8 Pages

“A New View of Women’s Sexual Problems”–A Family Physician’s Response

Specialized physicians take for granted the authority of other special­ ized physicians to speak the truth about their own area of expertise. Although the validity of the DSM categorization schema for mental health problems has been questioned by feminists for almost twenty years (Caplan, 1991; Kaplan, 1983; Ritchie, 1989), medical physicians have largely been unaware of that controversy. Thus it is not surprising that medical practitioners have not questioned the legitimacy of the DSM-IV diagnostic categories on sexuality. On the other hand, medical physicians are more tolerant than psychiatrists that day-to-day clinical presentations of sexual concerns do not need to match any categorical diagnostic schema, perhaps because medical clinicians do not need to apply a DSM diagnostic code for billing purposes. A revised version of the DSM-IV designed especially for use in primary care, which happens to use the identical sexual dysfunction categories of the DSM-IV, is not widely known or used (APA, 1995). The reality is that many primary care physicians would blandly accept the DSM-IV categorization of sexual dysfunctions but would also make little use of it.