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Ask psychologists or other clinicians to define female sexual dysfunction, and you're likely to get different answers and some heated discussion.

The Diagnostic and Statistical Manual of Mental Disorders (DSM) first tackled what it called men's and women's "psychosexual dysfunction" in its 1980 edition, revised the section in the 1987 edition and expanded the list of sexual dysfunctions in the current 1994 edition. According to the DSM-IV, sexual dysfunctions consist of disturbances in the processes of the sexual response cycle or pain during intercourse. For women, the list of specific diagnoses now includes hypoactive sexual desire disorder, sexual aversion disorder, sexual arousal disorder, orgasmic disorder, dyspareunia, vaginismus and sexual dysfunctions caused by medical conditions, substance use or other unspecifed causes.

The World Health Organization's (WHO) International Statistical Classification of Diseases and Related Health Problems, 10th Revision, defines sexual dysfunction as people's inability to participate in sexual relationships as they wish. Specific diagnoses include lack or loss of desire, sexual aversion and lack of sexual enjoyment, vaginal dryness, markedly delayed or nonexistent orgasm, vaginismus and dyspareunia not attributable to physical problems and excessive sexual drive.

In 1998, sex experts came together at the pharmaceutical industry-funded International Consensus Development Conference of Female Sexual Dysfunction to craft a new classification system. Drawing on the DSM-IV and WHO's classifications, they grouped various problems into four broad classes of distress-causing disorders: a persistent absence of desire, inability to get or stay excited, difficulty achieving orgasm and pain associated with stimulation or intercourse. They published their conclusions in the Journal of Urology (Vol. 163, No. 3).

The New View Campaign and other critics note, among other problems, that these systems assume that women's sexual experience follows the male model of desire, excitement and orgasm. Instead, the New View defines women's sexual problems as discontent or dissatisfaction with any of the emotional, relational or physical aspects of sexual experience. Countering the reduction of sexual experience to what it calls "genital biology," the campaign gives clinicians a way to explore and address all the real-life dimensions that affect women's desire.

—R.A. Clay

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