A rejoinder to the comments of Hartman & fithian and pomeroy & brown on the female sexological examination

Abstract

Although the first examinations were carried out on 879 women by a team of five gynecologists in the framework of Kinsey's study on the female (Responses to tactile stimulation and to pressure in female genital structures), the term itself rightfully belongs to Hartman, Fithian, and Morgan (Hartman & Fithian, 1972, 1973). Hartman and Fithian are not physicians, but underwent extensive tutelage by a prominent gynecologist to acquire the necessary training for the female pelvic examination. Items 11, 12, and 13 of their list of purposes of the sexological examination, as performed in their Center, are feasible for thoroughly trained therapists such as themselves, but seem to me not permissible and even dangerous if performed by most nonmedically trained sex therapists, even if they underwent a few weeks intensive training period. Moreover, in many parts of the world, probably also including most states of the U.S.A., the sexological examination might rightfully be regarded as illegal if performed by such personnel because of the mere fact that it helps (among other things) to distinguish between organically and psychologically originating sexual problems. I, therefore, agree with Hartman and Fithian that professionals planning on providing sex therapy services should first contact the local authorities and health professionals in this regard. On the other hand, doing a sexological examination without taking into consideration the physical aspects would be doing a serious disservice to the patient to say the least. Most of the female patients undergoing a sexological examination in our clinic have (from the beginning of or after counseling) a basically good relationship with their sexual partners and are primarily seeking help for not being able to be orgasmic in sexual intercourse. Most of them are, however, perfectly able to be orgasmic by non-coital external self or partner stimulation of breast, body, clitoris, etc. Therefore, it