The normative significance of the distinction between therapy and enhancement has come under sustained philosophical attack in recent discussions of the ethics of shaping future persons by means of preimplantation genetic diagnosis and other advanced genetic technologies. In this paper, I argue that giving up the idea that the answer to the question as to whether a condition is “normal” should play a crucial role in assessing the ethics of genetic interventions has unrecognized and strongly counterintuitive implications when it (...) comes to selecting what sort of children should be brought into the world. According to standard philosophical accounts of the factors one should take into account when making such .. (shrink)

The allocation of scarce medical treatments, such as antivirals and antibody therapies for COVID-19 patients, has important legal dimensions. This Essay examines a currently debated issue: how will courts view the consideration of characteristics shielded by equal protection law, such as race, sex, age, health, and even vaccination status, in allocation? Part II explains the application of strict scrutiny to allocation criteria that consider individual race, which have been recently debated, and concludes that such criteria are unlikely to succeed under (...) present Supreme Court precedent. Part III analyzes the use of sex-based therapy allocation criteria, which are also in current use, and argues that they also face substantial legal obstacles, despite only being subject to intermediate scrutiny. Parts IV and V examine the use of age and health status in allocation. Part VI discusses how the nascent law on “vaccination status” discrimination might apply to therapy allocation. (shrink)

This paper is intended first for the formal argumentation community (see https://comma.csc.liv.ac.uk/). This community develops logics and systems modelling argumentation and dialogues. The community is in search of major applications areas for their models. One such application area e.g. is Law. The message of this paper is that there is another major application area for formal argumentation. There is an international community of sex offender therapist that is well established and well funded, and their therapy methods use (methods that (...) can be modelled by) formal argumentation and logic. This community presents a natural application area for formal argumentation. We thus describe in this paper how the sex offender therapists work, to give the formal argumentation researcher a view of this application area. What is especially important about this application area is that in order to model it and learn from it, the formal argumentation community have to evolve their formal methods and adapt to this new application. Part of this enhancement is to modify and import certain methods from other areas of Logic e.g. from Non-Monotonic logic. The members of the formal argumentation community are not familiar, on average, with other areas of logic, and so we also describe in this paper, what we need from neighbouring logics. This makes this paper of interest also to sex offender therapist as well. They may be already familiar with their own practices, but the additional logics described will be of interest to them. (shrink)

Gender dysphoria in children has become a hot-button topic; however, clinical data still remain sparse on the effects of hormone therapy and transitional surgery on the physical and psychological well-being of those children. The American College of Pediatricians cites studies indicating that anywhere from 77 to 94 percent of boys and 73 to 88 percent of girls desist in GD; that is, following puberty the majority of children who experience GD will identify with their assigned biological sex. After reviewing (...) the clinical studies, this paper addresses the notion of gender from a Thomistic perspective, locating gender as a differentiation in the matter of the person flowing from the essence of the soul, resulting from the power of generation as opposed to other differences such as sight, which functions the same regardless of material differences. As a result, the paper concludes that hormone therapy cannot be morally licit for children. (shrink)

In the tradition of Simone de Beauvoir and Julia Kristeva, Luce Irigaray is one of France's most versatile feminist critics. _Sexes and Genealogies, _a collection of lectures delivered throughout Canada and Europe, introduces her writing to a wider American audience. Irigaray's most famous work, _Speculum of the Other Woman, _prompted her expulsion from the Lacanin Ecole Freudienne because of its searing depiction of Platonic and Freudian representations of women. Now _Sexes and Genealogies _analyzes sexual difference according to what she terms (...) the double dimension of gender and ideology. Irigaray covers major issues in religion, the law, psychoanalysis, and literature, such as: the continued neglect by psychoanalysts of the sexual and gender dimensions of therapy, the urgency of female divinity for contemporary feminist movements, and a reconsideration of women's relation to the market economy. _Sexes and Genealogies _also includes Irigaray's dazzling reading of the _Oresteia, "Body Against Body: In Relation to the Mother," _now acknowleged as a feminist classic. (shrink)

Sex reassignment surgery is a therapy for gender dysphoria standardly provided only upon a psychiatric authorization. Transgender scholars criticize this practice as unjustified medicalization and stigmatization of transsexual people. By demanding that sex reassignment surgery is not classified as therapy, they imply it should be classified as some kind of a biomedical enhancement. It is argued in this article that this reclassification is empirically and morally implausible because sex reassignment surgery is incompatible with two major views of enhancement. (...) It is incompatible with the nontherapeutic view because it does not improve or augment, above average, any physical or mental trait or function. It is incompatible with the welfarist view because this view, contrary to the transgender scholars’s demands, is compelled to retain the standard practice of providing sex reassignment surgery in order to ensure the optimal balance between its availability, beneficence, and possible harmfulness. (shrink)

In the tradition of Simone de Beauvoir and Julia Kristeva, Luce Irigaray is one of France's most versatile feminist critics. _Sexes and Genealogies, _a collection of lectures delivered throughout Canada and Europe, introduces her writing to a wider American audience. Irigaray's most famous work, _Speculum of the Other Woman, _prompted her expulsion from the Lacanin Ecole Freudienne because of its searing depiction of Platonic and Freudian representations of women. Now _Sexes and Genealogies _analyzes sexual difference according to what she terms (...) the double dimension of gender and ideology. Irigaray covers major issues in religion, the law, psychoanalysis, and literature, such as: the continued neglect by psychoanalysts of the sexual and gender dimensions of therapy, the urgency of female divinity for contemporary feminist movements, and a reconsideration of women's relation to the market economy. _Sexes and Genealogies _also includes Irigaray's dazzling reading of the _Oresteia, "Body Against Body: In Relation to the Mother," _now acknowleged as a feminist classic. (shrink)

Osteoporosis is characterized by reduced bone density and strength. Bone mass peaks between age 30 and 40 and then declines. This can be accelerated by factors including menopause and insufficient dietary calcium. Hormone replacement therapy (HRT) is currently the standard treatment for osteoporosis. However, growing concern over potential side effects of HRT has driven a search for alternative therapies. A recent report1 reveals a potential alternative to HRT: a gender‐neutral synthetic steroid that increases bone mass and strength without affecting (...) reproductive organs. This compound acts via a novel extranuclear sex steroid receptor signaling mechanism that has important implications for nuclear receptor biology and human health. BioEssays 25:195–199, 2003. © 2003 Wiley Periodicals, Inc. (shrink)

Cet article cherche à montrer qu’amour et politique sont étroitement liés dans le De natura rerum de Lucrèce. D’une part, l’amour-passion, au Livre IV, se révèle aussi vain que le désir du pouvoir politique; d’autre part, le livre V oppose implicitement le désir sexuel des premiers êtres humains au « bien commun » qui gouverne les organisations sociales. En outre, la description, au livre IV, d’une sexualité exempte de passion, ou amour libre, caractérisée par un désir mutuel et un plaisir (...) partagé, fait office de contre-modèle ou de paradigme alternatif face à l’aliénation et à la violence politiques et sociales. En d’autres termes, l’objet de cet article est de montrer qu’amour, sexe et politique font l’objet chez Lucrèce d’une même approche, où l’on peut voir à la fois une composante importante de sa thérapie de l’âme et une profonde défiance à l’égard de la vie sociale et des activités politiques. (shrink)

Sex is not the answer to everything, though young men think it is, but it may be the answer to the intractable debate over the ethics of human embryonic stem cell research. In this paper, I advance one ethical principle that, as yet, has not received the attention its platitudinous character would seem to merit. If found acceptable, this principle would permit the beneficial use of any embryonic or fetal tissue that would, by default, be lost or destroyed. More important, (...) I make two appeals to consistency, or to parity of reasoning, that I believe show that no one who either has used or intends to use sexual reproduction as their means of procreation, nor indeed anyone who has unprotected heterosexual intercourse, nor anyone who finds in vitro fertilization acceptable, nor anyone who believes that abortion is ever permissible can consistently object on principle to human embryo research nor to the use of embryonic stem cells for research or therapy. (shrink)

Since the 1950''s effective control of conception has allowed modern men and women to differentiate procreational from recreational sexual exchange. What is considered highly erotic has differed widely through time and in various cultures. In the U.S. the female breast has come to mean far more than nurturing an infant. Sexuality symbolizes youth, attractiveness, desirability and as such is used for effective commercial marketing. The reality of cancer remains to be dealt with in health care at a physical level but (...) more is needed to assist the emotional adjustment of affected women and their partners. Brief sex therapy for sex symptoms is outlined. (shrink)

During the 1890s, animal development became associated with glandular activity, with profound implications for pediatric nosology and treatment. The significance of this endocrinological turn of developmental physiology and pathophysiology in part hinges on an often-overlooked continuity with ubiquitous early modern medical thought concerning semen as a recrementitious (reabsorbed) nutrient or stimulant. Mid-19th-century interests in adult sexual physiology were increasingly nerve-centered and antihumoral. Scattered empirical, particularly veterinarian, interests in gonadal developmental functions failed to moderate these explanatory trends. While Brown-Séquard’s rejuvenation experiments (...) still offered no clear starting point for a developmental endocrinology, in 1892 Gaston Variot and Paul Bezançon more explicitly deduced a testicular developmental endocrinological function from various observations on testicular ectopy and a local form of animal “demi-castration.” Ensuing interest in the thyroid, the thymus and in the testicles led to various working conceptions of their respective and putatively reciprocal developmental properties, including the idea of a thyroid–testis axis. From 1896, the pubertal affliction of chlorosis became the subject of multiple opotherapeutic approaches, providing an experimental basis for theories of ovarian internal secretion. Polyglandular therapy, piloted for divergent developmental conditions, remained routine until the 1930s despite the biological inefficacy of many endocrine products. (shrink)

The compilers of the Hippocratic gynaecological treatises often recommend sexual intercourse as part of treatments for women’s diseases. In addition, they often prescribe the use of ingredients that are obvious phallic symbols. This paper argues that the use of sexual therapy in the Hippocratic gynaecological treatises was more extended than previously considered. The Hippocratic sexual therapies involve a series of vegetable ingredients that were sexually connoted in antiquity, but have since lost their sexual connotations. In order to understand the (...) sexual signification of products such as myrtle and barley, one must turn to other ancient texts, and most particularly to Attic comedies. These comedies serve here as a semiotic guide in decoding the Hippocratic gynaecological recipes. However, the sexual connotations attached to animal and vegetable ingredients in these two genres have deeper cultural and religious roots; both genres exploited the cultural material at their disposal. (shrink)

Theorizing interconnections of sexual and racial differences remains a core problematic within feminist theory. In this article the author argues that these connections might in some cases usefully be understood as constituting a chiasmas. The term ‘chiasmas’ is taken from MichËle Le Doeuff’s analysis of the writings of 18th-century physiologist Pierre Roussel. Le Doeuff argues that Roussel’s understanding of sexual difference is chiastic. An examination of contemporary medical and scientific discourses around the menopause and its treatment through hormone replacement (...) class='Hi'>therapy takes the argument onto new ground. The author argues here that menopause-related discourses rely on a chiastic logic that connects sexual difference with racial differences. Identification of such logics may prove useful to feminist analyses of specific entanglements of the logics of sexual and racial differences, in contemporary and historical instances. (shrink)

Abstract This paper aims to describe an objective account of sexual perversion. That is, it seeks to characterize sexual perversion as something which is not simply a deviation from a statistical norm but rather as something which violates an objective naturalistic norm. The central point is that perversion consists in the introduction of a strange and extraneous loop in the aetiology of sexual sensations, and this extraneous loop makes it possible to characterize sexual perversion as an objective disorder which is (...) in need of therapy. (shrink)

In ‘The Complex Case of Ellie Anderson’, Joona Rasanen and Anna Smajdor raise several ethical questions about the case. One question asks, but does not answer, whether Ellie faced discrimination for being transgender when her mother was not allowed access to Ellie’s sperm following her death. In raising the question, the authors imply anti-trans bias may have influenced this determination. However, this inference is not supported by current ethical and legal guidance for posthumous use of gametes, with which Ellie’s case (...) is consistent. We consider the authors’ responses to their other ethical queries, and how their suggestions for what options might have been available to Ellie and her family are instructive for addressing attempts in the USA and UK to restrict minors’ access to gender-affirming medical treatment, including puberty-blocking therapy. (shrink)

This article examines one kind of conscientious refusal: the refusal of healthcare professionals to treat sexual dysfunction in individuals with a history of sexual offending. According to what I call the orthodoxy, such refusal is invariably impermissible, whereas at least one other kind of conscientious refusal—refusal to offer abortion services—is not. I seek to put pressure on the orthodoxy by (1) motivating the view that either both kinds of conscientious refusal are permissible or neither is, and (2) critiquing two attempts (...) to buttress it. (shrink)

Le couple vient consulter au moment où monsieur a reconnu la photo du corps nu de sa femme exhibé sur Internet. L’auteur interroge la fonction de cette image pour le couple et la fonction du regard du thérapeute de couple. L’image servirait à dire l’indicible, à savoir le sentiment d’inexistence et le sacrifice du couple pour élever leur enfant psychotique. Mais l’image persécute chacun et, dans le cadre de la thérapie, une mise à mort de la relation haineuse à la (...) mère se rejoue avec difficulté. (shrink)

Early in the COVID-19 pandemic, researchers reported a surprising trend in disease outcomes: men were more likely to require hospitalization and die from COVID-19 than women. Researchers looked to sex-linked biology to explain these disparities, hypothesizing innate sex differences in immune function, suggesting the use of estrogens or androgen-suppressants as therapy, and even pushing for sex-specific vaccine strategies. Leading bioethicists like Dr. Ezekiel Emanuel at the University of Pennsylvania recently described the sex disparity in COVID-19 outcomes as "the unsolved (...) mystery" of the... (shrink)

Many neuroanatomical alterations have been detected in patients with tinnitus in previous studies. However, little is known about the morphological and structural covariance network changes before and after long-term sound therapy. This study aimed to explore alterations in brain anatomical and SCN changes in patients with idiopathic tinnitus using voxel-based morphometry analysis 24 weeks before and after sound therapy. Thirty-three tinnitus patients underwent magnetic resonance imaging scans at baseline and after 24 weeks of sound therapy. Twenty-six age- (...) and sex-matched healthy control individuals also underwent two scans over a 24-week interval; 3.0T MRI and high-resolution 3D structural images were acquired with a 3D-BRAVO pulse sequence. Structural image data preprocessing was performed using the VBM8 toolbox. The Tinnitus Handicap Inventory score was assessed for the severity of tinnitus before and after treatment. Two-way mixed model analysis of variance and post hoc analyses were performed to determine differences between the two groups and between the two scans. Student-Newman-Keuls tests were used in the post hoc analysis. Interaction effects between the two groups and the two scans demonstrated significantly different gray matter volume in the right parahippocampus gyrus, right caudate, left superior temporal gyrus, left cuneus gyrus, and right calcarine gyrus; we found significantly decreased GM volume in the above five brain regions among the tinnitus patients before sound therapy compared to that in the HC group. The 24-week sound therapy group demonstrated significantly greater brain volume compared with the baseline group among these brain regions. We did not find significant differences in brain regions between the 24-week sound therapy and HC groups. The SCN results showed that the left superior temporal gyrus and left rolandic operculum were significantly different in nodal efficiency, nodal degree centrality, and nodal betweenness centrality after FDR correction. This study characterized the effect of sound therapy on brain GM volume, especially in the left superior temporal lobe. Notably, sound therapy had a normalizing effect on tinnitus patients. (shrink)

This paper argues that although Epicureans will never marry for love, they may find it therapeutic to marry for sex: Epicureans may marry in order to limit anxiety about securing a sexual partner if they are prone to such anxiety and if they believe their prospective partner will satisfy them sexually. The paper shows that Epicureans believe that the process of obtaining sex can be a major source of anxiety, that it is acceptable for the sage to marry under certain (...) circumstances, and that the desire for sex alone is free of the groundless assumptions that fuel love. Epicureans would therefore approve of marrying to alleviate sexual anxiety. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Feminist Studies 41, no. 3. © 2015 by Feminist Studies, Inc. 623 Jaye Cee Whitehead, Kath Bassett, Leia Franchini, and Michael Iacolucci “The Proof Is in the Pudding”: How Mental Health Practitioners View the Power of “Sex Hormones” in the Process of Transition In the United States today, popular discourse touts the power of “sex hormones” and hormone receptors in the brain to chemically produce gender expressions (manifested in (...) physical sex traits, behaviors, and attitudes) and identities (a sense of self as feminine or masculine). These accounts range from common assumptions that Western ideals of femininity (such as empathy understanding, cooperative orientation, nurturing behavior) and masculinity (rational/spatial understanding, competitive orientation, violent behavior) are produced by corresponding sex hormones, to studies that reduce complex gender identities and macrosocial economic phenomena to presocial, binary, hormonal processes.1 For sociologists, accounts that reduce complex identities to internal hormonal reactions are problematic for two primary reasons: first, they are inaccurate because they fail to examine how hormonal reactions are embedded in a complex cultural process of meaning and interpretation; second, they operate as bioreductive ideologies that obscure the social power inherent to the process of gender identity construction. In what follows, we extend both of these insights by examining mental health 1. For an example of a hybrid popular-scientific account of the power of sex hormones to destabilize economic structures, see Jon Coates and Joe Herbert, “Endogenous Steroids and Financial Risk Taking on a London Trading Floor,” Proceedings of the National Academy of Sciences 105, no. 16 (April 2008): 6167–72. 624 Whitehead, Bassett, Franchini, and Iacolucci practitioners’ divergent interpretations of the power of sex hormones in the process of gender transition.2 In doing so, we examine the cultural power of sex hormones in crafting gender identities without reproducing reductionist interpretations of trans embodiment. Perhaps what is most perplexing about the way we speak of sex hormones is that we know it is inaccurate to describe these hormones as sexed; scientists have acknowledged since the 1930s that they are neither sex specific in their function, nor in terms of their location in male or female bodies.3 In her extensive historicization of sex hormones, Anne Fausto-Sterling concludes that it is more accurate to call androgen- and estrogen-based hormones, “steroid hormones” as they have functions that are not confined to corresponding sexed bodies. In fact she urges scientists to “break out of the sex hormone straightjacket” and to look at steroids as just one of a number of components that are important to the creation of sex and gender, including environment and experience.4 Scholars also point to an inextricable link between the chemical operation of hormones and the social process of constructing meaning, both at the level of social interaction and macrocultural constructions of sex categories and gender ideologies.5 While brain organization/activation theory attributes sex and gender differences to hormonal interactions within the developing brain, Fausto-Sterling questions the distinction between activation and organization by pointing out how “the brain can respond to hormonal stimuli with anatomical changes…hormonal systems, after all, respond exquisitely to experience, be it in the form of nutrition, stress, or sexual activity (to name but a few possibilities ).”6 Drawing from Elizabeth Grosz, Fausto-Sterling argues that the power of hormones is best understood according to the model of the 2. “Gender transition” is a controversial phrase, as it implies that transgendered individuals who receive hormone therapy are changing identities. We are only using it for lack of clear alternative phrasing, not because we believe body modifications change gender identities. 3. See Anne Fausto-Sterling, Sexing the Body: Gender Politics and the Construction of Sexuality (New York: Basic Books, 2000); Rebecca Jordan-Young, Brainstorm: The Flaws in the Science of Sex Differences (Cambridge, MA: Harvard University Press, 2010); and Nelly Oudshoorn, Beyond the Natural Body: An Archeology of Sex Hormones (New York: Routledge, 1994). 4. Fausto-Sterling, Sexing the Body, 193–94. 5. Fausto-Sterling, Sexing the Body. 6. Ibid., 232. Whitehead, Bassett, Franchini, and Iacolucci 625 Möbius strip, wherein internal components of the self are always connected to and continuous with outer components such as culture and environment.7 In other... (shrink)

This article addresses the treatment of individuals who experience conflict between their religious convictions and their same-sex attraction. Recently, attention has been drawn to the ethical issues involved in the practice of sexual reorientation therapy (SRT) with such conflicted individuals. This article reviews the ethical arguments for and against SRT through the lens of the general ethical principles of the American Psychological Association's (2002) ethics code. Practitioners are then challenged to think about how they might respond virtuously (Meara, Schmidt, (...) & Day, 1996) when presented with such a client. Thought questions are presented to assist therapists to develop in virtue while working with religious clients who are conflicted about same-sex desire. (shrink)

There has been a troublesome anomaly in the UK between cash payment to men for sperm donation and the effective assumption that women will pay to donate eggs. Some commentators, including Donald Evans in this journal, have argued that the anomaly should be resolved by treating women on the same terms as men. But this argument ignores important difficulties about property in the body, particularly in relation to gametes. There are good reasons for thinking that the contract model and payment (...) for gametes are both inappropriate, and that a model based on altruism should be applied to both sexes. (shrink)

A national survey sent to 450 female and 450 male licensed psychologists (return rate = 42%) found that about 73% of the participants reported encountering at least one patient who claimed to recover previously forgotten memories of childhood sex abuse. About 21% of the therapists concluded that, for at least one patient, the memory was false; about 50% of the therapists reported that at least one patient had found external validation for the abuse; about 12% of the therapists reported at (...) least one client who later decided that the memory was false; and about 15% of the therapists reported that at least one client who recovered memories filed a civil or criminal complaint. About 15% of the therapists reported encountering at least one patient alleged to have sexually abused a child who later recovered previously forgotten memories of the abuse. About 21% of these therapists concluded that, in at least one case, the memory was false; about 6% of the therapists concluded that, in at least one case, there appeared to be external validation for the memories; about 1% reported that, in at least one case, the person recovering the memories concluded that the memories had been false; and about 6% of these therapists reported at least one case in which a civil or criminal complaint had been filed against their client. Findings were analyzed in terns of therapist gender, patient gender, and theoretical orientation. (shrink)

There has been a troublesome anomaly in the UK between cash payment to men for sperm donation and the effective assumption that women will pay to donate eggs. Some commentators, including Donald Evans in this journal, have argued that the anomaly should be resolved by treating women on the same terms as men. But this argument ignores important difficulties about property in the body, particularly in relation to gametes. There are good reasons for thinking that the contract model and payment (...) for gametes are both inappropriate, and that a model based on altruism should be applied to both sexes. (shrink)

A brief review of Amia Srinivasan's book _The Right to Sex_.

By definition, feminism is concerned with the historical, social and political meanings of sexual difference in the human body, and the spectrum of experiences those meanings produce. At the beginning of the twenty-first century, gendered forms of violence persist, abortion remains a political issue, reproductive and cosmetic technologies and their concomitant ethical questions are proliferating, and the presence of women's bodies in public spaces and for public consumption produces a range of anxieties about women's well-being and the common good. Feminist (...) scholars from across the disciplines grapple with these issues in Feminism and the Body. In so doing they continue a history of intellectual endeavor that, for centuries, has striven to identify the interplay between corporeal differences and relationships of power. This collection will take the reader on a journey into myriad domains in which a variety of discursive effects come to life in the embodied subject: from the theatres of medical surgery and law to the discussion fora of sex therapy and marriage guidance experts; from Peruvian villages of the late twentieth century to African American plays of the 1920s and 1930s; from explicitly feminist novels and films to the mainstream press and right into feminist scholarship that theorises the female body. In so doing, this collection restates and reinvigorates feminism's long-standing, necessary and emphatic engagement with the female body. (shrink)

This new edition of Psychiatric Ethics continues to serve as the most authoritative and comprehensive text on the many complex ethical dilemmas which face the clinician in everyday practice. In addition to addressing questions about drug therapy, sex therapy, suicide, and child psychiatry, among others, this up-to-date revision adds six new chapters discussing abuses in psychiatry in Japan and Nazi Germany; a conceptual analysis of what mental illness is; psychiatry as a profession; the ethical aspects of psychogeriatrics; and (...) deinstitutionalization. This book is essential reading for all mental health professionals. (shrink)

Religious beliefs and attitudes have long been recognized as playing an important role in sexual functioning, but the relationship between religion and sexual behavior has rarely been studied in a comprehensive way. The essays in this volume bring the views of sex counsellors, therapists. theologians, and bioethicists to bear on the relationship between religion and sexuality. A major theme emerging from these essays is that religion and counselling need to learn from one another. Religious traditions, at the popular or theological (...) levels, are often marked by ignorance and misinformation about sexuality and can benefit by the insights of those who work closely with patients in medical and counselling settings. Counsellors, in turn, need to develop a sensitivity to past and present religious attitudes toward sexuality in order to assist their patients achieve sexual health. (shrink)

The aim of this article is to analyze the effects of comunication, conflicts, and body language on sexual dysfunctions. As explained in the work of Merleau Ponty, the everyday experience goes through the body and communicates its being in the world through external stimuli, generating emotions and developing affectivity. In this perspective, the sexuality is something more than a set of biological mechanism. Simultaneous, experiencing of conflicting feelings and emotions, such as anger, may affect the body sexual response, such as (...) vaginism and dyspareunia. One of the most important purpose of Sex Therapy is the integration of all the contributing professional and academic disciplines both from the points of view of research and clinical practice. This perspective requires a change in the attitude of the disciplines in recognising the importance of the integrated study of sexuality for the future happines of human beings and the implications for society. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Reviewed by:Diagnosing Desire: Biopolitics and Femininity into the Twenty-First Century by Alyson K. SpurgasTheodora K. Hurley (bio)Diagnosing Desire: Biopolitics and Femininity into the Twenty-First Century by Alyson K. Spurgas Columbus: The Ohio State University Press, 2020What are the stakes of research on women's sexuality? Alyson K. Spurgas takes on this deceptively straightforward question with an impressive examination of scientific research on women's sexuality and subsequent treatments for women with (...) low sexual desire. The result, Diagnosing Desire: Biopolitics and Femininity into the Twenty-First Century, merges analysis of clinical sex research and therapeutic discourses, data from interviews with women who consider themselves to have low sexual desire, and a wealth of critical theoretical perspectives on embodiment, sexuality, and disability. This investigation of scientific approaches to women's sexuality hinges on Spurgas's concept of the "feminized responsive desire framework," which integrates several components of "expert" information on women's sexuality: the prominence of research into the "discordance" between women's externally monitored and self-reported arousal; a receptive model of feminine sexuality in which arousal precedes sexual desire; the recent inclusion of female sexual interest/arousal disorder (FSIAD) in the DSM-5; and a suite of therapeutic interventions aimed at rehabilitating women's deficient or discordant sexuality, including mindfulness-based sex therapy. Spurgas's analysis of this multipronged framework for understanding women's sexuality innovatively considers how laypeople internalize and contend with scientific ideas, how sexological and sex therapeutic discourses contribute to neoliberal mandates of bodily improvement, and how scientific discussions of women's sexuality neglect questions of power and trauma.Spurgas opens the book with an incisive examination of how early ideas in sexology, behaviorism, evolutionary psychology, and the sex therapies they inspired framed women's sexuality as inherently responsive, fluid, and restrained. Following sexological discourses into the twenty-first century, chapter 2 examines how contemporary sex researchers and therapists argue that women's desire responds to or follows arousal. With an eye toward governmentality and selfoptimization, Spurgas considers how contemporary sex research paradigms and [End Page 232] therapeutic interventions deliver a new normative model of women's sexuality "based on receptivity, responsiveness, and a willingness to be seduced or coaxed into sex by an initiating male partner" (91). Spurgas's close reading of sexological texts provides a detailed view of the feminization of responsive desire. These texts, however, speak less clearly about why some researchers and practitioners consider the model of feminine sexual receptivity to be "feminist," as the book argues. Despite locating the responsive desire framework within regimes of gender difference and neoliberalism, the book leaves unanswered questions about how the framework fits into larger trends in neoliberal feminism (Rottenberg 2018). Despite this specific underdeveloped claim, these chapters shine in their close readings of texts produced by sex researchers and therapists, and indeed provide a template for how social science scholars might analyze scientific research articles and paradigms.The second half of the book considers how women who report low sexual desire interact with these expert ideas about their sexuality. Tracking how women come to understand their sexual desires and experiences through the prism of scientific and therapeutic discourses (what Spurgas calls "sexual difference socialization"), Diagnosing Desire argues that these discourses construct a population of "women-with-low-desire" and encourage low-desiring women's sexual rehabilitation—and compulsory sexual performance—in service of their partners, who are typically straight cisgender men. Turning the biomedical model of receptive feminine sexuality on its head, chapter 5 considers the pleasures and possibilities of agentic feminine receptivity through sexual submission. In a stirring conclusion, Spurgas insists that models of receptive feminine sexuality paint over the violence, trauma, and power relations that permeate women's experiences of sexuality, calling instead for community-based forms of care that supersede the individualistic foci of current sex research and treatment programs.Throughout the monograph, Spurgas maintains theoretical dialogues with critical lineages including feminist science studies, queer studies, and disability and madness studies; the breadth and richness of theoretical conversation allow Spurgas to robustly contribute to several areas of scholarship. Perhaps most centrally, the book offers a rare view of how patients and would-be patients internalize, modify... (shrink)

Definition of the problem: Every decision for or against life-sustaining measures in ICUs is a result of different factors, the kind and course of the illness, probable prognosis, age of the patient, but also character, experience and knowledge of the acting staff members. These factors may combine in an accidental way. The aim of the investigation was to evaluate these factors as far as possible. Arguments and conclusion: 287 physicians from intensive care units (ICU) in 43 hospitals were interviewed. In (...) a questionnaire, 6 case vignettes of severely ill patients served for hypothetical reasons and eventually decisions to act. Maximum medical activity was recommended in university hospitals, but acute lifesustaining measurements were equally accepted in all three kinds of hospitals. Other factors – such as duration of medical activity of the doctors, years of experience in intensive care medicine, motivations to act, sex and life attitude, but also the age of the patients – were of no significance. Because of the traditional close cooperation in ICUs, the nursing staff was also interviewed. For reanimation, intubation/artificial ventilation and pain relief therapy there where no differences in the group of doctors. These were significant in invasive diagnostic and therapeutic measurements, which were generally rejected earlier and more easily by the nursing staff. (shrink)

I argue that the existence of sexual dimorphism poses a profound challenge to those philosophers who wish to deny the moral significance of the idea of ‘normal human capacities’ in debates about the ethics of human enhancement. The biological sex of a child will make a much greater difference to their life prospects than many of the genetic variations that the philosophical and bioethical literature has previously been concerned with. It seems, then, that bioethicists should have something to say about (...) the choice between a male and a female embryo. Either, 1) parents have reason to choose boys over girls; (2) parents have reason to choose girls over boys; or, (3) parents have neither reason to choose girls over boys nor reason to choose boys over girls. Embracing either of the first two alternatives has strongly counterintuitive – and arguably morally repugnant – consequences. To motivate the third option we must either make reference to the idea of ‘normal human capacities’ or argue that parents should consider the interests of society when thinking about what sort of children they should bring into the world – an implication that should be extremely controversial in debates about the ‘new eugenics’. I conclude, then, that the idea of ‘normal human capacities’ is properly crucial to reasoning about the ethics of shaping future persons. (shrink)

Abstract: This essay explores recent trends and major issues related to gay and lesbian philosophy in ethics (including issues concerning the morality of homosexuality, the natural function of sex, and outing and coming out); religion (covering past and present debates about the status of homosexuality and how biblical and qur'anic passages have been interpreted by both sides of the debate); the law (especially a discussion of the debates surrounding sodomy laws, same-sex marriage and its impact on transsexuals, and whether the (...) law should be used to enforce morality); scientific research into the origins of homosexuality (including discussion of arguments against such research); and metaphysics (especially the question of whether homosexuality is socially constructed during particular times and in particular cultures, or whether sexual orientation is an essential trait cutting across times and cultures). (shrink)

As technology continues to grow (and sex-robots gain a more prominent position in our society), so too does concern about the way they will impact our lives and our sexuality. While many ethicists have started to assess what this impact could be (and if it would be positive or negative), the challenges and opportunities presented by sex-robots span over a wide range of topics and cannot be assessed easily. Hence, in this paper, I will attempt to categorize the main questions (...) concerning the ethics of sexual robotics in order to help ethicists gather their thoughts on this new technology. While doing so, I will principally identify four overarching issues: (1) how robots’ representation of human sexuality affects human gender issues; (2) how robots could potentially be utilized for medical purposes; (3) if robots could possibly deceive their users; (4) if sex-robots could end up as a new form of sex-slaves. (shrink)

Gender dysphoria is a clinically significant incongruence between expressed gender and assigned gender, with rapidly growing prevalence among children. The UK High Court recently conducted a judicial review regarding the service provision at a youth-focussed gender identity clinic in Tavistock. The high court adjudged it ‘highly unlikely’ that under-13s, and ‘doubtful’ that 14–15 years old, can be competent to consent to puberty blocker therapy for GD. They based their reasoning on the limited evidence regarding efficacy, the likelihood of progressing (...) to cross-sex hormone therapy and the ‘life-changing consequences’ of puberty blockers. In this article, I offer two concurrent arguments to dispute their reasoning. First, I argue that minors can be competent to consent to puberty blockers for GD, because the decision to undergo puberty blocker therapy is no more complex or far-reaching than other medical decisions that we accept a child should be able to make. Second, I argue that—irrespective of competence—such legal restriction for all children fundamentally contradicts the central ethical tenet of child healthcare: best interests. For these two reasons, the high court should not restrict access to puberty blockers for competent GD children. (shrink)

In this essay, I outline fundamental anthropological and moral principles related to human sexuality and gender identity and then apply these principles to analyze and evaluate the views of several authors who attempt to carve out a “middle way” between liberal and traditionalist approaches to these issues. In doing so, I engage especially with the claim that gender dysphoria, rather than being a psychological issue, is a type of biological intersex condition in which one’s “brain sex” is out of line (...) with one’s genital and chromosomal sex. I argue that understanding the human person as a unity of body and soul and recognizing human sexuality as ordered toward the human good of marriage understood as inseparably unitive and procreative reveals the flaws in this position and helps to show why hormonal or surgical gender reassignment therapy is not a medically or ethically appropriate response to gender dysphoria. I also offer an alternative characterization of gender dysphoria and suggestions for responding with true compassion to those who suffer from it. (shrink)

The term body integrity identity disorder (BIID) describes the extremely rare phenomenon of persons who desire the amputation of one or more healthy limbs or who desire a paralysis. Some of these persons mutilate themselves; others ask surgeons for an amputation or for the transection of their spinal cord. Psychologists and physicians explain this phenomenon in quite different ways; but a successful psychotherapeutic or pharmaceutical therapy is not known. Lobbies of persons suffering from BIID explain the desire for amputation (...) in analogy to the desire of transsexuals for surgical sex reassignment. Medical ethicists discuss the controversy about elective amputations of healthy limbs: on the one hand the principle of autonomy is used to deduce the right for body modifications; on the other hand the autonomy of BIID patients is doubted. Neurological results suggest that BIID is a brain disorder producing a disruption of the body image, for which parallels for stroke patients are known. If BIID were a neuropsychological disturbance, which includes missing insight into the illness and a specific lack of autonomy, then amputations would be contraindicated and must be evaluated as bodily injuries of mentally disordered patients. Instead of only curing the symptom, a causal therapy should be developed to integrate the alien limb into the body image. (shrink)

In the context of transgender health, most people are not comfortable with allowing a twelve‐year‐old child with gender dysphoria to elect to undergo gender reassignment surgery. The likelihood is too high that the child would be unable to fully comprehend the scope of a decision that carries significant, permanent consequences, particularly because the decision to surgically change gender is based upon a conception of gender that can fluctuate during adolescent years. Conversely, however, most people would not contend that this fluidity (...) is reason to wholly deny certain medical care such as hormonal treatments to transgender youth, a demographic with extremely high rates of violent behavior, self‐harm, and suicide. This paper will explore ethical considerations to this emerging debate of what therapeutic options should be offered to transgender children and adolescents.Pediatric endocrinologists have been treating gender dysphoric adolescents with puberty‐suppressing drugs and, to a lesser extent, with cross‐sex hormone therapies for more than twenty years. Clinicians and thought leaders have mentioned ethical components of this emerging practice in the few cohort studies and clinical review articles about the subject. However, ethics have generally been a secondary consideration in the medical academic literature. In this paper, I will provide a brief overview of the practice, summarize the current research on hormone treatment for transgender minors, and provide an ethical analysis of the practice. (shrink)