Book Review

Comparative/World

Rachel P. Maines's book is a fascinating foray into an under-explored subject: the medicalization of women's orgasm. Throughout centuries of shifting nomenclature, the lack of female orgasm—it was rarely called orgasm, the word reserved for male ejaculation—has been called at various times hysteria, "suffocation of the mother," "uterine congestion," pelvic inflammation, hysterical paroxysm, hysteroneurasthenia, and frigidity.	1
Maine attributes this medicalization of women's orgasm to andocentrism: the belief that heterosexual vaginal penetration within marriage (resulting in male ejaculation) was the only "normal," healthy way for women to reach orgasm. She contends that vaginal sex failed to produce orgasm in more than fifty percent of women across time in Western cultures. This lack was presumed to be the result of the woman's physical (and, later, psychological) abnormalities. But the premise was never questioned that male sexual satisfaction equaled female sexual satisfaction—or the even more blasphemous premise that men might be inadequate lovers. Pathologizing women's different sexual needs resulted in perceived "symptoms" such as temperamentality and aversion to heterosexual intercourse; female sexual pleasure being mistaken for orgasm; women being condemned for masturbating to climax; and male ejaculation heralded as mutually satisfying for both men and women.	2
Maines traces the medical naming and management of women's "lack" of vaginal orgasm through medical texts, physicians' treatises, their correspondence to professional journals, and the infrequent studies that actually surveyed women and gave them a discernable voice (albeit frequently misinterpreted). She documents hysteria from the medical corpus as early as 2000 B.C. in Egypt, through the abandonment of the term by the American Psychiatric Association in 1952, into the present day. Her extensive use of sources is solid and her analysis of them as texts, technically competent. She charts physicians' and philosophers' beliefs about heterosexual women's sexual responsiveness and its shortcomings.	3
Unfortunately, Maines's close reading of medical texts is not complemented by an equally diligent reading/analysis of extant relevant work in women's studies/history, or the social history of medicine. The secondary literature enlisted and cited from these fields is skeletal at best (Peter Gay's and Carl Decker's works are noted for their andocentrism and little else). Moreover, the near exclusion of feminist scholarship on this topic produced over the last thirty years impairs Maines's analytic voice. Repeatedly, androcentrism (the presumption that male sexuality and pleasure are the measure of normalcy for both men and women) is held accountable for men's perceptions of women's sexual dysfunction: first by husbands, then by cultural commentators, and ultimately by the medical experts who claim knowledge about this condition. Maines lacks the larger historical context within which to situate her work; this context is amply provided by feminist scholarship.	. . .