I’ve had a number of men and women, both friends and clients, confide in me privately about their concern about never feeling “horny.” They’ve heard people talk about this phenomenon, and perhaps looking at porn has given them the impression that most people are hot to trot at the spur of the moment, all hours of the day and night. And they worry that there’s something wrong with them, Men often think it’s their masculine duty to pop a boner on command, and that’s one of the perceptions that leads men to succumb to the “low-T” industry and take testosterone supplements or injections. Women fret that if they’re not sufficiently orgasmic, they will be perceived as frigid, unfeminine, unsexy. As a sex therapist, a big part of my job is helping people get to the place of accepting that your sexuality is your sexuality — it can be as individual as your fingerprint, and it doesn’t have to match anybody else’s, though it may take working through a lot of fears, assumptions, and social/cultural pressures to get there. Emily Nagoski’s op-ed piece in today’s New York Times gave me some new language to articulate a particular concern about sexual desire. Nagoski, a sex educator and the author of a forthcoming book called Come As You Are: The Surprising New Science That Will Transform Your Sex Life, takes as her starting point the effort of a company called Sprout Pharmaceuticals to get the Food and Drug Administration to approve a drug called flibanserin to treat low sexual desire in women.

“Researchers have begun to understand that sexual response is not the linear mechanism they once thought it was,” she writes. “The previous model, originating in the late ’70s, described a lack of ‘sexual fantasies and desire for sexual activity.’ It placed sexual desire first, as if it were a hunger, motivating an individual to pursue satisfaction. Desire was conceptualized as emerging more or less ‘spontaneously.’ And some people do feel they experience desire that way. Desire first, then arousal. But it turns out many people (perhaps especially women) often experience desire as responsive, emerging in response to, rather than in anticipation of, erotic stimulation. Arousal first, then desire. Both desire styles are normal and healthy. Neither is associated with pain or any disorder of arousal or orgasm.”

Nagoski acknowledges that medical or psychiatric treatment may be warranted for women who lack both spontaneous and responsive desire and are distressed by this. For these women, research has found that nonpharmaceutical treatments like sex therapy can be effective.

“But I can’t count the number of women I’ve talked with who assume that because their desire is responsive, rather than spontaneous, they have ‘low desire’; that their ability to enjoy sex with their partner is meaningless if they don’t also feel a persistent urge for it; in short, that they are broken, because their desire isn’t what it’s ‘supposed’ to be. What these women need is not medical treatment, but a thoughtful exploration of what creates desire between them and their partners. This is likely to include confidence in their bodies, feeling accepted, and (not least) explicitly erotic stimulation. Feeling judged or broken for their sexuality is exactly what they don’t need — and what will make their desire for sex genuinely shut down.”

I can attest that it’s not just women who have these concerns. While it is definitely an observable fact that plenty of men register the thought “Hey, I’m horny” and then go looking for a partner to satisfy the craving for sexual satisfaction (hello, Grindr!), it’s equally true that for other men that is a completely alien experience. Gay men who have that particular sexual temperament can feel completely inept and dysfunctional in many contemporary social environments, including social media, sex parties, cruising situations, even cocktail parties where single guys mix and mingle. It’s not uncommon for guys, whether strangers just meeting or people in established relationships, to engage in “checking” behavior — subtly or not so subtly reaching for the other guy’s crotch to see if he has a boner and if he doesn’t interpreting that to signal lack of interest. And yet, for each person, there are almost certainly specific circumstances under which their hearts and bodies get turned on — it’s probably in private, one-on-one, with a partner who has taken the risk of expressing desire or at least a context where mutual acceptance, appreciation, and flirty attraction have made themselves evident. Maybe it takes affectionate touching, or making out, or direct physical contact for arousal to happen, rather than waiting for an erection before making the first move. I’m happy to have Nagoski’s term “responsive desire” to describe that phenomenon.

Think about how your erotic body works. Do you experience spontaneous desire frequently, seldom, or never? Are you someone whose desire emerges in response to someone else’s stimulation? Check out the complete article online here and let me know what you think.