PE Drugs as Lifestyle Drugs
Numerous challenges loom over the success of any drug, and for one that extends intercourse the most significant factors will be pricing and efficacy. “Because premature ejaculation is in such a broad range of patients and doesn’t have a correlation with age, it is actually much more in line with a lifestyle drug,” says Sarah Terry, of Life Science Analytics. “As a lifestyle drug, it won’t be reimbursed by health insurance. People will have to pay out of pocket for it.”
Getting men to schedule an appointment to talk about an ostensibly embarrassing disorder and then persuading them to cough up money for treatment will require a costly display of advertising acumen. The battle over direct-to-consumer advertising is nothing new, with one side considering it patient education and the other considering it a tool of deception. Such drug ads are almost exclusive to the United States, coming to the airwaves only in the 1990s. The stakes are now huge: Pfizer has recruited the likes of Bob Dole, Rafael Palmeiro, and NASCAR driver Mark Martin to pitch Viagra. Eli Lilly’s ad for Cialis that features a couple in separate bathtubs gazing toward the horizon has been cited by Nielsen as one of the most remembered commercials. As the erection market has grown and competition increased, the ads have became more risqué, sparking complaints and FDA warnings that the drugs are being hawked as party pills. It is unclear how American households will respond when copywriters start churning out euphemisms for ejaculate, but chances are there will be some uproar. Any opposition to such ads will give pause to drug companies and research institutes contemplating new ventures in sexual health.
But advertising is essential for any premature ejaculation drug. “We looked at the examples of Viagra, Levitra, and Cialis as a benchmark for the impact of direct-to-consumer advertising,” Sarah Terry says. “What we found qualitatively is that, after the launch of Viagra, the marketing of each subsequent product expanded the opportunity of those drugs by nearly 15 to 20 percent each. The amount of marketing out there continued to push the population base that much each time.” A similar pattern will presumably emerge with premature ejaculation drugs. The market will swell by millions with each additional approval letter the FDA mails.
Some experts see the real problem as the imposition of normative structures on what is a variable phenomenon. Dr. Leonore Tiefer, associate professor of psychiatry at New York University, is in the vanguard of a movement to undermine the quantification of sexual function. She admits that a drug to delay ejaculation can be useful to some but says there is no such thing as premature ejaculation, and efforts to create drugs to treat it are disingenuous. Sex, Tiefer says, is more like dancing than digestion.
“Fundamentally, being fat or thin is a matter of live variation throughout history and culture,” she says. “The same thing is true of coming quickly or not, having a hard erection when you’re 60 or not. There’s a great deal of variability. To try to stuff it into some simple-minded bottom line is to deny the reality of sex.”
Michael Perelman, the New York psychologist, says ejaculatory latency is just another human characteristic, similar to blue eyes, best plotted along a skewed distribution curve. He would like to see the definition of premature ejaculation divided into four categories of severity: when a man can’t enter the vagina, when sex lasts less than a minute, when sex lasts one to two minutes, and when it lasts two to four minutes. Perelman reasons that the average physician will see people who consider themselves to be suffering from premature ejaculation who last more than one minute but not as long as they would like to.
Remember that Brendan was nearing two minutes that night in New York. We don’t know if he ever felt in control, but distress certainly reared its head. No doctor can fully answer Susan’s question as to what the fuck was wrong with Brendan, and no drug can address the underlying factors that determine how long he lasts on any given occasion.
If Brendan had popped a pill that night, would he have been treating a disease or just enhancing an aspect of everyday life? Our regulatory system is designed to weigh the risks and benefits of drugs used to treat defined diseases, not to improve our lifestyles. But the line between treatment and enhancement is now more blurred than ever.
“Such uses of pharmaceuticals pose challenges for us as a country,” says Perelman. “The challenge is always greater when we talk about sex.”
Big Pharma isn’t going to shy away from this conversation. It’s adept at dictating what’s good and what’s bad and what is normal and what isn’t. Ejaculation won’t be an exception.
Atheists Do It Better: Why Leaving Religion Leads to Better Sex
Greta Christina
Do atheists have better sex? Yes, according to science—more specifically, according to the recently released study “Sex and Secularism.”
In January 2011, organizational psychologist Darrel Ray Ed.D. (a psychologist for 30 years and author of The God Virus as well as two books on psychology) and Amanda Brown (an undergraduate at the University of Kansas who focuses on sexuality and sex therapy) conducted a sex survey of over 14,500 subjects—atheists, agnostics, and other people in the secular community. The survey looked at religion, atheism, and sex: how religion affects sex, how leaving religion affects sex, whether lifelong atheists feel differently about sex than people who have recently deconverted, and so on. The report—“Sex and Secularism: What Happens When You Leave Religion?”—is on the Internet, and if you want all 46 pages of the naughty details, including the charts and graphs and personal stories, you can download it free; you only have to register on the website.
But if you just want to know the gist: leaving religion improves people’s sex lives. A lot.
Atheists and other nonbelievers, as a whole, experience a lot more satisfaction in their sex lives than they did when they were believers. They feel much less guilt about their sex lives and their sexuality. The sexual guilt instilled by so many religions tends to fade, and indeed disappear, when people leave religion—much more thoroughly than you might expect. And, according to the respondents of this study, nonbelievers give their children significantly better sex education than believers do.
Now, when it comes to people’s actual sexual behavior, religion doesn’t have nearly as much impact as you might think. Religious and nonreligious people have pretty much the same kinds of sex, at pretty much the same age of onset, and at pretty much the same rate. Believers are just as likely to masturbate, watch porn, have oral sex, have sex outside marriage, and so on, as nonbelievers, and they start at about the same ages. So it’s not that religious sexual guilt is actually making people abstain from forbidden sexual activity. All it’s doing is making people feel crummy about it. And when people leave religion, this crumminess decreases—at a dramatic rate. Believers and atheists are having pretty much the same kinds of sex—but when it comes to the pleasure and satisfaction experienced during this sex, it’s like night and day.
Okay. Before anyone squawks, I’ll start the squawking myself : there are some demographic problems with this study, and it shouldn’t be relied on as the final word on this topic. In particular, the participants in the study aren’t statistically representative of the population; they’re statistically representative of whoever heard about it on the Internet, and they’re disproportionately represented by readers of the hugely popular atheist blog Pharyngula. (In fact, in several places throughout the report, the researchers themselves freely acknowledge the limitations of their research.)
But the results of this report are entirely consistent with the results of other research. Lots of other research, both on human sexuality and on religion/atheism. And that makes these results much more plausible. As researcher Darrel Ray told me, “Our data is virtually identical to other national surveys on the basics of when and how people start sexual behavior.” (Citations of those surveys are in the report.) Yes, it’s virtually impossible to get completely accurate, statistically representative information about human sexuality under any circumstances; there’s not really
any ethical way to get information about sex other than relying on people’s self-reporting, and it’s a topic that people tend to, you know, lie about. But on the reliability scale for human sex research, this report seems to rank at the high end.
You might also argue—as I did when I first saw this research—that atheists are often pretty hostile to religion, and they aren’t going to give a fair assessment of their sex lives when they were religious. I think this is a valid point, and one that’s worth investigating. In fact, I hope this report marks the beginning of research into this topic rather than the end of it; I would be very interested to see studies about how religious people see their sex lives. I would be especially interested to compare the “Sex and Secularism” results to data from people who have converted from one religion to another, and whether they view their sex lives differently in light of their new religion.
But I’d also point out that the atheists who responded to this survey gave answers that were far from homogeneous. Their responses varied depending on which religion they used to belong to and how intensely religious their upbringing was. They ranged from “ZOMG, my sex life totally sucked and now it’s beyond awesome—I was blind but now I see” to “Meh, it’s a little better, but it’s really not all that different.” So the idea that this report simply reflects a knee-jerk atheist hostility to religion is worth considering, but it’s probably not what’s going on here.
So what is going on here? What does this report say, and what is its take-home message—both for believers and atheists?
Atheism Is for Lovers
Here’s one take-home message: atheists fuck better. Or rather, atheists have a better time fucking. They feel less guilt about it; they experience more satisfaction with it. And the effect on their sex lives of leaving religion is almost universally positive.
These effects vary with the religion. According to “Sex and Secularism,” some religions have a harsher impact on people’s sex lives than others. People raised as Mormons and Jehovah’s Witnesses, for instance, ranked much higher on the sexual guilt scale than people raised as Buddhists and Episcopalians. And no, we shouldn’t just assume that Catholicism is the guiltiest party. In fact, when it comes to which religions make their practitioners feel guilty about sex, Catholicism is pretty much smack in the middle. At the top of the list are Mormonism, Jehovah’s Witness, Pentecostal, Seventh-day Adventist, and Baptist. This is just one of many results in this report that run counter to conventional wisdom.
A similar pattern shows up again and again throughout the report. Conservative religions have a much more harmful effect on people’s sex lives than more moderate or progressive ones—in terms of guilt, sexual education and information, the ability to experience pleasure, the ability to accept one’s sexual identity, and more.
But with only two exceptions—Unitarianism and Judaism—atheists experience less sexual guilt than religious believers of any denomination. On a scale of 1 to 10—1 being no sexual guilt and 10 being extreme sexual guilt—atheists ranked 4.71 and agnostics ranked 4.81. Only Unitarianism and Judaism ranked slightly lower, at 4.14 and 4.48 respectively; all other religions ranked higher in sexual guilt: from 5.88 for Lutherans to 6.34 for Catholics, all the way up to a whopping 8.19 for Mormons.
And sexual guilt doesn’t rise only with the conservativeness of the religion. It rises with religiosity, period. The more religious your upbringing is, the worse your sexual guilt is likely to be. Of people raised in very religious homes, 22.5 percent said they were shamed or ridiculed for masturbating (to give just one example), compared to only 5.5 percent of people brought up in the least religious homes. And of people raised in very religious homes, 79.9 percent felt guilty about a specific sexual activity or desire, while among people raised in the least religious and most secular homes, that number drops to 26.3 percent. That’s a huge difference.
But one of the most surprising conclusions of this research is that sexual guilt from religion doesn’t wreck people’s sex lives forever.
According to conventional wisdom—and I will freely admit that I held this conventional wisdom myself—religious guilt about sex continues to torment people long after the religion itself has lost its hold. But according to “Sex and Secularism,” that’s rarely the case. Once people let go of religion, they report positive experiences of sex, and relative lack of guilt about it, at about the same rate as people who were never religious in the first place.
Ray was surprised by this result as well. (Surprising results—a sign of good science!) “We did think that religion would have residual effects in people after they left,” he told me, “but our data did not show this. That was a very pleasant surprise. That is not to say that some people don’t continue to experience problems, but the vast majority seem to shake it off and get on with their sexual lives pretty well.” So letting go of religion means a rebound into a sex life that’s as satisfying, and as guilt-free, as a sex life that was never touched by religion in the first place.
Now, some hard-core religious believers might argue that this isn’t a good thing. “People should feel sexual guilt!” they’d argue. “Sex is bad, mmmkay? God doesn’t approve. People should feel guilty about it.”
But two things are worth pointing out. First of all, the activities studied by this research are, from any rational perspective, morally neutral. This report doesn’t consider rape, or nonconsensual voyeurism, or groping people on the subway. It considers masturbation, oral sex, nonmarital sex, homosexuality: sex acts and sexualities that are consensual, egalitarian, reasonably safe, and harmless to society. The taboos against them are just that: taboos. If there ever were any solid practical or moral reasons behind them, they’re buried in the mists of history. And different religions have entirely different sets of these sexual taboos: One religion may denounce certain sex acts and accept others, while another accepts Column B but denounces Column A. If God has a message for us about who and how he wants us to boff, he’s not being very clear about it.
Maybe more to the point, religion has essentially no effect on people’s actual sexual behavior, according to the report. Atheists and believers engage in the same practices, at basically the same rate, starting at essentially the same age. We’re all doing pretty much the same stuff. Believers just feel worse about it. As Ray told me, “Our data shows that people feel very guilty about their sexual behavior when they are religious, but that does not stop them: it just makes them feel bad. Of course, they have to return to their religion to get forgiveness. It’s as if the church gives you the disease, then offers you a fake cure.” So the argument that religious sexual guilt is good because it polices immoral sexual behavior fails on two fronts. The sexual behavior it’s policing isn’t actually immoral—and the policing is almost entirely ineffective.
Oh, by the way—this improvement in people’s sex lives when they leave religion isn’t just about relieving sexual guilt. The improvement shows up in many aspects of their sex lives, such as their willingness to share sex fantasies with a partner, for example. Most important, it shows up in people’s assessments of their sex lives overall. This is truest of the people who were heavily religious before their deconversion. On a scale of 1 to 10—1 being a sex life that is much worse after leaving religion, 10 being a sex life that is much improved—people who had the most religious lives before averaged a very high 7.81; 61.6 percent gave an answer of 8, 9, or 10—“greatly improved.” People with little or no religion in their life before they became atheists mostly report that their sex lives didn’t change that much.
In fact, for the handful of atheists who reported that their sex lives worsened when they left religion—2.2 percent of participants—almost all tell the same story: their sex lives got worse because—well, to put it bluntly, their partners or potential partners were still religious, and now that they were atheists, they weren’t getting any. Their spouses got upset because they’d become atheists ; their pool of potential sex partners dried up. As one respondent commented
, “My wife said to me, ‘How can I sleep with someone who doesn’t share my faith? ’” Another, somewhat more waggishly, said, “When I was a Christian I could lay any girl in church, now that I am an atheist, they won’t even talk to me.”
Perhaps one of the most powerful messages in this report—if one of the least surprising—is the decidedly negative effect of religion on sexual education and information. People raised in more strongly religious homes ranked the quality of their sex education as significantly worse than people raised in less religious homes: 2.4 on a 5-point scale, as opposed to 3.2 from the less religious folks. And the more-religious kids were less likely to get sex information from their parents than the less-religious ones—13.5 percent, as opposed to 38.2 percent—and more likely to get it from personal sexual experience and pornography.
In case the irony escapes anyone, let me hammer it home. The highly religious, “family values” crowd are more likely to get their sexual information from porn and fooling around—while the less religious folks are more likely to talk to their parents. And in case anyone is wondering why sex education was included in this study on sexual happiness: accurate sex education and information has been consistently shown to be one of the cornerstones of a happy, satisfying sex life.
Which, again, atheists are a lot more likely to have.
Happy Endings
So what does this research say to believers?
Well, the most obvious message would be: come on in—the water’s fine.
In debates with atheists, many believers argue for religion on the basis of how good it makes them feel. They argue that religion is emotionally useful, psychologically useful, socially useful: that religion gives people a sense of meaning, moral guidance, comfort in hard times, etc. It’s an argument that drives many atheists up a tree—myself included—since it has absolutely nothing to do with whether religion is, you know, true. (Believing in Santa Claus might make kids happy and better-behaved, but you wouldn’t argue that people should keep putting cookies by the fireplace on Christmas Eve well into their adult years.)
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