Current Sexual Health Reports
Curr Sex Health Rep
Gender Differences and Similarities in
Samantha J.Dawson & Meredith
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CURRENT CONTROVERSIES (P KLEINPLATZ AND C MOSER, SECTION EDITORS)
Gender Differences and Similarities in Sexual Desire
Samantha J. Dawson &Meredith L. Chivers
#Springer Science+Business Media, LLC 2014
Abstract Sexual desire can be operationalized as the motiva-
tion to seek out solitary or partnered sexual experiences. A
large body of evidence suggests that men experience sexual
desire more strongly and more frequently than do women;
however, it is not clear whether sexual desire is truly gendered
or if gender differences are influenced by how sexual desire is
operationalized and assessed. Moreover, little research has
examined similarities and differences in trait versus state
sexual desire in women and men. Recent changes to the fifth
edition of the Diagnostic and Statistical Manual of Mental
Disorders (DSM-5) reflect the movement away from situating
desire as the onset of the traditional linear model to framing
desire as a state emerging from sexual excitement. We exam-
ine evidence for gender differences and similarities in trait and
state sexual desire in both clinical and nonclinical populations.
We conclude that sexual desire emerges similarly in women
and men and that other factors may influence the observed
gender difference in sexual desire. We then discuss the impli-
cations of conceptualizing desire as responsive for sexual
Keywords Sexual desire .Gender differences .Gender
similarities .Sexual motivation .Sex drive .Sexual interest .
Incentive motivation model .Trait sexual desire .State sexual
Researchers and clinicians use myriad terms to describe the
desire to seek out sexual partners or to engage in sexual
activities (e.g., partnered intercourse or masturbation), such
as libido, sexual interest, sex drive, sexual appetite, and sexual
motivation [1–5]. In addition to terminology differences, there
is evidence supporting different types of sexual desire; for
example, solitary versus dyadic, state versus trait. In this
review, we first discuss the gender difference observed in
clinical settings for disorders of desire. We then engage in a
discussion of whether sexual desire should be characterized as
a trait or whether it is best conceptualized as an emotional
state, with consideration of how gender interacts with the state
of sexual desire. Despite a large body of literature suggesting
that men experience sexual desire more frequently and more
intensely than women [for a review see 6], using the concep-
tualization of desire as an emergent property of sexual arousal
[7,8] and data from laboratory research [e.g., 9••], we suggest
that sexual motivation arises similarly in women and men and
that other factors (e.g., measurement, gender norms, report
biases) influence whether or not gender differences are
Sexual Desire in Clinical Populations
Historically, sexual desire and arousal were conceived as
linearly related, whereby desire spontaneously initiated the
sexual response cycle, leading to subsequent arousal and
orgasm . More recently, desire has been framed as emerg-
ing from the experience of sexual arousal, operating in a
circular, reciprocally reinforcing fashion [8,11]. Using this
contemporary framework,sexual desire and sexual arousal are
seen as responsive to sexual cues. This reconceptualization of
sexual desire is now reflected in recent changes to the fifth
This article is part of the Topical Collection on Current Controversies
S. J. Dawson :M. L. Chivers (*)
Department of Psychology, Queen’s University, 354 Humphrey Hall,
62 Arch Street, Kingston, ON K7L 3N6, Canada
S. J. Dawson
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revision of Diagnostic and Statistical Manual of Mental
Disorders (DSM-5) , whereby hypoactive sexual desire
disorder (HSDD) was expanded to include concomitant diffi-
culties with arousal into a new diagnosis called sexual interest
and arousal disorder (SIAD). The new polythetic criteria for
SIAD make it possible for women to receive a diagnosis based
on symptoms of low arousal, low desire, or a combination of
both. The impetus for this change was, in part, based on the
observed high comorbidity among arousal and desire disor-
ders in women, reported difficulties distinguishing arousal
from desire, and research suggesting that desire can precede
or emerge from arousal [for reviews see 12,13].
There is, however, some evidence to suggest that individ-
uals who have problems with arousal can be distinguished
from those who have problems with desire [14–16]. A recent
study showed that women with low desire (HSDD) versus low
arousal (female sexual arousal disorder; FSAD) exhibited
different psychophysiological response patterns to sexual
stimuli. Specifically, women with FSAD, HSDD,
FSAD/HSDD, and controls each exhibited similar patterns
of genital response when exposed to sexual stimuli; however,
women with HSDD and FSAD/HSDD reported significantly
less arousal than the other groups . Of note, women with
FSAD did not show impaired genital response, contrary to the
expectation that weak physiological arousal is characteristic of
the disorder. Kleinplatz  argues that women can distin-
guish arousal and desire and that expanding HSDD to include
difficulties with arousal may not be appropriate. However, it is
important to note that despite the somewhat unique patterns of
responding observed across clinical groups of women, women
with HSDD and FSAD were similar with respect to many
psychosocial factors (e.g., Female Sexual Function Index total
score, sexual inhibition and excitation scores, sexual attitudes,
and Beck Depression Inventory scores) suggestingsig-
nificant overlap across these disorders.
In contrast, evidence from one study suggests that it is
possible to distinguish men with low desire from those with
impaired arousal based on psychophysiological patterns and
psychosocial variables . This provides support for the
utility of separate diagnoses of disorders of arousal and desire
for men. The DSM-5 workgroup chose to retain the diagnosis
of HSDD for men, based on a paucity of empirical research
documenting the relationship between sexual arousal and
sexual desire difficulties in men .
Gender differences in the prevalence of low sexual desire
suggest that between 7–46 % of women [reviewed in 12],
compared to 1–20 % of men, experience difficulties with
desire [reviewed in 18], with fluctuations depending on sam-
ple characteristics (e.g., clinical versus community samples,
age, relationship status). Although not currently recognized in
the DSM-5 , the prevalence of hypersexuality (i.e., distress
caused by low control over excessive sexual thoughts, fanta-
sies, or behaviors) also demonstrates a gender difference. A
number of studies have reported that men experience dysreg-
ulated sexuality more frequently than women [19–21]. For
example, Långström and Hanson reportedthat12.1%of
men compared with 6.8 % of women in a nationally represen-
tative sample were classified as hypersexual based on their
self-reported sexual interests and behaviors.
Gender differences in the prevalence of disorders associat-
ed with sexual desire—that women appear to be overrepre-
sented for disorders associated with lower desire and men are
overrepresented for disorders associated with higher desire—
are interesting and warrant explanation. Winters et al. 
found that measures of hypersexuality and high sexual desire
loaded onto one uniform factor, suggesting that hypersexual-
ity is one end of the desire spectrum, with hypoactive or low
sexual desire on the opposing end. Sensitivity to sexual cues
may provide clues to the gender difference in prevalence rates
for low versus high sexual desire. Bloemers et al. [23••]
reported that some women with low sexual desire exhibit
relatively low or blunted sensitivity to sexual cues, as assessed
using a behavioral task (variant of the emotional Stroop task
versus self-report [23••]). In a series of studies [23••,24], they
found that responsiveness could be augmented with testoster-
one (T) and phosphodiesterase type-5 inhibitor (PDE5i), with
T increasing sensitivity to sexual cues and PDE5i facilitating
genital blood flow, together resulting in improvements in
sexual desire . Men, on the other hand, generally have
higher levels of circulating T than do women , and T is
associated with heightened sensitivity to sexual cues, showing
significant increases after exposure to sexual stimuli or sexual
targets [26,27]. Thus, higher levels of T in men may be
associated with greater sensitivity to sexual cues, leading them
to be more likely to exhibit symptoms consistent with high
sexual desire. These hypotheses (e.g., that hypersexual men
have greater levels of T) are tentative, and additional research
is needed to explore these possibilities.
The relationship between T and sexual desire is complex,
and caution should be exercised when hypothesizing relation-
ships between T and sexual desire. For example, there is a
general misconception that differences in women’s and men’s
T levels are responsible for the observed gender difference in
sexual desire [reviewed in 28]. Studies examining T and
sexual desire in healthy women yield mixed results [29–31],
and studies in healthy men consistently find no evidence
linking T with sexual desire [29,32–34]. Complicating mat-
ters further, the different types of sexual desire (i.e., solitary
versus dyadic) yield different associations with T in women
, and contextual factors (e.g., sexual activity) strongly
affect the association between T and sexual desire . The
relationship between T and sexual desire is also dependent on
whether the T is protein-bound or unbound, with unbound T
exhibiting a stronger relationship with behavioral outcomes,
such as sexual desire [reviewed in 36]. Thus, differences in
baseline T are unlikely to be sufficient for fully explaining
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gendered sexual desire in healthy women and men. Among
clinical groups, there is a body of evidence suggesting that the
administration of T among menopausal women [e.g., 37],
women with HSDD [e.g., 38], and hypogonadal men [e.g.,
39] significantly improves sexual functioning, including
levels of sexual desire; however, this does not mean that
differences in desire are caused by differences in T. Instead,
the examination of contextual factors and the different types of
sexual desire in women and men will likely yield more defin-
itive answers regarding these complex relationships.
Is Sexual Desire Best Characterized as a Trait or a State?
Trait theory, an influential guiding principle for understanding
personality, suggests that individuals possess a suite of char-
acteristics—traits—that are relatively stable across time and
vidual’s typical patterns of behavior, thought, or emotion .
Measures of traits, such as personality (e.g., extraversion),
demonstrate consistency across time points (e.g., from child-
hood through adulthood) and in different situations, indicative
of their temporal stability [40,41]. Furthermore, assessments
of personality traits demonstrate predictive validity for future
behavior . Emotional states are exemplified by an indi-
vidual’s behaviors, thoughts, or emotions in a given moment;
states are therefore contextually dependent and can fluctuate
across time and situations, whereas traits are less likely to do
so . Endler  proposed an interaction model for under-
standing the relationship between traits and states. He sug-
gested that the level of a state (e.g., sexual desire) is dependent
upon the persons’trait and requires the presence of a specific
situation or cue (e.g., a sexual partner). The situation or cue
must be consistent with the trait in order to evoke the expected
increase in the state. For example, an erotic image of a woman
is likely to evoke a state of arousal and sexual desire in a
heterosexual man, whereas the same image is unlikely to elicit
arousal and desire in a gay man.
The most widely used assessment tool for assessing sexual
desire as a trait-like construct—the Sexual Desire Inventory
(SDI) —asks women and men to report their desired
frequency of sexual activity with a partner and with them-
selves and actual frequency of sexual thoughts with and
without a partner during the last month. The SDI yields two
related but distinct factors for women and men, representing a
desire for sexual activities with a partner (i.e., dyadic sexual
desire) and desire for sexual activity with oneself (i.e., solitary
sexual desire). Studies using this measure have consistently
shown a gender difference (medium effect size) in the male
direction for both types of sexual desire [28•,45].
Despite the SDI being a valid measure of sexual desire, and
showing adequate discriminant and convergent validity [see
45], there has been no empirical investigation into whether
this measure assesses sexual desire as a trait or a state.
Reviewing the available evidence suggests that sexual desire
does not exhibit the degree of stability expected of a trait. For
example, women’s sexual desire ebbs and flows and is more
fluid than it is stable; women’s desire fluctuates across the
menstrual cycle [46,47], during pregnancy , and the
postpartum period [49–51]aswellasperi-andpost-
menopausally [52,53]. Similarly, the examination of sexual
desire across the lifespan yields data suggesting that both
women and men report steady declines in sexual desire across
time [54–56]. Evidence of situational stability of trait sexual
desire is also lacking [28•]. Examination of desire across
relationships demonstrates that sexual desire fluctuates
throughout the course of a romantic relationship and can differ
between relationships with different people [56,57]. Addi-
tionally, there is a paucity of research investigating how state
and trait sexual desire interact. One study has examined this
relationship and found that self-reports of trait desire are
influenced by whether or not a person has been exposed to
sexual stimuli (i.e., experience state sexual desire) [58••],
suggesting that trait sexual desire in this study was subject to
Recently, some researchers have shifted their focus to
examining sexual desire as a state, examining the contextual
factors influencing responsive desire. Three studies provide
empirical support for the conceptualization of desire as re-
sponsive to sexual cues, demonstrating rapid fluctuation in
feelings of sexual desire (within minutes) rather than desire
remaining stable across time [9••,58••,59]. Moreover, these
studies find that desire emerges similarly in women and men
[9••,58••,59]. Both et al.  found that women and men
responded with similar intensity in terms of their self-report of
lust (e.g., desire to make love and a desire to masturbate) after
viewing sexual versus nonsexual films. Dawson and Chivers
[9••] observed that heterosexual women’s and men’s self-
reported levels of dyadic and solitary sexual desire to audio-
visual stimuli depicting a preferred sexual stimulus (e.g.,
male–female intercourse) were not significantly different from
one another. Goldey and van Anders [58••] reported a similar
finding, such that no gender difference was observed for
reports of solitary or dyadic sexual desire in response to three
different modalities of sexual stimuli (e.g., imagined social
situation exercise, sexual story, and sexual fantasy).
Data from these studies highlight a notable discrepancy in
terms of gender differences in desire; gender differences are
observed for measures of “trait”desire, but not for “state”
desire. One possible explanation for this discrepancy is that
the assessment of state sexual desire, immediately after expo-
sure to a sexual stimulus, is less subject to retrospective
reporting biases that can affect recall of sexual experiences
and cognitions (e.g., over the past month). The current emo-
tional state of the person may also influence self-report.
Goldey and van Anders [58••] observed that reporting of
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sexual desire was affected by engagement with sexual stimuli
and that this differed by gender. Exposure to sexual stimuli led
to increases in the reporting of trait sexual desire for women,
but not for men, suggesting that contextual factors influence
how desire is reported in women. There is other evidence
suggesting that women are less susceptible to impression
management, that is responding in a socially desirable manner
(in this case, lower desire and arousal, in keeping with gender
stereotypes of men having greater sexual desire than women)
, when in a sexually aroused state (i.e., after exposure to
sexual stimuli) .
It is possible that reporting biases influence whether or not
a gender difference is detected, such that recall biases are
activated when reporting trait sexual desire retrospectively
(e.g., during the previous month), whereas these are not pres-
ent when reporting sexual desire when in a sexually aroused
state (e.g., after a sexually arousing film). Interestingly, the
three studies reported above found that sexual stimuli elicited
similar ratings of responsive sexual desire in women and men,
suggesting that responsive sexual desiremay not be inherently
gendered. An alternate possibility is that the women recruited
for these sexuality studies are less representative of the female
population, such that they are more sexually open, and expe-
rience and report greater desire than other women thereby
attenuating the gender difference in sexual desire .
Sexual Desire as Measured by Sexual Behaviors
In the sections that follow, we further discuss sexual desire as
a motivational state rather than a trait and the impact of how
and when desire is assessed on the gender difference. First, we
discuss how the presence of sexual cues leads to sexual
arousal and motivated sexual behaviors. Second, we consider
how arousal and desire shift depending on the sexual cues that
are present. Third, we review how sexual deprivation influ-
ences sexual arousal and desire.
It has been proposed that sexual arousal and desire emerge
only in the presence of sexual incentives and that the quality of
these incentives determines the strength of sexual motivation
. For example, seeing an attractive sexual partner might,
depending on the context, evoke strong feelings of sexual
motivation [8,11]. Sexual actions have often been quantified
using an “outlet”approach, whereby the frequencies of sexual
activity with a partner or with oneself are assessed. Studies
using this approach find that men report that they engage in
significantly more sexual activity with partners, and with
themselves, than do women [6,63,64]. This particular gender
difference may be due, in part, to the influence of gender
norms, social desirability biases, and practical restrictions on
women’s expression of their sexuality as opposed to actual
differences in sexual behavior.
The sexual double standard hypothesis posits that men are
socialized and encouraged to hold more permissive attitudes
towards sexuality, whereas women have been socialized to
hold more conservative sexual attitudes and suffer greater
social repercussions when they are sexually expressive and
assertive [65,66]. Alexander and Fisher  examined the
influence of these gender stereotypes on the reporting of
sexual behaviors using a bogus pipeline paradigm. In this
experiment, participants were told that the veracity of their
responses could be detected while they responded to questions
about their sexuality. Gender difference in the reporting of
sexual behaviors was attenuated for women and men assessed
under bogus pipeline conditions. When in the bogus pipeline
condition, men reported fewer sexual partners and women
more sexual partners compared to the men and women in
the control condition, consistent with the prediction from the
sexual double standard hypothesis. It is possible that gender
stereotypes have a similar impact on the reporting of sexual
desire using an outlet approach, whereby men may overreport
and women may underreport their sexual encounters, thereby
obscuring similarities between genders and inflating a gender
difference in frequency of sexual behaviors. Fisher re-
cently emphasized that this reporting bias is specific to ques-
tions about sexuality and is not present for questions about
nonsexual, but still traditionally gendered behaviors such as
exaggerating strength (men) and misrepresenting body
Women ’s sexual expression—both partnered and solitary
—and their reported frequency of behaviors may be influ-
enced by physiological factors that do not affect men, thereby
falsely creating a gender difference; this would be particularly
true when an outlet approach is used to estimate sexual desire.
For example, cycling women may experience practical restric-
tions on sexual expression, owing to factors such as premen-
strual dysphoria, discomfort of menstruation, and breast ten-
derness, among others [e.g., 69–72]. In the average month,
this could reduce the time available for comfortable sexual
activity by approximately 20 %, depending on the number of
days a woman menstruates [70,72,73], whereas men do not
experience similarly restricting physiological events. To our
knowledge, no research has adjusted the estimate of women’s
sexual desire to accommodate for this window of reduced
opportunity to engage in sexual behavior.
While sexual desire may lead to motivated sexual behav-
iors, this does not necessarily mean that behavior is a good
proxy for sexual desire; this assumption may lead to underes-
timates or overestimates of desire and may affect women and
men differently. For instance, the presence of sexual desire
does not always lead to sexual action (e.g., if no partner is
present or if it is an inopportune time), thus making it possible
to experience sexual desire without resulting sexual behavior.
This finding in particular—desire in the absence of sexual
action or behavior—appears to be more applicable to women
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than to men [6,74–76]. Thus, gender differences in sexual
desire could be an underestimate for women (and possibly for
men), if other factors prevent sexual action or behavior from
taking place. Alternatively, using sexual behavior as a proxy
can also inflate desire estimates, failing to recognize that
sexual behavior can occur for a multiplicity of reasons, some
of which do not involve sexual desire (e.g., stress reduction, to
attain resources or status, to boost self-esteem) [76–81].
Along similar lines, there is evidence suggesting that wom-
en and men differ in the objects or goals of sexual desire.
Mark, Fortenberry, Herbenick, Sanders, and Reece re-
ported gender differences in what people want when they
experience sexual desire, finding that men desired pleasing
their partner, pleasure, and orgasm, whereas women desired
intimacy, feeling sexually desired, and emotional closeness.
Similarly, Brotto and colleagues  found that women with
and without sexual difficulties reported desiring enhanced
intimacy rather than sexual activity. Meana  has asserted
that the goal of desire, particularly among women, may be the
reward of being desired. Across all of these goals or outcomes
of desire, the presence of a sexual cue (e.g., a partner, an
emotional connection) elicits feelings of sexual desire, even
if the goal of desire is not always sexual behavior or even
sexual in nature .
Research suggesting that women and men may differ in
terms of the outcomes of their sexual desire is worth consid-
ering in terms of understanding the most valid and reliable
indicators for assessing sexual desire. For example, sexual
desire in men appears to be closely related to sexual behavior
(e.g., pleasure, orgasm), thus an outlet approach to sexual
desire may accurately capture men’s sexual desire. For wom-
en, sexual behavior does not appear to be the sole goal of
desire. The inclusion of relational variables (e.g., intimacy and
emotional closeness) that more accurately capture women’s
experiences of sexual desire may be more appropriate (e.g.,
asking about how frequently they desire intimacy with their
partner) when trying to operationalize and assess women’s
degree of sexual motivation or desire.
The alternative to a behavioral outlet approach, which may
produce a bias towards finding higher desire in men, is to
focus on cognitions (e.g., sexual thoughts) associated with
sexual desire. Studies using nationally representative samples
find that men report thinking about and desiring sex more
often than women and that this pattern is reflected across the
lifespan [54,55]. Similarly, studies using convenience sam-
ples (e.g., university students) report medium to large effect
sizes for gender differences in favor of men for cognition-
based items such as lifetime experience of sexual desire,
frequency of sexual desire, and overall level of sexual desire
. While these single-shot, cognition-based approaches
avoid some of the limitations of the behavioral outlet ap-
proach, they are limited in that they fail to capture the flux
in sensitivity to sexual cues and sexual desire over time [5,85]
and may still be subject to the report biases mentioned above
. In addition, recent research has found that relying on
cognitions and frequency of sexual thoughts as a proxy for
sexual desire may be problematic for other reasons. Men
report more frequent thoughts about a variety of internal
states, not just thoughts about sex, suggesting that perhaps
the gender difference may have more to dowith the report bias
of internal states than actual differences in sexual desire .
Objective assessment of sexual motivation is one method
of addressing the limitations of self-report, although this in-
troduces other challenges. One method is to examine action
tendencies or automatic physiological responses that are as-
sociated with motivation; these can be avoidant, for instance
in the presence of threat, or appetitive, in the instance of a
rewarding incentive. To objectively assess sexual motivation,
Both et al. [59,87,88]examinedAchillestendonreflex(T-
reflex) modulation—a reliable indicator of motor preparation,
showing sensitivity to cues of stimulus intensity [88,89]—in
women and men in response to sexual stimuli. Both et al. 
found that both women’s and men’s T-reflexes were similarly
activated in the presence of sexual stimuli. Sexual stimuli also
evoked reports of approach motivation (e.g., focused on the
pursuit of positive experiences with a partner), and these were
positively correlated with T-reflexes. In a second study, Both
et al.  found that, in addition to activated T-reflexes in the
presence of sexual stimuli, subsequent sexual behaviors in the
24-hrs post-testing were positively related to T-reflex activa-
tion for women and men, demonstrating positive relationships
between T-reflexes elicited by sexual stimuli, self-reported
approach goals (i.e., pursuit of a partner), and subsequent
sexual behavior. These three studies demonstrate that not only
do sexual incentives elicit sexual arousal and desire but they
also elicit action tendencies associated with future sexual
behaviors and that this process occurs similarly for women
and men [59,87,88].
Sexual Desire Across Time
Circular and incentive models of arousal and desire propose
that desire is influenced by the presence of sexual cues and
that the hedonic quality of these cues may change across time
resulting in similar shifts in arousal and desire [8,11]. Studies
of habituation to sexual stimuli in women and men demon-
strate that genital [90–96] and subjective sexual arousal [90,
91,93–96] decline with repeated exposure to the same sexual
stimulus, presumably because the hedonic quality associated
with the stimulus changes as a function of repeated exposure.
These studies also find that when novel stimuli are introduced,
sexual arousal is restored [90–96]. Results from observational
studies find a similar pattern; sexual desire can wane for both
women and men in long-term relationships [56,57]. There is
some evidence to suggest that for women, sexual desire
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declines while in a relationship and is reenergized with the
addition of a new sexual partner [56,57], whereas for men,
desire declines with age rather than with a specific sexual
partner (i.e., less responsivity or sensitivity to sexual cues over
time) ; however, more research is needed to examine
changes in desire from a longitudinal perspective.
Sensitivity to sexual cues may also be affected by the
timing of assessment. The single-shot versus longitudinal
approaches likely have implications for whether or not gender
differences or similarities are observed. This is especially true
given that women experience greater variability in hormone
levels than do men, and women’s sexuality appears to be
sensitive to these fluctuations across the menstrual cycle [for
a review, see 97] and to oral contraceptive use [for a review,
see . Prospective studies of naturally-cycling women’s
sexual desire, as measured by sexual fantasies and sexual
thoughts recorded daily across entire menstrual cycles, show
marked increases during ovulation [e.g., 46,47,99,100],
suggesting a greater sensitivity to sexual cues at midcycle.
Unfortunately, there are very few equivalent studies examin-
ing fluctuation in men’s sensitivity to sexual incentives over
time. Irrespective of menstrual cycle status, however, Mark
 found that partnered women and men reported similar
degrees of sexual desire when desire was assessed daily over a
30-day period. This particular finding points to the importance
of how and when sexual desire is assessed and the subsequent
impact on the gender difference in sexual desire. Thus, it is
possible that, at a given point in time, women may experience
desire equal to or greater than men; when hormonal status is
not taken into account or if the assessment of sexual desire is
limited to one point in time, then these effects may be ob-
Sexual Desire in the Context of Deprivation
Some researchers have conceptualized sexual desire as a
drive, stemming from Allport’s view that depriva-
tion, or lack of sex, acts as an intrinsic motivator .
This has led to research focused on understanding the
consequences of sexual deprivation, that is, whether
deprivation motivates sexual activity or results in in-
creased arousal and desire. Incentive motivation theory
would suggest that deprivation alone does not facilitate
or drive sexual motivation, but rather deprivation acts
on the reward value associated with the sexual cue [8,
102]. Thus, the incentive value of a sexual stimulus will
be greater for someone in a sexually deprived state,
thereby rendering them more sensitive to its reward
value, and thus more motivated to seek out sexual
Men report experiencing greater aversive effects of absti-
nence and more frequent desire for partnered and solitary
sexual activity than do women [5,6], suggesting that men
are more affected by, or more aware of, the effects of depri-
vation than women. Recent research suggests that this effect
may not reflect a gender difference in sexual drive per se, but a
gender difference in overall perception and reporting of other
drives. Fisher and colleagues  found that men were more
likely to report thoughts about hunger, sleep, and sex, sug-
gesting that men may be more sensitive to range of biological
drives than are women, not just sex drive. Additional research
is needed to examine the effects of abstinence in women and
men to establish whether or not a gender difference in sexual
desire exists in the context of sexual deprivation.
Implications for Sexual Medicine Practitioners
Throughout this review, we have argued that the methodology
used to assess sexual desire, whether it be a single question
about sexual behavior or a validated questionnaire, assessed at
one point in time or longitudinally, influences whether or not a
gender difference is observed. In a clinical context, this gender
difference can manifest as a desire discrepancy in heterosexual
couples, that is, the perceived or real difference between
partners in their desire for sex [5,101], with men typically
reporting more desire than women. We believe that this dis-
crepancy may be exacerbated or attenuated depending on how
sexual desire is operationalized and assessed in the clinical
context and suggest that careful consideration should be given
to how clinicians choose to assess sexual desire in their clients.
Educating clients about the sexual double standard and gender
stereotypes about sexual desire may aid in identifying unhelp-
ful beliefs about sexual response, such as unreasonable ex-
pectations about performance or levels of desire.
Common conjecture and meta-analytic findings sug-
gest that men are the more lustful gender [6,63,64].
Moving away from this trait-based view of sexual desire
toward a state-based conceptualization may offer some
remoralize couples, helping them to see that sexual
desire is contingent on the presence of sexual cues
and that the desire discrepancy is not necessarily hard-
wired or gender-linked, but rather is perhaps evidence
of the absence of suitable incentives and triggers. Thus,
challenging the assumptions that men experience more
desire than women, by situating desire as responsive,
may be a useful therapeutic tool when educating clients
about the nature of their sexual responses. Clinicians
can then use this framework to encourage clients to
explore the cues relevant in eliciting their arousal and
desire, noting that the cues for women may be different
than the cues for men and that finding gender-specific
cues may be integral to reducing the desire discrepancy
that many couples face [reviewed in 5].
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Sexual medicine has moved away from linear conceptualiza-
tions of sexual desire towards models that situate sexual desire
as responsive [7,8,11]. Based on the available research, it
appears that state or responsive desire manifests similarly in
women and men, emerging from exposure to relevant sexual
incentives and accompanying sexual arousal. Observed gen-
der differences in the magnitude of sexual desire are likely
influenced by the ways in which desire is assessed, that is, by
the timing and methods of assessment. Studies examining
state sexual desire or sexual desire longitudinally find no
gender differences in the frequency of sexual desire. Future
research could focus less on differences between women and
men, and more on factors influencing within-gender variations
in the contextual, relational, and physiological elements
influencing sexual desire using longitudinal and multidimen-
sional methods of assessment. Sexual medicine practitioners
should carefully consider how they choose to operationalize
and assess sexual desire with their clients, with special focus
on the impact of these various methodologies on the desire
discrepancy (i.e., gender difference in desire). Situating desire
as responsive may be therapeutically useful for identifying the
pertinent sexual cues and incentives necessary to elicit arousal
and desire in clients with sexual difficulties.
Acknowledgments The authors wish to thank Michael C. Seto for his
helpful comments on an earlier draft of this review.
Compliance with Ethics Guidelines
Conflict of Interest Meredith L. Chivers has received grant support
from the Canadian Institutes of Health Research.
Samantha J. Dawson declares that she has no conflict of interest.
Human and Animal Rights and Informed Consent This article does
not contain any studies with human or animal subjects performed by any
of the authors.
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