Erwin J. Haeberle


A Brief History of Female Sexuality


Invited keynote lecture at the 3rd conference of the SSSST
(Society for Scientific Study of Sexuality in Taiwan),
Shu-Te University, Kaohsiung, Taiwan, ,
November 11, 2007.
Copyright © 2007 Erwin J. Haeberle.

I. Introduction
         Patriarchal Traditions in East and West
II. Female Sexuality in the Western World
            1. Women in Politics
The Fight for Contraception
The Need for Sex Education
A First Definition of Sexual Health
Overcoming the “Reproductive Bias”
Scientific Studies of Female Sexuality
Three Current International Problems
            1. The Mutilation of Female Sex Organs
The Empowerment of Women in the Fight against AIDS
The Medicalization of Female Sexual Problems

I. Introduction

By allowing me, a male, to speak about female sexuality, you have greatly honored me and, at the same time, saddled me with a heavy burden. After all, for us men this is a dangerous subject. It carries the temptation to say more than we actually know. Actually, when confronted with a largely female audience, as I am  here today, any man would probably be wise to say nothing at all and thus avoid revealing the extent of his ignorance.

However, having accepted your invitation, I now  feel obliged to share with you some of what I have said and written over the years. It is "on the record" anyway, and I might as well stand by it. Thus, if you permit me, I will try to give you a brief survey of bits and pieces  from my web site that touch on today's subject. You can find all of the following remarks scattered about here and there in my various writings, but for this special occasion I will try to pull the scraps together in some coherent, if rather modest, whole:

Biologists know  that women are the stronger, and men are the weaker sex. On the average, men die earlier than women, they are less able to take care of themselves when they are old, their sexual development is more precarious, their sexual response is less reliable, and more of them  tend to suffer from sexual dysfunctions. Men are also more likely to show strange and unacceptable sexual behaviors. Most sex crimes are committed by men, and most sexual violence is caused by men. In short: Male sexuality is fragile and easily threatened while, in comparison, female sexuality is stable and strong.

Indeed, modern science has taught us that the female sex is the basic and primary sex. Just look at the human embryo: Without the production of testosterone, the embryonic development will "automatically" take a turn towards the female. In other words: The female sex is the basic or primary sex. From the standpoint of evolutionary biology, it is also the older sex. The male sex can develop only if "something is added", i.e. if certain hormones help it along during certain periods during pregnancy. In mythological or poetic language: Eve was created first, and after her Adam was made from her rib.

The creation of Adam?

Of course, we all know that the Bible tells us the opposite: God created Adam first and Eve second as his companion, explaining: “It is not good that the man should be alone” (Genesis 2, 18). However, since the famous book of Simone de Beauvoir of 1949 we know that “The Second Sex is no longer content with being defined as God’s afterthought. Indeed, in the last few decades the modern women’s movement has produced many other rebellious books, of which “The Feminine Mystique” by Betty Friedan of 1963 is probably the best known, because in the United States it led to the founding of a powerful, still very active organization: The National Organization for Women (NOW). The various American feminist initiatives, in turn, found their echo in many other countries and thus, we now see not only feminist writings and feminist organizations all over the world, but also new academic fields like “Women’s Studies” and “Gender Studies” which are shaking up the male “establishment” in the groves of academe.

At the same time, the traditional lower social status of women has also become an international political issue: In 1973, the United Nations General Assembly formally adopted a Convention on the Elimination of all forms of Discrimination against Women. Two years later, in 1975, the first World Conference on Women was held in Mexico City, the second 1980 in Copenhagen, the third 1985 in Nairobi, and the fourth 1995 in Beijing. These conferences articulated a whole series of demands that are still waiting to be met in all too many parts of the world. In the meantime, countless internationaI and national agencies and organizations have joined the work of elevating the status of women by developing and pursuing a great variety of projects. They all have the same goal: The complete political, economic, social, cultural and legal equality of the sexes.  

Patriarchal Traditions in East and West

Of course, these recent developments have their roots deep in ancient human history. The issues that are so hotly debated today have been fought over for thousands of years. However, a women’s movement in the modern sense began only with the Age of Enlightenment in Western Europe. Before that time, there had been a few powerful women in certain countries and historical situations, and there had even been occasional attempts to empower women in general, but, in the end, not much was accomplished. The reasons for this are still being debated, but it would take us too far afield to go into details here. This is not the time and place to delve into the arguments about a long-past benevolent matriarchal world that was overthrown by power-hungry men or about the presumed universal reign of a peaceful moon goddess who was eventually replaced by an aggressive sun god. The fact of the matter is that for the last few   thousand years in most parts of the world men have dominated women, have made the most important decisions for them and have given them only very limited opportunities to develop their intellectual and sexual potential.

In feudal China, the most obvious demonstration of male dominance was the custom of binding female feet which, after more than 1000 years, was finally banned by the first republican Chinese government in 1911. The unnaturally small female feet were quite clearly a mark of oppression, because women with crippled feet could not walk very far and thus were prevented from “running away”. Instead, they were tied to the household and restricted to the domestic sphere. This also ensured their obedience to their husbands. At the same time, female crippled feet were considered erotically attractive and increased a girl’s chances in the marriage market. Indeed, many girls were sold as brides or concubines to rich men who paid handsome sums to their parents. The last point is interesting for sexologists, because it seems to indicate some culturally nurtured, widespread male foot fetishism. Indeed, for hundreds of years, the erotic obsession with small female feet seems to have been an integral part of Chinese culture. Of course, it is now no longer possible to find out how many men actually shared this obsession. Perhaps only a minority ever did, and for the others it played only a very minor role or was even irrelevant. We do know, however, that the small size of the feet was the real attraction. Men usually did not look at the feet themselves, but were fascinated by the tiny “lotus shoes” with their special colors and decorations. Thus, the shoes as proof of the woman’s sexual desirability acquired a fetishistic character of their own. One might call this an “indirect fetishism”, an obsession with the cover of a desired body part rather than with the part itself. Thus, it may have been the obsession with a substitute of a substitute of the whole person. In any case, it is not easy to disentangle the various motives that might have been at work here.

Chinese erotic statuette
The jade sculpture, dating from the 15th century A.D., very clearly shows the small, pointed feet produced by the practice of foot binding.
Courtesy China Sex Museum, Tongli

Be that as it may, many forms of foot and shoe fetishism have also been known in the Western world. Not only the feet, but the soles of the feet and the toes have been, and still are, sexual fetishes for some men. This also applies to footwear, especially at times when very high heels or elaborate boots are in fashion. However, one has to keep in mind that fetishism is a matter of degree, and that much depends on the circumstances whether it becomes a problem. In imperial China, no foot fetishist would ever have been considered abnormal, because his entire social environment took his erotic interest for granted and catered to it. Thus, the case of Chinese footbinding once again that sexual normality and abnormality are not absolutes, but are defined differently by different cultures.

At this point, I must confess my complete ignorance of the cultural and social history of Asia. Apart from the single example I just mentioned, I know next to nothing about the past role of women in China, Japan, Korea, India and all the other Asian countries. Therefore, when I now turn to the international movement to fight male dominance, I hope you will forgive me if I concentrate on the so-called Western world with which I am more familiar.

II. Female Sexuality in the Western World

1. Women in Politics

In the Judeo-Christian West, we have known about some powerful women in antiquity, from the biblical Queen of Sheba to the historical Cleopatra, Queen of Egypt, who charmed both Julius Caesar and Marc Anthony. However, as it soon turned out, she did not have any real power. She killed herself when the Roman army advanced on her palace, and Egypt simply became another Roman province. It was not until the 16th century that the first truly powerful women emerged in Europe, the English Queen Elizabeth I, and, in the 18th century, the Austrian Empress Maria Theresia and the Russian Czarina Catherine the Great. In the meantime, many other countries have had women heading their governments: Sri Lanka, India, Pakistan, the Philippines, Indonesia, Israel, Chile, Turkey, Great Britain, Poland, Norway, and now my own home country Germany. Some observers believe that the US could be next and elect their first female president in 2008.

(From the left) Elizabeth I. (1533-1603) Queen of England; Maria Theresia (1717-1780) Archduchess of Austria, Queen of Hungary and Bohemia, Empress of the Holy Roman empire; Catherine II the Great (1729-1796) Empress of Russia

At the same time, women have advanced in many other fields, but still have not achieved their goal of complete equality. Whatever progress they have been able to make over the years has been the result of a long, arduous struggle, and it is mainly owed to many courageous women. Today, I can name only a few of them:

In 1792, the English writer
Mary Wollstonecraft published her book "Vindication of the Rights of Woman, in which she demanded female equality in education, private and public life, including politics. She unmasked the alleged 'natural' role of women in her time as the product of a patriarchal ideology. However, her dreams remained unfulfilled in spite of much subsequent official human rights rhetoric. The French Revolution, in 1789, adopted a “Declaration of the Rights of Man and of the Citizen”, which inspired various social movements in other countries, but women remained second-class citizens in both Europe and the United States.

In 1848, the American feminists Elizabeth Cady Stanton and Lucretia Mott convened the first women's rights convention in Seneca Falls, N.Y. This convention passed a “Declaration of Sentiments“, demanding equal rights for women. This time, the demand soon found increasing moral support in other countries.

In 1869, the great English libertarian John Stuart Mill published his book "The Subjection of Women", in which he argued for the legal and social equality of the sexes. Interestingly enough, he did not acknowledge his co-author - his wife Harriet.

Finally, in 1893, New Zealand was the first self-governing country in the world to give women the right to vote. Eventually, other countries followed in the early 20th century, especially after World War I, when many men had died on the battlefield and women had proven their capabilities in work formerly reserved for men. However, even this progress was slow. American women did not get access to the ballot box until 1920, and in Switzerland women were not allowed to vote until 1971. Indeed, there are still a few countries in the world today, where women have only partial or no voting rights.

2. The Fight for Contraception

Still, as already mentioned, the legal equality of the sexes is now an international issue, and progress continues to be made. However, at least equally important is equality in the social sphere, and here again, from the very beginning, women have made significant contributions. One of these was the struggle for a woman’s right to use contraception. This struggle began in earnest in the early 19th century in England, where Thomas Malthus had warned against the dangers of overpopulation. In his name, a group of activists, the so-called Neo-Malthusians advocated general access to contraception information. Overcoming enormous legal obstacles, they founded a Malthusian League in 1878 and began to edit a journal The Malthusian. From about that time, the English birth rate began a steady decline. It is noteworthy, however, that some of the great "champions of the poor" chose not to become involved. Karl Marx, for example, failed to support the struggle of working class women for contraception.

The Rev. Thomas Robert Malthus

Three early Neo-Malthusians, Charles Bradlaugh Annie Besant, Charles R. Drysdale

In any case, the decisive breakthrough did not come until the middle of the 20th century, and it was mainly due to the tireless efforts of one woman: Margaret Sanger. She had begun as a nurse in the poorer sections of New York, where she saw much sexual misery. She soon realized that she could help poor women best by giving them information about how to prevent unwanted pregnancies. Therefore, she began writing and publishing about this then very touchy subject. In the process, she coined the term "birth control".

In 1916, Sanger and her sister opened a birth control clinic in Brooklyn, the first of its kind in the US. This The clinic was immediately closed as a "public nuisance", and the Sanger sisters were sentenced to 30 days in the workhouse.  Many subsequent accusations, prosecutions and police actions against Sanger eventually led to increasing public support for her work and to a 1936 court decision allowing doctors to prescribe contraceptives. However, many states still retained laws against their sale, and it was not until after two US Supreme Court decisions in 1965 and 1970 that the last restrictions were removed. In 1927 Sanger organized the "American League for Birth Control" and in 1942, after several organizational mergers and name changes, a "Planned Parenthood Federation" came into existence. In 1953 Margaret Sanger became the first president of the "International Planned Parenthood Federation", and she devoted her remaining years mainly to problems of birth control in Asia.

Margaret Sanger

Eventually, in 1953, Margaret Sanger encouraged and supported Gregory G. Pincus, an American biologist, in the development of an oral contraceptive. Taking advantage of earlier hormonal research by the chemists Carl Djerassi and Frank Colton, who worked for different pharmaceutical companies, he was able to produce a contraceptive pill. Together with John Rock, an obstetrician at Harvard, he then began human trials of the new pill first in Massachusetts, later in Puerto Rico. In 1960 the pill became generally available in the US.
Soon it turned out, however, that the hormonal doses in these first pills were much too high and that they had severe side effects. Subsequently, therefore, the dosage in newer pills was reduced further and further until the manufacturers arrived at the formulas used today that are safe for most women.

Carl Djerassi
(b. 1923)

Frank Colton
(b. 1923)

Gregory Pincus

John Rock

Their combined research led to the development of
the first contraceptive pill.

Today we know that this scientific breakthrough was the decisive factor in the subsequent “sexual revolution”. The “pill”, which soon found almost universal acceptance, finally made it clear to everyone that sex and reproduction had become separate issues. Once women could decide for themselves if and when they wanted to bear children, their sexual attitudes changed, and the traditional psychosocial balance between the sexes had to be readjusted.


3. The Need for Sex Education

However, before talking about this in greater detail, I should first mention two American women who have done more than anyone else to promote scientifically based sex education for both the young and the old – Mary S. Calderone and Ruth Westheimer.  The German-born American sex therapist Ruth Westheimer, the younger of the two, was the most remarkable sex educator in the late 20th century. Through her radio and television shows as well as her public lectures and numerous publications, she became an immensely popular spokesperson for an enlightened, progressive approach to sex. Her grandmotherly appearance and manner, combined with a heavy German accent, made her the darling of the media and overcame all resistance to her sex- positive message. If anyone, it was she who made it possible for many Americans to talk more openly and without embarrassment about sex.      


Mary S. Calderone

Ruth Westheimer
(1928 - )


However, an equally great or even greater contribution was made by Westheimer’s most important forerunner. In 1964, the physician Mary s. Calderone, with several others, founded, the “Sexuality Information and Education Council of the US” (SIECUS) in New York. To this day, this membership organization is devoted to sexuality education for people of all ages and backgrounds. It maintains a research library and continues to publish position papers, books, brochures, newsletters and pamphlets in both English and Spanish. It also maintains a very informative web site (

4. A First Definition of Sexual Health

Mary Calderone also played an active part in the decision by the World Health Organization (WHO) in 1975 to propose, for the first time, a definition of sexual health:                                                                                                          

Sexual health is the integration of the somatic, emotional, intellectual, and social aspects of sexual being, in ways that are positively enriching and that enhance personality, communication, and love. Fundamental to this concept are the right to sexual information and the right to pleasure.”  

This definition and several others that followed are well worth an extended discussion, but here we do not have the time for it. Today let me simply point out that, among other things, it also marked a watershed in the understanding of female sexuality.

Throughout the 19th century, the main purpose of sexual activity was still believed to be procreation, a goal now barely mentioned by the WHO. Moreover: At least women would not have been granted a right to sexual pleasure. On the contrary: A healthy woman was believed to have little interest in sex. She tolerated marital intercourse mainly because she wanted children and then fulfill her true calling as a mother. A typical  statement of this belief was provided by the eminent Victorian physician William Acton (1813 -1875) in his book  "The Functions and Disorders of the Reproductive Organs” (1857):

"I should say that the majority of women, happily for them, are not very much troubled with sexual feeling of any kind".

Women who insisted on their sexual satisfaction were often considered "nymphomaniacs", subjected to medical treatments designed to dampen their desires or were even committed to insane asylums. On the other hand, the sexual pleasure potential of women - denied and feared at the same time -  caused a great deal of anxiety among men. This became evident in many literary, artistic and musical works until well into the early 20th century. Plays, treatises, and novels by Strindberg, Weininger, Wedekind and Heinrich Mann testified to this overwhelming male fear. They described "vamps", i.e. women who, like insatiable vampires, sucked the life blood out of men, ruined and destroyed them. Women like Salome in the play by Oscar Wilde and the opera by Richard Strauss, “Lulu” in the play by Wedekind and Alban Berg's opera, but also Marlene Dietrich's "Lola" in "The Blue Angel" embody this male nightmare. Officially, however, female sexual health consisted in "modesty" i.e. lack of sexual desire - the very same condition that today is believed to require treatment.

Oscar Wilde’s play “Salome” (1891) was set to music word for word by Richard Strauss (1905). Salome loves John the Baptist who rejects her. However, once his head has been cut off, she succeeds in kissing him.

Scene from the film “The Blue Angel” (1930), based on a novel by Heinrich Mann (1905). Marlene Dietrich plays a nightclub singer who ruins the life of her husband, a formerly respectable teacher (Emil Jannings), by always “falling in love again” with other men, because she “can’t help it”.

5.  Overcoming the “Reproductive Bias”

As I already mentioned, breaking the link between sex and reproduction, has irrevocably changed the way we think about female sexuality. Still, I believe that even today, many people do not yet understand how far-reaching the implications of this development really are. To take only one example: When the government of the People’s Republic of China adopted the policy of “one-child per couple”, it implicitly declared that reproduction and sexual activity are different matters which must be understood and judged on their own terms. Chinese couples should have only one child, but obviously this does not mean that they should practice sexual abstinence ever thereafter. Thus, for the first time, a government officially recognized sexual intercourse for its own sake as valid in itself.

This is quite a contrast to the traditional teachings of certain Western religions which saw (and still see) reproduction as the only justification of sexual activity. Indeed, for many centuries Western criminal and civil laws were based on this premise. The long struggle fought by contraception advocates - from the Neo-Malthusians to Margaret Sanger – illustrates how difficult it has been to remove the “reproductive bias” from the law. Indeed, until early in the 20th century doctors were punished for giving women contraceptive information. In the US, even married women had to wait until the1960’s when the US Supreme Court finally declared the prohibition against contraception unconstitutional on the grounds that it violated the "right to marital privacy" (Griswold vs. Connecticut).

However, the “reproductive bias” still persists in another legal area - that of marriage itself. For example: Recent years have seen a growing demand by lesbian and gay couples for the right to get married. In many countries this demand has met with fierce resistance and the argument that marriage must always be reserved for couples of different sex. Some legislatures have therefore declared that “marriage is permitted only between one man and one woman”. The main reason given for this restriction is that the purpose of marriage is the raising of children and that only couples of different sex can produce children.

However, this argument is not likely to prevail in the long run. After all, marriage has always been permitted, even recommended, for post-menopausal women. Thus, the law  has, in fact, always recognized that love, companionship, and economic, social, and emotional security are valid reasons to get married. All of these factors also apply to same-sex couples. To deny them the right to marry is therefore nothing less than discrimination and inherently unjust. As long as a woman over fifty is allowed to marry a man so that she can turn loneliness into togetherness, it is hard to explain why she should not be allowed to marry another woman for the same reason.

In view of this, some countries have now given same-sex unions the full status of marriages: South Africa, Canada, Belgium, Spain, and the Netherlands. Other countries grant some, but not all privileges of marriage to registered same-sex civil unions: Denmark, Norway, Sweden, Iceland, Finland, France, Germany, Portugal, the Czech Republic, Slovenia, the United Kingdom, and New Zealand. Still other countries recognize unregistered same-sex partnerships in some legal fashion. In the USA, there is a great deal of resistance to same-sex marriage, but some of the states are supportive in various degrees. The situation is fluid, and thus it is not possible to provide a definite list today. New developments can be found on special web sites.

Since today our topic is female sexuality, we should perhaps seize this opportunity to take a brief look at lesbian couples. Many of them are now becoming parents by artificial insemination, proving once again that the formerly unbreakable link between sex and reproduction has definitely been broken. Obviously, the sexual expectations, experiences and attitudes of these women are quite different from those living in traditional heterosexual relationships. However, even these relationships are now undergoing profound changes. The sexual revolution that made same-sex marriages possible has liberated all women by promoting more sex research and thus helping everybody to gain a better understanding of female sexuality in general.

6. Scientific Studies of Female Sexuality

The first woman to research female sexuality seems to have been the young American physician Clelia Mosher who, in 1892, began a survey among educated middle-class women concerning sexual attitudes and experiences. The results remain unpublished until 1980. They document an unexpected openness and sensuality of the women who answered the questionnaires.

Clelia Mosher

Alfred C. Kinsey
(1894 -1956)

From a historical point of view, however, the first truly revolutionary study of female sexuality was Alfred C. Kinsey’s survey “Sexual Behavior in the Human Female” of 1953. He was able to show that, in essence, the sexual behavior of women was not all that different from than that of men, indeed, that the female sexual potential was, in certain ways, greater than that of males. This created a firestorm of outrage in religious and politically conservative circles, and thus the Rockefeller Foundation, which had supported Kinsey’s research, was forced to end its support. Kinsey never recovered from this blow and died shortly thereafter with many of his other ambitious research projects unrealized. The entire episode proved once again, that female sexuality was - and still is - an important political issue.

Since Kinsey’s time, many women have begun their own sex research, especially into the physiological aspects of female sexuality, and they more than confirmed Kinsey’s findings. The most prominent of these initially they worked with their husbands. For example, in 1966 Virginia Johnson and William A. Masters published their study “Human Sexual Response”, followed in 1970 by "Human Sexual Inadequacy". These two books, more than any others, laid the groundwork for modern sex therapy. In 1972, another couple, the California sex therapists Marilyn A. Fithian and William E. Hartman published another very influential book: "Treatment of Sexual Dysfunction: A Bio-Psycho-Social Approach". Still another outstanding American sex therapist was the Viennese-born Helen S. Kaplan, who combined behavioral therapy with psychoanalysis. The best known of her many publications is probably “New Sex Therapyof 1974. Since then, many other American female sex therapists have gained an international reputation through their writings, such as Sandra R. Leiblum, Lonnie Barbach, and Julia R. Heiman, who is now the director of the Kinsey Institute. Fortunately, since most of them are well known, there is no need to expand the list here.

William H. Masters
Virginia Johnson

Marilyn A. Fithian
William E. Hartman

Another female sex researcher who gained prominence in the later 20th century was Shere Hite, who became very well known through her two best-selling studies “The Hite Report on Female Sexuality” (1976) and “The Hite Report on Men and Male Sexuality” (1981). Her highly individualistic research methods have remained controversial, since she used non-representative samples of subjects who filled out anonymous questionnaires, but in any case, she gave voice to many women who had not been heard before, and she succeeded in stimulating a new discussion of long neglected aspects of female sexuality.

Shere Hite


In any event, the accumulated recent research has undermined many previously held assumptions. Once it was demonstrated that females and males had essentially the same sexual capacities, it became necessary to make practical use of this insight. For example: Most current textbooks of sex therapy still distinguish between male and female sexual dysfunctions in a way similar to the following table:

Female and Male Sexual Dysfunctions: Traditional Definitions

Sexual Dysfunctions in Women

Sexual Dysfunctions in Men

General Sexual Dysfunction (Frigidity)
Orgastic Dysfunction

Erectile Dysfunction (Impotence)

Premature Ejaculation
Retarded Ejaculation
Ejaculatory Incompetence
Ejaculation without Orgasm








This table of traditional terms lists three female and five male sexual dysfunctions, and it seems, at first glance, that they are totally different phenomena without any common physiological basis. As a result of such traditional distinctions, many people are under the false impression that the physical reactions of men and women cannot really be compared. Modern sex research has clearly demonstrated, however, that such a comparison makes a great deal of sense. Indeed, we are now beginning to realize that, just as the sexual responses of males and females are quite similar, so are their sexual dysfunctions. We therefore need new special terms that can be applied to both sexes.

Female and Male Sexual Dysfunctions: New Definitions





Sexual Dysfunctions
General Overview
Since the sexual responses are comparable in both sexes, their sexual dysfunctions are also comparable.
Generally speaking, there are two kinds of dysfunctions:
1. Problems of tumescence, and 2. problems of orgasm.
In women only, there is a third possible dysfunction: Vaginismus, i.e. an involuntary vaginal spasm preventing the insertion of the penis.

In Females


(vaginal spasm)


In Both Females

 and Males

Problems of

(insufficient blood  sup
indicating a lack of


(unsatisfactory timing of or


ply to the sex organs,
 physical arousal).

 of Orgasm

gasm; absence of orgasm).





















Looking a little closer at the problems of orgasm, we see strange parallels, cross correspondences and a curious value system at work:

This new  chart undoubtedly deserves an extended discussion, but this is obviously not the right time for it. I show it here only to illustrate that much of what we see as substantial is actually conceptual - a matter of semantics. I personally believe that it is now high time to end the traditional terminological discrimination and to grant women equal rights with men when we talk about their sexual responses and dysfunctions. But that is a topic for another lecture. Right now, I prefer to turn to some more immediate concerns.

III. Three Current International Problems

In the area of female sexuality, many urgent problems are still waiting to be solved. Today, I will mention only the three I consider the most important: 1. The continued mutilation of female sex organs in some societies, 2. the still lacking, but indispensable empowerment of women in order to fight the AIDS pandemic, and 3. the attempts by the pharmaceutical industry to medicalize female sexual problems. The first two of these problems are of long standing, especially in some developing countries, but now they have acquired a new urgency. The third problem is relatively new, but no less important.

1. The Mutilation of Female Sex Organs

Today, the surgical mutilation of female sex organs in parts of Africa and the Middle East has become a controversial international issue. A simple circumcision, i.e. the removal of the clitoral foreskin is usually not considered controversial, but the following procedures are:

  1. Clitoridectomy, i.e. the surgical removal of the clitoral glans.
  2. Excision, i.e. a clitoridectomy plus the removal of all or part of the inner lips (labia minora).
  3. Infibulation of a very special kind, i.e an excision plus the the removal of all or parts of the outer lips (labia majora). The remaining edges of these lips are then sewn together, closing the vaginal opening. Only a small hole is left for passing urine and menstrual blood.

These operations are usually performed without anesthesia on very young girls. Their ages vary according to local customs from infancy to early adolescence. In most cases, the age lies between 3 and 8. The instruments are often unsterilized knives or razor blades. The procedure is one of the most brutal forms of violence against young females, and it is always performed with a good conscience by older women who derive their income from it.

The mutilation of female sex organs is now found mainly in some parts of Africa and of the Arabic peninsula. (To a limited extent, the practice is also found in Pakistan, India, Malaysia, and Indonesia). The map below identifies the most important countries and also shows where the main types of mutilation are being performed. As can be seen, the practice is common in some, but by no means in all Muslim countries. Indeed, in countries. Indeed, to the great majority of Muslims in the world, the practice is unknown. Very clearly, it is more a matter of regional culture than of religion.

Prevalence by country and form of mutilation
The map shows the countries where the traditional mutilation of female sex organs is practiced.
The colors indicate the two main forms of mutilation in various regions:
 Excision  Infibulation
Sources: UN agencies, Terre des femmes, Amnesty International, afrol News

Official Statements

United Nations
In March 2007, the UN Commission of the Status of Women urged the world to ban the mutilation of female sex organs and forced marriages. Some 6000 women from governmental and grassroots groups passed the respective resolutions. The first of these "urges states to take all necessary measures to protect girls and women from female genital mutilation, including by enacting and enforcing legislation to prohibit this form of violence and to end impunity."




The United Nations International Children's Emergency Fund (UNICEF) also has adopted a very clear position. It calls the mutilation of female sex organs “a fundamental violation of the rights of girls. It is discriminatory and violates the rights to equal opportunities, health, freedom from violence, injury, abuse, torture and cruel or inhuman and degrading treatment”. UNICEF further emphasizes that all of these rights are already protected in international law.


World Medical Association
The World Medical Association is an international organization devoted to achieving the highest medical standards for all people in the world. It unequivocally “condemns the practice of genital mutilation including the circumcision of women and girls and condemns the participation of physicians in such practices.”

Al Azhar in Cairo
The postage stamp, dating from 1957, commemorated the millennium of Al Azhar. The mosque was built in the 10th century AD and soon became the center of a university. It is one of the oldest in the world. Sunni Muslims consider it the most prestigious institution of Islamic studies.

In the meantime, all organizations trying to eliminate the practice have come to realize that this cannot be done by simply passing laws against it. Essential is a mentality change in the population. An important step in obtaining religious and civil support for the end of the traditional sexual mutilations was taken in 2003 in Cairo. Representatives from 28 African and Arab countries affected by the practice issued the “Cairo Declaration for the Elimination of Female Genital Mutilation”.
This document was important, because it could not be attributed to uncomprehending Western agitators. Especially significant were the statements of the two most influential Islamic and Christian religious leaders in Egypt, the Grand Sheykh of Al-Azhar, H.E. Sheykh Mohammed Sayed Tantawy, and the representative of the Koptic Pope, Shenouda III. Both reaffirmed that “no religious precept either in Islam or Christianity justifies the practice”.
The Cairo Declaration created a new basis for the co-operation between local and international agents for change.

2. The Empowerment of Women in the Fight against AIDS

Today, nearly half of all HIV infections world-wide are found in women (48%, much higher in some parts of Africa). In years past, these numbers were much lower, but there are now increasing quickly. Indeed, more and more women are becoming infected at an ever earlier age.
One of the reasons for this growing “feminization of AIDS” is the relative powerlessness of women in much of the developing world. It is all very well to preach the “prevention ABC” (Abstinence, Being faithful, Condoms), but it means nothing to women who have no say in their sexual relations. Abstinence is not an option where women cannot refuse the sexual demands of men. Being faithful does not protect women if men do not practice it, too. Condoms are no help as long as women cannot insist that men use them.

The only effective AIDS prevention in these circumstances is to raise the status of women, educating and empowering them so that they can reach an adequate level of sexual self-determination. However, this means asking for revolutionary changes in some countries that are still bound by ancient patriarchal traditions in religion, custom, and law. On the other hand, it is clear that these countries will court disaster if they fail to carry out the necessary changes and do it soon. There will be millions of AIDS orphans with no women to care for them, and where farming is still mostly women’s work, it will simply no longer be done, leaving the survivors without sufficient food.

4th World Conference on Women,
Beijing, China; September 4 - 15, 1995
The conference produced the United Nations Beijing Declaration and Platform for Action

3. The Medicalization of Female Sexual Problems

The recent enormous commercial success of so-called potency pills for men has prompted attempts to develop similar drugs for women. Certain pharmaceutical companies and many physicians hoped for a huge new market and corresponding profits. However, they were not really sure of the expected demand and therefore first began to construe a new disease – “Female Sexual Dysfunction or FSD”.

Manufacturing sexual diseases for men and women is nothing new in medical history. In the 18th century for example, the invention of  “masturbatory insanity” created an entirely new, very large class of patients, in the late 19th century, the invention of “contrary sexual feeling” (homosexuality) as a mental illness provided a lucrative business for psychiatrists and psychoanalysts for the next 100 years. Around the turn of the 20th century, a new, fashionable female malady commanded the public’s attention – hysteria. All of these diseases have, in the meantime, been removed from the diagnostic manuals, and indeed, they have disappeared from the public consciousness. However, in their time their existence was blindly accepted. No one questioned the medical assertions, and countless individuals were subjected to degrading and useless treatments.

In our own time, many people are still prone to be manipulated in this fashion. After all, large numbers of women and men continue to be ignorant about the sexual functioning of their own bodies; they feel shame and embarrassment when it comes to their sexual feelings and needs, and they quite unreasonably expect sexual gratification from their partners without any personal effort. The promise of a miracle drug that can bring instant sexual happiness fits all to well into this picture.

Thus, in the late 1990’s, the new disease FSD was invented and advertised. Fanciful statistics were presented about its prevalence, and pretty soon, guided by the “medical-industrial complex”, more and more people began to believe in its existence. This, in turn, set the stage for some industry-subsidized research which would find a cure. A minor detail was deliberately neglected: Nobody really knew the exact definition of the disease and its specific symptoms. 

Not surprisingly, therefore, a few feminist sex researchers began to organize a scientifically based response to this new attempt to medicalize female sexuality. The most important of these was - and is - the American psychotherapist Leonore Tiefer. Together with some like-minded colleagues, she started an active campaign against the new simplistic view of women and soon presented a positive manifesto under the title A New View of Women's Sexual Problems (2001).

Leonore Tiefer
Leonore Tiefer

The New View Manifesto demonstrates the weakness of the prevailing medical model of sexual dysfunctions. It emphasizes the social context of in which female sexuality develops and recommends that the effort to define “normal” sexual function should be abandoned. Most importantly: It offers an alternative classification system of causes for sexual problems rooted in society, relationships, psychology, and disease. Thus, the new view now groups female sexual problems in four categories:

1. Socio-cultural problems in the widest sense. These include sexual ignorance and anxiety due to inadequate sex education - - inability to articulate feelings and experiences - -lack of information about the formation and maintenance of gender roles - - inadequate access to contraception, STD prevention and treatment - - shame about one’s body or about one’s sexual orientation - - conflict about traditional and new cultural norms - - fatigue and lack of time due to family obligations.

2.  Relationship problems. These include inhibition, avoidance, or distress arising from betrayal, dislike, or fear of partner - -  discrepancies in desire for sexual activity or in preferences for various sexual activities - -  loss of sexual interest and reciprocity as a result of conflicts over commonplace issues such as money, schedules, or relatives, or resulting from traumatic experiences, e.g., infertility or the death of a child - - inhibitions in arousal or spontaneity due to partner's health status or sexual problems.

3. Psychological problems. These include sexual aversion, mistrust, or inhibition of sexual pleasure due to past physical, sexual, or emotional abuse - - general personality problems with attachment, rejection, co-operation, or entitlement - - depression or anxiety - - sexual inhibition due to fear of sexual acts or of their possible consequences, e.g., pain during intercourse, pregnancy, sexually transmitted disease, loss of partner, loss of reputation.

4. Medical problems. These include pain or lack of physical response during sexual activity despite a supportive and safe interpersonal situation, adequate sexual knowledge, and positive sexual attitudes - -. Such problems can arise from numerous local or systemic medical conditions affecting neurological, neurovascular, circulatory, endocrine or other systems of the body - - pregnancy, sexually transmitted diseases, or other sex-related conditions - - side effects of popular drugs, medications, or medical treatments.
(For details, see
As this summary already makes clear, it is more than short-sighted to reduce female sexuality to its physical aspects. It is the deliberate attempt to obscure its psychosocial - i.e. in the final analysis - political dimensions. However, as this brief historical sketch has shown, sex is and has always been political, and this is especially true of female sexuality. The long - and so far only partially successful - struggle of women to achieve equality is the best illustration of this truth. There was and never will be a pill that can give women or anyone else freedom and justice. In the meantime, even the big drug companies have had to face reality, and thus they have practically abandoned the search for a female equivalent of the male potency pill. Correspondingly, one now also hears much less about the disease FSD which it was meant to cure. The lesson for women is clear: They must and will achieve equality only through their own actions, and this is also the only way in which they can liberate their sexuality.