Editors: It is not surprising that the land that gave us Tolstoy, Dostoyevsksy, and Chekhov, Tchaikovsky, and Rachmaninoff, as well as Pavlova, Nureyev, and Baryshnikov, would give us a romantic view of sexuality. It is in this chapter of the book, and no other, that the idea of love is discussed in connection with sex. Fate also makes an appearance in the discussion of the existence of a
... [Show full abstract] hard-wired sexual constitution. According to some Russian sexologists, all men and women have a sexual constitution, which is a relatively fixed and stable level of sexual desire (strong, medium, or weak). If a person happens to marry someone with a different sexual constitution, therapy is geared toward helping that person, or the couple, understand that this is "just the way it is." This stands in stark contrast to the time and energy many American couples devote to trying to change or increase the level of sexual desire in the partner with less desire. While the notion of a sexual constitution may be foreign to many readers, challenging couples to find happiness together despite sexual differences is a treatment option that may be revisited upon reading this chapter. Sexual dysfunctions in Russia are, however, often the focus of aggressive and multidisciplinary treatment including talk therapy, medication, and mechanical devices. The latter treatment is primarily geared toward resolving male sexual dysfunction, specifically erectile dysfunction. Awareness of the importance of helping women experience orgasm is a more recent phenomenon in Russian sex therapy and in Russian culture. The authors of this chapter interviewed eight sex therapists (physicians and psychologists), reviewed the vast treatment literature, and present two case studies in order to show a view of Russian sexuality and sex therapy with the history, politics, culture, and religion of the country providing the contextual but ever changing backdrop. Introduction Sexual morality and behavior have changed radically in Russia during the last two decades. In the Soviet period, there was strict public control over sexual information and a great deal of ignorance and discrimination regarding sexual matters. Today, Russia is characterized by a myriad of often conflicting views on sex and sexual morality. The media are very outspoken on sexual matters and often promote a liberal and hedonistic view of sexuality. On the other hand, the Russian Orthodox Church opposes sex education, abortion, and the rights of sexual minorities. The threshold to seek professional advice for sexual problems is lower today, while the forms of therapy, treatment, and advice offered to clients vary widely. In this chapter, we first give an overview of the changes that have occurred in Russian sexual culture since the fall of the Soviet Union. We then turn to Russian sexual therapy and discuss two clinical cases, the first an example of problems with female orgasm in a young couple, the second an example of male erection problems in a middle-aged couple. We are especially interested in how gender equality and sexual pleasure are perceived in Russian sex therapy. The overview relies on previous research, including autobiographies and in-depth interviews on sexual issues conducted between 1996 and 2004 and two representative surveys in St. Petersburg conducted in 1996 and 2004. Parts of the chapter are based on interviews with eight experts that were conducted in 2009 and 2010 with practicing sexologists in different parts of Russia.