More Nonindustry Funding is Needed for Sexological Sciences to Endure

The article by Rowland, “Will medical solutions to sexual problems make sexological care and science obsolete?” is timely, thoughtful, and provocative, and is relevant for both sexological therapists and scientists. Rowland discusses the resurgence of interest in treatment of sexual complaints over the past 5–10 years as falling on the heels of the successful PDE-5 inhibitors for men. Despite bringing much positive attention to sexual health as being an integral component of quality of life, this resurgence has been largely medical, and has been coined “Sexual Medicine,” which many see as being distinct from sexological science or sex therapy. “Sexual Medicine” implies a disease model where there is an underlying pathophysiology that requires fixing. The primary research design within Sexual Medicine is the Randomized Controlled Trial (RCT), where participants are randomly assigned to either an active treatment or the control (placebo) group—a methodology that lends itself well to pharmaceutical trials. Because of the incredible success of the PDE-5 inhibitors (e.g., Rowland notes that between 1998–2004, 123 million prescriptions of ViagraTM were written), and because such treatment falls under the guise of medicine, sexual problems have become the near exclusive domain of the medical profession. As far as peer-reviewed science is concerned, there has been a large increase in the number of publications exploring medical treatments, but no change in the number of publications examining psychological or behavioural correlates of sexual problems in the past decade. Given these numbers, Rowland predicts that the future appears bleak for nonmedical healthcare providers in sexology given that this group will have less and less influence on the study and treatment of sexual problems and because the treatments they provide are less accessible and affordable for most people with sexual problems.