulation on anything other than the clitoral/vulva area causing the M&J identified muscle contractions of orgasm. You can read my more detailed response to each of his objections below in Appendix B. However, I do want to speak quickly on Ed's assertion about women with FMG. He cites a study from 1989 that surveys women in an area with an incredibly high incidence of a particularly ugly type of FMG in which the labia is sewn together leaving a flat surface with only a tiny whole left from which the women must pee, menstruate and eventually have intercourse (there is often a knife used on the wedding night). It has been long assumed that the clitoral glans was always cut off with this type of FMG (known as type III), but recently surgeons who do reconstructive surgery for women with FMG have discovered that this is not often the case. Intact clitoral glans are found behind the tissue. One study showed this finding in 40% of the women with type III FMG. So, at least some of the women in the study Ed cites may not be without a clitoris as he assumes they are. If these women are having orgasms (and it’s just a type of survey with no physical validation for their responses) they very well might be having them because they have clit-hiding scar tissue to rub up against their husbands’ pelvises.

Statement 2 conclusion

So, there are things that could easily make me change my mind on the basic need for clitoral/vulva area stimulation in order to orgasm. One of those things would be one study, any study, that makes a physically verified causal connection between stimulation not involving that clitoral/vulva area and orgasmic muscle contraction. There's certainly studies connecting other types of stimulation to arousal or to feelings of pleasure, and those are interesting and useful inquiries into human sexuality. However, this is about the orgasm, and studies like what I'm asking for are hard to come by, and I challenge anyone to find one. Studies trying to make this causal connection can be done and should be done. It's quite mystifying that they don't exist. 

Like I mentioned above, there is actually some debatable evidence for a direct connection between breast stimulation and orgasm, 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. Other than the M&J study, the only thing to go on is the accounts of women who say they can orgasm from other kinds of stimulation. These accounts are great starting points for investigation into female sexuality, and should never be discounted. However, there should be an effort to physically verify these claims, and as of yet, this has not been done properly. 

There's plenty more to read in the Appendices. Appendix C was added for my responses to Ed's objections that weren't categorization with Appendix A or B. Enjoy. Thanks again to Ed Clint!

Appendix A

Masters and Johnson made major contributions to knowledge about sex. 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. As a psychologist, I do believe I would be laughed out of the room if I proposed such a basis for some description of a pan-human bit of psychology. Here is a short list of the limitations and flaws of M&J 1966.

• Tiny sample sizes that offer no statistical power to generalize

It may be too small for Ed’s tastes, but there is no other physiological investigation into the body’s responses to arousal and orgasm that is near this large; 382 women and 312 men and a minimum of 7,500 complete cycles of sexual response (Masters 1966 p.12-15). I’d love a bigger study with more modern amenities, but this is the best we have, and honestly, I think calling it tiny is a bit of a stretch.

• Use of sex workers as participants, which can hardly be called representative of women in general

Not actually true - although, I don’t see this as a problem anyway. Sex workers were used as preliminary subjects, because they were available, as an investigation into how tests should be set up and run. M&J explicitly said that they did not use this population in their final analysis.  “The interrogative material and experimental results derived from the prostitution population have not been included in the material being presented.”  (Masters 1966 p.11) And frankly, even if they did use prostitutes, I don’t see why their physiological sexual response would be any different than any other woman or man. We all have the same parts down there (as long as no disease is present).

• Sex in a laboratory setting probably is not representative of other settings

Agreed. Sex in a laboratory setting is different from sex in other places. This is an issue to consider in any sexual study, and M&J knew this. My biggest worry here would be that people find it hard to become aroused in this situation. The people in the M&J study obviously were able to overcome that since they did physically become aroused and physically orgasmsed. Of course this may skew the study towards people who are able to become aroused in these situations, but that is a common problem among any study of the body during arousal and orgasm....and even people who get aroused by laboratories have the same genitals as the rest of us.

• No replications

Granted, a giant study where people are hooked up to physiologic monitors and asked to do sexual acts while the researchers measure and record has not, very unfortunately, been done since. However, like I said above, the work is fundamental and there have been many studies that replicate the measurement of arousal and orgasm in people without finding anything contradictory to what M&J found. There has even been findings that work within M&J's, but also expand on it. For instance THIS study found some more variation in the pelvic muscle responses than did M&J (1 male who could have multiple orgasms before his ejaculation). (3)

• Participants were “WEIRD” in the Henrichian sense: of a Western, Educated, Industrialized, Rich, and Democratic society. Trisha believes the study of one culture, ours, proves things about the human species.

Well, if Human Sexual Response was a study focused on behavior or psychology rather than physiological  reactions to arousal and orgasm then I think this would be an incredibly valid criticism. However, ladies all over the world have the same parts, just like men all over the world do. Granted, the women in other parts of the world might need to think and do different things to become aroused (this is incredibly dependent on psycho-social element), but when they do become aroused, it can be detected in their bodies just the same way we detect it in WEIRD bodies. We can also detect when they are having orgasms, just the same way we detect it in WEIRDs.

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.

Appendix B

V. Infibulated women in the SudanWomen in a non-western culture without all that Freud baggage and social expectation still have VIO’s. Hanny Lightfoot-Klein (1989) described the culture as such that women must hide all sexual interest and response in order to appear chaste and modest. They must hide orgasms, or, if they can’t hide them, deny that the outburst was caused by the sex acts. Nonetheless, 90% of the 300 women interviewed said they had orgasms, some even saying “always”. We know, too, that none of these were “clitoral” orgasms, because none of these women have a clitoral glans or labia. They all have a “full pharaonic” type infibulation that involves removal of virtually all external genitalia. I am beyond astonished that women who have been so tragically mutilated can ever enjoy sex at all (many of them do not). Lightfoot-Klein is not the only report of this phenomenon, in the paper she also cited Money et al. (1955) and Verkauf (1975).

First off – love this article. I had not heard of it before this. I found it to be informative, sincere, and thought provoking, but not contradictory to my stance for variety of reasons. Firstly, it is actually quite possible some of these women had partial or intact clits under their scar tissue that could be engaged for orgasmic response.

Let me explain a bit. In the study, the author interviews over 800 women and 300 men, and found that 90% of the women claimed to have orgasms with their husband anywhere from rarely to always. It doesn’t break down the percentages of the always or the sometimes or the rarelys, but it doesn’t matter too much. At the time this was written, the standard thought was that women with FGM could not possibly orgasm, and this article’s author, I think, really wanted to point out that this is simply not true. Since then, there have been plenty more studies suggesting that women with FGM can orgasm (4,5,12). This seemingly improbable ability is likely in no small part to what surgeons who do reconstructive surgery for FGM have begun observing.There is often some parts of the clitoral glans left after FMG. 

In fact, in the type of FGM that is practiced among the culture in this study, type III (also called infibulation), there was an unexpected reality that came to light when reconstructive surgery became more common (4,5,12). Nour et al found an intact clitoris in 48% of 40 infibulated/type III women undergoing corrective surgery. Type III FMG is pretty terrible.  At its worst, the clitoral glans inner labia are completely cut off, then the labia majora is sewn together leaving only a pinhole sized opening for, you know, urination, menstruation, childbirth, and intercourse (knifes are often used on the wedding night). As I discussed, it used to be assumed that the clitoris was always cut in this type III, but as surgeons have shown us more recently, this isn't always the case. In fact, after direct observation, this definition has been disputed enough that the World Health Organization changed the definition of Type III FMGs (the type from the ) from saying that the clitoris is always cut to defining it as one in which the skin is sewn together “with or without excision of the clitoris.” (14) Given that this article mentions that these surgeries, especially in the outlying areas, are done by untrained midwives, it doesn't seem that strange that there would be a variety in the types of cutting that is done. The statement from some women in the article that their scar tissue was erotically sensitive would also indeed point to some having a clitoris or part of a clitoris behind the scar tissue.

However, there’s not a lot of information to go on in this article besides a few specific anecdotes. It’s more like a thoughtful and informed story than a set of data being discussed. There is no distinction given about how all these women achieved the orgasm. Were they grinding against their husbands? One woman who said she orgasmed frequently said she “moved around a lot during intercourse.” Could she be grinding her hidden clitoris against her husband during intercourse? Or, was it a vaginally induced orgasm? We just don’t know. The “moving around a lot” woman was about as detailed as it got. It’s also questionable whether all or any of the events these women describe as “orgasm”  was even a physiological event. If I know anything about the word orgasm, I know that it is an incredibly culturally steeped word, so I have no idea what they mean when they say orgasm, and neither does the author.

My point here is that this study is not much different from any study asking women about orgasm. There simply isn’t any physical data to verify what they mean when they say it, and their method for getting an orgasm during intercourse (I’ll go ahead and assume there’s not a lot of oral or masturbating going on, but it’s not actually discussed) are not disclosed. Given that these FMG procedures do not universally leave women without an intact clitoral glans, these women could be getting these orgasms just about anyway any American woman could have gotten one.

(Just for fun, I’d like to openly wonder if these women and men in this culture, having probably not seen a lot of simulated sex on tv, movies, and porn, might be somewhat better off in terms of women reaching orgasm during intercourse than western folks. The fast, in-out-in-out style that is often depicted here, doesn’t tend towards a body position with the outer vulva in constant contact with the males body. Maybe, left to our own devices without pre-conceived ideas about what sex should look like, women and men tend to cling closer to each other and more gently move their pelvises in whatever ways feels good – making a grinding-the-clit style orgasm during intercourse more likely. Just a thought to ponder.)

VI. Women with spinal cord injuries experience orgasmsThe clitoris and vulva are innervated by the pudenda spinal nerve. However, in women who have no sensation in the pelvic region due to spinal cord injury, sexual response including orgasm have been documented in several papers. Komisaruk et al’s (2004) replication included fMRI brain imaging showing activation consistent with orgasm. They postulate this is possible due to the vagus nerve, a cranial, not spinal, nerve with projections in the pelvis. Several studies including that one also used as stimuli penetrative vaginal-cervical stimulation, not clitoral.See Sipski et al 1995a and b; Whipple et al 1996; and Komisaruk et al 2004.

I actually think the research into women with Spinal Cord Injury (SCI) and ability to orgasm is pretty cool stuff - and incredibly promising for many women with SCI. The studies Ed includes here show that although spinal injury has occurred at a location and to an extent that would seem to indicate a lack of ability to orgasm, orgasm does still occur for many women with SCI. Sipski et al tends toward this having something to do with reflex autonomic activity and Komisaruk , and Whipple tend towards this having something to do with the Vagus nerve having a direct path from the cervix to the brain. 

Also, the approaches in these 2 articles were different. Sipski’s work compared SCI and non SCI women, finding that when left to their own devices to stimulate themselves to orgasm, all of the non-SCI and about 50% of the SCI women verbally reported orgasm within 75 minutes (although many as quickly as under 10 minutes). All but 3 of the women chose the clitoris as part of their preferred stimulation (the other 3 reported their stimulation as vaginal area. None reported vaginal penetration). Physiologic data including blood pressure, heart rate, and respiration were recorded and reported. Pelvic muscle contractions were recorded, but not reported - and it doesn't say why.

In the Komisurak, Whipple study, 5 women were given cervical stimulation (and it’s a particular kind of cervical stimulation that involves a pessary, which is kinda like a hard cervical ring that had to be sutured to the cervix. Then there is a piece on the pessary that can be attached to the cervical stimulator device that is inserted into the vagina. It sort of puts suction-y pressure on the cervix that the woman controls herself. It’s not your average vaginal stimulation, ya know?) and 3 of them verbally reported orgasm which was accompanied by an increase in brain activity in places the researchers felt, given some past studies, were consistent with what would be expected during orgasm.  Pelvic muscular contraction, heart rate, respiration, and blood pressure were not measured and neither was pelvic muscular activity. They suggest the Vagus nerve bypasses the spine and makes this possible.

The first study does not support the idea that any kind of inner vaginal stimulation causes orgasm. All the stimulation to orgasm in it was in the form of some kind clitoral/vulvar stimulation (although 3 seemed to be closer to the vagina than the clitoris). The 2nd article doesn’t even discuss it. The Komisurak,Whipple study supports a very type of particular type of cervical stimulation having some amount of direct pathway to the brain. It also found increased brain activity at the time women stimulating their cervix this way claimed to orgasm. However, as of yet there is no clear understanding of whether that brain activity is a reliable marker to indicate any particular kind of climactic sexual experience, much less the muscle contractions identified by M&J’s work (which were not tested for). There is also no understanding of what that brain activity correlates to physically, or if it correlates to anything physical at all.  None of these studies discredit the 2 statements in question.

The dildo problem[The sex shop called] Sh™  have an extensive lesbian clientele who have no motivation to pander to male egos, expectations or even existence in sexual terms. Thus they provide an interesting test of what women actually want, away from ideological constraint, voting with their wallets. A typical, although by no means universal, lesbian desire, as represented by products bought, is for penetration. For example the Fun Factory Strap-on™ provides internal stimulation for both (female) partners. If it were true that penetration in sex is something done only to pander to male egos then the existence of such toys requires explanation.

How exactly does this defy my explanation? I certainly never said penetrative sex is something done only to pander to male ego. I never even said women don’t like vaginal penetration. In fact I took great pains in the last two responses I wrote to Ed to make that point clear. Of course vaginal stimulation and penetration can be and often are desired, arousing, and well liked sexual activities. My beef is about people saying or insinuating that stimulation on the inner parts of the vagina – alone - cause orgasm. Women buying dildos doesn’t also mean they are orgasming from vaginal stimulation. I think that is obvious.

VIII. On sensitivity and innervationIt is argued that the vagina has little or no sensitivity, and therefore it is unlikely to be instrumental in orgasm, particularly compared to the highly sensitive clitoris. It is a fact that the vagina is not especially sensitive compared to other body parts. However, there are three reasons I think this argument is inadequate...

He’s got a valid point. The simple fact that the vagina has a lower amount of nerves doesn't automatically lead to the vagina's inability to induce orgasm. I admit I have used the lack of vaginal innervation in this way even though it's not a good argument. I have seen the errors of my ways, and I don’t do it anymore (even though it is mentioned in the movie…Sorry - I talk about that HERE). However it is still true that there is no positive evidence that stimulation of the inner vagina causes orgasm.

Appendix C

I further submit that M&J is not considered the “gold standard” among psychologists, psychiatrists and other researchers. Seminal, perhaps. But the reigning and authoritative model? Not hardly. One of the problems M&J stipulated themselves: the relationship between physiologic, psychological, and sociological factors is qualitatively and quantitatively “totally variable” from one woman to the next (p. 127). M&J focus on the physiologic, calling it an admittedly limited jumping off point that has a degree of objectivity, even if it does not capture the nature of the phenomenon.

It might not be the reigning and authoritative model on how people feel about orgasm or how they describe them or any other thing psychologists study, but it’s pretty fundamental to the physiologic understanding of orgasm and arousal. That’s pretty hard to deny. There is simply not another large study that recorded and described what the body does during sufficient sexual stimulation. It’s clear that Masters and Johnson understood that there were subjective psycho-social aspects to arousal and orgasm – things like; the way a person subjectively feels about their orgasm, how a person prefers to control their orgasmic response, what kind of noises a person makes, what stimulus halts the progression of arousal, and what stimulus increases arousal. The options are unlimited. These are not unimportant to a person’s experience. However, they don’t change the basic physical path the body takes.

If you read further in that passage Ed takes from above,

“Where possible, material presented reflects consideration of three interacting areas of influence upon female orgasmic attainment previously recognized in attempts to understand and to interpret female sexual response: (1) physiologic (characteristic physical conditions and reactions during the peak of sex tension increments); (2)psychological (psychosexual orientation and receptivity to orgasmic attainment); (3) sociologic (cultural, environmental, and social factors influencing orgasmic incidence or ability. The quantitative and qualitative relationship of these factors appears totally variable between one woman’s orgasmic experiences, and orgasm as it occurs in other women. Only baseline physiological reactions and occasional individually characteristic modes of expression remain constant from orgasm to orgasm, reflecting the human female’s apparent tendency toward orientation of sexual expression to psychosocial demand.”

It seems that M&J were actually saying that even with the incredibly variable psycho-sociol elements that make women’s relationship to orgasm quite diverse, the physiological markers of orgasm were the only constant. So, yes, to have a deep, full, complex understanding of what an orgasm is in the human experience is quite complicated and beyond Human Sexual Response, but to have a clear, detailed, seemingly universal understanding of what an orgasm looks like physically, is not that complicated at all and within the scope of Human Sexual Response.

Kaplan (1977) wrote that M&J did not even mention sexual desire! How can a coherent account of human sexual response neglect to consider sexual desire? As if sexuality and sexual experience is about quantified muscle contractions and blood flow.

I honestly don’t know how to be more clear about this. Sexuality and human sexual experience does not need to be quantified or described in order to understand what an orgasm is. An orgasm is an orgasm. Obviously sexuality and sexual experience is not merely about muscle contractions and blood flow, but the physical definition of an orgasm is very much about that.

Research has expanded in other directions as well. MRI and sonography have provided better understanding of the biomechanics of sex than M&J ever had. They wrote that the sole purpose of the clitoris was to create or elevate sexual tension by stimulation of the glans. This is almost certainly not correct. Research is on-going, but more recent studies suggest the erectile tissue of the clitoral complex helps tent the vagina for intercourse. During intercourse, the penis tends to compress the clitoral body and jam the anterior vagina against the root of the clitoris, causing a pumping action on the Kobelt plexus (Buisson et al, 2010).

MRI and sonography have certainly expanded on the understandings of biomechanics of sex. M&J actually did acknowledge their limitations in understanding the clitoris.

“It should be emphasized that the exact roles of the crura (clitoral legs), suspensory ligaments, and various muscle bundles in clitoral retraction have not been determined with total conviction.” (Masters 1966 p51)

I think these and other technologies could be promising in allowing observation of the physical reactions during intercourse in women who say they have orgasms from nothing more than inner vaginal stimualtion. Unfortunately, to date, these observations have never been made. The Buisson et al 2010 paper Clint speaks of was useful and interesting in that it did in fact show that in one couple the erect penis compressed the clitoral legs during intercourse. Although the woman in this study claimed that she regularly has vaginally induced orgasms (VIO), she nor her partner orgasm in this study, so it really gives us nothing but a possible future investigative direction when it comes to the question of what VIOs are, what stimulation is needed to attain them, and how the body reacts. And on a side note, the study doesn’t give a reason why the couple stops before orgasm. Wouldn’t it have been a great aspect to this study?

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]

Maybe women with more attractive men orgasm more frequently during intercourse, and maybe they don’t. It doesn’t matter to the physical definition of orgasm.  Just to humor it though, if this is meant to have something to do with the idea of a VIO, then it is a terribly inconclusive study on the topic. The questionnaires the women answered did not differentiate between orgasms from vaginal intercourse only and those caused with ancillary clitoral stimulation. It’s also a questionnaire without physical verification of these women’s answers, so any claims of VIO are subject to doubt.

Are There Different Types of Female Orgasm? [Link]

This is based on analysis of a questionnaire that 1) did not include physical verification for the women’s claims about how the event they describes as “orgasm” was achieved or what the physical reality of that event was, and 2) did not make a distinction between intercourse with ancillary clitoral grinding vs. intercourse with no ancillary clitoral stimulation. These results are an interesting look into how women describe a thing that they call orgasm, but that is it. It is not certain that experiences these women are speaking of have anything to do with each other in a physical sense, and if the scientific community is going to accept that anything any woman says is an orgasm should be defined as an orgasm, I would think that to be  incredibly confusing and problematic for getting any kind of meaningful understanding about female sexual response.

Genetic influences on variation in female orgasmic function: a twin study [Link]

This study indicates, using a traditional twin study questionnaire, that the variability in the ability to orgasm for women may be somewhere between 34 and 45% due to genetics. This is due to the fact that genetically identical twins answered questions about their ability to orgasm through masturbation and through intercourse more alike than sets of non-identical twins. As the authors say, this might be due to genetic qualities of the genitals or hormones or it might have to do with things like depression and temperament, so it’s an interesting angle to investigate further. However,  I’m not sure what it’s supposed to convince me of in relation to psychology and/or social elements changing the meaning of orgasm.

M&J took pains, several times, to spell out the importance of non-physical factors and influences: the psychosocial. To wit,A detailed psychosocial study of the research population cannot be presented within the framework of this text. Yet neither this book nor this chapter can be considered complete without emphasizing an acute awareness of the vital, certainly the primary influence, exerted by psychosocial factors upon human sexuality, particularly that of orgasmic attainment of the female. . . .physiologic detail is of value only when considered in relation to [behavioral theory and sociologic concept].M&J are saying that the physical signs are correlative indicators of orgasm, not that they literally are orgasm themselves. If you believe M&J is the “gold standard” (I would not recommend it), you should accept their contention that physiology is not the definition of orgasm.

What M&J are saying there is that social and physiological aspects are incredibly important to human sexuality and to the attainment of female orgasm – meaning the female’s ability to get to the point of having those muscle spasms we call orgasm. I would agree. In Human Sexual Inadequacy, their book describing research into therapy for sexual dysfunction, they were clear that arousal and orgasm are basic functions of the human body, but that psycho-social factors can easily put a stop to the physiological progression of sexual response. They were, as am I, quite aware that orgasm is attained and experienced through a filter of infinitely diverse psycho-social variables, but beyond “orgasmic attainment” there is an objective physiological aspect that is the physiologic orgasm. If you want to call that merely the indicator of an orgasm, I’m okay with that. I would call the blockage of oxygen rich blood to a section of heart muscle a heart attack. However, I’m okay with you calling it an indicator of a heart attack, given all the psycho-social elements that go into the lead up it

Asserting that it is of critical importance to one’s sexual experience the fact of whether the key sensors are in the vaginal tissue, or a couple centimeters away in the clitoral body that can often be smashed against it during penetrative intercourse, strikes me as pedantic and a little silly.

For the record, I don’t and wouldn’t argue whether the key sensors are in the vaginal tissue, clitoral legs sitting close to and being smashed by a penetrated vagina, nor even in the prostate tissue. I would argue they are on none of those and as yet have only been proved to be in and around the clitoral glans. However, if we do find that something within the vagina which seems to trigger orgasm also, I think it is absolutely of scientific import to clearly understand what the mechanism and what the key sensors are. I also think it is of personal import for many people, because knowing what the mechanism is can help people describe and teach how to attain orgasm this way.

Cited

1. Buisson, O., Foldes, P., Jannini, E., & Mimoun, S. (2010). Coitus as revealed by ultrasound in one volunteer couple. The journal of sexual medicine, 7(8), 2750-2754.

2. Barry R. Komisaruk, Beverly Whipple, Audrita Crawford, Sherry Grimes, Wen-Ching Liu, Andrew Kalnin, Kristine Mosier, 2004. Brain activation during vaginocervical self-stimulation and orgasm in women with complete spinal cord injury: fMRI evidence of mediation by the Vagus nerves, Brain Research, Volume 1024, Issues 1–2, 22. Pages 77-88.

3. Carmichael MS. Relationships among cardiovascular, muscular, and oxytocin responses during human sexual activity. Arch Sex Behav. 1994 Feb;23(1):59-79.

4. Catania L. Pleasure and orgasm in women with Female Genital Mutilation/Cutting (FGM/C). J Sex Med. 2007 Nov;4(6):1666-78.

5. Fazari AB et al. Reconstructive surgery for female genital mutilation starts sexual functioning in Sudanese woman: a case report. J Sex Med. 2013 Nov;10(11):2861-5

6. Lightfoot-Klein, Hanny, 1989. The Sexual Experience and Marital Adjustment of Genitally Circumcised and Infibulated Females in the Sudan. The Journal of Sex Research. Vol. 26, No. 3, pp. 375-392.

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

8.Masters, W and Virginia Johnson. Human Sexual Inadequacy. Little, Brown and Co., Boston, 1970.

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

10.M. Sipski, C. Alexander, R. Rosen, 1995a. Orgasm in women with spinal cord injuries: a laboratory-based assessment. Arch. Phys. Med. Rehabil., 76, pp. 1097–1102.

11.M.L. Sipski, C.J. Alexander, 1995b. Spinal cord injury and female sexuality. Annu. Rev. Sex Res., 6 (1995), pp. 224–244.

12. Nour et al. Defibulation to Treat Female Genital Cutting: Effect on Symptoms and Sexual Function. Obstet Gynecol 2006;108:55–60

13. B. Whipple, C.A. Gerdes, B.R. Komisaruk, 1996. Sexual response to self-stimulation in women with complete spinal cord injury J. Sex Res., 33, pp. 231–240.

14. World Health Organizations. Classifications of female genital mutilation.
 http://www.who.int/reproductivehealth/topics/fgm/overview/en/ Accessed January, 14 2014.