Dr. Sara McClelland, an Assistant Professor in the psychology department at University of Michigan, recently published an article in Sexuality Research & Social Policy titled “Who is the “Self” in Self Reports of Sexual Satisfaction? Research and Policy Implications” that addresses the clinical, research, and policy implications of relying on sexual satisfaction as a measure of well-being.
Sexual satisfaction defined
Positive affect has been a common focus of definitions of sexual satisfaction, and McClelland offers an overview of the various ways in which sexual satisfaction has been defined thus far in the literature. However, she did offer one common theme underlying all of the definitions:
“The common theme that unifies these definitions is the assumption that feeling satisfied is a subjective experience and that the appraisal of satisfaction rests within the person and emerges from the idiosyncratic experience”
However, this article discusses how this assumption of subjectivity may be inaccurate. Especially when sexual satisfaction has become influential in public policy in the area of female sexual dysfunction.
Why does it matter?
Many researchers use measures of sexual satisfaction in clinical settings and sexual satisfaction has increasingly become a clinical threshold of sorts that has been used as part of the assessment of sexual problems and sexual dysfunction.
Female Sexual Dysfunction (FSD) has been a hot topic in the pharmaceutical world for some time now. I’ve written posts such as “A Little Pink Pill? Medicalizing Women’s Sexuality” or “Potential Impact of ‘Desire Drug’ on Women’s Sexuality” and “Placebo Elicits Improvement on Women’s Sexual Satisfaction” that outline some of the reasons for that focus. In McClelland’s article, she argues that the FDA’s reliance on sexual satisfaction as a guide for decisions about clinical interventions may be problematic.
There are a lot of really great details (that are a little dense for a blog entry) that can be found in the original article such as a case study on the Flibanserin drug approval attempt and a wealth of information on how the FDA and public policy are related to sexual satisfaction.
This was a mixed-method study, which means it incorporated both qualitative (e.g., interviews) with quantitative (e.g., questionnaires or surveys) methodology. McClelland collected data in the form of semi-structured interviews and close-ended survey measures of sexual satisfaction from 41 men and women in order to assess the cognitive and interpersonal strategies individuals used when asked about their own level of sexual satisfaction.
One great feature of this study was that it recruited participants for four groups of interest: heterosexual men, heterosexual women, sexual minority (e.g., LGBT) men, and sexual minority women. These were the demographics in terms of those conditions:
- 46.3% men
- 51.2% women
- 2.4% trans
- 56.1% heterosexual
- 43.9% lesbian/gay/bisexual/queer/all
Having this rich qualitative data paired with the more generalizable quantitative data offers a combination that has been shown effective at examining the strengths and weaknesses of available measures. Data triangulation was employed in this study, where both the qualitative and quantitative portions were collected at the same time so they could then be compared and contrasted.
There were differences found in terms of how participants assessed their sexual satisfaction. Some participants did use subjectively derived criteria (as is assumed by many measures of sexual satisfaction). However, interestingly, some participants looked instead toward their partner’s level of sexual satisfaction to assess their own – thereby not using the subjectivity that is sometimes an underlying assumption of measuring sexual satisfaction. More interesting findings:
- Closeness felt with a partner was sometimes used as a proxy for sexual satisfaction
- Partner’s sexual satisfaction level was sometimes used as a proxy for own sexual satisfaction
- “Doing a good job” was sometimes used as a proxy for level of sexual satisfaction
Interestingly, presence of self-orgasm was used mainly by men as a proxy for sexual satisfaction (both heterosexual and LGBT), but not for women. Women relied on their partner’s orgasm instead of their own and tended to rely less on physiological indicators of satisfaction.
Overall, this is a very important addition to the literature on sexual satisfaction. At the micro level, it can challenge us to ensure we define our constructs of interest in a way that is accurately portrayed in the data we collect, which may require more vigorous psychometric evaluation of our measures. At the macro level, it may have policy implications in changing the way the FDA and clinical trials define success when it comes to sexual dysfunction.