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"I'm Just a Girl Who Can't Say No" - Women, Consent, and Sex Research

Posted Sep 13 2008 3:52am

Female sexual functioning is an area that has long been under researched, with many activists arguing greater efforts need to be made to find out more about women's sexual health. This is particularly important given the negative treatment of women by medics/social scientists in the past and the current focus on men's sexual functioning and pharmaceuticals, where women are being left behind.
Accounts of sexuality have presented women as lacking interest in sex, or being less sexually interested than men. This is frequently attributed to innate biological differences, and may be used to avoid dealing with women's sexual problems. More critical approaches have acknowledged that women can have a variety of views about sex , so suggesting 'all' women either like or dislike sex is misleading. However, there is little research examining women's views about sex and participation in sex research. Concerns have been expressed that we are becoming 'obsessed' with sex in the West, but it seems this obsession may not extend to participating in sex research - particularly where women are concerned.

With the need for further research on women, it perhaps seems naive to propose a paper addressing issues of consent. Yet within social research on sex, the issue of who consents to participate in studies continues to be overlooked or underplayed. Whilst we can argue for more research, and design studies of our own, these efforts will be wasted if women do not want to talk about sex.

Efforts have been made to strengthen the consent process, including better explanations of participant's roles and the right to refuse participation. Though, checklists of 'good practice' for sex research exist it is unlikely that this information is accessible to consenting participants. Some, like Leonore Tiefer, argue it is impossible to even discuss issues of informed consent in relation to sex research because of "participant's lack of comprehensive sexual knowledge" (a problem that particularly affects women from developing nations). However, it seems discussions of VIC haven't helped increase the number of female volunteers to sex studies; and there is little critical evaluation of why this might be.

Anecdotal and research evidence suggests that sex research is not viewed as being as important than other social or health topics as Tiefer observes - "sex research has always seemed too risky or 'risqu�' to be a legitimate specialty" . This could be the reason why women, who are normally more likely to volunteer for research seem less keen to take part in sex-related studies. However, it is likely that there are a number of more complex reasons that dissuade female participants.

Who Volunteers for research?

Research literature indicates that there are particular people who volunteer for studies, particularly those on sex. Certain research has identified that volunteers for research on sexual topics report higher levels of sexual interest and experience than participants who volunteer for non-sex studies. In one example, participants were invited to choose from the following conditions, viewing a sex film only, or a sex film combined with increasingly invasive measurements of sexual response. Male participants were significantly more likely to volunteer, but levels of co-operation dropped as the levels of intimacy demanded by the research increased. Again, when compared with non-volunteers, the participants in this study were sexually more interested and experienced; and overall women were less likely to participate. Evidently the volunteers and their perceptions of the research will impact upon the results.

While not all men will volunteer for research, it seems they are more likely to volunteer than women; although more detailed investigations are required to identify the specific reasons why women do not participate.

Women have also been found to differ from men in the questions they will not answer in sex research. We have already seen that women are less likely to participate in sex research and are more likely to refuse if a study seems particularly invasive. Alternatively, women may agree to participate, but refuse to answer certain questions or perform certain tasks in a study, thereby affecting the overall results of the research.

At present, the studies investigating participation rates in sex studies seem to accept that if womendo not volunteer for research, or refuse to answer a question it must be the result of their study (which is investigating the circumstances under which participants will opt-out of research). What is required is more critical evaluation to discover from participants exactly what factors are preventing them from taking part - and what would encourage them to join a sex study.

Anecdotal evidence suggests differences in response also exist within groups of female participants. Therefore younger women may be more likely to in sex studies than older women; straight women might be more likely to volunteer than lesbian or bisexual women; and (in the West) English speaking participants might be more inclined (and able) to participate. Studies suggest that lesbian and bisexual women do have different beliefs and concerns around their sexual health, do older women compared to younger women. It is therefore important that research accounts for (and celebrates) differences between women, rather than presenting them as a homogenous group. Such an approach needs to begin with study design, and last until the research has been reported.


It has been suggested that certain methods are more appropriate when studying 'sensitive issues', and that choosing the 'right' method is important given that this may increase or decrease levels of consent. In certain situations face-to-face interviews can be comforting, whilst in others they might be intimidating. Questionnaires can be a useful means of collecting anonymous data - and computerised interviews have been suggested as an appropriate means of encouraging high response rates in sensitive studies. Overall, self administered questionnaires on sensitive topics have been found to be as reliable as face-to-face-interviews, and in fact may be better received by participants.

Yet studies need to be sensitive to the needs of participants - many of whom might not be familiar with a computer, may lack the literacy skills to complete a questionnaire, or who might feel intimidated by having a sensitive interview tape-recorded. Therefore piloting should account for both participant understanding and wellbeing - and be sensitive to the needs of participants in terms of age, ability, culture and gender. Discussions of research methods have frequently approached studies as though gender did not exist. With research on female sexual functioning, it is important that we develop methodologies that are women-friendly.

Given the increased focus on large-sample, quantitative surveys (where participants are required to agree or disagree with a standardised version of sex); it is equally important that methods that allow participants to speak for themselves are advocated. As researchers Fisher and Grenier have argued, the result of a "reliance on...findings...based on methods and conceptually flawed research...may hinder the development of remedies for the very real problem of sexual violence against women" [or other sex-related problems]. Women are under-represented in sex research, and frequently silenced by the way research is conducted or presented.

It has been suggested that if people perceive researchers to be similar to them, they are more likely to co-operate. Within sex research it may be that the gender of the researcher could influence volunteer rates, along with the behaviour of participants in any subsequent studies. Evidence suggests that women are more likely to complete personal studies if a the researcher is female and for very sensitive issues, or research completed in the participant's home, it is preferable to have a same-sex interviewer. It may also be beneficial to utilise researchers who the participant feels they have a relationship with, as women have been found to reveal more to women they know. In addition, offering participants a choice of researcher has been found to be empowering, particularly if the researcher is from the same social or ethnic group as the participant. However, choice is the key here. We should not assume that because a researcher shares the same skin colour or gender they will automatically be the same as the participant. Nor that participants' will universally understand or appreciate a Western definition of consent. Ultimately researchers should be trained to appreciate and be sensitive to difference.

Sex researchers have found being linked to a particular area of research has led to them being perceived negatively, with some popular media reports highlighting the sexual practices, or marital problems of famous sex researchers. If participants are aware of these factors, their behaviour towards a researcher may alter - as may their reasons for consenting. Yet as these details are not always collected and reported, and as researcher's may feel that their status could be detrimentally affected by discussing them, problems surrounding the role of the researcher may continue.

In addition, researchers are frequently not trained, supported or monitored. Given that many research assistants are female, and participants may request a female researcher, it is important that support for personal wellbeing and safety is also offered to the researcher. Mentoring of researchers can also mean the way in which they consent participants to studies can be further monitored - as evidence suggests people become less concerned about ethics and the wellbeing of participants/patients, the longer they work in an area.


Many concerns about sex research are not necessarily linked to the sex component, but to the manner in which the research is conducted - therefore if work is completed in an ethically and methodologically sound manner, additional concerns and problems may be managed more successfully. However, this does not answer the original question about women in sex research, nor how to increase female volunteers, so the following points should also be considered.

Ten Tips for Improving Women's Participation in Sex Research

1. Researchers should critically evaluate existing studies on female sexual functioning, and ensure all future research is gender-sensitive.

2. Researchers may wish to include women-centred theories and methodologies in the design and planning of studies.

3. Increasing participant involvement in the research process may assist the development of research questions, and encourage more ethical studies. With the new focus on consumer involvement, women's user groups could be further encouraged to help with the design and running of research.

4. If female participants are refusing, it might be worth finding out more about the issues that are putting them off research. Researchers may wish to collect information about what motivates participants to agree or refuse to volunteer (and monitor whether participant's views change during the course of a study).

5. The way in which a study is presented to participants, and how participants are consented should be carefully evaluated. Female participants might be more inclined to participate if the approach is tailored to their social and cultural needs.

6. Training and monitoring of researchers (at all levels) should be encouraged, particularly around sensitive topics and areas of 'difference'.

7. Literature searchers in traditional sources will reveal existing studies - but there may be additional studies reported outside academic sources (eg in magazines, or internal reports), that may be informative and help avoid repetition of studies (or mistakes), and suggest culturally diverse/sensitive approaches. These searches may also reveal topics of relevance or concern to women of different ages. For example, if you are completing research on women's attitudes to breast cancer, look at how the popular media handles the issue. It is from this source your participants will be getting their information, not medical journals.

8. As sex research has been described as having 'novelty value', it may be that presenting or organising research in non-academic settings may devalue an already sensitively-placed area of investigation. However, as many people learn about research from non-academic sources, and given that sex is a 'sexy' issue, it may be more appropriate for researchers to consider making their findings more available to the popular press, and complete research in more 'natural' settings. This is of particular relevance to the women's magazine market, which represents sex in a highly stereotypical way. We have an opportunity to spread research information about women to women, and hopefully increase participation in future research by other women too.

9. Participants and the public need more information about how research is conducted, and why sex research is important. If researchers improve the public face of sex research, levels of consent may increase. Women in particular may feel reassured that the work is both professionally recognised, and can be of benefit to them.

10. Researchers should support each other, swap ideas and discuss successful schemes of participant recruitment. We need to ensure women become as likely to volunteer for sex studies, as for any other research project.
Problems of consent are inherent in all social research, but are more noticeable in work on sensitive areas. (Sex) researchers have already begun to interrogate the research process and future studies should continue this, paying particular attention to who consents - and who they are - making women's voluntary participation a pleasant and beneficial experience.

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