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Leaving a lot to be desired? Sex therapy and the discourses of heterosex

In this thesis I explore the social construction of sexuality and sexual dysfunction.
Interviews were undertaken with 20 sex therapists practising in Aotearoa/New Zealand
in order to elicit accounts of contemporary sex therapy practice in the local context.
Using a feminist poststructuralist lens, I explicate and critically examine the dominant
discourses informing the construction of sex therapy, and heterosexual sexual
relations, and what these discourses enable and constrain. I draw attention to some of
the assumptions embedded in the construction of the sexual dysfunctions in the
Diagnostic and Statistical Manual of Mental Disorders (DSM-IV-TR, APA, 2000),
and in accounts of sex therapy practice, examining the ways in which these are based
on taken-for-granted norms of (hetero)sexuality and highlighting the differently
enabled gendered sexual subjectivities they (re)produce. Although there are nine
sexual dysfunctions identified in the DSM-IV-TR, all of which I briefly outline in
Chapter Four, I restrict my focus in the analytical chapters to the conceptualisation and
treatment of vaginismus, orgasm difficulties in women, discrepancies in desire and,
relatedly, the gendering of desire through powerful sociocultural discourses and
representations. I pay particular attention to the implications of these for heterosexual
women’s sexuality. I also explore some of the generic concepts that dominate the
construction of therapy at a broader level than that of sex therapy alone, arguing that
while these offer some useful ways of framing therapy they also constrain therapy
practice in important ways.
Through a critical review of the sex therapy literature and accounts of practice from
those interviewed, I contend that contemporary sex therapy tends to reify dominant
cultural and sexological norms rather than challenge them. My analyses show that the
dominant discourses informing constructions of sex therapy and heterosexual sexual
relations produce particular types of sex as normal whilst marginalizing sexual acts or
practices that fall outside of such restrictive parameters. In particular, I argue that the
genital-coital-orgasm construct that is hegemonic within sex therapy restricts
possibilities for alternative erotic pleasures and possibilities amongst heterosexuals
whilst contributing to the invisibilization of sexual identities other than heterosexual. Accounts of sex therapy practice that were able to contest such framings are also
highlighted. Because these came from sex therapists drawing on radical feminist or
feminist poststructuralist discourses, I suggest that these discourses offer important
possibilities for a deconstructive (sex) therapy practice that is able to challenge an
often inequitable sexual status quo. Attention is also drawn to the significant
constraints which act to restrict clients’ choices and possibilities for sex therapists to
practise in more critically questioning ways. I conclude this thesis with an ‘invitation
to reflection’ where I briefly discuss some deconstructive approaches that I have found
useful for developing ongoing reflexive analysis of my own taken-for-granted
assumptions in the area of sexuality, and for aiding my thinking about therapeutic
practices that support my political and theoretical commitments and that attend to
some of the issues outlined in this thesis. / Whole document restricted, but available by request, use the feedback form to request access.

Identiferoai:union.ndltd.org:AUCKLAND/oai:researchspace.auckland.ac.nz:2292/3454
Date January 2009
CreatorsGuerin, Bernadette M.
ContributorsAssociate Professor Nicola Gavey, Dr. Virginia Braun
PublisherResearchSpace@Auckland
Source SetsUniversity of Auckland
LanguageEnglish
Detected LanguageEnglish
TypeThesis
RightsWhole document restricted but available by request. Items in ResearchSpace are protected by copyright, with all rights reserved, unless otherwise indicated., https://researchspace.auckland.ac.nz/docs/uoa-docs/rights.htm, Copyright: The author
RelationPhD Thesis - University of Auckland, UoA1871238

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