“Graham, Brotto, & Zucker (2014). Response to Balon and Clayton (2014): Female sexual interest/arousal disorder is a diagnosis more on firm ground than thin air.” – Article summary

There are gender differences in sexual response and there is widespread recognition for conceptualizing women’s sexual problems differently from those of men. In the FSIAD diagnosis, there is no differentiation between sexual desire and sexual arousal as there is no evidence that these are two different things in women. Many women who were diagnosed with HSDD or FSAD also met the diagnostic criteria for FSIAD.

It was criticized that the FSIAD diagnosis does not contain a lack of lubrication as an essential diagnostic criterion. However, this symptom is a different problem with a mainly biological basis. It should thus be treated by a gynaecologist rather than a psychologist. Besides that, the symptom of lack of lubrication is included in “absent/reduced genital sensations during sexual activity”. Therefore, a lack of lubrication may be a presenting problem but is not a sufficient or necessary one. Furthermore, measures of genital response do not differentiate between women who report sexual arousal problems from those who do not.

All in all, the critique of Balon and Clayton on the FSIAD diagnosis appears to be unfounded. The FSIAD is a move away from the outdated and unidimensional views of the nature of the sexual response.

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