The Guidebook of Sexual Medicine
Finger, Bill, Contemporary Sexuality
The Guidebook of Sexual Medicine By Waguih William IsHak. A&W Publishing, 2008. $29.95.
IsHak's Guidebook of Sexual Medicine provides an introduction to the history of sexual medicine, an overview of the sexual response cycle and the biopsychosocial approach, and a summary of organic, pharmacological and psychological etiologies and treatments for the sexual dysfunctions identified in the Diagnostic and Statistical Manual of Mental Disorders (DSM). Also included are chapters on alternative medicine and women's sexual health issues. Appendices include a summary of sex survey findings, online screening measures and guidelines for psychiatric diagnosis of DSM sexual dysfunctions. Other than the first two chapters and the last two chapters, the book fairly closely follows the DSM categories of sexual dysfunctions. The chapters on dysfunctions are consistent in content, covering definitions, epidemiology, etiologies, pathophysiology and treatment approaches. Biological and psychosocial factors are addressed both in etiology and treatment.
While the chapter on biopsychosocial approaches provides a nice overview of biological, psychological and pharmacological etiologies and outlines various treatment options, using the DSM for the structure actually limits the extent to which psychological and medical aspects of sexual concerns can truly be integrated. The DSM model is based on a step-wise progression of sexual response, focuses on physical responses at the expense of subjective satisfaction, and separates physical, pharmacological and psychological etiologies, ignoring the complex interplay among these factors. Those familiar with recent concerns about the DSM model, especially as it relates to women's sexual response and satisfaction, may be disappointed, although Laura Berman's chapter addresses some of the complexities of women's sexuality. However, I know from my own teaching that it is difficult to fully explore the complexity of sexuality without abandoning or at least questioning the DSM, and given that this is the accepted paradigm, any introduction to sexual concerns is constricted by it. …