What if I just don't feel like having sex?

I went to a spectacular lecture last year by Leonore Tiefer, founder of the New View campaign. Ms Tiefer, amongst other things, is a sex therapist who works with people having problems with their sex lives, for whatever reason. The New View campaign was established because:

The pharmaceutical industry wants people to think that sexual problems are
simple medical matters, and it offers drugs as expensive magic fixes. But sexual
problems are complicated, sexuality is diverse, and no drug is without side
effects.
The goal of the New View Campaign is to expose biased research and
promotional methods that serve corporate profit rather than people's pleasure
and satisfaction. The Campaign challenges all views that reduce sexual
experience to genital biology and thereby ignore the many dimensions of real
life.

Ms Tiefer's particular focus has been the creation of pharmaceutical solutions to women not wanting to shag as often as we're supposed to. Yep, really. There's been a disorder about it and everything. Since 1997, medical types have been talking about "Female Sexual Disorder". The first time was at an invite-only sexologist conference funded by pharmaceutical companies, where they agreed no one agreed if this even existed.

Nevertheless, pharmaceutical companies put loads of dosh into finding a "solution". First Pfizer's "female Viagra" came belly-up, despite seven years worth of trials, when their magic shagging pill didn't work any better than a placebo.

Commenting on these trial results on Viagra, John Bancroft, director of the Kinsey Institute, told the BMJ: “The recent history of the study of female sexual dysfunction is a classic example of starting with some preconceived, and non-evidence based diagnostic categorisation for women's sexual dysfunctions, based on the male model, and then requiring further research to be based on that structure. Increasingly it is becoming evident that women's sexual problems are not usefully conceptualised in that way."

The drugs companies kept trying. Next along came Proctor and Gamble, with a testosterone patch called Intrinsa to make us all horny as hell. Sadly, again, it didn't actually work, nor was it deemed clinically safe enough for release by the FDA. More recently, Boehringer Ingelheim's Flibanserin failed to boost women's desire more than a placebo, and was also turned down by the FDA.

In order to create a need for intervention, pharmaceutical companies have consistently stated that as many as 1 in 10 women are suffering from low sexual desire. Quite where this figure comes from, or what it actually means is rarely explored. It is taken as given that if women don't want to be having "sex", then there is something wrong, and that something can be fixed with a magic pill.

I've said this many times before. Whether or not you feel like sex - assuming you are not wrestling with depression; getting used to early motherhood and the sleep deprivation that entails; or in a situation where consent is impossible, for whatever reason - whether or not you feel like sex is enormously dependent on what sex means. And given how lacking in imagination much advice to women having sex with men is, could any woman be blamed for feeling less than enthusiastic?

How about this advice from Women's Health? Sex life a bit stale? Try "maintenance sex", or as their experts explain, "meat and potatoes sex".

On the nights you’re too drained for long, drawn-out foreplay, boil it down to a couple of well-placed caresses that you can count on to expedite arousal. When you’re both riled up enough for intercourse, the goal is to orgasm – fast. To that end, choose O-friendly positions that lend themselves to clitoral contact. Woman on top is your best bet because it lets you control the pace, but don’t count out positions that allow for manual stimulation (side-by-side, from behind).
“You don’t want this to be the only way you have sex, but you should have it a lot,” says Dr Schwartz. “So if you’re having sex four times a week, maintenance sex should account for two or three of those times.”

Thank the goddess I'm vegetarian - because this would bore me stupid, and I'm fairly certain I'm not suffering from low female sexual desire. Aside from the (welcome but not always the be all and end all) instruction to have an orgasm as (less welcome) quickly as possible, is this really any different from women being told to lie back and think of England because their husbands need it?

And the other three kinds of sex which will keep you coming back for more according to Women's Health are not much better I'm afraid.

When this is all sex means, why should we want it? What if we were to reimagine the whole shebang, and come up with some more exploratory ideas of both activities and desires? This doesn't mean I'm suggesting every sexual encounter needs to be a full opus to be worth reading - but nor should it only ever be a short story.

And if you're a sex therapist calling everything other than intercourse "foreplay", you probably need another job. Or to go get some supervision from Leonore Tiefer.