Introduction

The undeniable evidence of the orgasm gap, which is the phenomenon where women experience significantly fewer orgasms during heterosexual sex compared to men, is highly prevalent in today’s literature (Frederick et al., 2017; Lloyd, 2006; Mahar et al., 2020; Wetzel et al., 2024; Wetzel & Sanchez, 2022). However, there has yet to be a definitive explanation as to why this gap persists. Some explanations include women’s orgasm difficulty, biology, men’s fault, interpersonal communication issues, and sociocultural influence (Wetzel & Sanchez, 2022). However, in this research project, I will argue that there is one reason that synthesizes all of these, which is the overmedicalization of the female orgasm. The overmedicalization of female orgasm has significantly contributed to the orgasm gap as well as significant barriers in women’s sexuality, and I propose a fix by properly educating both men and women about female anatomy, consent, and sexuality as a whole. The goal of my solution is to both decrease the orgasm gap and provide women the tools of self-acceptance if they do not feel like they orgasm “enough.” This paper will provide a discussion of the research on the gender gap in orgasms in heterosexual sex and overmedicalization of explanations of the gap, as well as a discussion of an alternate framework to more holistically understand and educate individuals in sexual knowledge and health.

The orgasm gap is a well-researched, well-acknowledged problem in sexual health. The orgasm gap is defined by the disparity in orgasm frequency in women compared to men in heterosexual relationships (Frederick et al., 2017; Lloyd, 2006; Mahar et al., 2020; Wetzel et al., 2024; Wetzel & Sanchez, 2022). The orgasm gap is specific to heterosexual relationships, as research has shown it is notably absent from lesbian relationships (Frederick et al., 2017).

Additionally, there is very little research that has been conducted that explains how those outside of the gender binary fit into the orgasm gap. As a result, this research paper will only be discussing cisgender male and female penile-vaginal intercourse, which will commonly be simplified to “sex.” I chose to focus on penile-vaginal intercourse as the medical literature has hyperfocused on this because of its relation to biological reproduction, and due to the amount of literature focusing on this style of intercourse, I felt it would be the most valid to make claims about. Men routinely are orgasming more than women during sex, but why is this happening? In a survey that asked college students why they believed the orgasm gap existed, the answers were filed into five different categories: women’s orgasm difficulty, biology of men and women, men’s fault, interpersonal communication issues, and sociocultural influence (Wetzel & Sanchez, 2022). These categories are reflected in other literature about the orgasm gap, and thus will be the topics investigated throughout this paper. I will argue that overmedicalization can be related to all of the reasons aforementioned for the orgasm gap. Overmedicalization, as used in this context, is defined as a nonmedical issue that is turned into a medical issue. In this case, the female orgasm has been historically overmedicalized which has perpetuated the orgasm gap.

Literature Review

Before delving in, it is highly important to note that the initial medicalization of the female orgasm was a positive advancement in women’s sexual health. This medicalization has brought to light the argument that because women’s orgasm has positive psychological, physical, mental, and emotional effects, it should be considered just as important as men’s orgasm in heterosexual intercourse (Dienberg et al., 2023). This belief has had important implications in sex for women, as there is more equality as it relates to pleasure. As women’s orgasm has become more important in a medical sense, more women have felt validated enough in demanding equality in sex, and, moreover, liberated enough to take charge of their sexuality and feel empowered by it. However, many feminist scholars have argued that the hyper-prioritization of the female orgasm from physicians, clinicians, and scientists has resulted in women feeling pressured to orgasm in order to have “healthy, normal, and ‘good’ sex” (Dienberg et al., 2023). What began as an effort to equalize men and women during sex, became a tool of the medical field to overdiagnose and over-treat women which ends up exacerbating the orgasm gap, weaponizing pleasure, and simply making women feel bad about themselves. There has also been a strong history of the grassroots women’s health movement; ordinary women fighting for their own sexual equality both in and out of the bedroom. This has its beginnings in the 1970’s book “Our Bodies, Ourselves,” which served to educate women about their own sexual health, and as a result, demedicalize women’s sexuality (Our Bodies, Ourselves, 2025). It served as a catalyst in the fight for women’s sexual autonomy, and worked against the biomedical model and its pathological structure to overmedicalizing female orgasm (Our Bodies, Ourselves, 2025).

The orgasm gap being rooted in women’s difficulty in orgasming is perhaps the most overt form of overmedicalization. It generally takes women a longer amount of time to orgasm in comparison to men, however, “traditional” sex puts pressure on women to orgasm before or in conjunction with her male counterpart (Muehlenhard & Shippee, 2010). This puts women in a position where they feel like they are doing something wrong if they do not orgasm during sex (Chadwick, 2024; Lavie & Willig, 2005; Lavie-Ajayi, 2005; Nicolson & Burr, 2003). Feeling insecure about a lack of climaxing during sex causes women to seek out medical care to see what is “wrong with them,” which leads to an overmedicalization of women and their orgasms.

Directly correlating to the last example, overmedicalization can be tied to the biology of men vs. women when considering issues of overdiagnosis of gendered sexual diseases, such as hypoactive sexual desire disorder and anorgasmia (Halwani, 2023). It has been well-researched that women tend to, on average, have lower sex drives than men (Halwani, 2023). However, instead of educating both men and women on this, the medical field prioritizes overdiagnosis, overprescription, and overmedicalization for an “issue” that is not an issue at all, rather simply a biological difference. Placing blame on women for having lower sex drives by creating, defining, and categorizing them into bell curves feels ridiculous when biologically this tends to be the observed trend.

Moving on, overmedicalization is also the root of the theory that it is ‘men’s fault’, as in, men just do not prioritize or have concern for women’s orgasm. Because a woman’s orgasm does not impact whether or not fertilization of a gamete will occur, their orgasms are regarded as a sort of “extra bonus,” while men’s orgasms are perceived as “strictly necessary” (Laan et al., 2021). In other words, a man needs to ejaculate to make a baby, while a woman does not. Overmedicalization, in this context, can be considered in how “only those problems that interfere with… procreative sex are deemed worthy of complaint or treatment” (Hall, 2019; Laan et al., 2021). Reducing orgasm to a strictly biomedical model has resulted in a degradation of the importance of women’s orgasm in sexual pleasure.

A lack of interpersonal communication, of course, is once again a symptom of overmedicalization. Research shows that women have greater orgasm frequency with partners that are familiar to them in comparison to first time unfamiliar sexual partners (Armstrong et al., 2012; Wetzel & Sanchez, 2022). One likely reason for this is because of the comfortability women feel with repeat partners, and how they are more likely to communicate their sexual desires if they feel more comfortable. However, overmedicalization has made women feel like their physiological or psychological issues are to blame for their orgasm absence, thus, they feel less entitled to orgasming as a whole and do not feel as though they can advocate for themselves in the bedroom (Chadwick, 2024).

For the example of how sociocultural influence is shaped by overmedicalization, I will be taking a slightly different perspective. Research shows that there are significant differences in orgasm gaps across different races, showing that Black couples have the smallest orgasm gap in comparison to whites, asians, and latinos(as) (Wetzel et al., 2024). The overmedicalization of enslaved Black women created and shaped a narrative of Black women being “promiscuous, hypersexual, dysfunctional, and disorderly,” which allowed whites to justify medical experiments and rapings (Campbell, 2021). Due to this history, Black women have been severely hypersexualized, as well as there being a justification in racist sexual violence against Black women (Campbell, 2021). Despite this, research shows that Black women have since reclaimed their sexuality, showing higher rates of sex-positivity, which tends to positively correlate with orgasm experience (Townes et al., 2021). What originated as a means of discrimination against Black women, has been reclaimed into self-confidence, better sex, and more orgasms for them (Wetzel et al., 2024). I absolutely acknowledge that due to the intersectionality between racism and sexism, Black women face disproportionate sexual discrimination, specifically in the doctor’s office, however, I am using this example to show how their strength and perseverance has provided an opportunity for better sexual liberation within their own community (Campbell, 2021).

I share this different perspective because I think it is a hopeful symbol that overmedicalization is a barrier that can be overcome. What began as a tool of racist physicians, Black women have reworked and changed the narrative in a way that benefits them. I do believe that other women can learn from Black women, and that healthier sex can be achieved if we deal with the other ways that overmedicalization has come to define the female orgasm, if approached correctly. I think that this approach is proper sexual education. There are two primary pillars of the implementation of this education: the medical literature and the public’s perception.

Discussion

The medical literature needs to be reworked to implement a more sociological and anthropological perspective, in order to account for the overmedicalization that is currently happening. In order to close the orgasm gap and fight for women’s sexual equality, there needs to be a concession from clinicians, physicians, and scientists alike that the research they produce promotes overmedicalization. By reducing the female orgasm to a purely biological force, they are stripping away all of the cultural and societal implications of women’s sexuality and women’s orgasm. After this medical literature is reworked, this will have a snowball effect as it will likely infiltrate and alter the public’s perception of the female orgasm. As a sociological and anthropological perspective becomes normalized, more people will understand the overmedicalization of female orgasm, and be able to make choices about their sexuality as a result. However, this is not the only education that needs to be administered. I believe that implementing better, more comprehensive sexual education in schools will allow for both men and women to become more knowledgeable about female orgasm, and make adjustments in their personal lives accordingly. Topics like anatomy, consent, body image, intersectionality, sexuality, and the gap would all be discussed in detail. Using this new sociological perspective, a biomedical model can be used in conjunction with a holistic explanation as to why these issues are happening, and what we can do to close the orgasm gap without making women feel like they have to orgasm to have pleasurable sex.

Commonly, it is suggested that patriarchal worldviews are to blame for the inequalities women face in the medical sphere (Matheson et al., 2021). However, I think that a better, more comprehensive application of the blame is overmedicalization. The state uses the medical field to reflect and support its ideals of the time. While this does have positive influences, such as wanting people to be healthy and happy citizens and wanting people able to work and support the economy, this also has negative implications, like men’s fault and sociocultural influences. I believe that because the state prioritizes men in power, the current views on sex in America also prioritize men. Overmedicalization can not be distinguished from patriarchal ideologies of sex, because they are two sides of the same coin. One is a belief from the state, and the other is an application of the belief. This patriarchal lens asserts itself in the biomedical model and leads to women being at the brunt of overmedicalization. This consequently perpetuates issues like the orgasm gap without proposing solutions that will equate sex between men and women.

Conclusion

The implications of the overmedicalization of the orgasm gap go beyond patriarchal ideologies. It is impossible to discuss this overmedicalization without also discussing the significant profit motives of pharmaceutical companies. Because the biomedical model incentives data, diagnoses, innovation, and quick fixes to problems, people think of sex and sexuality as a cut-and-dry “normal” or “abnormal” aspect of their lives and identity (Tiefer, 2012). Therefore, when women are being told they have a sexual disorder, like hypoactive sexual desire disorder or anorgasmia, they have been conditioned to seek out medical care and pharmaceutical therapies. Like we discussed in class, the pharmaceutical companies work to support these narratives in order to bring more consumers into their pockets (Greene, 2008).

Coupled with spending millions in advertisements to physicians, supporting the lowering of disease thresholds, supporting the biologicalization of the sexual experience, and more, it is difficult to grasp how much power these pharmaceutical companies actually contain (Greene, 2008). This is why I believe that ongoing sexual health research is necessary and important; it serves as a reminder to clinicians that by taking a sociological perspective, they have the ability to better serve the needs of their people, rather than a for-profit company. While larger discussions about big pharmaceutical companies have been widespread in the medical sphere, I think that by tackling smaller issues at a time through a holistic perspective, there is a much higher chance that change will actually be implemented.

The patriarchal, overmedicalized lens is not the only perspective. Just as Black women did by reclaiming their sexuality, more women, armed with the right tools of education, can fight against the overmedicalization of the female orgasm, and fight against the orgasm gap. Understanding that overmedicalization is the true root cause of all of these social issues as it relates to female orgasm and the orgasm gap is the first step in fixing these disparities. And while I concede that this paper is not exhaustive in every single way that overmedicalization can be tied to female orgasm and the orgasm gap, it is certainly compelling that each of the primary reasons blamed for the orgasm gap have strong correlations with at least some type of overmedicalization. I believe that a medium can be found where orgasm is highlighted, but not the over-focus of sex, and where the orgasm gap decreases as a result. Refocusing the biomedical model onto holistic, sociological, education-based information will give both men and women the tools they need for the pleasure they deserve.