The Psychophysiology of Sex

How Do Men and Women Feel? Determinants of Subjective Experience of Sexual Arousal

How Do Men and Women Feel? Determinants of Subjective Experience of Sexual Arousal ellen laan and erick janssen According to one of the founding fathers of psychology, William James, bodily responses and emotional experience are two sides of the same coin (James, 1884). In James’s theory, bodily (visceral) changes follow directly the perception of the emotional stimulus, and “our feeling of the same changes as they occur IS the emotion” (p. 190). James’s position implies that, in order for bodily changes to take this central role, they need to be consciously perceived and processed. What is more, without these bodily changes, “a cold and neutral state of intellectual perception is all that remains ” (p. 193). Recent cognitive neuroscience perspectives acknowledge that bodily changes are an apparent aspect of emotional response. According to Damasio (2003), feelings consist, among other things, of “the perception of a certain state of the body” (p. 86). The question is, however, to what extent bodily changes contribute to emotional experience and whether this contribution is similar in men and women. James’s theory appears less appropriate for women than for men with respect to the experience of sexual emotions. A review of the literature on female sexual arousal reveals that there is little agreement between reported genital sensations and changes in genital vasocongestion (Laan & Everaerd, 1995a). Across studies, between- and within-subjects correlations between changes in genital vasocongestion and subjective sexual arousal range from signi¤cantly negative, to nonsigni¤cant, to signi¤cantly positive. In contrast, correlations between genital and subjective sexual arousal in men are usually signi¤cantly positive, despite differences in methodology and procedures. Studies designed to compare female and male sexual arousal patterns in one experimental design, thus precluding methodological variation, consistently report higher correlations in men than in women (cf. Dekker & Everaerd, 1988; Heiman, 1977; Steinman, Wincze, Sakheim, Barlow, & Mavissakalian, 1981; Wincze, Venditti, Barlow , & Mavissakalian, 1980). A very recent study found that the association between genital and subjective sexual arousal was lower for women than for men and postoperative male-to-female transsexuals (Chivers, Rieger , Latty, & Bailey, 2004). Anecdotal evidence suggests that discrepancies between genital response and sexual feelings are not limited to laboratory situations. Accord278 ing to reports of subjects, therapists, and patients, women may notice that they have increased vaginal lubrication, but in such instances often do not experience any feelings of sexual arousal, nor any inclination to engage in sexual activity. Other anecdotal evidence suggests that during rape or other types of sexual abuse women may notice increased vaginal lubrication even though they ¤nd the situation highly aversive. There have even been reports of women having had an orgasm during such situations (Levin & van Berlo, 2004). This paper reviews possible explanations for the observed gender differences in agreement between genital response and sexual feelings and offers some tentative answers to the question of what, if not genital response, determines the experience of sexual arousal in women. Measurement Artifacts A number of explanations have been forwarded to explain the low correlations between genital response and sexual feelings in women. The most obvious one is measurement error of instruments designed to assess vaginal vasocongestion. However, low correlations between genital response and sexual feelings are not restricted to a single measure of genital response (e.g., Slob, Bax, Hop, Rowland, & van der Werff ten Bosch, 1996). Heiman and colleagues compared the most often used instrument to assess vaginal vasocongestion, the vaginal photoplethysmograph, with pelvic MRI during erotic ¤lm (Heiman et al., 2001). They found that correlations with MRI were even lower than with the vaginal photoplethysmograph. The discrepancy between genital arousal and sexual feelings in women is not affected by the way in which sexual feelings are assessed (by Likert scales to be ¤lled out directly after exposure to an erotic stimulus, or by continuous measures with which the intensity of feelings can be assessed concurrent with erotic stimulus exposure) or which sexual feelings are measured (from a single item about sexual or genital sensations to extensive emotion questionnaires with a wide range of possible sexual feelings). Anatomy or Sensitivity? Many men seem to infer their sexual feelings from changes that take place in their genitals (Sakheim, Barlow, Beck, & Abrahamson, 1984), which is what William James suggested we all do. When it comes to sexual arousal, men are likely to have more cues they can use to detect genital response than women do. Think, for instance, of visual feedback, or tactile feedback when an erect penis is pressing against clothing. It is...