Social constructs act to repress female sexuality so that self-reporting does not give an accurate picture. One very telling case is how women self report that orgasm is not important to their sexual satisfaction. However, in studies where women are asked to rate their sexual encounters, orgasm incidence is strongly correlated with higher ratings. While women are not be consciously lying here, it is clear there is a psychological disconnect that arises from the way we are taught to think about sex.

For example, sex is framed around male orgasm and women’s magazines contain countless articles on how to please your man. From an early age, women are subjected to messages that vulvar anatomy and sexual response is unimportant or a mere bonus rather than a sexual imperative. Women are taught to be sexy, not sexual, female masturbation and sexuality has historically been more stigmatized than male, slut shaming gets in the way of women knowing and being comfortable with their own sexuality, etc.

There are also issues with how female sexual arousal is measured. For example, genital engorgement is a better indicator than lubrication. It would make sense, from an evolutionary standpoint, for lubrication to arise when sex is expected but not necessarily wanted. Even when genital engorgement is used as a measure of physiological arousal, correlations with reported arousal are weak in women compared to men. This can be explained by how female engorgement is not as visible or obvious and women don’t get the same feedback to learn. There is also a denial of and minimization of the volume of female genital erectile tissue. The vestibular (clitoral) bulbs, crura, and even clitoral shaft (bodies) are often not well represented in medical or patient education literature.