According to sex researcher Emily Nagoski, our culture’s tendency to consider men’s sexual experience the standard perpetuates a lot of misinformation about what’s sexually normal and healthy for women. This tendency forces women to view themselves through a scope that wasn’t made for them, ultimately inflicting harm to their sexual health and well-being.
(Shortform note: These false ideas about what’s normal with regards to women’s sexual experience stem from a long history of contempt toward female sexuality, even in the medical field. Research examining attitudes toward female sexuality demonstrates that, as recently as the 19th century, doctors were advocating for clitoridectomies to "cure" masturbation and nymphomania.)
Nagoski believes that to put an end to these misguided cultural standards and the damage they cause, women must better understand the science behind their sexuality. She says that by viewing their sexuality from a scientific rather than cultural perspective, women can free themselves from unrealistic standards, learn to appreciate their sexuality for what it is, and ultimately improve their overall well-being.
(Shortform note: In advocating for a scientific perspective, Nagoski doesn’t acknowledge how difficult it can be to identify factual scientific information in an environment that allows for the quick and easy spread of misinformation and pseudoscience. For example, in 2017, the popular wellness website Goop was sued for making false claims about a product it claimed could improve your sex life just by inserting it into the vagina for hours at a time. After many customers had already purchased the product, a lawsuit ultimately condemned Goop’s claims as counterfactual, and health experts warned that using the product could cause bacterial infections.)
With this in mind, we’ll first cover the basics of anatomy and the mechanism in our brain that governs our sexual response. Then, we’ll discuss the influence of context on our sexual experience, the concepts of arousal, desire, and orgasm, and how to find true enjoyment in sex by cultivating confidence and joy in ourselves.
According to Nagoski, both men’s and women’s genitalia have the same origins, stemming from the same embryonic tissue. However, these organs ultimately develop in unique ways, take distinct shapes, and serve different functions depending on a person’s sex. For example, according to Nagoski, the male equivalent of the clitoris is the penis. Whereas only the head of the clitoris is visible outside of a woman’s body—as the rest extends far inside—much of the penis is visible outside of a man’s body.
(Shortform note: The fact that Nagoski points out the true size and shape of the clitoris is important, as many people don’t realize just how far it extends into the body. In fact, it took until 1981 for any health body to create an anatomically correct diagram of the clitoris, and many school textbooks don’t even mention this organ, let alone explain its true size and shape. This persistent misinformation and misconception support her argument for the need for a biological understanding of female genitalia.)
Nagoski argues that their differences in appearance have everything to do with their differences in function. Whereas the clitoris is only responsible for sensation, the penis is responsible for sensation, penetration, ejaculation, and urination. (Shortform note: Nagoski doesn’t elaborate on why these differences in function lead to differences in appearance. The penis must extend further than the clitoris as it must be long enough to penetrate and ejaculate into the vaginal canal, which is inside a woman’s body.)
Nagoski tells us that just as men and women have similar parts organized in different ways, female genitalia, too, can vary a lot from woman to woman. In particular, she notes that the size, shape, and even color of everything from the clitoris to the labia can differ greatly depending on the person. Understanding this from a biological perspective can help women realize that whatever the unique appearance of their genitalia, they’re normal and healthy.
(Shortform note: While Nagoski specifically mentions women here, men have a lot of genital variation too. For instance, the penis and scrotum can differ in size, shape, and color in much the same way as female genitalia. What’s more, men also face feelings of shame about the appearance of their genitals—for instance, the size of their penis—that stem from a toxic and pervasive standard for what it means to be masculine.)
Next, Nagoski tells us that according to a groundbreaking theory developed by sex researchers at the Kinsey Institute, everyone is born with a two-system mechanism in the brain that determines their unique sexual personality. The two systems are called the Sexual Excitation System (SES) and Sexual Inhibition System (SIS):
According to Nagoski, the Sexual Excitation System (SES) is responsible for the process of arousal. It constantly scans our environment for potential sexual stimuli. (Common examples could be the scent of cologne or seeing our partner in a bathing suit.) When the SES identifies sex-related stimuli, it sends a signal from our brain to our genitals so that our body can prepare for sex.
In contrast to the SES, Nagoski says that the Sexual Inhibition System (SIS) controls the process of impeding arousal. The SIS scans our environment for reasons not to have sex (for example, the risk of unwanted pregnancy) and sends a signal to our brain when something relevant is identified.
Nagoski tells us that each individual’s SES and SIS have different levels of sensitivity to stimuli in the environment that determine a person’s particular sexual needs. For example, someone with a sensitive SES wouldn’t need nearly as many (or as specific) stimuli to become aroused as someone with an insensitive SES.
(Shortform note: Nagoski tells us that each individual’s level of sensitivity varies, but she doesn’t discuss which factors contribute to those differences. According to the Kinsey Institute for Research in Sex, Gender, and Reproduction, which developed the two-system model, each person’s sensitivity levels depend on both genetic and environmental factors, including their unique sexual physiology, history, and personality.)
Further Analysis of the Two-System Mechanism of Sexual Response
As Nagoski points out, the two-system mechanism developed by the Kinsey Institute was highly influential in the field of human sexuality. This is evidenced by a variety of factors: First, it’s been widely applied in research across the world, including studies in Belgium, Italy, Portugal, and Australia. In addition, it’s impacted pharmaceutical research related to sexual dysfunction, leading to the proposal of new treatment options. Mainstream news outlets such as CNN and Psychology Today have covered it, as well as a variety of online health websites. Finally, it features in the popular human sexuality textbook, Sexuality Today.
However, although the theoretical model was undoubtedly groundbreaking and influential, its development wasn’t flawless. Initially, its foundational research was conducted solely on men: The model was first proposed as part of a 1999 study on male sexual inhibition. From there, Kinsey researchers continued their exploration of the model by considering its implications for the treatment of erectile dysfunction as well as using it to predict and measure male sexual response. It wasn’t until the 2000s that Kinsey researchers began to consider the experience of women in relation to the model. The lack of female representation in these earlier studies is indicative of the larger, ongoing issue of male-centric medical research we mentioned previously.
Nagoski also tells us that contextual factors, such as who we’re with, potential risks, and even our mood, can make something that’s normally a turn-on have little effect (or even the opposite effect) on our arousal. But why exactly does this happen and how does the process work? Research shows that it’s all about how our brain processes the environment around us: If we perceive it to be comfortable and safe, Nagoski says our brain will almost always see stimuli as pleasurable enough to warrant desire. On the other hand, if we perceive the environment to be stressful or dangerous, our brain will almost always approach the stimuli with avoidance and anxiety, even if they would usually arouse us.
(Shortform note: Here, Nagoski’s discussion of the role of context focuses exclusively on sexual response. However, context influences far more than our brain’s perception of sexual stimuli—in reality, it shapes the way we process all types of information. One example of context’s role in information processing is the way it influences our interpretation of emotions through facial expressions. For instance, we’re likely to perceive the emotion behind a photo of a crying woman as sadness. However, if we were to add context by broadening the scope of the photograph to reveal a man on one knee with an engagement ring in hand, our interpretation of the emotion would change to happiness.)
Although context plays a role in everyone’s sexual response, Nagoski states that research shows that women are more sensitive to it than men, especially mood and relationship factors. While on average women respond best to contexts that are low stress, high affection, and explicitly erotic, there’s variation from woman to woman and situation to situation.
(Shortform: Research suggests that the reason for women’s higher level of sensitivity to context relates to parental investment theory, which predicts that the parent who’s more invested in raising their offspring will be more sexually selective. In other words, because women have historically taken a more active role in raising their children than men, they’ve developed a higher sensitivity to contextual factors that might inhibit sexual response, such as having sex without a condom.)
According to Nagoski, emotional factors like stress and love are important contextual factors that impact not only our sexual response but also our overall sexual experience and well-being. Let’s explore each of these factors in detail.
According to Nagoski, stress is a process or system of changes in our minds and bodies that occurs in response to threats. Although it used to be an evolutionary adaptation to respond to real, life-threatening situations—a lion chasing us—these days, it’s a response to more subtle and ongoing things that threaten our well-being, like bills to pay. Nagoski argues that such long-lasting stress can have various negative effects on our sexual response, including reducing physical arousal and interest in sex.
(Shortform note: Although Nagoski herself doesn’t go into detail about why stress affects sexual response, other sources point to some possible answers. For instance, hormonal changes could be responsible for reducing interest in sex during stressful periods. When our bodies produce more of the stress hormone cortisol, the production of testosterone—the hormone that most greatly impacts desire levels—is simultaneously reduced. Additionally, relational factors may play a role: When we’re stressed, we tend to close ourselves off from our partner, which negatively impacts intimacy and desire for sexual contact.)
Nagoski suggests that to prevent our ongoing stress from inhibiting our sexual response, we must take deliberate steps to allow our bodies to complete the stress cycle, therefore ridding itself of the adrenaline and cortisol. Although physical activity is the most efficient way of accomplishing this, Nagoski recognizes sleep, affection, meditation, crying, screaming, art, and even grooming rituals as effective ways of managing stress.
Lifestyle Changes for Managing Stress
Other researchers support Nagoski’s claim that activities like exercise, sleep, affection, meditation, and hobbies like art can reduce the adrenaline and cortisol in our systems. They also back up her assertion that methods of venting such as crying (which helps to expel cortisol from our system) and screaming (which releases tension) are useful stress relievers.
However, the ongoing nature of stress tends to keep our daily stress level high, meaning that even after completing the cycle as Nagoski suggests, the adrenaline and cortisol are likely to return fairly quickly. To supplement Nagoski’s recommendations, here are some lifestyle changes you can make to keep your stress at a manageable amount: You might try to focus on the positive things in life, take a break from social media to avoid the negativity often present in online spaces, or simply take a break from the things bringing us stress (for instance, work).
Nagoski tells us that love is the innate process that bonds us with other people—whether they be friends, caretakers, or romantic partners—and that the name for this bonding process is attachment. Nagoski argues that depending on how our caregivers cared for us as children, we develop different styles of attachment that not only dictate our behavior in our romantic relationships but also affect our sexual experience: If our primary caregiver was a reliable source of love and safety, we will likely develop a secure attachment style, which often leads to more frequent and enjoyable sex. On the other hand, if our caregiver wasn’t dependable, we will likely develop an insecure (anxious or avoidant) attachment style, and our sex lives will suffer.
Attachment Style Characteristics
Although Nagoski identifies the three types of attachment styles, she doesn’t discuss the general characteristics of each type and how they lead to a specific kind of sexual behavior.
According to the book Attached, individuals with a secure attachment style are loving partners who are comfortable with intimacy and communication. These characteristics naturally lead to healthier and more enjoyable sex because having a close and vulnerable relationship with your partner makes it easier to experience pleasure during sex.
On the other hand, those with an anxious attachment style are plagued by low self-esteem and constantly worry about the state of their relationship. Because of this, they tend to use anything they can to become more attached to their partner—including sex—and their fear can turn sex into something emotionally painful rather than enjoyable.
Finally, people with an avoidant attachment style are emotionally distant and threatened by intimacy. They don’t like to talk about their feelings and have a strong preference for autonomy. It’s this inclination toward independence and avoidance of emotional intimacy that ultimately leads to less frequent and more casual sex.
According to Nagoski, cultural context also impacts our sex lives. Whether we’re aware of it or not, culture dictates our beliefs and ideals, including how we feel about sex. Women in particular grow up hearing a lot of negative messages about sex, which creates deep-seated feelings of shame and fear that can be detrimental to their sexual experience and well-being.
(Shortform note: Men, too, develop feelings of shame due to negative cultural messaging. Research shows that there are several factors comprising men’s sexual shame, including distress about their sexual inexperience, guilt about masturbation and viewing pornography, dissatisfaction about their body, and insecurity about their sexual performance, among others.)
Nagoski says the negative impact of cultural context is especially evident in women’s internalized self-criticism and sexual disgust, which can have long-term, damaging effects on women’s sexuality due to their tendency to create stress and inhibit sexual response.
The first negative effect of cultural context that Nagoski identifies is self-criticism, which usually takes the form of criticism toward the body. Nagoski asserts that the practice of self-criticism is so deeply ingrained in our culture that by the time girls hit puberty, they’ve already begun to internalize the practice of body shaming. Even before adulthood, young girls’ self-confidence is severely neglected.
(Shortform note: The rise of social media use in recent years by children and teens has greatly contributed to this problem. Research conducted by Facebook, for example, showed that Instagram worsens body image issues for 1 in 3 girls.)
In addition, our culture has also created a reality where girls worry about their weight from an early age. Nagoski claims this because mainstream media outlets, and even some academics, equate lower weight and thinness with health and beauty. Because of this, Nagoski adds, countless girls and women desire to lose weight to improve their health or appearance, and in some cases, they even develop eating disorders.
(Shortform note: Although Nagoski focuses on the media and academics as the main sources of women’s fear of fat (and, consequently, eating disorders), it’s not the only culprit. Familial dynamics or peer pressure can also cause fear of gaining weight. For example, if you grew up with a mother who constantly scrutinized her weight, you would be likely to internalize the same fears.)
Nagoski tells us that another negative effect of cultural context is sexual disgust. She says that sexual disgust is a withdrawal response we have toward sex-related things that we’re conditioned to consider gross. Nagoski claims that our culture has taught us to feel disgusted by many natural aspects of sex (for example, the sound of a queef, which is a release of air from the vagina). (Shortform note: Here, Nagoski presents disgust as a negative reaction that disrupts our sexual enjoyment. However, in other cases, our sexual disgust response helps us avoid destructive sexual behaviors like incest, rape, and pedophilia.)
What’s more, Nagoski adds, research shows that women are more sensitive to learned disgust than men, especially in terms of sex-related triggers. And depending on the woman, it can take as little as one instance of a negatively portrayed sex-related stimulus for her brain to classify it as disgusting. (Shortform note: While it’s true that women are more sensitive to learned disgust, research has yet to provide a conclusive answer for why this is the case—though there are some theories. One potential explanation is that women are better able to reproduce when they avoid things that could infect them or their children with disease.)
According to Nagoski, another important factor influencing our sexuality is arousal. In particular, she notes that our subjective experience of arousal and genital response don’t always overlap, a phenomenon called non-concordance.
To demonstrate with an example, imagine you’re watching a sex scene in a movie. The scene doesn’t appeal to you because you don’t think the actors are attractive. Despite this, you find yourself becoming physically aroused at the sight of sex on the screen.
(Shortform note: While here, Nagoski talks purely about non-concordance in a sexual capacity, in a TED talk on the subject, she noted that the phenomenon can occur in non-sexual situations, too. For instance, we can bite into a piece of food that we think tastes disgusting but still experience the physical response of salivation, which usually means we find food appealing.)
Nagoski notes that research shows marked differences in the frequency of non-concordance between the sexes, although it’s common for both. Men experience non-concordance about 50% of the time; for women, that number jumps to around 90%.
(Shortform note: The differences observed between men’s and women’s arousal may be based on a problematic comparison between their genitalia. Many studies have compared the sexes by measuring the response of the penis and the vagina. However, as Nagoski pointed out earlier, the equivalent of the penis is the clitoris—not the vagina. Preliminary research measuring clitoral response suggests that women’s physical response and subjective arousal may align more than previously thought.)
Despite non-concordance being remarkably common, Nagoski argues that society still tends to spread a lot of misinformation about the relationship between subjective experience and genital response.
For example, she says that our culture gives us the false impression that genital response automatically equates to sexual pleasure (such as women and men in the media saying “I’m so wet” and “I’m so hard” to express that they’re turned on). She argues that the reason for this misconception is that men—who experience lower levels of non-concordance—are considered the standard, which creates the expectation that alignment of genital response and subjective experience should be the norm for everyone.
(Shortform note: Although Nagoski bases her argument on the fact that men experience lower levels of non-concordance, some scientists have questioned whether research supporting this claim has found accurate results. They suggest that certain methodological flaws could have misrepresented concordance estimates in both men and women. These include potential issues with the sexual stimuli chosen by researchers, self-reporting measures, assessments of genital arousal, statistical methods, or participant characteristics like age and hormone levels.)
Because misinformation about non-concordance is so prevalent in our culture, Nagoski suggests that women may need to explicitly address it within their relationships. One way to do this is to reassure your partner that non-concordance is normal and that you’re perfectly healthy. (Shortform note: Although Nagoski doesn’t elaborate on how to provide this reassurance, one strategy could be to point out that men also experience non-concordance, like when they have erections in inappropriate situations or while sleeping.)
The next element of sexuality we’ll explore is desire. Nagoski tells us that the best way to think about desire is that it’s the result of context interacting with what we find pleasurable. In other words, depending on the contextual factors at any given time, we may or may not find something pleasurable enough to want more of it (as discussed in Chapter 3). According to Nagoski, exactly how pleasurable a person needs to find something before they experience desire depends on the individual.
(Shortform note: Although Nagoski acknowledges that everyone has a different desire threshold, she doesn’t touch on cases where people experience no desire at all. For instance, some people identify as asexual, which means they have little to no sexual attraction to others or desire to have sex. Depending on the person, the absence of desire can extend more broadly: For example, some asexual individuals feel no desire to masturbate or even be involved in romantic relationships involving non-sexual intimacy.)
Although there’s a wide array of variation from person to person, Nagoski says we can generally divide our experience of desire into two types: spontaneous and responsive.
Nagoski defines spontaneous desire as when a person wants sex immediately after recognizing a sex-related stimulus, such as getting turned on by the scent of a partner’s perfume. Someone with a low pleasure threshold would experience this type of desire more easily because it generally takes very little stimulation to make them want more.
(Shortform note: Why might someone have a low pleasure threshold—or, as some might put it, a high libido—and experience high levels of spontaneous desire? According to research, factors like hitting either puberty or middle age, increasing your daily physical activity, and lowering your stress levels can increase your levels of desire.)
In contrast, Nagoski defines responsive desire as when a person experiences desire in response to sexual pleasure, such as physical stimulation like kissing or touching. This type of desire is especially common for those who have a higher threshold because they generally require higher amounts of pleasure to become turned on.
(Shortform note: One point that Nagoski’s discussion doesn’t touch on is why people with responsive desire still choose to initiate or engage in sex before actually wanting it. A potential answer could be that, although pleasure is often the primary motivation, there are other reasons that people may want to have sex. For instance, because sex involves a high level of intimacy, someone might want to engage in it because they crave emotional bonding with their partner. Another factor could be that sex makes a person feel more attractive. Additionally, having sex could satisfy feelings of nostalgia for a previously enjoyable sexual experience.)
But what about when people struggle to feel desire? Nagoski says that a lack of desire is caused by emotional factors—like stress, depression, and a lack of self-compassion—that are made worse by our sex-negative culture and mismatched desire types in relationships. By this, she means the toxic dynamic that often develops between partners with spontaneous and responsive desire: The partner with responsive desire feels increasingly defensive and guilty in turning down sex, and the partner with spontaneous desire feels increasingly frustrated and rejected in initiating it.
(Shortform note: Lack of desire isn’t the only consequence that arises from the toxic dynamic that can develop between partners of mismatched desire types. The rise in tension that develops as the cycle continues can also negatively impact the couple’s emotional well-being and relationship. For example, it can cause individuals to feel hurt because their partner isn’t addressing their needs, loss of confidence (especially in the partner who feels consistently rejected), and a lack of trust in the relationship.)
Now that we’re clear on how desire works, we’ll move on to a related sexual experience: orgasm. Nagoski says that although scientists define orgasms as the climactic release of built-up tension during a sexual experience, they are much more complex than this definition allows for, and each individual experiences them in a unique way. Let’s explore this idea in detail.
According to Nagoski, although many people think that orgasms are primarily a genital response, in reality, orgasms are about what happens inside the brain. What’s more, research shows no relationship between our subjective experience of orgasm and our genital response (just like arousal). In other words, muscle contractions can happen without orgasm, and the reverse is also true.
(Shortform note: If orgasms are about more than just a genital response, what exactly is the full picture? By using fMRI and PET scans to measure the blood flow and neuron activity of individuals experiencing orgasm, scientists have been able to observe what happens in the brain during this climactic experience. Specifically, they found that multiple remote brain regions become activated and a variety of hormones and neurochemicals are released that promote enjoyment, bonding, pain reduction, and relaxation).
In addition, Nagoski tells us that despite the media’s depiction of orgasms as purely enjoyable, the way we feel about an orgasm depends on the context, just like other sensations. Often orgasms are pleasurable, but they can also be frustrating, painful, or even not feel like much at all.
(Shortform note: While Nagoski acknowledges the role of context in our experience of orgasm, she doesn’t provide specific examples of which types of context influence bad orgasms. Research shows that some of the most common reasons for these unpleasant experiences include having sex to avoid arguing about sex, feeling obligated to orgasm, or having sex that lacks emotional connection.)
Nagoski also argues that regardless of the means through which a woman experiences orgasm, there’s no right way to have one, and no single type of stimulation produces an orgasm that feels inherently better than another: Whether it’s through vaginal, anal, clitoral, thigh, breast, earlobe, or even mental stimulation, orgasm simply feels different.
(Shortform note: New research on the female orgasm may call into question Nagoski’s claim that no orgasm feels inherently better than another. Preliminary findings from a pilot study show that there may be two different types of female orgasm—clitoral and vaginal—rather than different types of stimulation triggering one single type of orgasm. If this proves to be true, further research would be required to understand how exactly they differ and whether one could produce a more pleasurable sensation than the other.)
Nagoski insists that it’s important to acknowledge that women in particular often have difficulty reaching orgasm. In fact, she says that this is one of the most common reasons for seeking sex-related treatment or therapy.
(Shortform note: Compared to women, men experience much lower levels of difficulty with orgasm and ejaculation. According to research, anywhere between 1–4% of men experience delayed ejaculation, which is when men take 30 minutes or longer to be able to ejaculate. Additionally, a 2009 study showed that men are almost 30% more likely to orgasm than women.)
So why is it that so many women seem to have difficulties? Nagoski says the answer is most often over-activation of the SIS due to negative emotions like stress, depression, anxiety, and shame. For example, if you’re feeling self-conscious about your body during sex, that activates the SIS, making it difficult for you to reach orgasm.
(Shortform note: Another important factor contributing to women’s difficulty with orgasm is the lack of knowledge they have about the clitoris. One study, for example, found that the less knowledge a woman has about her clitoris, the less frequently she’s able to orgasm during masturbation.)
Nagoski says that despite all of the encouraging new information we may learn about our sexual experience, that doesn’t automatically equate to a pleasurable, problem-free sex life. She argues that when it comes to finding true enjoyment in sex we must find confidence and joy in ourselves. She defines confidence as trusting in what we know about ourselves and our sexuality, and joy as deeply appreciating those things despite any doubts or disappointment we may have. In other words, we must first understand ourselves before we can fully accept and cherish who we are.
(Shortform note: While Nagoski’s definition of confidence aligns with other perspectives—such as psychologists' view of confidence as the trust we have in our capabilities—her definition of joy is unique in comparison to others. Merriam-Webster, for example, describes joy as a feeling of happiness brought on by success or prosperity. It’s also distinct from other authors’ definitions, such as the one provided by Brené Brown in her book The Gifts of Imperfection. For Brown, joy is the profound satisfaction one feels from practicing gratitude.)
Nagoski also acknowledges that these two components aren’t equal in weight—joy is much more difficult to cultivate than confidence. This is because although we may learn the truth about something, we may still doubt its validity or wish it wasn’t true. She elaborates by saying that when we’ve internalized so much negative misinformation for so long, it’s difficult to overcome, no matter how much our new knowledge may contradict it.
(Shortform note: While it’s true that the frequency of negative messaging makes it more difficult to reject, we also find it harder to dismiss because of our inherent tendency to notice and internalize negative information more than positive information, even when the amount of positive information is greater. This means that we’re at an automatic disadvantage when it comes to combating negative misinformation, as our brain is wired to prioritize that type of information.)
Fortunately, despite how difficult it may be, Nagoski assures us that it’s possible to cultivate joy. One way to do this is by learning to be neutral toward our inner selves. She says it’s not enough to simply be aware of how we feel, because that awareness is often accompanied by judgment (for example, thoughts like “I shouldn’t be feeling this way”). Instead, we must actively resist the urge to judge ourselves when feelings arise so that we can create an environment of acceptance rather than criticism.
(Shortform note: Although Nagoski insists that it’s in our best interest to stop judging ourselves, she doesn’t provide any actionables for how to do this. Some strategies we can try are to practice mindfulness, stop overgeneralizing single failures, show appreciation for compliments, focus on our good qualities, and practice self-compassion.)
Come As You Are by Emily Nagoski explores women’s sexuality using scientific research and the author’s years of experience as a sex educator. Nagoski decided to write the book to change the negative way that many women talk, think, and feel about themselves due to harmful cultural messaging that encourages self-criticism and perpetuates misinformation about what constitutes “normal” sexuality.
To prove to women that they’re healthy and normal just the way they are, Nagoski discusses the science behind women’s sexuality and how each person’s sexual experience is unique. Specifically, she covers the basics of anatomy and the sexual response system, the powerful influence of emotional and cultural context on sexual response, and the mechanisms of arousal, desire, and orgasm.
Emily Nagoski is an award-winning author, researcher, educator, and activist who specializes in women’s sexuality. She began her career as a sex educator as an undergraduate at the University of Delaware, where she educated her peers about health-related topics such as nutrition, physical activity, and sex.
Nagoski’s experience working with her peers inspired her to pursue a career in sex education. She went on to earn an M.S. in Counseling Psychology and a Ph.D. in Health Behavior at Indiana University. While earning her degrees, she worked as an intern at the renowned Kinsey Institute for Research in Sex, Gender, and Reproduction and learned from some of the greatest experts in her field. She also taught classes in human sexuality, relationships, communication, stress management, and sex education.
In addition to her educational background, Nagoski is also trained in Gottman’s Seven Principles for relationship success, bystander intervention, motivational interviewing, and cultural inclusivity.
Following her graduate education, Nagoski worked for eight years as a lecturer and Director of Wellness Education at Smith College before deciding to pursue a full-time career in writing and speaking. Now, she travels the world teaching professionals, college students, and the general public about the science of sex and relationships through a variety of talks, programs, and training courses. She lectures at venues ranging from research conferences and universities to bookstores and sex toy stores.
Connect with Emily Nagoski:
Publisher: Simon and Schuster
Come As You Are was originally published in 2015 and was Nagoski’s first book. It became a New York Times bestseller and won several awards, including the Society for Sex Therapy and Research’s 2017 Consumer Book Award and a Goodreads Choice Award for Top 5 Science and Technology Books. In 2021, Nagoski revised and updated the book with the latest science and perspectives on sexuality, and she also narrated and released an audiobook version. We reference the revised and updated version in this guide.
After the publication of Come As You Are, Nagoski authored several other publications on female health, including Burnout: The Secret to Unlocking the Stress Cycle, which she wrote with her twin sister, Amelia Nagoski.
Come As You Are’s publication coincided with several relevant cultural factors that set the stage for the book’s impact. In particular, the book was published amidst growing research exploring the negative effects of social media on self-esteem and body image, the rise of the Me Too movement against sexual abuse and harassment, and heightened tension surrounding the abortion debate and the female “my body, my choice” narrative.
These factors contributed to a cultural discourse surrounding standards for women’s beauty, sexuality, and health that left women feeling particularly targeted and misunderstood. Although society had finally begun to address these women-centered issues, the judgment underlying the conversations made women feel as if their voices were still going unheard.
For example, despite research acknowledging the psychological harm of social media, women continued to feel surrounded by content targeting their self-esteem. Similarly, although more women were coming forward with reports of sexual abuse, they faced accusations of lying and attention-seeking. Likewise, as many women argued for the right to make choices about their bodies during pregnancy, they felt as if society placed little value on their lives due to pro-life opponents’ argument that we should prioritize the life of the fetus above all else.
Through this contextual lens, it becomes clear why Nagoski’s book was so influential. Not only did it provide a wealth of information on women’s anatomy, female sexuality, and the negative effects of culture on women’s well-being that was relevant to the current issues of the time, but it also empowered women by giving them access to clear and factual information that validated their experience.
The ideas presented in Come As You Are are primarily based on current scientific research in fields like anatomy, physiology, psychology, gender studies, and media studies. The author also relies heavily on her own experiences as a sex educator, which she describes to add relatability and context to the information provided by the research.
Although Come As You Are wasn’t the first book of the 21st century to explore women’s sexuality, it was by far the most comprehensive, covering everything from the development of anatomy to the experience of orgasm. It was also unique in its exploration of the ways culture affects our beliefs about sexuality.
As a point of comparison, Ian Kerner’s She Comes First, released in 2009, discusses female sexuality from a more narrow perspective. Specifically, it focuses only on women’s arousal and pleasure, primarily advocating for the use of oral sex to make women reach orgasm. What’s more, a man wrote the book and targeted it toward men, which speaks to the historical trend of viewing women’s sexuality through the scope of men’s. In contrast, Nagoski speaks broadly about women’s sexuality as a woman and directly to women, which adds relatability and authenticity that Kurner’s book lacks.
Come As You Are was revolutionary in its genre due to its thorough and science-backed exploration of women’s sexuality. What’s more, its supportive, easy-to-read nature made the compilation of years of scientific research on women’s sexuality easily accessible to women across the globe.
The scale of the book’s impact is evident in the sharp increase of publications related to women’s sexuality that followed from its success. Other female authors followed in Nagoski’s footsteps by either expanding on or deepening her ideas. Some examples include:
Come As You Are received a positive critical reception overall, demonstrated by both favorable editorial reviews and high audience ratings. In particular, field experts such as John Gottman and Carol Queen praised the book, stressing the impact of the book as an insightful source of information for anyone looking to learn about sex.
Positive reviews of the book highlight its credibility and educational value, with many suggesting that anyone and everyone should read it due to its thoroughness and research-based perspective. They also spotlight the author’s fun and accessible writing style, which they say makes it a pleasurable and easy read.
On the other hand, negative reviews criticize the writing style, stating that it’s condescending. They also complain that the book contains too much fluff and not enough actionables. Additionally, some reviews criticize the author for being liberal-slanting and biased toward those who experience less sexual desire because her discussion focuses on their sexual needs.
Nagoski’s approach in this book is overall thorough, logical, and easy to follow. Each chapter of Come As You Are begins with an anecdote from the author’s personal experience as a sex educator. Each anecdote centers on one of several couples whose stories demonstrate various aspects of our sexual experience.
Following the anecdote, the author introduces the main idea of the chapter, accompanied by a roadmap that guides the reader through the idea’s main principles. The body of the chapter then explores the main idea from a scientific perspective, citing research and utilizing examples and diagrams (when appropriate) that serve to make the science as accessible as possible to the reader. The author also uses a fun and conversational tone to add relatability.
In several instances, the author provides practical tools to apply the ideas introduced in the chapter. In Chapter 2, for example, she includes self-evaluation scales to help readers reflect on their sexual response.
Despite being largely straightforward, the book contains a few instances in which Nagoski tries to increase understanding through the use of a metaphor or example but doesn’t explain it thoroughly enough to be helpful. For instance, in Chapter 4, the author suggests that the key to managing stress and attachment in a committed relationship is having “sex that advances the plot.” Unfortunately, the explanation that follows this idea doesn’t adequately inform readers about how to apply the principle—they’re left without actionables or a clear understanding of what “sex that advances the plot” actually entails.
Nagoski divides the book’s nine chapters among four parts that progress from the most basic aspects of sexuality to the most complex. The first part talks about sexuality from a scientific perspective, focusing on anatomy and the brain mechanisms responsible for sexual response and context. The second part discusses the emotional and cultural factors that interact with our internal mechanisms to influence our sexual experience. The third part dives deeper into the concepts of arousal and desire, which are some of the most largely misunderstood aspects of female sexuality. Finally, the fourth part talks about sexual pleasure and how to cultivate confidence and joy in yourself.
This organization is hierarchical in that ideas introduced in the first chapters are essential to understanding the ideas in later chapters. It also moves from concrete ideas to more abstract ones. The benefit of this approach is that it’s logical and easy for the reader to follow—each idea leads neatly to the next. On the other hand, because so many of the ideas interconnect, even with the hierarchical organization, there are times when the reader can’t fully understand certain ideas until they’re explained in more detail in later chapters. For example, desire is first mentioned in Chapter 2 when exploring models of sexual response, but it isn’t until Chapter 7 that we thoroughly understand how the mechanism of desire works.
In our guide, we’ve reorganized material within chapters to present concepts more logically. Furthermore, we’ve divided the nine chapters into parts differently from the author to keep similar ideas together. Specifically, we’ve moved Chapter 3 to Part 2 to group all chapters focusing on context. We’ve also moved Chapter 8 to Part 3 because we felt that the topic of orgasm was more closely related to the other mechanisms of sexual response—namely arousal and desire—than to the process of cultivating confidence and joy.
We’ve also included commentary throughout this guide that both expands on and challenges the ideas presented by the author. In particular, we compare the author’s ideas to those of other experts in her field, discuss additional research on human sexuality, and add historical or cultural context to the author’s ideas.
According to sex researcher Emily Nagoski, our culture tells women that there’s a standard for female sexuality, and they aren’t living up to it. What our society considers sexually “normal,” in terms of everything from anatomical structure to a person’s level of desire for sex, is based on the experience of the average man. This is because until relatively recently, research has focused heavily on men and male-centric models of sexuality.
(Shortform note: The issue of gender inequality in research isn’t exclusive to the field of human sexuality. In fact, there’s a widely acknowledged gender gap throughout medical research that has led to a dangerous lack of information regarding women’s health and how it might differ from men’s. For example, although cardiovascular disease affects men and women differently in terms of symptoms, risk factors, and outcomes, only one-third of cardiovascular clinical trial subjects are female, leaving the unique female experience underexplored.)
There are two problems with using an average man as the societal standard. First, it discounts the existence and experience of women, who make up about half of the world’s population. Because of this, women must view themselves through a scope that wasn’t made for them, which helps to perpetuate false ideas about what’s normal and healthy. Second, it disregards individual variation, whether among men or women. According to Nagoski, there are as many or even more differences within groups than between them.
(Shortform note: These false ideas about what’s normal with regards to women’s sexual experience stem from a long history of contempt toward female sexuality, even in the medical field. Research examining attitudes toward female sexuality demonstrates that, as recently as the 19th century, doctors were advocating for clitoridectomies to "cure" masturbation and nymphomania. Even within the last 50 years, doctors have regarded women’s low levels of desire and lack of sexual response—which Nagoski later identifies as normal and variable aspects of female sexuality—as disorders that require treatment.)
Nagoski believes that to put an end to these misguided cultural standards and the harm they inflict on women’s understanding and acceptance of themselves, women must better understand the science behind their sexuality. She says that by viewing their sexuality from a scientific rather than cultural perspective, women can free themselves from unrealistic standards, learn to appreciate their sexuality for what it is, and ultimately improve their overall well-being.
(Shortform note: Although Nagoski expresses the importance of examining the science behind women’s sexuality, she doesn’t acknowledge how difficult it can be to identify factual scientific information in an environment that allows for the quick and easy spread of misinformation and pseudoscience. For example, in 2017, the popular wellness website Goop sold a product it claimed could improve your sex life and balance your menstrual cycle if inserted into the vagina for hours at a time. After many customers had already purchased the product, a lawsuit ultimately condemned Goop’s claims as counterfactual, and health experts warned that using the product could cause bacterial infections.)
With this in mind, the first part of this guide introduces our sexual biology. Here, we’ll cover the basics of anatomy and the mechanism in our brain that governs our sexual response. In the remaining three parts, we’ll discuss the influence of context on our sexual experience, the concepts of arousal, desire, and orgasm, and how to find true enjoyment in sex by cultivating confidence and joy in ourselves.
Beginning with Chapter 1, we’ll introduce one of the fundamental takeaways that Nagoski wants readers to internalize, which is that each of us has a unique anatomy made up of similar parts. In other words, while we all develop from the same tissues, there’s also quite a bit of variation—not only between men and women but also among them. What’s more, it all falls into the realm of what’s normal and healthy.
To understand this idea, we’ll first break down some of the common misconceptions about the appearance and function of female genitalia. Then, we’ll explore the biology of female genitalia, their analogous male counterparts, and the wide variation in their appearance. This will help solidify the idea that what makes you unique doesn’t make you abnormal.
As we’ve already noted, Nagoski argues that the fact that men are the standard for society’s understanding of sexuality has created a knowledge gap with regards to women’s unique experiences and biology. This lack of awareness has allowed our society to perpetuate many misconceptions about female anatomy that directly impact the way women see themselves and their sexuality.
What’s more, these misconceptions come from a variety of different places. Nagoski identifies two primary avenues through which society has developed a skewed perception of female anatomy: culturally driven metaphors and media representation. In addition, she points out some other harmful but common misconceptions perpetuated by society. Let’s explore each in detail.
Nagoski explains that our society tends to take biological facts regarding anatomy and transform them into inaccurate metaphors based on cultural values like purity and virginity. She mentions two specific examples of metaphors people have associated with the female genitalia:
According to Nagoski, during the medieval period, people called the female genitalia pudendum (from Latin pudere, “to make ashamed”). The reasoning for this was that women’s genitalia (in contrast to men’s) appear hidden inside the body, as if women are trying to conceal something they’re ashamed of.
(Shortform note: Although Nagoski points to the medieval period as the first time people named women’s genitals pudendum, the term itself actually dates back to first-century Roman writers. Originally, the word was used to refer to any person or animal’s genitalia, regardless of sex. It was only later that people narrowed the meaning of pudendum to just women’s genitals.)
In reality, the female genitalia aren’t “hidden” at all. Nagoski tells us that instead, the various parts have different sizes and locations from their male counterparts due to biological reasons (which we’ll discuss more in the next section). Assigning such a negative name to women’s genitalia not only points to a lack of biological understanding, but it also perpetuates the idea that there’s something fundamentally wrong with their genitalia. If there wasn’t, why else would women try to hide them?
Nagoski explains that although modern culture doesn’t suggest that women are hiding something disgraceful in a literal sense, the idea that women’s genitalia is somehow shameful remains prominent in the way both men and women feel and talk about female sexuality. For example, both sexes shame women when their clothing inadvertently (and often unavoidably) accentuates the shape of their vulva—what is commonly known as a “camel toe.”
Shame’s Effect on Women’s Health
While Nagoski addresses the fact that (unfair and unwarranted) feelings of shame toward women’s genitalia remain prominent in our modern society, she doesn’t specify how these negative feelings affect the health and well-being of women.
In many cases, shame prevents women from not only understanding their bodies but also seeking the care they need. For example, according to one 2014 survey, as many as one-third of young women avoided going to the doctor for gynecological issues out of embarrassment. Additionally, less than half of women felt that they were well informed about gynecological health, and many were unable to correctly identify the basic parts of their anatomy using a diagram.
Overall, these statistics demonstrate that the effects of shame are both psychological and physical, as they have the potential to put women’s gynecological health at risk.
Nagoski notes that society has come to view the hymen—a membrane found at the opening of the vaginal canal—as a marker of virginity. Because of its location and potential to change over the course of a woman’s life, there’s a common but incorrect belief that the hymen is a barrier that’s permanently “broken” the first time that a penis penetrates the vagina.
(Shortform note: Nagoski observes that the hymen has evolved into a token of virginity, but she doesn’t speak to how this idea came into existence. The belief stems from an evolutionary theory claiming that, historically, men would have preferred to mate with a woman who could prove—through her “intact” hymen—that she had never had sex with another man. This would guarantee that any offspring produced would be his, so he could avoid wasting time and resources on other men’s children who didn’t carry his genes.)
Nagoski warns that this misconception is especially dangerous because of the powerful impact it can have on women’s lives. When an unmarried woman’s hymen is absent or torn, she’s seen as impure or marked as “damaged goods.” In some cultures, this has resulted in women feeling pressured to have surgical reconstruction of their hymen as if it were a medical necessity. Nagoski adds that in some extreme cases, women are even beaten or killed because people have seen anything but a fully intact hymen as proof that she has had sexual intercourse outside of marriage.
On the other hand, Nagoski maintains that people have used the presence of a hymen as proof that a woman couldn’t have been raped, preventing her from seeking justice for the crime committed against her. The logic goes that if the hymen is a barrier and it’s still intact, there was no penetration and thus no rape.
Nagoski concludes that the basis of these real-world consequences is an idea that’s entirely false. In reality, the hymen serves no biological function (including being a barrier). Some women are born without them, and when they’re present, they simply stretch with penetration. If they do happen to tear, they heal.
(Shortform note: While Nagoski claims that the hymen is an evolutionary byproduct serving no real function, in reality, biologists don’t agree about why it exists. In addition to the virginity theory mentioned previously, other theories suggest that the hymen’s purpose is to make sex painful—therefore encouraging more caution amongst young women interested in sex—or that it evolved to prevent foreign objects from accidentally entering the vagina.)
The Hymen and Virginity Testing
Although Nagoski discusses some possible outcomes of evaluating the state of a woman’s hymen, such as shame, the denial of rape, and even death, she doesn’t provide information about how people conduct this evaluation.
Both historically and cross-culturally, people have subjected women to so-called “virginity testing.” Usually conducted by a doctor—though sometimes carried out by other community members when a medical professional isn’t available—virginity testing is an invasive procedure that involves inspecting a woman’s genitalia to determine whether her hymen is still intact. The World Health Organization (WHO), as well as other global organizations, condemns the practice as a human rights violation and a violent act against women that has the potential to cause both physical and psychological harm.
Despite having no scientific merit, the practice is still used today in certain cultures around the world. As recently as 2020, for example, virginity testing was being used on rape victims in Pakistan before the Lahore High Court banned it at the beginning of 2021.
In addition to cultural values driving inaccurate metaphors, Nagoski says there’s a lack of representation of female genitalia in the media. What’s more, when it is present it’s often a false portrayal of the real thing. For instance, the vulva is usually presented to fit the “Barbie doll” ideal: neat and hairless.
Nagoski explains that this poor representation contributes to womens’ negative views of their genitalia and sexuality because the only examples they have reinforce a false ideal that they were never meant to achieve in the first place.
(Shortform note: Although Nagoski doesn’t provide any specific examples demonstrating the impact of this lack of representation, there’s evidence showing that the cultural ideals presented by the media profoundly influence women, both psychologically and physically. For example, statistics point to a growing global trend of women undergoing genital cosmetic surgery to make their vulva fit the desired standard. In particular, these procedures have increased dramatically in the United States, Australia, and the UK.)
Beyond the influence of metaphors and media representation, Nagoski mentions a few other misconceptions related to female genitalia that are prevalent in the conceptualization of female sexuality.
Men get “hard” and women get “wet”: Nagoski points out that our culture portrays sexual arousal for men and women differently: an aroused man gets “hard” and an aroused woman gets “wet”. She says the truth, however, is that men and women do both. A man’s penis and a woman’s clitoris both become engorged when blood rushes to the area. Similarly, men and women both release fluid as they become aroused.
(Shortform note: Although Nagoski clarifies that both men and women get “hard” and “wet,” she doesn’t explain why this is the case. In the first instance, the swelling of blood in the penis and clitoris that creates erections also increases sensitivity for the purpose of pleasure. In the second instance, the fluids that men and women release during the process of arousal eliminate acidity, which helps to create the proper environment for sperm to survive.)
Ejaculation is masculine: Nagoski adds that many also believe that because it’s uncommon for women to release fluid during orgasm, ejaculation is only for men. This idea creates one of two problematic and conflicting assumptions: 1) female ejaculation is unacceptable and abnormal, or 2) because it’s uncommon, it’s a prize to idealize. In reality, Nagoski reassures readers that whether a woman ejaculates or not, it’s entirely acceptable and healthy.
(Shortform note: One additional reason for the prevalence of this misconception that Nagoski doesn’t mention is the lack of research on female ejaculation. Because there have been few studies on the subject, scientists still don’t fully understand how female ejaculation happens, what its purpose is, or even how many women experience it. One study, for example, concluded that anywhere between 10–50% of women ejaculate, which is quite a wide estimate.)
Now that we’ve looked at some of the misconceptions driving the negative perception of women’s sexuality, we can examine a biologically-based account of female genitalia. This includes both how it compares to male genitalia and the completely normal variation we see amongst women.
According to Nagoski, what we find is that both men’s and women’s genitalia have the same origins, stemming from the same embryonic tissue. However, these organs ultimately develop in unique ways, take distinct shapes, and serve different functions depending on a person’s sex. The scientific term for these similar-but-different parts is homologues. Let’s explore homologues in detail below.
Nagoski asserts that we can better understand the identical origins but different functions of men’s and women’s homologous genitalia by examining some of the female organs and comparing them to their male counterparts. Although she provides various comparisons, we’ll limit our discussion to just two crucial sets of organs.
According to Nagoski, the clitoris is the anatomical source of female sexual pleasure. The visible part is right below where the inner labia or “lips” of the vulva (i.e. external parts of the female genitalia) meet, although it extends far inside a woman’s body.
(Shortform note: The fact that Nagoski points out the true size and shape of the clitoris is important, as many people don’t realize just how far it extends into the body. In fact, it took until 1981 for any health body to create an anatomically correct diagram of the clitoris, and many school textbooks don’t even mention this organ, let alone explain its true size and shape. This persistent misinformation and misconception support her argument for the need for a biological understanding of female genitalia.)
The male equivalent of the clitoris is the penis, Nagoski notes. Just like the clitoris, the penis is the sexual pleasure center and is positioned front and center on the body. However, whereas only the head of the clitoris is visible outside of a woman’s body, the head and half the length of the entire penis is visible outside of a man’s body. Nagoski argues that their differences in appearance have everything to do with their differences in function. Whereas the clitoris is only responsible for sensation, the penis is responsible for sensation, penetration, ejaculation, and urination.
(Shortform note: Nagoski doesn’t elaborate on why these differences in function lead to differences in appearance. The penis must extend further than the clitoris as it must be long enough to penetrate and ejaculate into the vaginal canal, which is inside a woman’s body.)
Nagoski explains that the outer labia, or “lips,'' are fleshy and hairy folds of skin around the vaginal opening. (Shortform note: The function of the outer labia is to protect the vagina—and therefore internal organs connected to the vagina like the ovaries, urethra, and clitoris—from damage.)
The male counterpart of the outer labia is the scrotum, which is the fleshy and hairy bag of skin hanging below the penis that holds the testicles. Nagoski notes that upon close inspection, you can see the seam on the scrotum where it would have split into outer labia had the embryo been female. (Shortform note: Just as the outer labia serve to protect some of the most vital sexual organs, the scrotum acts as a layer of protection for the testicles, which are the organs that produce sperm.)
(Shortform note: Why must the scrotum extend further out from the body than the outer labia? Nagoski doesn’t explore this, but it’s because the scrotum must keep the testicles cooler than the internal body temperature to produce sperm. On the other hand, the ovaries—which are the female equivalent of the testicles and produce eggs and hormones—don’t require the same environmental conditions to function. Because of this, they’re located inside the body rather than externally with the outer labia.)
Nagoski tells us that just as men and women have similar parts organized in different ways, female genitalia, too, can vary a lot from woman to woman. In particular, she notes that the size, shape, and even color of everything from the clitoris to the labia can differ greatly depending on the person. Understanding this from a biological perspective can help women realize that whatever the unique appearance of their genitalia, they’re normal and healthy.
(Shortform note: While Nagoski specifically mentions women here, men have a lot of genital variation too. For instance, the penis and scrotum can differ in size, shape, and color in much the same way as female genitalia. What’s more, men also face feelings of shame about the appearance of their genitals—for instance, the size of their penis—that stem from a toxic and pervasive standard for what it means to be masculine.)
Learn to embrace what makes you unique by getting to know your anatomy.
Take some time to examine your naked body in the mirror, paying special attention to the size, shape, and color of your genitalia. Describe what you see.
Now, write down how you feel about what you saw. (For example, did you feel pleased with the appearance of your genitals? Did you feel ashamed?)
If you noticed any negative feelings arising as you observed yourself, reflect on why that might be. (For example, have any societal expectations of what genitals should look like impacted how you view your own?)
Now, based on what you’ve learned in this chapter, reflect on how to combat the sources of your negative feelings. (You might consider what, according to the author, is actually true about genitalia and how this differs from the societal expectations you hold yourself to. For instance, is it really true that all vulvas must look a certain way?)
After reflecting on your body, how you feel about it, and why, how do you feel about your body, particularly your genitalia? Do you feel more or less confident in your appearance? Explain your answer.
In the previous chapter, we discussed Nagoski’s proposition that when it comes to anatomy, everyone has the same basic parts, but they’re configured uniquely from person to person. Now, we’ll extend this idea, applying it not just to anatomy but to a person’s sexuality. As we’ll see, although everyone is born with the same brain mechanism that controls sexual response, certain aspects are distinct to each person. According to Nagoski, these differences produce unique sexual personalities that determine our individual sexual needs, such as what it takes to turn us on.
In this chapter, we’ll discuss the two-system mechanism in our brain that determines our sexual personality, including what it is, how it works, and how it varies from person to person. Specifically, we will:
Before diving into details about the modern model of the sexual brain, let’s explore how we arrived at our current understanding. Nagoski identifies two previous models that made an impact on our conceptualization of human sexual response: the four-phase model and the triphasic model.
According to Nagoski, a research lab at Washington University in 1964 conducted an experiment to determine how the female body responds during an orgasm. To do this, they asked a woman to masturbate in a lab setting while they observed her body’s physical response.
From the experiment, Nagoski says the researchers identified four different phases of physical arousal, from stimulation to post-orgasm. This model would become the foundation of scientists’ and therapists’ understanding of human sexual response.
She goes on to explain that during the first phase, excitement, the body starts reacting to the sexual experience (for example, by lubricating the vaginal wall and increasing the body’s heart rate). Throughout the second phase, plateau, these processes continue, along with the contraction of different muscle groups. During the third phase, orgasm, the vagina and other organs contract, followed by a sudden release of tension throughout the body. Finally, at the fourth phase, resolution, everything returns to baseline.
Criticisms of the Four-Phase Model
In her discussion of the four-phase model, Nagoski doesn’t address the fact that many experts have criticized it, nor does she highlight its specific shortcomings.
First, the model had a limited scope. It described only the physical aspects of sexual response, like muscle contraction and lubrication. Psychological and relational factors weren’t considered. In addition, because the researchers’ study only included individuals experienced in having orgasms, the results on which they based the model aren’t representative of the average population (who don’t necessarily experience regular orgasm). Furthermore, they give the impression that orgasm is necessary for pleasure. Finally, the fact that it’s a stable, linear model means that it doesn’t account for individual and situational variation that may not align with what it depicts.
Despite these criticisms, modern medical professionals—including psychiatric and medical clinicians as well as pharmaceutical companies—still reference the four-phase model to define and treat sexual health problems. Popular healthcare website WebMD, for example, published an article in 2020 that references the four-phase model to explain sexual response to its readers.
Nagoski tells us that, by the 1970s, sex therapists were using the four-phase model to treat clients with different types of sexual dysfunction. However, they discovered that the model was ineffective for treating those with a lack of interest in sex.
Nagoski claims that psychotherapist Helen Singer Kaplan realized that the model was missing a phase of sexual desire. Kaplan observed that within the context of a sexual relationship, a person needs to want to have sex before they can become aroused. To address this omission, Nagoski says Kaplan developed a triphasic model, which added a phase for desire and combined the phases of excitement and plateau to produce three phases: desire, arousal, and orgasm.
Transitioning From a Linear to Circular Model
Just as with the four-phase model, Nagoski’s discussion of the triphasic model doesn’t cover many of its criticisms. Like its predecessor, the triphasic model was criticized for presenting sexual response as a linear progression. Further research showed that individuals, and especially women, can skip stages in the process and often experience desire after arousal. In addition, like the four-phase model, the triphasic model failed to capture the psychological, emotional, and contextual aspects involved in sexual response.
Experts later developed other models in an attempt to address these criticisms. One of these, proposed by Dr. Rosemary Basson, posited a circular model of sexual response that accounted for the non-linear experience of many women. Specifically, the model presented sexual response as a cyclical process where desire can happen in advance of (or in response to) arousal, love, and other emotional factors can influence desire and arousal, and orgasm is not necessary for satisfaction.
Nagoski tells us that although the triphasic model went on to serve as the basis for diagnostic criteria for the American Psychological Association, it raised many questions about desire—namely, why do different people seem to have different levels of desire? Additionally, neither the triphasic model nor its predecessor contained a description of what was happening in the brain during sexual arousal.
To fill these gaps, Nagoski says researchers at the Kinsey Institute in the late 1990s developed the theoretical model that makes up our modern understanding of human sexual response. Their model describes a two-system mechanism in the brain that determines our sexual personality. Nagoski nicknames these two systems our sexual “accelerator” and “brakes,” but moving forward, we’ll refer to them as the Sexual Excitation System (SES) and Sexual Inhibition System (SIS), the model’s original terms.
Nagoski explains that the Sexual Excitation System (SES) is responsible for the process of arousal. It constantly scans our environment for potential sexual stimuli. (Common examples could be the scent of cologne or seeing our partner in a bathing suit.) When the SES identifies sex-related stimuli, it sends a signal from our brain to our genitals so that our body can prepare for sex.
In contrast to the SES, Nagoski says that the Sexual Inhibition System (SIS) controls the process of impeding arousal. The SIS scans our environment for reasons not to have sex (for example, the risk of unwanted pregnancy) and sends a signal to our brain when we identify something relevant.
Further Analysis of the Two-System Mechanism of Sexual Response
As Nagoski points out, the two-system mechanism developed by the Kinsey Institute was highly influential in the field of human sexuality. This is evidenced by a variety of factors: First, it’s been widely applied in research across the world, including studies in Belgium, Italy, Portugal, and Australia. In addition, it’s impacted pharmaceutical research related to sexual dysfunction, leading to the proposal of new treatment options. Mainstream news outlets such as CNN and Psychology Today have covered it, as well as a variety of online health websites. Finally, it features in the popular human sexuality textbook, Sexuality Today.
However, although the theoretical model was undoubtedly groundbreaking and influential, its development wasn’t flawless. Initially, its foundational research focused solely on men: The model was first proposed as part of a 1999 study on male sexual inhibition. From there, Kinsey researchers continued their exploration of the model by considering its implications for the treatment of erectile dysfunction as well as using it to predict and measure male sexual response. It wasn’t until the 2000s that Kinsey researchers began to consider the experience of women in relation to the model. The lack of female representation in these earlier studies is indicative of the larger, ongoing issue of male-centric medical research we mentioned previously.
Fortunately, as more researchers work with the model, they will continue to refine it and open up new avenues of investigation. Future directions could include studies that utilize brain imaging to establish a neurophysiological model, studies that aim to improve the existing SIS/SES questionnaires, and studies that continue to explore gender differences and similarities related to the sensitivity levels of the two systems (which we’ll discuss in more detail shortly).
So if there are two systems in our brain that are scanning our environment for signs that it’s time for sex (or not), how do they know what to consider a turn on and a turn off? Nagoski explains that although we may assume this knowledge is innate, in reality we learn almost all sexual stimuli through culture. In other words, society teaches us what to find arousing and off-putting.
(Shortform note: Culture has such a powerful impact on our perception of sexuality that people can view even the same body part through an entirely different scope in different parts of the world. For example, while in many western cultures a woman’s breast is likely to trigger arousal, in other communities, the breast is treated as a neutral body part in comparison to others, such as the buttocks.)
Nagoski tells us that each individual’s SES and SIS have different levels of sensitivity. How sensitive each of a person’s systems is to stimuli in the environment determines their particular sexual needs. For example, someone with a sensitive SES wouldn’t need nearly as many (or as specific) stimuli to become aroused as someone with an insensitive SES.
(Shortform note: Nagoski tells us that each individual’s level of sensitivity varies, but she doesn’t discuss which factors contribute to those differences. According to the Kinsey Institute for Research in Sex, Gender, and Reproduction, which developed the two-system model, each person’s sensitivity levels depend on both genetic and environmental factors, including their unique sexual physiology, history, and personality.)
Nagoski asserts that understanding the two-system mechanism of sexual arousal, especially in a culture that bases its sexual standards on the average man (who often has a more sensitive SES and less sensitive SIS), can reassure women that their experience of sex is completely normal, no matter what combination of sensitivities they have.
(Shortform note: Research, including cross-cultural studies, supports the differences in sensitivity levels between men and women that Nagoski cites. For instance, researchers applied the model to Portuguese men and women, the results aligned with previous research demonstrating higher excitation and lower inhibition in men compared to women.)
But this reassurance doesn’t simply come from knowing what the mechanism is and how it works. Nagoski argues that instead, it arises from developing an understanding of our unique balance—our unique personality. While it isn’t an exact science, asking ourselves some questions about our individual experiences can help increase our awareness of how we function and what we need. For brevity, we’ve simplified the questionnaire while retaining its major themes.
(Shortform note: Another potential benefit of understanding the nature of our own SES and SIS is that it can help us determine our sexual compatibility with our partner. Although differences in sexual personality don’t guarantee incompatibility, they may help us predict potential challenges in our sexual relationship that could threaten our overall satisfaction, such as one partner initiating sex significantly more than the other.)
Here are some questions to help you think about your SES:
If you answered yes to these questions, you most likely have a sensitive SES. In particular, Nagoski says this means you’re very sensitive to sexual stimuli, even things like smell and taste. If you answered no, you most likely have an insensitive SES. Specifically, Nagoski says this means you don’t easily respond to sexual stimuli and need to devote specific attention to become aroused. If you couldn’t provide a definitive yes or no answer, then you probably fall somewhere in between.
Now, here are some questions to help you think about your SIS:
If you answered yes to these questions, you most likely have a sensitive SIS. In particular, Nagoski says this means you must feel relaxed and trust your partner to become aroused. If you answered no, you most likely have an insensitive SIS. Specifically, Nagoski says this means you’re not worried about your performance, body image, or potential consequences of sex. If you couldn’t provide a definitive yes or no answer, then Nagoski says you’re most likely somewhere in the middle.
Variations on the SIS/SES Questionnaire
Nagoski’s questionnaire is partially based on the original SIS/SES questionnaire (which you can view as part of an online questionnaire on Qualtrics). The Kinsey Institute created this original questionnaire while developing its two-system theoretical model. Overall, Nagoski’s version follows the format of the original relatively closely, though it departs in two specific ways: First, whereas the original asks participants to choose from four options—“strongly agree,” “agree,” “disagree,” and “strongly disagree”—Nagoski’s version utilizes a sliding scale, where 0 indicates “not at all like me” and 4 indicates “exactly like me.” This creates the possibility for a central or neutral option that the original lacks. Second, while the original combines questions targeting both the SIS and SES, Nagoski’s version separates questions into two sections.
For the questions themselves, Nagoski condensed the questionnaire from 7 questions targeting each system down to only 5. Furthermore, her questions vary significantly from the original’s. While hers focus more on psychological/emotional factors (for example, “sometimes I feel so ‘shy’ or self-conscious that I cannot become fully aroused”), the original’s focus more on situational factors (for example, “If I am having sex in a secluded, outdoor place and I think that someone is nearby, I am not likely to get very aroused”).
The differences between Nagoski’s questionnaire and the original reflect further research on the applicability of the two-system model that revealed women might need a separate questionnaire from men. This is due to men’s and women’s differing experiences of sexual excitation and inhibition. Because researchers developed the original questionnaire following a study that initially only focused on men, they didn’t take gender differences into account. Ultimately, other researchers developed a questionnaire that is not only made exclusively for women but also expands on the factors considered by the original, including sexual power dynamics and partner characteristics.
We can see the influence from the new, woman-centered questionnaire in Nagoski’s version, although hers is significantly condensed. Despite the difference in length, both questionnaires focus much more heavily on psychological and emotional factors like self-esteem and relationship dynamics, which research has shown are important aspects of women’s experience of sexual excitation and inhibition.
In the previous chapter, we introduced the idea that everyone’s sexual response is unique because we all differ in our level of sensitivity to stimuli in our environment. However, this is only part of the story. In reality, Nagoski argues that our sexual response is determined not only by our systems’ inherent sensitivity levels to stimuli but also by the context in which those stimuli appear.
In Part 2, we’ll dive deeper into the role of context, exploring both the mechanics of how it works and the specific effects of emotional and cultural context. To begin our discussion, this chapter will talk about the basics of how context interacts with our brains and how this interaction affects our sexual response, especially for women.
Nagoski tells us that contextual factors, such as who we’re with, potential risks, and even our mood, can make something that’s normally a turn-on have little effect (or even the opposite effect) on our arousal. Take the example of your partner’s cologne: Under normal circumstances, the scent may be arousing. But imagine that one day, you have an uncomfortable encounter with a coworker who happens to wear the same cologne. From that point on, you may no longer feel the same level of arousal when exposed to that scent—it may even repulse you.
But why exactly does this happen and how does the process work? Research shows that it’s all about how our brain processes the environment around us: If we perceive our environment to be comfortable and safe, Nagoski says our brain will almost always respond to sex-related stimuli with curiosity, seeing the stimuli as pleasurable enough to warrant desire. On the other hand, if we perceive our environment to be stressful or dangerous, Nagoski says our brain will almost always respond to stimuli with avoidance and anxiety, even if the stimuli would usually arouse us.
Nagoski argues that understanding this mechanism is important because it offers a scientific explanation for why sex might not feel great all the time. It doesn’t mean that there’s something wrong with you—it simply means that the context isn’t quite right.
Context’s Influence on the Brain
Here, Nagoski’s discussion of the role of context focuses exclusively on sexual response. However, context influences far more than our brain’s perception of sexual stimuli—in reality, it shapes the way we process all types of information.
One of the simplest examples of context’s role in information processing is optical illusions. Depending on the way objects appear, our perception of them changes. For example, in the famous Ebbinghaus illusion, two separate circles are enclosed by their own ring of circles: One is surrounded by large circles, and the other by small circles. Although the two center circles are exactly the same size, our brain doesn’t see them that way because of the influence of the size of the circles that surround them—the circle enclosed by large circles appears smaller than the circle enclosed by small ones.
Another demonstration of the power of context is the way it influences our interpretation of emotions through facial expressions. For instance, we’re likely to perceive the emotion behind a photo of a crying woman as sadness. However, if we were to add context by broadening the scope of the photograph to reveal a man on one knee with an engagement ring in hand, our interpretation of the emotion would change to happiness.
With these examples, it’s easier to see how context could affect our perception of sexual stimuli. Just like the size of a circle or the emotion behind a facial expression, the way our brain interprets something like the smell of cologne is largely dependent on the context in which it appears.
Although context plays a role in everyone’s sexual response, Nagoski states that research shows that women are more sensitive to it than men, especially mood and relationship factors.
(Shortform: Research suggests that the reason for women’s higher level of sensitivity to context relates to parental investment theory, which predicts that the parent who’s more invested in raising their offspring will be more sexually selective. In other words, because women have historically taken a more active role in raising their children than men, they’ve developed a higher sensitivity to contextual factors that might inhibit sexual response, such as having sex without a condom).
Although Nagsoki claims that on average women respond best to contexts that are low stress, high affection, and explicitly erotic, there’s variation from woman to woman and situation to situation.
(Shortform note: In addition to the contexts that Nagoski mentions, research shows that the type of relationship is also a major factor affecting sexual arousal and enjoyment. One study showed that, in general, women in committed rather than casual relationships have higher sexual pleasure and satisfaction.)
While context has the potential to disrupt our desire for sex, Nagoski reassures us that by changing aspects of our environment—such as the circumstances or our state of mind—we can still create good opportunities for uninhibited sexual arousal.
To do this, however, Nagoski argues we must understand which particular environmental factors, both positive and negative, affect us most strongly. She says the most effective way to determine your best and worst environments is to reflect on your past experiences and focus on the details of what made those experiences so pleasurable or unappealing: things like your mental state, the setting, and the nature of your relationship with your partner. For example, have your best sexual experiences always happened when you were in a comfortable and familiar place?
(Shortform note: While Nagoski suggests reflecting on your past experiences to determine your best and worst environments, she doesn’t acknowledge how difficult it can be to recall the details of those experiences—particularly if they were a while ago—or offer any alternative strategies. One solution to this memory obstacle could be to document your sexual experiences, both good and bad, in a journal shortly after they occur. By recording this information over time, you can easily access details without having to remember them and identify patterns that can help you determine which factors create the most and least enjoyable sexual experiences.)
Once you’ve identified which factors contribute to your best and worst environments, Nagoski advises considering what you could do to make positive factors occur more frequently and negative factors less frequently.
Changing Your Environment: Easier Said Than Done
The overall applicability of Nagoski’s advice in this section is arguably limited. While we can change some of the factors making up our environment fairly easily, such as the setting we’re in and the type of sex we have, many others are largely outside of our control.
For example, if the main factor affecting your sexual desire is a battle with depression, it could take a significant amount of time to overcome—weeks, months, or even years depending on the individual and access to resources. What’s more, in 20–30% of cases, depression is a long-term illness that can’t be entirely cured, even through treatment.
Similarly, certain life circumstances may act as inhibiting factors that are difficult or impossible to change. For instance, if you’re taking care of a terminally ill loved one, it’s likely that such a large responsibility would significantly impact both your physical and emotional capacity for sex due to factors such as time limitations, lack of privacy, stress, and even grief.
Overall, no matter our level of effort, certain changes to our mental state, relationship, and life circumstances may only be possible over a long period—if at all.
By this point, we have a clear understanding of the basic mechanics of context’s interaction with the brain and how that affects our sexual response. In this chapter, we’ll continue the discussion on context by focusing on just how much emotional factors impact not only our sexual response but also our overall sexual experience and well-being. Specifically, we’ll discuss the significant effect of stress and love on sexual response and how understanding and managing these systems can positively affect our sexual experience.
According to Nagoski, stress is one of the two emotion-based systems in the mesolimbic cortex that most greatly impact our sexual arousal and pleasure. It’s a process or system of changes in our minds and bodies that occurs in response to threats, and it underlies all types of negative emotions, including anxiety, fear, irritation, frustration, and anger.
Nagoski explains that although stress used to be an evolutionary adaptation to respond to real, life-threatening situations—such as a lion chasing us or a neighboring tribe attacking ours—these days, it’s a response to more subtle things that threaten our well-being: bills to pay, problems at work, or tension between family members at home.
(Shortform note: Not only have our stress triggers become more subtle and ongoing, but they also vary in accordance with national or global concerns. According to surveys conducted by the American Psychological Association (APA), in 2011, the primary causes of stress were things like money, work, and the economy, which correspond to the state of the world economy during the recession. In contrast, the primary causes of stress in 2020 included the coronavirus pandemic, health care, mass shootings, and climate change, which similarly align with the issues of the time. What’s more, research shows that stress levels have become so high for so many people that the APA has declared the situation a mental health crisis.)
Nagoski maintains that regardless of the severity of the threats we’re exposed to, our bodies continue to respond in the same way: the perceived threat triggers a flood of adrenaline and cortisol to our bloodstream, preparing us to act. Physically, she adds, we experience an increase in blood pressure, heart rate, and respiration, suppressed immune and digestive functioning, and dilated pupils.
Nagoski asserts that, once physically prepared, we react to the threatening situation in one of three ways depending on the context:
Additional Responses to Stress
Although Nagoski defines the three most common ways that humans respond to perceived threats, they aren’t the only possible reactions. Researchers have identified additional stress responses that may prove more appropriate in certain situations than the responses listed above.
As previously mentioned, modern-day threats are more subtle and complex than those of our ancestors. Because of this, there may be certain circumstances in which running away or standing your ground may not be the most effective way of handling a threat. For example, if a coworker is threatening to report you to HR for something you didn’t do, you probably wouldn’t simply run out of the building or stubbornly stand your ground. Instead, your first reaction may be to negotiate to talk them out of their decision. In this case, you’re choosing a response that researchers call appease (or fawn), which is when we try to please the person acting as a threat.
Similarly, we may encounter particularly frightening situations that trigger a response even stronger than freezing. For instance, if you have a fear of heights and find yourself at the top of the Empire State Building, you may not just freeze but also faint due to fear overwhelming you. This is just one example of what researchers call flop (or tonic immobility), which is when we become physically or mentally unresponsive and entirely unaware of our surroundings.
Because modern threats are often more subtle and ongoing than the life-threatening events of our ancestors, Nagoski argues that stress wreaks havoc on our bodies and minds for an extended period. Such long-lasting stress can have various negative effects on our sexual response. Specifically, Nagoski notes that it can reduce physical arousal and interest in sex.
Though we don’t yet fully understand how this happens, Nagoski says we do know that stress makes us more likely to interpret stimuli as threats, which activates the SIS. And as we know, activation of the SIS makes our desire for sex decrease.
(Shortform note: Although Nagoski herself doesn’t go into detail about stress’s effect on sexual response, other sources point to some possible answers. For instance, hormonal changes could be responsible for reducing interest in sex during stressful periods. When our bodies produce more of the stress hormone cortisol, the production of testosterone—the hormone that most greatly impacts desire levels—is simultaneously reduced. Additionally, relational factors may play a role: When we’re stressed, we tend to close ourselves off from our partner, which negatively impacts intimacy and desire for sexual contact.)
How can we manage stress to prevent it from inhibiting sexual response? Nagoski suggests that we must take deliberate steps to allow our bodies to complete the stress cycle, therefore ridding itself of the adrenaline and cortisol that flooded our system when we became aware of the threat. Unfortunately, she adds, the ongoing nature of modern stress makes it more difficult to complete the cycle because there’s no clear beginning and end to the threats we’re exposed to.
(Shortform note: Nagoski acknowledges that there’s a continuous nature to modern stress that makes it difficult to manage. However, she doesn’t inform us how to recognize that we’re struggling with chronic stress, which is a necessary first step in completing the cycle. Fortunately, there are a series of physical and emotional signs we can watch out for that are indicative of chronic stress, including forgetfulness, fatigue, irritability, chronic pain and muscle stiffness, digestive issues, and drug abuse.)
Nagoski adds that we live in a culture that encourages us to dismiss emotions rather than address them. When it comes to stress, we either put off completing the cycle to a more convenient time, or we rationalize that we can eliminate what’s stressing us out in the first place. Unfortunately, Nagoski observes, that more convenient time never comes, and getting rid of stressors isn’t the same as getting rid of stress.
(Shortform note: Research not only supports Nagoski’s claim about western culture’s dismissal of emotions but also suggests that this emotional dismissal is particularly damaging to Americans in particular. According to some studies, when compared to East Asian cultures, Americans experience greater harm from emotional suppression because their culture idealizes self-expression. In other words, suppressing emotions is more damaging because it’s in direct conflict with a fundamental cultural value.)
Nagoski says that to complete the cycle, we must find a safe space and deliberately make time to participate in activities that allow the cycle to come to a natural end, therefore eliminating the adrenaline and cortisol from our systems. Although physical activity is the most efficient way of accomplishing this, Nagoski recognizes sleep, affection, meditation, crying, screaming, art, and even grooming rituals as effective ways of managing stress.
Lifestyle Changes for Managing Stress
Other experts agree with Nagoski’s claim that activities like exercise, sleep, affection, meditation, and hobbies like art can reduce the adrenaline and cortisol in our systems. Research also supports her assertion that methods of venting such as crying (which helps to expel cortisol from our system) and screaming (which releases tension) are useful stress relievers.
However, the ongoing nature of stress tends to keep our daily stress level high, meaning that even after completing the cycle as Nagoski suggests, the adrenaline and cortisol are likely to return fairly quickly. Therefore, it would be useful to have long-term strategies you can use to reduce the overall level of stress in your day-to-day life. To supplement Nagoski’s recommendations, here are some lifestyle changes you can make to keep your stress at a manageable amount:
Unplug from technology: When we take daily time away from our electronic devices, we’re not only able to take a break from the negativity in online spaces but also shift our focus from our overwhelming list of obligations.
Get organized: When we stop to take inventory of what we need to get done and prioritize our tasks, we take back control of our time instead of letting it consume us.
Set boundaries: Deciding on what we want and need and communicating that to others helps us navigate relationships and responsibilities with confidence rather than dread.
Take a break: Sometimes we just need a break from thinking about what’s bringing us stress. Distracting our minds with something positive—like hobbies, talking with friends, or spending time in nature—can make everything seem more manageable when we return to it.
Focus on the positive: Research shows that the more we focus on optimistic thoughts and imagery, the more positively we experience the world.
Make healthy choices: Being mindful of our dietary choices and making time for exercise can make a big impact on our mindset.
According to Nagoski, love is the second emotion-based system that greatly impacts sexual arousal and pleasure. Love is what underlies emotions such as passion and romance, as well as grief, jealousy, and heartbreak.
Nagoski tells us that love is the innate process that bonds us with other people—whether they be friends, caretakers, or romantic partners—and that the name for this bonding process is attachment. From an evolutionary perspective, it’s the mechanism responsible for establishing an emotional connection between children and caregivers.
Love vs. Attachment: Is There a Difference?
Nagoski defines love as the process of attachment. However, culturally, we tend to view love and attachment as distinct concepts, with attachment having more to do with possession and control than care and affection.
So what does the research have to say about love and attachment? In contrast to our tendency to separate the two, the attachment-theoretical framework considers the feeling of attachment to be a fundamental part of secure love, along with two other components: a desire for caregiving and sexual attraction. Although there are three components of secure love, the framework maintains that attachment is the most important, as it influences both our capacity for caregiving and disposition to feel sexual attraction.
Nagoski argues that depending on how our caregivers cared for us as children, we develop different styles of attachment that not only dictate our behavior in our romantic relationships but also affect our sexual experience. She specifies that if our primary caregiver was a reliable source of love and safety, we will likely develop a secure attachment style. On the other hand, if our caregiver wasn’t dependable, we will likely develop an insecure (anxious or avoidant) attachment style.
(Shortform note: The parenting style of our caregivers isn’t the only factor contributing to our attachment style. The authors of the book Attached identify several other conditions that affect attachment style, including the temperament we were born with, the stress levels of our parents, and how often we spent time with caregivers other than our parents. Additionally, they recognize the impact of our adult romantic experiences, which can cause our attachment style to shift over time. For example, if your partner has an affair, you may shift to a more anxious attachment style due to feelings of betrayal and inadequacy.)
Attachment Style Characteristics
Although Nagoski identifies the three types of attachment styles, she doesn’t discuss the general characteristics of each type and how they lead to a specific kind of sexual behavior (as described above).
According to the book Attached, individuals with a secure attachment style are loving partners who are comfortable with intimacy. They communicate their needs and also anticipate the needs of their partner easily. These characteristics naturally lead to healthier and more enjoyable sex because being open to vulnerability and having a close relationship with your partner make it easier to experience pleasure during sex.
On the other hand, those with an anxious attachment style suffer from low self-esteem and constantly worry about the state of their relationship, ultimately expending an enormous amount of emotional energy trying to manage it. Because of this, they tend to use anything they can to become more attached to their partner—including sex. Furthermore, because they experience so much fear toward their relationship, sex can turn into something emotionally painful rather than enjoyable.
Finally, people with an avoidant attachment style are emotionally distant and threatened by intimacy. They don’t like to talk about their feelings and have a strong preference for autonomy, often worrying that their partner is interfering too much in their life. It’s this inclination toward independence and avoidance of emotional vulnerability that ultimately leads to less frequent and more casual sex, as they don’t see it as a means of connection.
Better manage your stress by determining what stress management strategies work best for you.
Think about the last few times you were noticeably stressed. How did you try to manage it (if at all)? What patterns do you notice between instances—did you frequently use the same strategy (or strategies)?
Reflect on the outcome of the management strategy or strategies you chose. Did they reduce your level of stress? If so, why do you think they worked? If not, why weren’t they successful?
Choose one of the strategies that Nagoski recommends for completing the stress cycle that you’ve never tried before but want to experiment with (physical activity, sleep, affection, meditation, crying, screaming, art, or grooming). Make a plan for how you might make time to implement the strategy. (For example, plan to add 5 minutes of meditation to your morning ritual.)
How can you ensure that you’ll follow through on your plan? (For example, find an accountability buddy who can join you in your routine and check in to make sure you’re sticking to your plan.)
In the previous chapter, we discussed the impact that emotional states like stress and love have on our sexual experience. Now, we’ll shift our focus to another type of context that plays an important role—cultural context. According to Nagoski, whether we’re aware of it or not, culture dictates our beliefs and ideals, including how we feel about sex.
Nagoski tells us that women in particular grow up hearing a lot of negative messages about sex, which creates deep-seated feelings of shame and fear that can be detrimental to their sexual experience and well-being.
(Shortform note: Men, too, develop feelings of shame due to negative cultural messaging. Research shows that there are several factors comprising men’s sexual shame, including distress about their sexual inexperience, guilt about masturbation and viewing pornography, dissatisfaction about their body, and insecurity about their sexual performance, among others.)
In this chapter, we’ll discuss the specific messages regarding women’s sexuality that our culture perpetuates and how they negatively impact women. Then, we’ll discuss several strategies that you can use to combat their harmful effects.
The first line of messaging that Nagoski identifies, and perhaps the most deep-rooted, comes from the moral ideals that our culture has developed surrounding sex, and women’s sexuality in particular. For hundreds of years, society has made women feel as if their sexuality makes them morally impure. Specifically, Nagoski says that society teaches us ideas like:
Virginity is women’s most valuable asset, and to lose it makes them impure. (Shortform note: Where did this cultural concept come from? The idolization of virginity arguably rose in popularity with the Roman Catholics’ worship of the Virgin Mary, mother of Jesus. Catholics’ devotion to Mary elevated the status of women from source of evil to maiden of purity. Before long, worship of Mary evolved into worship of virginity itself, which placed women’s value almost exclusively on the status of this socially constructed concept.)
If women embrace their sexuality by desiring sex or having multiple partners, they’re shameful. (Shortform note: This treatment of women is notably different from that of men, who are often praised, rather than shamed, for the same behavior. Research suggests that there are both evolutionary and socio-cultural reasons for the development of this double standard.)
Being desired and being loved are mutually exclusive—if women are sexually desirable, they’re automatically unlovable. (Shortform note: One way in which culture communicates this messaging is through the concept of “marriage material”—in other words, a woman must behave according to certain standards to prove she's worthy of being a wife. For example, relationship gurus often advise women to wait to have sex with a man until at least the third date to gain her partner’s respect.)
Nagoski argues that this messaging teaches women that their sexuality is something awful to repress. And repressing a part of who you are is damaging not only to your sexual experience but also to your overall well-being.
(Shortform note: One major aspect of repressing a part of yourself is repressing your emotions. Research shows that there are physical, psychological, and social consequences of emotional repression. These include a lowered immune system, chronic pain, lack of motivation and sleep, disordered eating, anxiety and depression, substance abuse, and a reduced ability to ask for help and connect with others.)
In addition to these harmful moral ideals, Nagoski tells us that women receive medical messaging that disregards their sexual experience. In particular, they’re told that sex is for reproduction—not pleasure—and any sexual functioning that differs from men, such as her level of desire, is problematic. More specifically, the medical field warns women that:
They should strongly consider functional elements of sex such as the risk of disease and unwanted pregnancy before having it, above any thoughts of pleasure or enjoyment. (Shortform note: Messaging painting sex as a high-risk, functional-only activity often starts in sex education programs. According to an article published by the Center for American Progress, many states require that programs stress abstinence, and when issues of sex are discussed, they focus on pregnancy and STI prevention. What’s more, few states cover topics addressing relational aspects of sex, such as consent and healthy relationships.)
If they do engage in sex, there’s a medically correct way for it to happen, namely desire, then arousal, and then orgasm with their partner. If women’s sexual experience differs in any way from this, they must be medically treated. (Shortform note: Fortunately, it seems as if these ideas may be changing. For example, the Mayo Clinic explicitly states that sexual dysfunction is only a problem if you feel it’s negatively affecting you and your relationship. They also suggest non-medical treatment to deal with sexual issues within your relationship, like talking with your partner, using lubricant and sex toys, and practicing mood-boosting healthy lifestyle habits.)
Nagoski says that a third type of messaging, which has become especially prevalent since the mid-20th century, comes from the media, and it specifically targets women’s sexual confidence. Daily traditional and social media tells women:
They’re boring and prudish if they’re not sexually explorative (for instance, willing to use sex toys or try a variety of different positions). (Shortform note: These expectations aren’t necessarily limited to women. For example, there’s an overall cultural stigma against “vanilla sex,” which is a term we use to refer to boring and conventional sex. Although it was originally intended to refer only to sex practices outside of BDSM and the mainstream media, it now acts as a label used to shame those who are less sexually adventurous.)
Their bodies aren’t good enough, and if they don’t try to change, they’re lazy and full of themselves.
Nagoski believes that on their own, these messages set impossibly high standards for women, making them unlikely to ever feel adequate in terms of their sexuality. (Shortform note: What’s more, in combination with the other core messages, these ideals create contradictions that obscure what’s right in the eyes of society—should women rein in their sexuality to become purer or be wildly adventurous to avoid others labeling them as dull?)
The History of Cultural Influence on Women’s Body Image
Although Nagoski points to the mid-20th century as the start of a rise in messaging that scrutinizes and criticizes women’s bodies, cultural ideals have pressured women into achieving a certain body type for much longer. To demonstrate, let’s discuss some of the historical ideals present in different cultures throughout history, including those of Victorian England and the Tang Dynasty in China.
In 19th-century Victorian England, the cultural ideal was an hourglass shape. This influenced women to wear corsets, which would physically mold their bodies to have thin waists and full hips. Despite dangerous medical consequences, such as deformed ribs and even muscle atrophy, women felt pressured to continue the practice because in striving for the ideal, they had a better chance at accruing social power.
In contrast, during the Tang Dynasty, which lasted from 618 to 906 A.D., people considered full-figured and even obese women beautiful. This was because having enough food to maintain such a figure was indicative of wealth. Just like in Victorian England, women of the Tang Dynasty felt that their bodies could give them a source of power in society.
The same societal pressures continue to influence modern women. Research demonstrates that people who fit societal beauty standards have clear advantages in life. Specifically, they’re more likely to get a job and receive higher pay, and they even have greater chances of success in negotiating loans.
Nagoski says the negative feelings caused by cultural context can have long-term, damaging effects on women’s sexuality and overall well-being. She focuses on two of these interrelated effects in particular: self-criticism and sexual disgust.
The first negative effect of cultural context that Nagoski identifies is self-criticism, which usually takes the form of criticism toward the body. Research shows that there’s a direct connection between this type of self-criticism and harm to a woman’s sexual well-being. This is because self-criticism creates stress, which as we know, inhibits sexual response.
(Shortform note: While research suggests that women are more severely impacted by negative body image, men are far from immune. One study, for example, found that over 90% of men struggle with body dissatisfaction. What’s more, men may face different effects than women. Specifically, research shows they’re more prone to substance abuse and atypical eating disorders and also seek treatment for body image issues less frequently than women.)
Unfortunately, despite the harm caused by self-criticism, Nagoski argues that it’s difficult for women to abandon because our culture encourages it. She says that two ways in which this is accomplished are by distorting self-criticism into something positive and convincing women that fat is something to avoid at all costs. Let’s look at each in detail.
Nagoski asserts that the practice of self-criticism is so deeply ingrained in our culture that by the time girls hit puberty, they’ve already begun to internalize the practice of body shaming. Even before adulthood, young girls’ self-confidence is severely neglected.
(Shortform note: The rise of social media use in recent years by children and teens has greatly contributed to this problem. Research conducted by Facebook, for example, showed that Instagram worsens body image issues for 1 in 3 girls.)
What’s more, Nagoski observes that culture permits us to criticize but not love ourselves. For example, it’s perfectly acceptable to complain to our friends about how much we hate our stomachs but not to celebrate how much we love our hips.
(Shortform note: Although this mentality persists, the body-positivity movement has made great strides in attempting to combat it since the late 1960s. What first began as fat activism in the United States evolved into a global movement that encourages people of all sizes to love themselves as they are.)
This prevalence of self-criticism in our day-to-day lives creates the impression that we can use it to motivate ourselves to be better. According to Nagoski, however, not only does it not motivate us, but it also creates stress.
(Shortform note: Although Nagoski claims that self-criticism doesn’t motivate us, others would disagree. Some say that as long as self-criticism doesn’t turn into self-deprecation, we can use it as a tool to constructively analyze our behavior. In particular, self-criticism can raise awareness of the things we need to improve and help us unlock our full potential.)
Our culture has also created a reality where girls worry about their weight from an early age. Nagoski claims this is because mainstream media outlets, and even some academics, equate lower weight and thinness with health and beauty. Because of this, Nagoski adds, countless girls and women desire to lose weight to improve their health or appearance, and in some cases, they even develop eating disorders.
(Shortform note: Although Nagoski focuses on the media and academics as the main sources of women’s fear of fat, it’s not the only culprit. Familial dynamics or peer pressure can also cause fear of gaining weight. For example, if you grew up with a mother who constantly scrutinized her weight, you would be likely to internalize the same fears.)
Nagoski argues that in reality, weight isn’t indicative of our health but is instead a simple measure of gravity. It says nothing about our wellness or beauty, and losing weight won’t necessarily make us healthier. Instead, we can improve our health by adopting healthy lifestyle habits and treating ourselves with respect.
(Shortform note: Many experts agree with Nagoski’s claim that a person’s weight has no bearing on their health. In particular, they criticize the use of the Body Mass Index (BMI)—which calculates a person’s size based on height and weight—as a measure of health, claiming that it’s unreliable and advocating for abandoning it altogether. However, there isn’t consensus across the board. Some say that while BMI may have its shortcomings, it’s still a useful tool in predicting future health outcomes when combined with other measures.)
The Effect of Eating Disorders on Women’s Sexual Health
Above, Nagoski discusses eating disorders as a consequence of women’s internalized self-criticism. However, she doesn’t address the variety of negative effects these disorders can have on women’s sexual health. Research shows that eating disorders specifically cause a variety of physiological, emotional, and behavioral consequences related to women’s sexual functioning.
On a physiological level, women who suffer from eating disorders experience a marked decrease in desire, sexual dysfunction issues like lack of lubrication and vaginismus, and overall less sexual satisfaction. Emotionally, they tend to experience sexual anxiety rooted in body dissatisfaction as well as symptoms of depression and anger that further reduce interest in sex. As for behavioral effects, women with eating disorders not only have fewer sexual partners and encounters than healthy women, but they also exhibit more abnormal self-pleasure behaviors.
Nagoski tells us that another negative effect of cultural context is sexual disgust. To define what this is and why it’s harmful, we must first understand general disgust and why we experience it.
In basic terms, disgust is a withdrawal response we have toward things that we consider gross. What each of us perceives as gross isn’t innate but learned through experience. Nagoski explains that according to one theory, disgust developed as an evolutionary strategy to avoid dangerous contaminants, such as vomit: When we encounter a contaminant, we experience an immediate reaction that draws us away. Over time, humans have learned to generalize this withdrawal response to conceptual contaminants as well, meaning that we’re disgusted by not only the sight of vomit but also the mere thought of it.
(Shortform note: Although Nagoski’s discussion of disgust centers on one single theory, in reality, experts have proposed many theories to explain our inherent withdrawal response. Some of the alternatives include the taste-toxicity theory, which frames disgust as protection against ingesting unhealthy substances, the animal-heritage theory, which explains disgust as humans’ natural withdrawal from things that remind us of our animal origins, and the death theory, which links disgust to a fear of death.)
So if disgust is the experience of withdrawing from things we’ve learned to find repulsive, sexual disgust is the same experience but specifically in response to sex-related stimuli. How do we come to find such things revolting? Nagoski claims that our culture—heavily influenced by Judeo-Christian traditions—has taught us to feel disgusted by many natural aspects of sex (for example, the sound of a queef, which is a release of air from the vagina). (Shortform note: Here, Nagoski presents disgust as a negative reaction that disrupts our sexual enjoyment. However, in other cases, our sexual disgust response becomes incredibly important. For example, we’re largely repulsed by things such as incest, rape, and pedophilia, which are destructive sexual behaviors.)
What’s more, Nagoski adds, research shows that women are more sensitive to learned disgust than men, especially in terms of sex-related triggers. And depending on the woman, it can take as little as one instance of a negatively portrayed sex-related stimulus for her brain to classify it as disgusting. (Shortform note: While it’s true that women are more sensitive to learned disgust, research has yet to provide a conclusive answer for why this is the case—though there are some theories. One potential explanation is that women are better able to reproduce when they avoid things that could infect them or their children with disease.)
According to Nagoski, the reason sexual disgust harms our sexual experience is that, much like stress, disgust also inhibits sexual response. Therefore, the more aspects of sex that repulse us, the lower our desire. (Shortform note: Though Nagoski points out the negative impact that disgust can have on sexual response, she doesn’t speak to its potential to negatively affect our relationship if our partner doesn’t share the same disgust triggers. For example, if you’re repulsed by anal sex but your partner isn’t, you may feel confused or even disgusted by your partner for taking an interest in something you find revolting.)
Nagoski says that there are three strategies we can use to combat self-criticism and sexual disgust’s impact on our sexual experience and overall well-being:
Self-compassion is the unconditional love we have for ourselves. Citing research by self-compassion researcher Kristin Neff, Nagoski tells us it has three components: treating ourselves with kindness, viewing our suffering as a point of connection with others, and being nonjudgmental about what’s happening in the present moment. Nagoski also clarifies that, despite the stigma self-compassion carries in society, it isn’t about self-esteem or self-indulgence.
(Shortform note: In addition to the cultural misconceptions about self-compassion that Nagoski mentions, Kristin Neff identifies several other myths that prevent us from fully embracing the practice, including the ideas that self-compassion is selfish, a kind of self-pity, a sign of weakness, and a practice that makes us complacent about self-improvement. In reality, practicing self-kindness, connection, and nonjudgmental thinking makes us more motivated, capable of loving others, able to cope with life’s difficulties, and positive about negative experiences.)
By being kind to ourselves and foregoing judgment, we can not only counter our culturally-ingrained self-criticism but also begin to build awareness of, and resistance to, our sexual disgust triggers.
(Shortform note: Another reason why self-compassion is beneficial is that it makes us more caring and supportive of our partner. Research shows that when we’re self-critical, we’re more detached, aggressive, and controlling in our relationship with our partner. In contrast, when we treat ourselves with compassion, we’re more gentle, accepting, and supportive of our partner’s autonomy.)
(Shortform note: While Nagoski suggests that we confront cognitive dissonance, she doesn’t explain what it actually is and how it manifests in terms of cultural context. Cognitive dissonance is when we have inconsistent thoughts or beliefs. One of the ways in which this manifests itself is our tendency to judge ourselves by harsher standards than we would other people. In particular, we readily judge our bodies with criticisms—criticisms passed to us by cultural context—that would never cross our minds when thinking of others.)
To combat cognitive dissonance, Nagoski suggests a daily practice of examining your naked body in the mirror and listing everything you like. When self-critical thoughts arise, let them go by reconnecting with your younger, non-judgmental self. In other words, remember the perspective you had of your body before society taught you to internalize self-criticism.
By doing this every day, Nagoski assures you that you can gradually unlearn the cultural tendency of self-judgment, as well as the self-disgust your body may trigger.
Combating Negative Body Image
While Nagoki’s strategy for combating negative body image could be useful, it might not be the easiest place to start. Coming face-to-face with your body can be intimidating even for those who don’t struggle with severe body image issues. For those who may need or want alternatives, here are some simpler strategies you can use to develop a more positive view of yourself and your body:
Appreciate everything your body helps you do—like playing sports, exploring nature, and spending time with your children.
List the things you like about yourself that aren’t related to your appearance.
Remind yourself that beauty is a state of mind rather than the current state of your body.
Surround yourself with supportive friends and family who appreciate you for who you are.
Repeat positive affirmations when you’re feeling negative about your body, such as “I deserve to be happy.”
Wear clothes that make you feel good about yourself.
View social media through a critical lens.
Practice self-care by doing something nice for your body, such as painting your nails, taking a shower, or drinking a warm beverage.
Dedicate some time to helping others, which is one of the best ways to feel better about yourself.
According to Nagoski, exposing ourselves to media that reinforces self-criticism harms our self-esteem and encourages self-criticism. She suggests that the solution to these issues is to stop consuming media that makes us feel bad about ourselves and instead fill our feeds with media that makes us feel comfortable with who we are.
(Shortform note: Although Nagoski’s recommendation to ignore negative media can be an effective self-esteem booster, research shows that women who fill their feeds with body-positive images still end up objectifying themselves. In other words, they focus their attention more heavily on their appearance than other qualities. One solution to this problem could be to fill your feed with non-body-related content, such as content about your favorite hobbies.)
Overhaul your social media feeds to provide you with more feel-good content.
Identify 3 to 5 accounts on your social media feeds that are regularly body-focused or discuss body-image issues. What are the accounts and what type of content do they post?
Take some time to analyze the content and describe how it makes you feel, both generally and about your body. Which accounts make you feel particularly positive or negative about yourself?
Why do you think these accounts make you feel especially positive or negative? What specific characteristics of their content are driving your feelings? (For example, you may notice you feel bad when seeing posts focused on diet culture.)
Finally, based on what you’ve learned through this reflection, write down what you could do to add more feel-good content to your social media feeds. (For example, you could follow more accounts that focus on your hobbies rather than body-related content.)
In previous chapters, we talked a lot about the mechanisms in the brain that govern our sexual response. In particular, we discussed the sexual excitation and sexual inhibition systems, how the brain learns what to consider turn-ons and turn-offs, and how different types of context affect sexual response.
Now, in Part 3, we’ll dive deeper into our mechanism of sexual response by examining some of its components—arousal, desire, and orgasm—on a more complex level. This chapter starts the discussion by focusing on arousal. In particular, we’ll discuss another one of Nagoski’s fundamental ideas—that there are times when 1) we feel turned on but experience no genital response, or 2) experience a genital response despite experiencing no pleasure. This mismatch between what our brains identify as sex-related and what we actually find appealing is called non-concordance.
(Shortform note: While here, Nagoski talks purely about non-concordance in a sexual capacity, in a TED talk on the subject, she noted that the phenomenon can occur in non-sexual situations, too. For instance, we can bite into a piece of food that we think tastes disgusting but still experience the physical response of salivation, which usually means we find food appealing.)
To demonstrate with an example, imagine you’re watching a sex scene in a movie. The scene doesn’t appeal to you because you don’t think the actors are attractive. Despite this, you find yourself becoming physically aroused at the sight of sex on the screen.
To better understand non-concordance and why it’s normal, we’ll discuss in detail why it happens and how the experience differs from person to person. Additionally, we’ll address three misunderstandings surrounding this idea and ways to approach them within the context of a relationship.
The explanation behind non-concordance concerns the fact that there are multiple components of emotional experience. Nagoski says that in basic terms, we can think of emotions as happening on three levels: physiological response, which is the physical changes (like heart rate, pupil dilation, and genital response) that happen in response to stimuli, involuntary expressive response, which is things like vocal inflection and facial expressions, and subjective experience, which is how we decide we feel at any given moment.
In short, Nagoski concludes, genital response and subjective experience are two distinct aspects of the full emotional experience, which is why they can occur separately.
Although research supports Nagoski’s claim that emotions are comprised of multiple components, there is no agreed-upon definition for the word “emotion.” In other words, despite a great deal of overlap in scientific opinion regarding which aspects emotions involve, there isn’t consensus about what emotions are.
A 2010 study surveying 34 emotion experts revealed that while there were certain things various researchers agreed on—such as that emotion consists of things like neural circuits, response states, and feeling states—there were far more unique characteristics that made it impossible to derive a succinct definition from their responses. This nebulous definition makes it hard to determine whether sexual response is an emotion at all, meaning this three-component framework may not fit sexuality in the way Nagoski suggests.
We’ve learned how non-concordance happens, but how often does it occur? According to Nagoski, research shows that non-concordance is extremely common for both men and women, though there are marked differences in frequency between the sexes. Men experience non-concordance about 50% of the time; for women, that number jumps to around 90%.
(Shortform note: The differences observed between men’s and women’s arousal may be based on a problematic comparison between their genitalia. Many studies have compared the sexes by measuring the response of the penis and the vagina. However, as Nagoski pointed out earlier, the equivalent of the penis is the clitoris—not the vagina. Preliminary research measuring clitoral response suggests that women’s physical response and subjective arousal may align more than previously thought.)
However, Nagoski adds that gender differences don’t account for all of the variation. The frequency of non-concordance also changes from person to person. For example, women with a sensitive SES and less sensitive SIS won’t experience non-concordance as often as the average woman.
(Shortform note: In addition to women and individuals with a more sensitive SIS, sufferers of Obsessive-Compulsive Disorder (OCD) experience higher levels of non-concordance due to unwanted obsessive sexual thoughts. Their genital arousal is due to the sexual nature of their obsessive thoughts and not their subjective feelings about those thoughts.)
Despite non-concordance being remarkably common and varying in degree between people and situations, Nagoski maintains that our culture insists that how we feel and what our genitals are doing are always in sync, and anyone who experiences something different is broken. Specifically, Nagoski focuses on three interrelated things that our culture gets wrong about the relationship between subjective experience and genital response. Let’s look at each of them individually.
Nagoski argues that through various forms of media, and especially pornography, our culture gives us the false impression that genital response automatically equates to sexual pleasure. For example, women and men in the media often say “I’m so wet” and “I’m so hard” to express that they’re turned on. She says that the reason for this misconception is that the standard for sexual experience is based on the average man, who experiences low levels of non-concordance. This creates the expectation that alignment of genital response and subjective experience should be the norm for everyone.
(Shortform note: Although Nagoski bases her argument on the fact that men experience lower levels of non-concordance, some scientists have questioned whether research supporting this claim has found accurate results. They suggest that certain methodological flaws could have misrepresented concordance estimates in both men and women. These include potential issues with the sexual stimuli chosen by researchers, self-reporting measures, assessments of genital arousal, statistical methods, or participant characteristics like age and hormone levels.)
Nagoski maintains that what’s even more problematic is the idea that women who experience non-concordance are either in denial or lying about their inner desires. They’re told that their genitals’ response reveals the truth about how they really feel. We see the prevalence of this idea in romance novels, where men insist that a woman likes a sexual experience because her genitals are responding to it (for example “see, you’re wet”), even if she says she’s not enjoying what’s happening.
What’s more, Nagoski tells us that even some researchers frame non-concordance as women misreporting their subjective experience. For example, after one study, researchers deemed women to be lying because they denied feeling turned on by bonobos having sex despite experiencing a genital response.
The Prevalence of Dishonesty in Sex Research
While Nagoski condemns the researchers of the study for suggesting that women were being dishonest in reporting their subjective experience of arousal, lying is actually a common phenomenon in research targeting sexual behaviors. Both men and women are frequently untruthful, especially when reporting on how often they have sex or how many sexual partners they’ve had. Particularly noticeable is when women claim to have had virgin pregnancies or young people report STI contraction despite claiming to have had no sexual contact.
Why is it that so many people lie when reporting sexual behaviors? In many cases, it’s because they simply want to fit in; both men and women commonly underreport stigmatized behaviors and overreport normalized ones, thinking that their actual behaviors are socially unacceptable.
Nagoski argues that this serious misunderstanding becomes especially dangerous when applied to instances of rape. Put simply, if this myth were true, then the response of a woman’s genitals during sexual assault would mean that she actually likes what’s happening to her. Modern politicians have even used this line of reasoning to argue against abortion. Nagoski provides the example of Republican representative Todd Akin, who in 2012 claimed that “If it’s a legitimate rape, the female body has ways to try to shut the whole thing down,” implying that a rape resulting in pregnancy isn’t a “true” rape. Therefore, pregnant rape victims shouldn’t be allowed to get abortions, as they weren’t “really” raped.
(Shortform note: The reasoning behind Todd Akin’s claim dates back to a 13th-century British legal text, which stated that a woman could only get pregnant if she had an orgasm during sex. But how do those two ideas connect? At the time, people believed that a woman could only orgasm if she consented to and enjoyed sex—though as we will discuss later, we now know this to be false. If that were true, then the logical argument is that if a woman manages to get pregnant from a sexual encounter, it couldn’t have been rape, because pregnancy presupposes orgasm, which presupposes consent.)
Nagoski states that in reality, like all other physiological responses, genital response is simply the body’s automatic reaction to a sex-related stimulus. It says nothing about our subjective feelings about something. For example, just because your eyes water while cutting onions, that doesn’t mean you feel sad.
(Shortform note: Nagoski isn’t the only sexuality expert who recognizes the need to emphasize this fact and dispel misinformation about genital response and subjective experience. For example, in working closely with patients, one sex therapist realized that many sexual problems stem from a lack of knowledge about basic physiology and the mechanics of sex, like the reality of genital response. To combat this issue, she uses her blog as a platform to provide people with accurate information about a variety of issues related to sexuality, including the difference between sexual desire and arousal.)
The fact that our culture treats non-concordance as an abnormality has earned it the reputation of being associated with sexual dysfunction. In short, Nagoski explains, people believe that because non-concordance and sexual dysfunction are both linked to low desire, that means non-concordance is indicative of issues with sexual functioning.
Despite their apparent correlation, one doesn’t cause the other. We know this based on how context affects each. According to Nagoski, both healthy and sexually dysfunctional women will experience sexual inhibition. The difference, however, is that a healthy woman’s sexual response will only be inhibited when an unfavorable context activates her SIS, potentially causing non-concordance. On the other hand, a sexually dysfunctional woman’s sexual response will be inhibited regardless of the context. In other words, Nagoski concludes, non-concordance isn’t an issue of functioning. It occurs only in cases where certain contexts reduce a healthy person’s desire for sex.
Although this and other myths perpetuate the idea that non-concordance is abnormal or even nonexistent, Nagoski assures us that in reality, it’s a normal part of everyone’s sexual experience.
Are Non-Concordance and Sexual Dysfunction Related?
Nagoski’s primary argument against linking non-concordance to sexual dysfunction is that correlation doesn’t equal causation. In other words, simply observing an apparent relationship between the two isn’t enough evidence in and of itself to claim that non-concordance is a problem of sexual functioning. While her argumentation is logically sound, researchers aren’t actually sure about whether the link is purely correlative.
Although many studies have examined the relationship between non-concordance and sexual dysfunction, their combined results are inconclusive. Specifically, some studies determined that women without sexual dysfunction experience higher concordance, some studies found no significant difference between groups, and one study concluded that women who specifically deal with sexual arousal disorder experience lower concordance.
In short, although there still isn’t enough evidence to prove a causative link, it would be misleading to claim that non-concordance and sexual dysfunction are related by nothing more than correlation—at this point, we simply still don’t know.
Because misinformation about non-concordance is so prevalent in our culture, Nagoski suggests that women may need to explicitly address it within their relationships. This can be tricky because the beliefs many of us have about non-concordance are so deeply ingrained. To aid in the process, Nagoski offers women several recommendations for opening up a dialogue with their partner:
Reassure them that non-concordance is normal and that you’re perfectly healthy. (Shortform note: Although Nagoski doesn’t elaborate on how to provide this reassurance, one strategy could be to point out that men also experience non-concordance, like when they have erections in inappropriate situations or while sleeping.)
Let them know about the many other signals, aside from genital response, they can use to assess whether or not you’re enjoying yourself, such as faster breathing, muscle tension, and verbal communication. (Shortform note: While raising this issue within the context of your relationship is undoubtedly a good place to start, it could have even more impact as a part of the general cultural dialogue about consent. Not only is genital arousal not a reliable sign of pleasure, but it’s also not a non-verbal invitation to continue engaging in sexual behaviors.)
Assure them that needing lubrication is normal and doesn’t speak at all to their sexual performance—it’s simply a result of your genitals not being on the same page as your feelings. Suggest that you buy some lubrication together and keep it handy, reframing it as a bonding experience that encourages curiosity and play. (Shortform note: Nagoski doesn’t suggest specific ways that couples can introduce lubrication into their sex lives, but other sources offer some helpful tips. You can try using flavored lube for oral sex, using lube in the shower, or using it during manual stimulation to make the experience easier and more enjoyable.)
In the previous chapter, we focused on arousal non-concordance, which is how we describe the misalignment between our genital response and subjective experience. In this chapter, we’ll continue our conversation on sexual response by talking about what happens when our subjective experience of pleasure combines with context to evolve into something more: desire. (Although we’ve already touched on desire briefly, this chapter will discuss it at length.)
We’ll first describe desire, including the two basic types identified by Nagoski: spontaneous and responsive. Then, we’ll discuss both the misconceptions and reality of what causes lack of desire. Finally, we’ll explore how to increase desire, specifically within the context of long-term relationships.
Nagoski tells us that the best way to think about desire is that it’s the result of context interacting with what we find pleasurable. In other words, depending on the contextual factors at any given time, we may or may not find something pleasurable enough to want more of it (as discussed in Chapter 3). According to Nagoski, exactly how pleasurable a person needs to find something before they experience desire depends on the individual. Essentially, everyone has a different desire threshold—some people require more pleasurable sensation than others to cross the threshold into “I want more.”
(Shortform note: Although Nagoski acknowledges that everyone has a different desire threshold, she doesn’t touch on cases where people experience no desire at all. For instance, some people identify as asexual, which means they have little to no sexual attraction to others or desire to have sex. Depending on the person, the absence of desire can extend more broadly: For example, some asexual individuals feel no desire to masturbate or even be involved in romantic relationships involving non-sexual intimacy.)
Although there’s a wide array of variation from person to person, Nagoski says we can generally divide our experience of desire into two types: spontaneous and responsive.
Nagoski defines spontaneous desire as when a person wants sex immediately after recognizing a sex-related stimulus, such as getting turned on by the scent of a partner’s perfume. (Another way of thinking about this type of desire is that it’s desire in anticipation of sexual pleasure.) Someone with a low pleasure threshold would experience this type of desire more easily because it generally takes very little stimulation to make them want more. In the aforementioned instance, for example, just the smell of someone creates enough excitement to incite desire.
(Shortform note: Why might someone have a low pleasure threshold—or, as some might put it, a high libido—and experience high levels of spontaneous desire? According to research, factors like hitting either puberty or middle age, increasing your daily physical activity, and lowering your stress levels can increase your levels of desire. Coming off some desire-inhibiting medications, such as antidepressants and anti-hypertensive drugs, can have the same effect.)
In contrast, Nagoski defines responsive desire as when a person experiences desire in response to sexual pleasure, such as physical stimulation like kissing or touching. This type of desire is especially common for those who have a higher threshold because they generally require higher amounts of pleasure to become turned on.
(Shortform note: One point that Nagoski’s discussion doesn’t touch on is why people with responsive desire still choose to initiate or engage in sex before actually wanting it. A potential answer could be that, although pleasure is often the primary motivation, there are other reasons that people may want to have sex. For instance, because sex involves a high level of intimacy, someone might want to engage in it because they crave emotional bonding with their partner. Another factor could be that sex makes a person feel more attractive. Additionally, having sex could satisfy feelings of nostalgia for a previously enjoyable sexual experience.)
Importantly, adds Nagoski, spontaneous desire doesn’t equate to more interest in sex, nor does responsive desire equate to less interest in sex. These descriptions are simply used to describe how different people come to experience desire, and this can change from person to person, context to context, or even over time.
(Shortform note: While Nagoski acknowledges that our experience of desire can change according to many different factors, she doesn’t provide specific examples. In the case of women, for instance, biological factors like ovulation, pregnancy, and being postpartum could impact their ability to experience more spontaneous desire due to the hormonal changes that accompany them.)
While needing more pleasurable sensation to cross the threshold doesn’t inherently mean that a person has a low level of desire (they might just have more responsive desire), Nagoski acknowledges that some people do seem to have less interest in sex than others.
(Shortform note: Although Nagoski’s discussion focuses primarily on women’s lack of interest in sex, there are certain medical reasons for low desire that can affect anyone, regardless of sex. These include chronic illnesses like diabetes and sleep apnea as well as certain medications, such as antidepressants and those that treat high blood pressure.)
Unfortunately, just as with many other aspects of sexuality, our culture spreads a lot of misconceptions about desire and why some (especially women) seem to have a lack of it. Nagoski mentions several in particular that harm women’s sexuality: desire as a drive, hormones and monogamy as causes of lack of desire, and drugs as a treatment option.
Despite the prevalence of the term “sex drive” in modern culture, Nagoski says that desire isn’t a drive like hunger or thirst. We know this because to go without it has no impact on our survival. Without food and water, we die—without sex, the most we feel is frustrated.
(Shortform note: While research supports Nagoski’s claim that there are no negative physical health effects of not having sex, there are positive effects of having sex regularly. Some of the proven benefits include improved immune system function, reduced blood pressure, lower stress levels, and reduced risk of cardiovascular problems.)
Nagoski observes that when people are told that desire is a drive, it makes them feel as if having less of it means there’s something fundamentally wrong with them. What’s more, she adds, portraying desire as a drive creates a dangerous sense of entitlement surrounding sex. If sex is a need like food or water, suddenly we can excuse inappropriate sexual behaviors as uncontrollable, and this puts people in very real danger.
(Shortform note: This same line of thinking is what underlies the idea that women are somehow at fault for their assault because of what they were wearing at the time. Asking the question “What was she wearing?” in response to a sexual assault allegation suggests that we can’t blame men for their behavior when women dress in a provocative way—in other words, they’re simply acting on an uncontrollable “drive” triggered by the woman’s attire.)
Nagoski tells us that, in reality, desire is a system motivated by incentive. What this means is that when we encounter an appealing external stimulus (like a kiss), our brain compels us to move towards it. Said more simply, when we find something pleasurable, we want more of it.
(Shortform note: Although Nagoski claims that desire is a system motivated by incentive, in reality, this is just as much of a theory as framing motivation as a drive. Researchers have developed several different theories to try to understand what motivates people, including instinct theory, arousal theory, humanistic theory, and expectancy theory.)
Nagoski asserts that another common misconception is that hormone levels cause lack of desire. Even medical experts are quick to blame a “low sex drive” or “low libido” on hormonal imbalances due to things like birth control, medications, and aging. Nagoski challenges that while it’s true hormones play a role, they have a negligible effect in comparison to emotional factors like stress. For this reason, targeting hormone levels won’t have a noticeable effect on lack of desire.
(Shortform note: In her argument against targeting hormone levels as a cause of desire, Nagoski doesn’t clearly define which hormones she’s referring to and instead groups them all together. However, she later attributes lack of desire to stress, which is itself linked to a type of hormone—cortisol. Does this mean that hormones can cause lack of desire after all? Or, could it be that Nagoski only means that specific hormones aren’t linked to lack of desire? It’s unclear.)
Nagoski notes that yet another misconception is that remaining in long-term, monogamous relationships decreases desire for our partner. One reason for this misconception’s persistence is the fact that many couples begin to have less sex over time.
Nagoski claims that the real culprit of reduced desire in all relationships is context. Because desire is pleasure interacting with context, contextual factors play a much larger role in wanting sex than we realize. She argues that regardless of whether you’re in a monogamous or open relationship, the wrong context will decrease your desire for sex.
(Shortform note: While Nagoski is adamant that context—not monogamy—causes decreased desire, other experts would disagree. For example, the authors of Sex at Dawn use evidence from the social behavior of great apes, remote hunter-gatherer societies, and human biology to argue that monogamy isn’t natural, and therefore it’s expected that we would lose sexual interest in a long-term, monogamous partner.)
According to Nagoski, many therapists, educators, and medical providers view lack of desire as a medical problem that we should treat with drugs. She says this belief stems from our culture’s favoring of spontaneous desire—the type of desire most often experienced by men. As we’ve already mentioned, our culture uses the average man as the standard for all sexual experiences.
Nagoski argues that the reason drugs can’t treat low levels of desire is that it was never a problem to treat in the first place. She says what is a problem, however, is the stress caused by telling women there’s something wrong with them, which inhibits sexual response and can prevent desire altogether.
(Shortform note: Since the publication of Nagoski’s book, the FDA has approved further medications made to target low desire. For example, scientists developed the drug bremelanotide to treat women who’ve experienced a sudden decrease in desire that they can’t attribute to any other known cause, such as depression, relationship issues, or medication side effects. However, research on the drug’s effectiveness mostly confirms Nagoski’s claim—it was shown to increase sexual desire only modestly, and the benefits were limited to just a portion of women.)
So if these misconceptions miss the mark regarding the causes of lack of desire, what’s the real reason it happens? Nagoski says that a lack of desire is caused by emotional factors—like stress, depression, and a lack of self-compassion—that are made worse by our sex-negative culture and mismatched desire types in relationships. By this, she means the toxic dynamic that often develops between partners with spontaneous and responsive desire: The partner with responsive desire feels increasingly defensive and guilty in turning down sex, and the partner with spontaneous desire feels increasingly frustrated and rejected in initiating it.
(Shortform note: Lack of desire isn’t the only consequence that arises from the toxic dynamic that can develop between partners of mismatched desire types. The rise in tension that develops as the cycle continues can also negatively impact the couple’s emotional well-being and relationship. One consequence of the cycle, for example, is that it can cause individuals to feel hurt because their partner isn’t addressing their needs. Another outcome is a loss of confidence, especially in the partner who feels consistently rejected. Additionally, the tension can ultimately lead to a lack of trust in the relationship, as the longer the problem persists, the more the couple loses faith in their ability to overcome obstacles together.)
In short, Nagoski concludes, the reality is that there isn’t really a lack of desire—just an abundance of the wrong contextual factors, such as the circumstances, emotional states, and cultural messaging that we discussed earlier on. All of these things activate the SIS and inhibit our desire for sex.
(Shortform note: While it may be true that contextual factors are responsible for lack of desire, the causes may be more nuanced than Nagoski explores in her discussion. For instance, research suggests that certain factors may be more relevant depending on the population. According to one study that examined the effect of socio-demographic factors on sexual desire in women in Iran, low satisfaction with income, being married for at least 10 years, and a woman being age 17 or under during her first sexual experience were significantly associated with low desire.)
Regardless of whether you experience spontaneous or responsive desire, crossing the threshold involves experiencing enough pleasure to want more—to want sex. But how do we make that happen? Nagoski suggests that the key is context. Because desire is the interaction of pleasure and context, creating an environment that makes us feel excited for sex and uninhibited by what our brain sees as threats is the best way to ensure great sex with our partner.
Although there’s variation in what each of us perceives to be a favorable context, Nagoski says research shows that partners agree on certain characteristics that make sex most enjoyable:
Vulnerability: Vulnerability comes from being fully present in the moment, allowing yourself to be free of distractions, and welcoming a sense of inner peace. It also means you’re willing to accept yourself as you are.
(Shortform note: Vulnerability researcher Brené Brown suggests several things we can do to help us be more comfortable with vulnerability: recognize that vulnerability takes courage, stop worrying about what others think of us, let go of being perfect, and practice mindfulness.)
Connection: Feeling connected to your partner during sex develops from a sense of respect, caring, and trust within your relationship. You encourage open communication with your partner and are attentive to each other’s needs.
(Shortform note: How can you build the respect, caring, and trust that leads to a stronger connection with your partner? Renowned psychologist John Gottman developed a list of 7 research-based principles to help couples build a deep and lasting connection.)
Exploration: Creating a space for sexual exploration comes from giving yourself the freedom to express yourself, taking risks, and having fun.
(Shortform note: Openness to expressing yourself and taking risks is only possible if you feel you’re in a safe space. One way to foster this sense of security is to explicitly discuss your sexual boundaries with your partner. To do this, start by deciding which sexual activities you’re each personally comfortable with on your own. Then, go through your lists together, taking time to discuss each one openly and without judgment.)
In the previous chapter, we learned about the different ways that people experience desire, what causes a lack of desire, and how we can increase desire within our relationship. Now, we’ll shift our attention to orgasms, which scientists define as the climactic release of built-up tension during a sexual experience. However, as we’ll discuss, Nagoski insists that orgasms are much more complex than this definition allows for, and each individual experiences them in a unique way.
To frame our discussion, we’ll start by clearing up some of the misconceptions that society has made us believe about orgasms to better understand what they are. Then, we’ll discuss in what ways one experience of orgasm can differ from another. Finally, we’ll identify why some people, especially women, have difficulty with orgasms and provide information about what they can do to have better and more frequent orgasms.
By now, we have a good understanding that our society perpetuates a lot of false information regarding sex. Nagoski tells us that this is no different when it comes to ideas about orgasms. In particular, she discusses several misconceptions that frame our culture’s understanding of orgasms and how these beliefs depart from the truth.
Nagoski says the first misconception about orgasms is that they’re primarily a genital response. This belief comes from the fact that orgasms are often accompanied by certain physical genital responses, such as pelvic floor contractions.
In reality, Nagoski argues, orgasms are really about what happens inside the brain, and research shows no relationship between our subjective experience of orgasm and our genital response (just like arousal). In other words, muscle contractions can happen without orgasm, and the reverse is also true.
Our Brains During Orgasm
If orgasms are about more than just a genital response, what exactly is the full picture? By using fMRI and PET scans to measure the blood flow and neuron activity of individuals experiencing orgasm, scientists have been able to observe what happens in the brain during this climactic experience.
First, multiple remote brain regions activate during orgasm, including the genital sensory cortex, motor areas, hypothalamus, thalamus, and substantia nigra. Specifically, the genital sensory cortex registers sensation in the genitals, the motor areas govern the body’s movement, the hypothalamus and substantia nigra produce hormones, and the thalamus helps bring together information related to senses, movement, memories, or fantasies that might be useful in reaching orgasm.
Additionally, the lateral orbitofrontal cortex, which is the part of the brain responsible for reason, decision making, and value judgments, becomes less active. Scientists say that one reason for this is to decrease fear and anxiety, which inhibit sexual response.
Finally, the brain also releases a variety of hormones and neurochemicals during orgasm that promote enjoyment, bonding, pain reduction, and relaxation, such as dopamine, oxytocin, serotonin, endorphins, and vasopressin. This is why we experience things like intense pleasure, closeness with our partner, lower sensitivity to pain, and a sense of calm after sex.
Nagoski tells us that the second misconception about orgasms is that they’re always enjoyable. This most likely stems from the depiction of orgasms as an experience of ecstasy in porn and other media. Nagoski argues, however, that the way we feel about an orgasm depends on the context, just like other sensations. Often orgasms are pleasurable, but they can also be frustrating, painful, or even not feel like much at all.
(Shortform note: While Nagoski acknowledges the role of context in our experience of orgasm, she doesn’t provide specific examples of which types of context influence bad orgasms. Research shows that some of the most common reasons for these unpleasant experiences include having sex to avoid arguing about sex, feeling obligated to orgasm, or having sex that lacks emotional connection.)
One situation in which this falsehood is especially problematic, according to Nagoski, is in the context of sexual assault. To believe that orgasms are always pleasurable is to believe that if a person has an orgasm while being sexually assaulted, then they’re enjoying the experience. On the contrary, we know from personal accounts (in addition to the science) that this isn’t the case—many victims have reported feeling disturbed and confused about experiencing orgasm during assault.
(Shortform note: Victim accounts have stressed numerous harmful consequences that arise from experiencing orgasm during sexual assault. For example, one victim was so traumatized by her experience that she made herself believe that she only enjoyed sex if it was violent. Because of this, she purposely sought out risky and violent sexual encounters, which led her to be assaulted two more times. Additionally, the trauma caused an immense amount of shame, difficulty orgasming, and dissociation during sex.)
Nagoski states that the third misconception about orgasms is that some are better than others. In particular, there’s a widespread notion in both the media and the medical field that penile-vaginal orgasms are the ideal. As discussed previously, this and many other false ideas stem from our society viewing men’s experience as the standard. Nagoski clarifies that in this case, however, men’s pleasure is the default. We’re led to believe that because men usually experience orgasm through vaginal penetration, women should too. However, Nagoski notes that many women rarely, if ever, orgasm in this way.
(Shortform note: We can trace the glorification of female orgasm through vaginal penetration—despite this method of orgasm being relatively uncommon—back to Freudian psychoanalysis. Sigmund Freud, considered to be the father of modern psychology, believed that orgasm through heterosexual, penile-vaginal sex was the proper way for a woman to orgasm. Anything else—including clitoral stimulation and masturbation—was considered to be immature and to make women prone to psychological disorders like psychosis.)
Nagoski says that regardless of the means through which a woman experiences orgasm, there’s no right way to have one. What’s more, no single type of stimulation produces an orgasm that feels inherently better than another, whether it’s vaginal, anal, clitoral, thigh, breast, earlobe, or even mental stimulation. Each orgasm simply feels different.
(Shortform note: New research on the female orgasm may call into question Nagoski’s claim that no orgasm feels inherently better than another. Preliminary findings from a pilot study show that there may be two different types of female orgasm—clitoral and vaginal—rather than different types of stimulation triggering one single type of orgasm. If this proves to be true, further research would be required to understand how exactly they differ and whether one could produce a more pleasurable sensation than the other.)
Nagoski’s claim that no orgasm is inherently better than another ties into her fundamental idea that no orgasm is the same. As we already saw, a person’s experience of orgasm can vary depending on the individual and the type of stimulation that produces it. But it can also differ depending on the situation.
In fact, Nagoski tells us that orgasms can happen in lots of different scenarios—far more than what the media depicts. People can experience orgasms alone or with a partner, while they’re asleep or exercising, or during any number of other regular activities.
(Shortform note: While Nagoski doesn’t go into detail about the diverse circumstances in which orgasms can occur, women have reported a variety of unexpected and even mundane scenarios that have led to orgasms. In particular, women have had orgasms while riding roller coasters, yawning, brushing their teeth, getting laser hair removal, birthing children, and even eating a particular type of mushroom.)
As part of the discussion about what orgasms are and what they aren’t, it’s important to acknowledge that women in particular often have difficulty reaching orgasm. In fact, Nagoski says that this is one of the most common reasons for seeking sex-related treatment or therapy.
(Shortform note: Compared to women, men experience much lower levels of difficulty with orgasm and ejaculation. According to research, anywhere between 1–4% of men experience delayed ejaculation, which is when men take 30 minutes or longer to be able to ejaculate. Additionally, a 2009 study showed that men are almost 30% more likely to orgasm than women.)
So why is it that so many women seem to have difficulties? Nagoski says the answer is most often the same as what causes lack of desire and non-concordance: over-activation of the SIS due to negative emotions like stress, depression, anxiety, and shame. For example, if you’re feeling self-conscious about your body during sex, that activates the SIS, making it difficult for you to reach orgasm.
(Shortform note: Another important factor contributing to women’s difficulty with orgasm is the lack of knowledge they have about the clitoris. One study, for example, found that the less knowledge a woman has about her clitoris, the less frequently she’s able to orgasm during masturbation. Interestingly, however, the research showed that a woman’s level of knowledge of the clitoris had no significant effect on the frequency of orgasm during partner sex—in other words, even if a woman is knowledgeable, the frequency with which she orgasms with her partner is no more than incidental. The researchers attributed these findings to a societal construction of sex that privileges men’s pleasure over women’s.)
However, in more specific terms, Nagoski says that orgasm difficulties arise from the way our brains process the gap between our expectations and reality, which our culture’s tendency to set the bar unreasonably high worsens.
Nagoski explains that our brains constantly evaluate our surroundings, making comparisons between the expectations we’ve developed based on our experiences and what’s actually happening. When our expectations don’t match up with reality, we try to close the gap by setting a goal to bring them back into alignment. Nagoski adds that when we think we’re making good progress toward that goal, we remain happy and motivated. But when we don’t see good progress, we become frustrated and increasingly desperate to close the gap, until we eventually give up in despair.
In the case of orgasms, the process Nagoski describes looks like this: Society has given you the expectation that you should be able to have an orgasm from vaginal penetration, but you find yourself unable to do so. Your brain notices this gap between your expectation and reality, and so you become determined to “fix” reality by continuing to try to have an orgasm this way. When it doesn’t work, you become increasingly anxious, which activates the SIS. Ultimately, this makes trying to have an orgasm even more difficult than before, creating a continuous cycle of frustration and anxiety that eventually ends with you giving up on having one altogether.
How Our Expectations Influence Our Judgments
In her discussion of how our brain compares our present surroundings to our set of expectations, Nagoski doesn’t go into detail about exactly how this process works. However, learning more about how our brain processes information can enhance our understanding of how we interpret what’s happening to us, including our experience of sex.
Over time, we come to develop many different expectations based on a wide range of experiences. Exactly which expectations we use to judge a given situation, however, depends on many different factors. One of these factors is that we tend to base our judgments on the stored information that’s most accessible to us. What’s most accessible at any given time is determined both by what’s important to us as individuals and by what we’ve been recently or frequently exposed to. Unfortunately, because certain information comes to mind more easily than anything else, it has the potential to influence our judgment—even when it’s counterfactual.
We can imagine, then, how this bias may affect our sexual experience. If society constantly tells us that we should be able to have an orgasm from vaginal penetration, that information will become more accessible. Furthermore, because our brain is wired to privilege accessible information, we’re likely to convince ourselves that we should be able to have this type of orgasm, regardless of what the truth may be. And ultimately, we’ll become frustrated and blame ourselves when it doesn’t work out in the way we expected—all because of our brain’s inherent bias. This leads to the type of negative feelings that activate our SIS and inhibit orgasm, making it even less likely we’ll live up to society’s expectations.
Despite the difficulty that many women seem to have with orgasms, Nagoski assures us that there’s hope for women to not only reach orgasm but also improve and have more of them. She says the solution is to deactivate the SIS and slowly activate the SES. In other words, we need to eliminate what our brain sees as reasons not to have sex and gradually increase the frequency and intensity of what turns us on.
To create an environment where this is possible, Nagoski insists we must get all of the internal states of our mesolimbic cortex—things like comfort, hunger, and sleepiness—to work together rather than against each other. What this means is that we need to be fully present in the moment, without any of our various internal states trying to pull us away from the goal at hand (the goal being having an orgasm). For example, even if you’re in the comfort of your own bed and relatively energized, you’ll find it difficult to focus on having an orgasm if you haven’t eaten in 8 hours.
Treating Our Needs as a Hierarchy
Nagoski’s insistence that our internal states must work together for us to be present in the moment is reflected in other theories as well. Maslow’s Hierarchy of Needs, for example, is based on the idea that there are more basic needs that must be met before a person can focus on other things. According to the hierarchy, physiological needs (such as food) are the most fundamental, followed by safety (financial security), love and belonging (friends), esteem (achievement), and self-actualization (fulfillment). In other words, if our basic needs aren’t met, we aren’t going to be able to focus on experiencing pleasure.
One fundamental way in which Nagoski and Maslow’s ideas differ, however, is that Maslow classified sex as a physiological need on the same level as food and sleep. As previously discussed, Nagoski would disagree with this categorization, because she argues that desire for sex isn’t motivated by survival, and going without sex causes no negative physical consequences. Most likely, she would classify sex—and especially pleasure—as higher on the hierarchy.
So, how do we become fully present in the moment? Nagoski says three things can make this happen. We discussed two of the key strategies—handling stress and creating a context conducive to sex—in Part 2. But the third strategy Nagoski suggests is to retrain our brain’s attempts at closing the gap between expectations and reality.
One example of this is adjusting the goal from having an orgasm to simply experiencing pleasure during sex—orgasm or not. This releases us from the expectation of orgasm and prevents anxiety from activating the SIS.
Another way to close the gap between expectations and reality is to live by the Zen philosophy of “emptying your cup.” According to the Zen proverb, when your mind—or “cup”—is full of preconceived ideas and beliefs, you become trapped by your patterns of thinking and behavior. To open yourself up to new possibilities, you must “empty” your existing expectations.
The best way to do this is to identify a problematic core belief and gather evidence that refutes it. For example, if you believe you’re broken because you don’t orgasm every time you have sex, you should search for evidence to contradict that idea—do the women you know have an orgasm every time they have sex? Is there any credible information to support your belief?
Improve your sex life by changing your perspective.
Below, list the different expectations you have surrounding sex. (For example, you may expect that you should enjoy every orgasm you experience.)
Consider how these expectations are reflected in your sexual experience. Which of them are consistently met? Which of them seem to always fall short of reality?
Now, think about where each individual expectation came from. Write down its possible source.
For each of the expectations that fall short, ask yourself these questions: Are they reasonable expectations to have based on what you’ve learned and where they came from? If so, what more could you or your partner be doing to meet them? If not, how could you adjust your expectations of sex to better align with reality?
Throughout the previous chapters, we’ve established all the ways in which a person’s individual sexual experience may not fit the cultural standard. Contrary to what we’re made to believe, each person has a unique anatomy, experience of arousal, desire threshold, and experience of orgasm. And no matter where we fall on the spectrum of possibilities, we’re normal and healthy just the way we are.
But despite all of the encouraging new information we may learn about our sexual experience, that doesn’t automatically equate to a pleasurable, problem-free sex life. Nagoski argues that when it comes to finding true enjoyment in sex, we must not only understand our own sexuality but also love it for what it is. In other words, we must find confidence and joy in ourselves.
In this final part, we’ll talk about what it means to find confidence and joy, why accepting and appreciating ourselves is so difficult, and what we can do to build a more loving relationship with our sexuality.
Although confidence and joy are separate components of an enjoyable sex life, Nagoski believes you can’t have one without the other. Whereas she defines confidence as trusting in what we know about ourselves and our sexuality, she defines joy as deeply appreciating those things despite any doubts or disappointment we may have. In other words, we must first understand ourselves before we can fully accept and cherish who we are.
(Shortform note: While Nagoski’s definition of confidence aligns with other perspectives—such as psychologists' view of confidence as the trust we have in our own capabilities—her definition of joy is unique in comparison to others. Merriam-Webster, for example, describes joy as a feeling of happiness brought on by success or prosperity. It’s also distinct from other authors’ definitions, such as the one provided by Brené Brown in her book The Gifts of Imperfection. For Brown, joy is the profound satisfaction one feels from practicing gratitude.)
Nagoski also acknowledges that these two components aren’t equal in weight—joy is much more difficult to cultivate than confidence. This is because although we may learn the truth about something, we may still doubt its validity or wish it wasn’t true. She elaborates by saying that when we’ve internalized so much negative misinformation for so long, it’s difficult to overcome, no matter how much our new knowledge may contradict it. For example, when people have always told you that you should experience spontaneous desire, learning about responsive desire won’t easily combat the pressure to fit the societal standard.
(Shortform note: While it’s true that the frequency of negative messaging makes it more difficult to reject, we also find it harder to dismiss because of our inherent tendency to notice and internalize negative information more than positive information, even when the amount of positive information is greater. This means that we’re at an automatic disadvantage when it comes to combating negative misinformation, as our brain is wired to prioritize that type of information.)
Fortunately, despite how difficult it may be, Nagoski assures us that it’s possible to cultivate joy. She suggests two ways to do this:
Nagoski suggests that the first way we can cultivate joy is to perform some reality checks, comparing what we know is true to our culturally-ingrained expectations. We can think of our preconceived expectations as a template in our brain: Without conscious awareness, we establish a set of certain “truths” based on what we’ve learned from the society we live in.
As we encounter new information, Nagoski explains, we can challenge our brain’s template in the same way we learned to redirect our brain in the previous chapter: by adjusting our expectations to fit reality rather than the other way around. To continue our previous example, once you’ve learned about responsive desire, instead of continuing to force the expectation of spontaneous desire on yourself, you can focus on creating opportunities that embrace the kind of desire you do have (like warming up to sex with a sensual massage).
Identifying Your Expectations
To perform reality checks and adjust your expectations as Nagoski suggests, you first need to identify what your expectations are. While you may already be aware of some of your expectations due to persistent cultural messaging (like coming to expect that you should be able to orgasm from penile-vaginal penetration), in other cases they’re harder to identify.
Although Nagoski doesn’t provide any recommendations for how to identify your expectations, there are practical steps you can take to figure out what they are:
Set aside time to brainstorm what expectations you have—not only in terms of your sex life and relationship but also in other areas of your life.
Dedicate a day to noticing your expectations. To do this, set a timer to go off at set intervals (for example, every two hours) and write down everything that you expected during that time.
Take notice of every time you feel frustrated or disappointed, and try to identify the expectation behind that emotion.
In addition to these steps, keep an eye out for psychological issues that commonly accompany unrealistic expectations. For example, things like perfectionism, low self-esteem, and fear of intimacy, failure, and change can be signs that you need to pay more attention to your expectations and do some adjusting.
The second way we can cultivate joy, according to Nagoski, is by learning to be neutral toward our inner selves. It’s not enough to simply be aware of how we feel, because that awareness is often accompanied by judgment (for example, thoughts like “I shouldn’t be feeling this way”). Instead, we must actively resist the urge to judge ourselves when feelings arise so that we can create an environment of acceptance rather than criticism.
(Shortform note: Although Nagoski insists that it’s in our best interest to stop judging ourselves, she doesn’t provide any actionables for how to do this. Some strategies we can try are to practice mindfulness, stop overgeneralizing single failures, show appreciation for compliments, focus on our good qualities, and practice self-compassion.)
Nagoski says there are five situations in particular where neutrality is especially useful:
Nagoski observes that there are often times when uncomfortable feelings like anxiety and sadness seem to happen for no reason. Being unable to identify the source of such feelings can be frustrating and lead us to judge ourselves (with thoughts like “you have no reason to be so anxious”).
Nagoski argues that by practicing neutrality toward these feelings—observing and accepting them rather than judging them—we can more easily complete the stress cycle, which reduces our sexual inhibition.
(Shortform note: Although Nagoski tells us that accepting our feelings can reduce stress, she doesn’t explain how this process works. What happens to our mindset when we choose acceptance over judgment or avoidance? There are several positive ways in which this strategy impacts us: First, by accepting our emotions, we spend less time worrying about how we feel, preserving energy to focus on our values and goals. In addition, acceptance gives us the opportunity to learn from our emotions, which makes them easier to manage in the future. Finally, when we accept our emotions, they lose their power over us—in other words, we become less easily affected by them.)
Nagoski acknowledges that letting go of expectations about how things should be sexually can feel like we’re accepting failure and even losing a part of our identity. For example, the thought that we may never experience an orgasm from vaginal penetration may cause us to mourn the loss of a woman we’ll never be.
Nagoski says that by choosing to be neutral in letting go of expectations, we can avoid judgment that makes us feel especially negative toward ourselves. And when we eliminate that negativity, we create a context that’s more favorable for sexual enjoyment.
(Shortform note: The way Nagoski describes letting go of expectations is similar to the Buddhist concept of non-attachment. Buddhism describes non-attachment as learning to accept, rather than mourn, change and impermanence; because nothing in life ever stays the same, we must learn to resist attaching ourselves to a certain reality or outcome. This perspective aligns especially well with our sexual experience, which is in constant flux throughout our lifetime. By practicing non-attachment, we can avoid negative feelings that arise from changes to our body, arousal, desire, and experience of pleasure.)
Nagoski notes that pain is another common target of our self-judgment. We don’t like the experience of pain, so we criticize ourselves for feeling it (with thoughts like “you’re weak”) and often refuse to acknowledge it altogether (for example, “you’re making something out of nothing”). And when that pain relates to sex, she adds, it can seriously interfere with our pleasure. By practicing neutral awareness of our pain, we can come to accept and address it rather than simply tolerate it.
Using Body Scan Meditation for Pain Management
One way of practicing neutral awareness of your pain is to use body scan meditation. Whereas a basic mindfulness practice cultivates awareness by focusing on the breath, body scan meditation builds specific neutral awareness of the sensations happening within your body. This can not only help change the way you think about your pain, but it can also reduce the negative effects of chronic pain, such as depression and poor quality of life.
To conduct a body scan meditation, follow these steps:
Lie down, close your eyes, and begin to focus on the inhale and exhale of your breath.
Begin to focus on one particular part of your body as you continue to breathe deeply. This could be anywhere you like—for instance, your head, hand, or knee.
As you focus on that spot, notice any sensations you feel, whether discomfort, tension, numbness, tingling, or pain. Make sure to give yourself anywhere from 20 to 60 seconds to observe.
If you notice any unpleasant sensations, accept them without judgment. In other words, don’t judge yourself for having the sensations or the emotions that may arise as you observe them.
Finally, imagine the unpleasant sensations disappearing with each inhale and exhale.
Continue the exercise by slowly moving through the different parts of your body, pausing to notice any sensations you experience. As you scan your body, notice when your thoughts drift to something else and gently guide them back.
As you close out the exercise, bring your awareness to your entire body, pausing to inhale and exhale several times. Then, release your focus and return to your present surroundings.
Like physical pain, Nagoski identifies trauma as another unpleasant experience that inhibits our ability to enjoy sex. What’s more, its long-lasting nature makes us especially resistant to acknowledging that it’s there. Unlike physical pain, however, trauma can’t heal if we numb ourselves to it. Nagoski says that it’s only by viewing our trauma from a neutral place that we can come to accept it—in other words, it’s only by learning to be comfortable with the presence of trauma that we can heal from it.
(Shortform note: An additional benefit of acknowledging our trauma without judgment is that it prevents us from trying to rationalize it. In our guide for The Body Keeps the Score, we discuss how attempting to understand our feelings surrounding trauma is actually detrimental to healing it. This is because while reasoning involves our logical brain, trauma involves our emotional brain. Trying to understand it not only fails to prevent us from feeling our emotions but also leads to self-judgment and frustration.)
Nagoski adds that practicing neutrality isn’t only useful in terms of addressing negative feelings, physical pain, and trauma. It can also increase our experience of sexual pleasure by resisting our tendency to judge our experience (for example, “Is it okay for me to feel this way?”). By freeing ourselves from judgment, we can be fully present in the moment and allow ourselves to experience pleasure.
(Shortform note: While refraining from judging our experience can help open us up to sexual pleasure, we can further enhance those sensations by practicing what scientists refer to as “savoring”. An extension of mindfulness, savoring is when we intentionally try to enhance positive feelings and sensations by focusing exclusively on the stimuli responsible for those feelings and sensations. For example, you can intensify the experience of orgasm by focusing your attention on all of the individual sensations it causes throughout your body.)
Nagoski acknowledges that an important part of cultivating joy is processing our grief. No matter how much we’re told that we’re normal, healthy, and perfect just as we are, we won’t internalize those messages if we don’t make space for it by allowing the grief to move through us.
When allowing ourselves to grieve, Nagoski insists that instead of grieving the cultural ideals society taught us to strive for, we should grieve the compassion that we deserved but never received.
How to Cope With Grief
Although Nagoski stresses the importance of completing the grief cycle, she doesn’t explain how that might look in practice. In other words, she suggests what to grieve but not how to grieve.
Grief researcher David Kessler says there are five stages of grief that people generally pass through when dealing with loss, and being aware of them can help us better navigate what we’re experiencing. Though they’re listed in a specific order, Kessler says that the grieving process doesn’t occur in a linear fashion, and each person’s experience of grief is unique: We may pass over certain stages, experience them in a different order, or return to the same stage again and again.
Denial: We enter a state of shock, denying the existence of our loss to get through each day.
Anger: We experience intense anger as an outward manifestation of our inner pain and take it out on everyone around us.
Bargaining: We feel stuck in the past, willing to do anything to go back to how things used to be. “If only…” and “what if…” consume our thoughts.
Depression: We feel a deep sense of sadness that seems like it will never end.
Acceptance: We accept the reality of our loss and realize that life will never be the same.
By allowing ourselves to pass through these phases, in whatever way feels right for us, we can fully process our grief and create space for the cultivation of joy.