On a trip to Trinity College a friend asked me if I had seen the film Orgasm, Inc.: The Strange Science Of Female Pleasure When I told her I had not, she began to tell me about the film. She had requested the library order it and it had just arrived when I was leaving. When I got back to NYC I decided to look into the film. I watched the trailer on the website (which you can see below) and sent a review request in which was quickly answered.

A pink folder of information about the film arrived a week later and I eagerly read the information preparing to watch the film.  Director Liz Canner (Deadly Embrace: Nicaragua, The World Bank and International Monetary Fund) has several documentaries she’s created and directed of various topics focusing on human rights and social justice. An award-winning filmmaker, Canner spent almost 10 years working on Orgasm, Inc. Below is the synopsis of the film from the website:

“In the shocking and hilarious documentary ORGASM INC., filmmaker Liz Canner takes a job editing erotic videos for a drug trial for a pharmaceutical company. Her employer is developing what they hope will be the first Viagra drug for women that wins FDA approval to treat a new disease: Female Sexual Dysfunction (FSD). Liz gains permission to film the company for her own documentary. Initially, she plans to create a movie about science and pleasure but she soon begins to suspect that her employer, along with a cadre of other medical companies, might be trying to take advantage of women (and potentially endanger their health) in pursuit of billion dollar profits. ORGASM INC. is a powerful look inside the medical industry and the marketing campaigns that are literally and figuratively reshaping our everyday lives around health, illness, desire — and that ultimate moment: orgasm.”

Canner’s original goals of creating a film about science and pleasure led her to the creation of this film: the medicalization of pleasure. What I found interesting, although sadly I was not surprised (until later) was that many doctors, researchers, and pharmaceutical companies see the big “prize” in women’s sexual health being billions of dollars, NOT women experiencing or increasing sexual pleasure. In the film, Canner shares her thought process with viewers and we discover with her how the “medical profession is attempting to change the meaning of health, illness, desire and orgasm.”

If that quote doesn’t frighten you I don’t know what will!

My initial thought is that Canner asks several important questions: Where did the term “female sexual dysfunction” (FSD) come from? What is female sexual dysfunction? And what does research tell us? Canner starts at the pharmaceutical company that initially employed her 10 years ago to create erotic videos for clients, Vivus. She asks the founder, CEO, and senior staff about the origins of the term “female sexual dysfunction” and their role in the creation of the term. The founder admits, as seen in the trailer, he does not know. We learn later from another staff member that during a television interview there seemed to have been a “slip” by the CEO about the work they were doing on male erectile dysfunction and mentioned they are working on a cream for women. It seems viewers interpreted this as being a feminized version of a sexual dysfunction and thus the interest and profit of such a product was produced.

Canner asks her gynecologist, Dr. Susan Bennett at the Harvard Medical School: what is female sexual dysfunction? Dr. Bennet’s response is that there is no new medical discoveries regarding women’s sexual dysfunction that have been reported in literature (i.e. medical peer reviewed journal). This leads us to a conversation with Ray Moynihan of The British Medical Journal, and author of Selling Sickness, who shares the one article that was published in 1999 in the Journal of the American Medical Association (JAMA) that discussed female sexual dysfunction. Authors Edward O Laumann, Anthony Paik, and Raymond C. Rosen co-wrote Sexual Dysfunction In The United States: Prevalence and Predictors. It is from this article that the statistic of 43 percent of women experience female sexual dysfunction.

Moynihan states that the article was based on a survey from the early 1990s that asked women about common sexual difficulties they experience. Of the handful of questions if any respondent answered yes at any time they were classified as having FSD. Here are the questions asked that respondents could only choose a response of Yes or No:

• Lacked interest in having sex
• Were unable to come to climax
• Came to climax too quickly
• Experienced physical pain during intercourse
• Did not find sex pleasurable even if sex was not painful
• Felt anxious just before having sex
• Had trouble lubricating

In this article author Edward O. Laumann states that the percentages are normal and most likely a result of normal responses regarding challenges and stress. In the next JAMA issue a correction was issued that stated the authors had financial ties to Pfizer Inc. Enter the perspective Canner presents: Pharmaceutical companies have profit interest in FSD being identified as a health illness. Once the FDA approved it as an illness all sorts of devices and medications began to be developed and sought people to participate in their trials.

Canner follows Charlotta, a woman who is one of nine participants for the Orgasmatron, a device that requires a surgical procedure. Wires are inserted into the spinal cord and there is a hand held controller that triggers a signal and is supposed to help her achieve an orgasm. We learn that Charlotta does not respond well to the Orgasmatron, as five other women in the study and that she had experienced orgasm during sex prior to entering the trial, it was just not through vaginal penetration. She was a perfectly healthy woman, yet still selected to participate in the study. Charlotta shares that she was challenged by her participation with the device and in the film.

The second half of the video focuses on activism by community members, doctors, and educators about the medicalization of pleasure and FSD. She interviews Leonore Tiefer, a sex therapist and professor of Psychiatry at NYU and heads the New View Campaign, an organization that seeks to “challenge the distorted and oversimplified messages about sexuality that the pharmaceutical industry relies on to sell its new drugs.”

We also discover another aspect of new devices and practices that have emerged within the realm of FSD: Laser Vaginal Rejuvenation and Designer Laser Vaginoplasty. Canner attends the World Association for Sexual Health (formerly World Association for Sexology) conference in Montreal, Quebec in 2005, which I also attended, and speaks to a representative. I was surprised to hear the ideas of “agency” popularized by feminists to be used for their marketing. The representative spoke of “giving women choices.” When she shared with Canner the pre-and post-operative photographs (not shown in the video) Canner’s response is “they want to look like little girls!” Canner interviews a woman who chose this elective surgery and she shared that she did not experience any increase in pleasure or orgasm post-surgery.

What I learned and found surprising was the following:

• The number of magazines that featured and promoted “vaginal rejuvenation” and “designer laser vaginoplasty” included: Latina, Closer, Bazaar, Jane, Cleo, Woman’s Own, Elle, New Woman, and Maxim.
• The Reagan Administration deregulated the direct-to-consumer advertising by pharmaceutical companies. This allowed companies to advertise on television and other forms of media. Currently only the US and New Zealand have direct advertising.
• Dr. Laura Berman (whom you see on television such as Oprah and Dr. Oz) has ties to pharmaceutical companies. The Berman twins led FSD discourse and medicalization. Dr. Laura was the principal investigator for “female Viagra,” which she continues to promote through off label use (which is illegal) even though Pfizer called off the trials, as part of a “comprehensive care plan.”
• Dr. Laura is NOT the only one with such investments and interests.

There was so much this film led me to think about such as:

• What does it mean when the sexuality information we are receiving is by people who have investments in creating a profit with and for large pharmaceuticals? How does this goal for profit impact education, care, and resources that are offered? Why are people surprised when historically oppressed communities still voice a resistance to Western physicians?
• When people discuss “comprehensive sexuality education” what do they really mean? Because when I discuss it I’m not just talking about sharing options in contraception, birth control, consent, etc. but I also include race, class, national origin, dis/ability, immigration status, and the criminalization of certain communities. Who decides what “comprehensive” means and includes/excludes?
• Why is the U.S. sexuality and sexual health field so racially White, able-bodied, English-speaking, doctorate degree having, and older…still?! All of the experts presented represented these identities and I found that discouraging as a person of Color who has been in the field for over a decade. The people of Color we do see in the film are rare, one Asian woman speaks about her orgasm at the beginning of the film for less than 30 seconds, and a Southeast Asian woman speaks about her history of sexual assault and abuse. We are professionals and experts and our ideas and perspectives matter regardless if you are “ready” for us.
• Why not mention the big elephant in the room: that FSD is focused on people whose sex assigned at birth is female and does not include transgender people or people who identify as intersex? How do we continue to “Other” and medicalize bodies that do not conform to what medical professionals have classified as “normal”?
• How does a disability framework complicate, challenge, or affirm the medicalization of sexual dysfunctions?
• What about working class and working poor people? Is sexual dysfunction just a illness of the middle and elite class who may have health insurance to cover such medications, procedures, access to entering into a trial, or the time to seek out specialized care?
• How does this “profit over pleasure” and medicalizing pleasure work (if at all) in a sex-positive  space?

Visit the Orgasm, Inc. website to learn how to order the film and/or host a screening.