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contents

Introduction: Yes, You Are Normal The True Story of Sex The Organization of This Book A Couple of Caveats If You Feel Broken, or Know Someone Who Does

part 1 the (not-so-basic) basics 1. Anatomy: No Two Alike The Beginning The Clit, the Whole Clit, and Nothing but the Clit Meet Your Clitoris Lips, Both Great and Small Hymen Truths A Word on Words The Sticky Bits Intersex Parts Why It Matters Change How You See A Better Metaphor What It Is, Not What It Means 2. The Dual Control Model: Your Sexual Personality Turn On the Ons, Turn Off the Offs Arousability What “Medium” Means Different for Girls . . . but Not Necessarily What Turns You On? All the Same Parts, Organized in Different Ways Can You Change Your SIS or SES? 3. Context: And the “One Ring” (to Rule Them All) in Your Emotional Brain Sensation in Context Sex, Rats, and Rock ’n’ Roll Your Emotional One Ring You Can’t Make Them “Is Something Wrong with Me?” (Answer: Nope)

part 2 sex in context 4. Emotional Context: Sex in a Monkey Brain The Stress Response Cycle: Fight, Flight, and Freeze Stress and Sex Broken Culture  Broken Stress Response Cycles Complete the Cycle! When Sex Becomes the Lion Sex and the Survivor Origin of Love The Science of Falling in Love Attachment and Sex: The Dark Side Attachment and Sex: Sex That Advances the Plot Attachment Style Managing Attachment: Your Feels as a Sleepy Hedgehog Survival of the Social The Water of Life 5. Cultural Context: A Sex-Positive Life in a Sex-Negative World Three Messages You Are Beautiful Criticizing Yourself = Stress = Reduced Sexual Pleasure Health at Every Size

“Dirty” When Somebody “Yucks” Your “Yum” Maximizing Yum . . . with Science! Part 1: Self-Compassion Maximizing Yum . . . with Science! Part 2: Cognitive Dissonance Maximizing Yum . . . with Science! Part 3: Media Nutrition You Do You

part 3 sex in action 6. Arousal: Lubrication Is Not Causation Measuring and Defining Nonconcordance All the Same Parts, Organized in Different Ways: “This Is a Restaurant” Nonconcordance in Other Emotions Lubrication Error #1: Genital Response = “Turned On” Lubrication Error #2: Genital Response Is Enjoying Lubrication Error #3: Nonconcordance Is a Problem Medicating Away the Brakes “Honey . . . I’m Nonconcordant!” Ripe Fruit 7. Desire: Actually, It’s Not a Drive Desire = Arousal in Context Not a Drive. For Real. Why It Matters That It’s Not a Drive “But Emily, Sometimes It Feels Like a Drive!” Impatient Little Monitors Good News! It’s Probably Not Your Hormones More Good News! It’s Not Monogamy, Either “Isn’t It Just Culture?” It Might Be the Chasing Dynamic Maximizing Desire . . . with Science! Part 1: Arousing the One Ring Maximizing Desire . . . with Science! Part 2: Turning Off the Offs Maximizing Desire . . . with Science! Part 3: Desperate Measures Sharing Your Garden

part 4 ecstasy for everybody 8. Orgasm: The Fantastic Bonus Nonconcordance—Now with Orgasms! No Two Alike All the Same Parts . . . Your Vagina’s Okay, Either Way The Evolution of the Fantastic Bonus Difficulty with Orgasm Ecstatic Orgasm: You’re a Flock! How Do You Medicate a Flock? Flying Toward Ecstasy 9. Meta-Emotions: The Ultimate Sex-Positive Context Can’t Get No . . . The Map and the Terrain Positive Meta-Emotions Step 1: Trust the Terrain Positive Meta-Emotions Step 2: Let Go of the Map (the Hard Part) How to Let Go: Nonjudging Nonjudging = “Emotion Coaching” Nonjudging: Tips for Beginners “No Good Reason” Healing Trauma with Nonjudging When Partners Dismiss! Influencing the Little Monitor Part 1: Changing Your Criterion Velocity Influencing the Little Monitor Part 2: Changing the Kind of Effort Influencing the Little Monitor Part 3: Changing the Goal “To Feel Normal” “This Is It” Conclusion: You Are the Secret Ingredient Why I Wrote This Book Where to Look for More Answers

Acknowledgments Appendix 1: Therapeutic Masturbation Appendix 2: Extended Orgasm About the Author Notes References Index

For my students

introduction YES, YOU ARE NORMAL

To be a sex educator is to be asked questions. I’ve stood in college dining halls with a plate of food in my hands answering questions about orgasm. I’ve been stopped in hotel lobbies at professional conferences to answer questions about vibrators. I’ve sat on a park bench, checking social media on my phone, only to find questions from a stranger about her asymmetrical genitals. I’ve gotten emails from students, from friends, from their friends, from total strangers about sexual desire, sexual arousal, sexual pleasure, sexual pain, orgasm, fetishes, fantasies, bodily fluids, and more.

Questions like . . . • Once my partner initiates, I’m into it, but it seems like it never even occurs to me to be the one to start things. Why is

that? • My boyfriend was like, “You’re not ready, you’re still dry.” But I was so ready. So why wasn’t I wet? • I saw this thing about women who can’t enjoy sex because they worry about their bodies the whole time. That’s me.

How do I stop doing that? • I read something about women who stop wanting sex after a while in a relationship, even if they still love their

partner. That’s me. How do I start wanting sex with my partner again? • I think maybe I peed when I had an orgasm . . . ? • I think maybe I’ve never had an orgasm . . . ?

Under all these questions, there’s really just one question: Am I normal? (The answer is nearly always: Yes.) This book is a collection of answers. They’re answers that I’ve seen change women’s lives,

answers informed by the most current science and by the personal stories of women whose growing understanding of sex has transformed their relationships with their own bodies. These women are my heroines, and I hope that by telling their stories, I’ll empower you to follow your own path, to reach for and achieve your own profound and unique sexual potential.

the true story of sex After all the books that have been written about sex, all the blogs and TV shows and radio

Q&As, how can it be that we all still have so many questions? Well. The frustrating reality is we’ve been lied to—not deliberately, it’s no one’s fault, but

still. We were told the wrong story. For a long, long time in Western science and medicine, women’s sexuality was viewed as

Men’s Sexuality Lite—basically the same but not quite as good. For instance, it was just sort of assumed that since men have orgasms during penis-in-vagina

sex (intercourse), women should have orgasms with intercourse too, and if they don’t, it’s because they’re broken.

In reality, about 30 percent of women orgasm reliably with intercourse. The other 70 percent sometimes, rarely, or never orgasm with intercourse, and they’re all healthy and normal. A woman might orgasm lots of other ways—manual sex, oral sex, vibrators, breast stimulation, toe sucking, pretty much any way you can imagine—and still not orgasm during intercourse. That’s normal.

It was just assumed, too, that because a man’s genitals typically behave the way his mind is behaving—if his penis is erect, he’s feeling turned on—a woman’s genitals should also match her emotional experience.

And again, some women’s do, many don’t. A woman can be perfectly normal and healthy and experience “arousal nonconcordance,” where the behavior of her genitals (being wet or dry) may not match her mental experience (feeling turned on or not).

And it was also assumed that because men experience spontaneous, out-of-the-blue desire for sex, women should also want sex spontaneously.

Again it turns out that’s true sometimes, but not necessarily. A woman can be perfectly normal and healthy and never experience spontaneous sexual desire. Instead, she may experience “responsive” desire, in which her desire emerges only in a highly erotic context.

In reality, women and men are different. But wait. Women and men both experience orgasm, desire, and arousal, and men, too, can

experience responsive desire, arousal nonconcordance, and lack of orgasm with penetration. Women and men both can fall in love, fantasize, masturbate, feel puzzled about sex, and experience ecstatic pleasure. They both can ooze fluids, travel forbidden paths of sexual imagination, encounter the unexpected and startling ways that sex shows up in every domain of life—and confront the unexpected and startling ways that sex sometimes declines, politely or otherwise, to show up.

So . . . are women and men really that different? The problem here is that we’ve been taught to think about sex in terms of behavior, rather

than in terms of the biological, psychological, and social processes underlying the behavior. We think about our physiological behavior—blood flow and genital secretions and heart rate. We think about our social behavior—what we do in bed, whom we do it with, and how often. A lot of books about sex focus on those things; they tell you how many times per week the average couple has sex or they offer instructions on how to have an orgasm, and they can be helpful.

But if you really want to understand human sexuality, behavior alone won’t get you there. Trying to understand sex by looking at behavior is like trying to understand love by looking at a couple’s wedding portrait . . . and their divorce papers. Being able to describe what happened— two people got married and then got divorced—doesn’t get us very far. What we want to know is why and how it came to be. Did our couple fall out of love after they got married, and that’s why they divorced? Or were they never in love but were forced to marry, and finally became free when they divorced? Without better evidence, we’re mostly guessing.

Until very recently, that’s how it’s been for sex—mostly guessing. But we’re at a pivotal moment in sex science because, after decades of research describing what happens in human sexual response, we’re finally figuring out the why and how—the process underlying the behavior.

In the last decade of the twentieth century, researchers Erick Janssen and John Bancroft at the Kinsey Institute for Research in Sex, Gender, and Reproduction developed a model of human sexual response that provides an organizing principle for understanding the true story of sex. According to their “dual control model,” the sexual response mechanism in our brains consists of a pair of universal components—a sexual accelerator and sexual brakes—and those components respond to broad categories of sexual stimuli—including genital sensations, visual stimulation, and emotional context. And the sensitivity of each component varies from person to person.

The result is that sexual arousal, desire, and orgasm are nearly universal experiences, but when and how we experience them depends largely on the sensitivities of our “brakes” and “accelerator” and on the kind of stimulation they’re given.

This is the mechanism underlying the behavior—the why and the how. And it’s the rule that governs the story I’ll be telling in this book: We’re all made of the same parts, but in each of us, those parts are organized in a unique way that changes over our life span.

No organization is better or worse than any other, and no phase in our life span is better or worse than any other; they’re just different. An apple tree can be healthy no matter what variety

of apple it is—though one variety may need constant direct sunlight and another might enjoy some shade. And an apple tree can be healthy when it’s a seed, when it’s a seedling, as it’s growing, and as it fades at the end of the season, as well as when, in late summer, it is laden with fruit. But it has different needs at each of those phases in its life.

You, too, are healthy and normal at the start of your sexual development, as you grow, and as you bear the fruits of living with confidence and joy inside your body. You are healthy when you need lots of sun, and you’re healthy when you enjoy some shade. That’s the true story. We are all the same. We are all different. We are all normal.

the organization of this book The book is divided into four parts: (1) The (Not-So-Basic) Basics; (2) Sex in Context; (3)

Sex in Action; and (4) Ecstasy for Everybody. The three chapters in the first part describe the basic hardware you were born with—a body, a brain, and a world. In chapter 1, I talk about genitals—their parts, the meaning we impose on those parts, and the science that proves definitively that yes, your genitals are perfectly healthy and beautiful just as they are. Chapter 2 details the sexual response mechanism in the brain—the dual control model of inhibition and excitation, or brakes and accelerator. Then in chapter 3, I introduce the ways that your sexual brakes and accelerator interact with the many other systems in your brain and environment, to shape whether a particular sensation or person turns you on, right now, in this moment.

In the second part of the book, “Sex in Context,” we think about how all the basic hardware functions within the context of your actual life—your emotions, your relationship, your feelings about your body, and your attitudes toward sex. Chapter 4 focuses on two primary emotional systems, love and stress, and the surprising and contradictory ways they can influence your sexual responsiveness. Then chapter 5 describes the cultural forces that shape and constrain sexual functioning, and how you can maximize the good things about this process and overcome the destructive things. What we’ll learn is that context—your external circumstances and your present mental state—is as crucial to your sexual wellbeing as your body and brain. Master the content in these chapters and your sexual life will transform—along with, quite possibly, the rest of your life.

The third part of the book, “Sex in Action,” is about sexual response itself, and I bust two long-standing and dangerous myths. Chapter 6 lays out the evidence that sexual arousal may or may not have anything to do with what’s happening in your genitals. This is where we learn why arousal nonconcordance, which I mentioned earlier, is normal and healthy. And after you read chapter 7, you will never again hear someone say “sex drive” without thinking to yourself, Ah, but sex is not a drive. In this chapter I explain how “responsive desire” works. If you (or your partner) have ever experienced a change in your interest in sex—increase or decrease—this is an important chapter for you.

And the fourth part of the book, “Ecstasy for Everybody,” explains how to make sex entirely yours, which is how you create peak sexual ecstasy in your life. Chapter 8 is about orgasms— what they are, what they’re not, how to have them, and how to make them like the ones you read about, the ones that turn the stars into rainbows. And finally, in Chapter 9, I describe the single most important thing you can do to improve your sex life. But I’ll give it away right now: It turns out what matters most is not the parts you are made of or how they are organized, but how you feel about those parts. When you embrace your sexuality precisely as it is right now, that’s the context that creates the greatest potential for ecstatic pleasure.

Several chapters include worksheets or other interactive activities and exercises. A lot of these are fun—like in chapter 3, I ask you to think about times when you’ve had great sex and

identify what aspects of the context helped to make that sex great. All of them turn the science into something practical that can genuinely transform your sex life.

Throughout the book, you’ll follow the stories of four women—Olivia, Merritt, Camilla, and Laurie. These women don’t exist as individuals; they’re composites, integrating the real stories of the many women I’ve taught, talked with, emailed, and supported in my two decades as a sex educator. You can imagine each woman as a collage of snapshots—the face from one photograph, the arms from another, the feet from a third . . . each part represents someone real, and the collection hangs together meaningfully, but I’ve invented the relationships that the parts have to each other.

I’ve chosen to construct these composites rather than tell the stories of specific women for two reasons. First, people tell me their stories in confidence, and I want to protect their identities, so I’ve changed details in order to keep their story their story. And second, I believe I can describe the widest possible variety of women’s sexual experiences by focusing not on specific stories of one individual woman but on the larger narratives that contain the common themes I’ve seen in all these hundreds of women’s lives.

And finally, at the end of each chapter you’ll find a “tl;dr” list—“too long; didn’t read,” the blunt Internet abbreviation that means, “Just get to the point.” Each tl;dr list briefly summarizes the four most important messages in the chapter. If you find yourself thinking, “My friend Alice should totally read this chapter!” or “I really wish my partner knew this,” you might start by showing them the tl;dr list.I Or, if you’re like me and get too excited about these ideas to keep them to yourself, you can follow your partner around the house, reading the tl;dr list out loud and saying, “See, honey, arousal nonconcordance is a thing!” or “It turns out I have responsive desire!” or “You give me great context, sweetie!”

a couple of caveats First, most of the time when I say “women” in this book, I mean people who were born in

female bodies, were raised as girls, and now have the social role and psychological identity of “woman.” There are plenty of women who don’t fit one or more of those characteristics, but there’s too little research on trans* and genderqueer sexual functioning for me to say with certainty whether what’s true about cisgender women’s sexual wellbeing is also true for trans* folks. I think it probably is, and as more research emerges over the coming decade we’ll find out, but in the meantime I want to acknowledge that this is basically a book about cisgender women.

And if you don’t know what any of that means, don’t worry about it. Second, I am passionate about the role of science in promoting women’s sexual wellbeing,

and I have worked hard in this book to encapsulate the research in the service of teaching women to live with confidence and joy inside their bodies. But I’ve been very intentional about the empirical details I’ve included or excluded. I asked myself, “Does this fact help women have better sex lives, or is it just a totally fascinating and important empirical puzzle?”

And I cut the puzzles. I kept only the science that has the most immediate relevance in women’s everyday lives. So

what you’ll find in these pages isn’t the whole story of women’s sexuality—I’m not sure the whole story would actually fit in one book. Instead, I’ve included the parts of the story that I’ve found most powerful in my work as a sex educator, promoting women’s sexual wellbeing, autonomy, and pleasure.

The purpose of this book is to offer a new, science-based way of thinking about women’s sexual wellbeing. Like all new ways of thinking, it opens up a lot of questions and challenges much preexisting knowledge. If you want to dive deeper, you’ll find references in the notes,

along with details about my process for boiling down a complex and multifaceted body of research into something practical.

if you feel broken, or know someone who does One more thing before we get into chapter 1. Remember how I said we’ve all been lied to,

but it’s no one’s fault? I want to take a moment to recognize the damage done by that lie. So many women come to my blog or to my class or to my public talks convinced that they

are sexually broken. They feel dysfunctional. Abnormal. And on top of that, they feel anxious, frustrated, and hopeless about the lack of information and support they’ve received from medical professionals, therapists, partners, family, and friends.

“Just relax,” they’ve been told. “Have a glass of wine.” Or, “Women just don’t want sex that much. Get over it.” Or, “Sometimes sex hurts—can’t you just ignore it?” I understand the frustration these women experience, and the despair—and in the second half

of the book I talk about the neurological process that traps people in frustration and despair, shutting them off from hope and joy, and I describe science-based ways to get out of the trap.

Here’s what I need you to know right now: The information in this book will show you that whatever you’re experiencing in your sexuality—whether it’s challenges with arousal, desire, orgasm, pain, no sexual sensations—is the result of your sexual response mechanism functioning appropriately . . . in an inappropriate world. You are normal; it is the world around you that’s broken.

That’s actually the bad news. The good news is that when you understand how your sexual response mechanism works,

you can begin to take control of your environment and your brain in order to maximize your sexual potential, even in a broken world. And when you change your environment and your brain, you can change—and heal—your sexual functioning.

This book contains information that I have seen transform women’s sexual wellbeing. I’ve seen it transform men’s understanding of their women partners. I’ve seen same-sex couples look at each other and say, “Oh. So that’s what was going on.” Students, friends, blog readers, and even fellow sex educators have read a blog post or heard me give a talk and said, “Why didn’t anyone tell me this before? It explains everything!”

I know for sure that what I’ve written in this book can help you. It may not be enough to heal all the wounds inflicted on your sexuality by a culture in which it sometimes feels nearly impossible for a woman to “do” sexuality right, but it will provide powerful tools in support of your healing.

How do I know? Evidence, of course! At the end of one semester, I asked my 187 students to write down one really important thing

they learned in my class. Here’s a small sample of what they wrote: I am normal! I AM NORMAL I learned that everything is NORMAL, making it possible to go through the rest of my life with confidence and joy. I learned that I am normal! And I learned that some people have spontaneous desire and others have responsive desire

and this fact helped me really understand my personal life. Women vary! And just because I do not experience my sexuality in the same way as many other women, that does not

make me abnormal. Women’s sexual desire, arousal, response, etc., is incredibly varied. The one thing I can count on regarding sexuality is that people vary, a lot. That everyone is different and everything is normal; no two alike. No two alike!

And many more. More than half of them wrote some version of “I am normal.” I sat in my office and read those responses with tears in my eyes. There was something

urgently important to my students about feeling “normal,” and somehow my class had cleared a path to that feeling.

The science of women’s sexual wellbeing is young, and there is much still to be learned. But this young science has already discovered truths about women’s sexuality that have transformed my students’ relationships with their bodies—and it has certainly transformed mine. I wrote this book to share the science, stories, and sex-positive insights that prove to us that, despite our culture’s vested interest in making us feel broken, dysfunctional, unlovely, and unlovable, we are in fact fully capable of confident, joyful sex.

• • • The promise of Come as You Are is this: No matter where you are in your sexual journey

right now, whether you have an awesome sex life and want to expand the awesomeness, or you’re struggling and want to find solutions, you will learn something that will improve your sex life and transform the way you understand what it means to be a sexual being. And you’ll discover that, even if you don’t yet feel that way, you are already sexually whole and healthy.

The science says so. I can prove it.

I. I’ll use “they” as a singular pronoun, rather than “he or she” throughout the book. It’s simpler, as well as more inclusive of folks outside the gender binary.

part 1 the (not-so-basic) basics

one anatomy

NO TWO ALIKE

Olivia likes to watch herself in the mirror when she masturbates. Like many women, Olivia masturbates lying on her back and rubbing her clitoris with

her hand. Unlike many women, she props herself up on one elbow in front of a full-length mirror and watches her fingers moving in the folds of her vulva.

“I started when I was a teenager,” she told me. “I had seen porn on the Internet, and I was curious about what I looked like, so I got a mirror and started pulling apart my labia so I could see my clit, and what can I say? It felt good, so I started masturbating.”

It’s not the only way she masturbates. She also enjoys the “pulse” spray on her showerhead, she has a small army of vibrators at her command, and she spent several months teaching herself to have “breath” orgasms, coming without touching her body at all.

This is the kind of thing women tell you when you’re a sex educator. She also told me that looking at her vulva convinced her that her sexuality was more

like a man’s, because her clitoris is comparatively large—“like a baby carrot, almost”— which, she concluded, made her more masculine; it must be bigger because she had more testosterone, which in turn made her a horny lady.

I told her, “Actually there’s no evidence of a relationship between an adult woman’s hormone levels, genital shape or size, and sexual desire or response.”

“Are you sure about that?” she asked. “Well, some women have ‘testosterone-dependent’ desire,” I said, pondering, “which

means they need a certain very low minimum of T, but that’s not the same as ‘high testosterone.’ And the distance between the clitoris and the urethra predicts how reliably orgasmic a woman is during intercourse, but that’s a whole other thing. I’d be fascinated to see a study that directly asked the question, but the available evidence suggests that variation in women’s genital shapes, sizes, and colors doesn’t predict anything in particular about her level of sexual interest.”

“Oh,” she said. And that single syllable said to me: “Emily, you have missed the point.”

Olivia is a psychology grad student—a former student of mine, an activist around women’s reproductive health issues, and now doing her own research, which is how we got started on this conversation—so I got excited about the opportunity to talk about the science. But with that quiet, “Oh,” I realized that this wasn’t about the science for Olivia. It was about her struggle to embrace her body and her sexuality just as it is, when so much of her culture was trying to convince her there is something wrong with her.

So I said, “You know, your clitoris is totally normal. Everyone’s genitals are made of all the same parts, just organized in different ways. The differences don’t necessarily mean anything, they’re just varieties of beautiful and healthy. Actually,” I continued, “that could be the most important thing you’ll ever learn about human sexuality.”

“Really?” she asked. …