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Disorders Of DesireReview - Disorders Of Desire
Sexuality And Gender In Modern American Sexology (Revised and Expanded)
by Janice Irvine
Temple University Press, 2005
Review by John Z. Sadler, M.D.
Dec 5th 2006 (Volume 10, Issue 49)

In 1970 I was a sophomore in a small-town Midwestern high school.† The only things to do on weekends were to get into trouble, hang out at the Burger Chef, play in a band, or read.† As a young nerd I had been reading Psychology Today for about a year, and had joined the Psychology Today Book Club.† The Club posted to me first-editions of books from the likes of R.D. Laing and Abraham Maslow.†† Apparently my parents were more progressive than I remember them today, because I had access to any Club book, and I had ordered a two-volume set of Masters and Johnson's Human Sexual Response and Human Sexual Inadequacy, which I read with complex mix of adolescent-hormonal prurience, wonderment, and curiosity.† I remember seeing Masters and Johnson in LIFE magazine and TV in their pristine white-coat uniforms, but what I remember most was the admiration and praise for their pioneering work in human sexual physiology.† I said I was naive, didn't I?

More recently, the biopic Kinsey and now Janice Irvine's social history of sexology has restimulated memories of this time of my life, but in my teen years I hadn't a clue about the substantial controversy surrounding the discipline of 'sexology' - the science of sex and sexuality. Reading this book by Professor Irvine was like revisiting my intellectual adolescence with the perspective of mature adulthood.†† I had the sense of remembering historical events, but now with an expanded consciousness of the ramifications.† However substantial, this was a fun book to read.

Irvine starts her detailed discussion of sexology's turbulent history with Kinsey, while mentioning earlier figures like Magnus Hirschfeld, Richard von Krafft-Ebing, and Havelock Ellis. †Through an analysis of Kinsey's white, largely heterosexual, upper-middle class research population, she establishes a major theme, the value-ladenness of sexology, one which persists strongly throughout the rest of the book. †In the second chapter she discusses Masters and Johnson's work in the context of medicalization and market forces, which she establishes, here and later, as an important aspect of sexology's impact on the public at large.† She identifies the split between medical and humanistic sexology as the key schism in Chapter Three, and situates humanistic sexology in the broader context of west-coast humanistic psychologies and therapies (e.g., Rogers, Maslow, Wilhelm Reich, and Esalen), as well as the larger cultural trends of the sixties and seventies: distrust of establishment authority, phallocentric sexual experimentation, multiple partners, and the marginalization of 'relationship' values like commitment, emotional intimacy, and sacrifice.† She intriguingly notes the 'heteronormativity' of both the medical and humanistic sexologies; despite the rise of gay awareness, sexual politics, and the emergence of transgenderism.† These political themes are developed more explicitly in Chapter Four, where she describes the tensions between sexology and the various feminisms, lesbian/gay liberation, and (later) social or cultural theorists like Foucault.† Three sexology landmarks, the 'Hite Reports', the 'G-Spot' research, and the appearance of AIDS, raise Chapter Five's question of 'Who defines sexuality?'.† I remember, even as a youth, the controversy evoked by Shere Hite's unconventional surveys of women's sexualities, and especially the attacks on her scientific credibility and feminist responses to these attacks.† What Irvine draws out, here and elsewhere, is that while sexology provoked people because of its value commitments, what tended to be attacked, publicly and professionally, was the 'science,' however defined.†† Chapter Six opens with a quotation from a sex therapy client that, to me, sums up sexology's problems: 'I know every way is normal.† Tell me which way is right.' (p. 140)† Irvine details the debates about 'what is normal' in sexuality and how medical and non-medical sex therapists cloaked their claims about sexual normality in the rubric of an allegedly value-free science.† This motif leads naturally into Chapter Seven's discussions of the development of 'inhibited sexual desire' and 'sexual addiction' as mental disorders.† Chapter Eight considers the emergence of 'gender' as a concept in relation to sexuality, and explores the blossoming of gender research, both scientific and 'humanities' oriented, as well as the emergence of gender-related disorders and the contrare appearance of transgenderism as an identity as well as a movement.† In the Afterword, (which appears to the most substantive change from the first edition, though I haven't read the latter), Irvine considers sexuality-related phenomena from the 1990's to the present, from the Viagra revolution to a careful consideration of the extensive politicization of sexuality in the past decade.†

Irvine writes clearly and engagingly - an impressive accomplishment considering the complexity of the history and the sophistication of her insights.† While I cannot claim any expertise in sexology or social history, her scholarship appears even-handed, perhaps even austere– one only gets a clear sense of her perspective in the Afterword and in a very few single sentences and phrases in the chapters. Irvine, however, does make a convincing case that medical or psychological accounts of sexuality and gender reflect powerful social forces, however unacknowledged they may be by sexologists.† Readers will be left with the conclusion that sexology needs to gets its value-priorities in order, that it has an unmade bed.

I have relatively few criticisms of substance.† I think the issues of Viagra, gender, and sexual enhancement deserve more extensive attention.† If there is a significant omission in the intellectual territory described by Irvine, I think she has neglected the role of the internet and Web in redefining gender identity, sexualities, and the like.† People today, especially Westerners, explore sexualities and genders online.† What does this mean for us?

As a scholar interested in values in psychiatric diagnostic classification, Irvine's book left me with stimulating questions.† The book's story arc, in implication, dismantles the idea that normalcy emerges from biostatistical averages, and repeatedly illustrates how value assumptions undergird clinical concepts and practices.† What remains unanswered by Irvine's book is the question of what values sexology should adopt in pursuing its studies.† For example, are binary divisions of sex (or gender!) the standard for 'normalcy'?† If there are few to no standards for sexual normalcy, should standards be developed?† By whom?† If there is only sexual/gender diversity, then what would be the basis of a 'clinical' practice of sex therapy (or sex surgery)?† What would be the basis for sexual disorders?† Will sexology ever address its own values, and to what effect?


© 2006 John Z. Sadler


John Z. Sadler, M.D. is Professor of Psychiatry and Clinical Sciences at the University of Texas Southwestern Medical Center at Dallas, and the author of Values and Psychiatric Diagnosis (Oxford University Press).


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