Monthly Archives: August 2015

Ethical issues surrounding Flibanserin/Addyi

Flibanserin, or Addyi, was recently approved by the FDA after being rejected twice for low effectiveness with a high risk of severe side effects. It was approved with warnings on the label, and will be handled by specially-trained professionals, but that on its own won’t be enough to stop the ways that it could be misused to further pathologize asexuality, low sexual desire, or not wanting sex.

If the existence of the drug itself isn’t the problem, since it could be useful for a specific group of people (women who lost their sexual desire, want it back for their own sake, and are distressed over the loss) who may find it worth the risks, then it’s how it could be marketed, when much of mainstream society isn’t aware that low sexual desire in general, and asexuality aren’t diseases. If it isn’t going to be accurately marketed towards the one group that may want it, then it could reinforce the stigmas that low sexual desire and asexuality already face, and further stigmatize women who don’t want sex with their partners for any reason. I haven’t seen any of the ads for it yet, but if anyone has, how accurate are they? Do they avoid stigmatizing asexuality or low sexual desire in general?

Rotten Zucchinis wrote an elaborate list that dispels the myths surrounding Flibanserin/Addyi, detailing the various risks, and the how the possibility to misuse the drug is wide open, even when it is prescribed on-label. They note that when prescribed on-label, it would be used for treating women who are distressed over their loss of sexual desire, and want it back, but since some asexual women have been misdiagnosed with either Female Sexual Arousal/Interest Disorder (FSAID) or Hypoactive Sexual Desire Disorder (HSDD), they could also be subject to this drug when they don’t want, and don’t need it.

The distinction made between low sexual desire and asexuality versus a diagnosis of what is now called Hypoactive Sexual Desire Disorder for men, and Female Sexual Arousal/Interest Disorder (FSAID) for women, is that HSDD or FSAID causes “clinically significant distress” and “interpersonal difficulties”. Those qualifiers are also listed in the criteria for HSDD in the DSM-IV, and Addyi is marketed specifically for treating HSDD in women, which is a diagnosis in the DSM-IV, but not DSM-5. I’m confused as to why Addyi is being marketed to treat an obsolete diagnosis.

At face value, the “clinically significant distress” and “interpersonal difficulties” qualifiers seem reasonable. However, as I’ve written here on FORTRESS about being pathologized for not wanting sex, and recently added a section about Addyi to it, those qualifiers don’t account for the cause of distress or interpersonal difficulties. There are ways that wording can be interpreted, and misused to justify coercing someone into unneeded and unwanted treatments, including pushing them into taking Addyi when they don’t need to, or don’t want to. Or if not coerced into it by a partner, they may still feel like they have to take Addyi to “fix” themselves.

A couple where one partner desires sex, and the other doesn’t (or does a lot less than their partner), could be considered to have “interpersonal difficulties”, and the person who doesn’t desire sex, could be considered distressed, because sexual desire is causing the difficulties between them and their partner. Because of the expectations that committed relationships are to be sexual, the partner who doesn’t desire sex is generally seen as the one who needs to change for their partner. They are seen this way by societal norms, and possibly also their peers, or even their partner, who has social leverage over them. It’s almost never the partner who wants sex more that’s expected to change, or expected to even try to understand their partner’s point of view.

If not coerced by their partners to “changing” for them, there are still the societal expectations that can make someone feel guilty over not desiring or not wanting sex when their partner wants it.

Asexual women and women who have low sexual desire, and aren’t distressed over it, and are either single or have supportive partners, aren’t those who are at risk of having Addyi pushed on them. It’s those who aren’t aware that asexuality and low sexual desire aren’t problems, regardless of whether they themselves are causing distress or not.

From my time spent in the asexual community, I’ve seen so many report that before they found the asexual community, they felt “broken”, and tried to force themselves to desire sex, and force themselves to try to enjoy it. Some went to therapy to try to “fix” themselves. Addyi may be another way that these individuals may try to, when what these individuals need is self-acceptance, and understanding from others.

I was disappointed that the FDA approved it this time around, but it’s not surprising that it passed. Since 1992, a law was passed requiring pharmaceutical companies to pay the FDA directly to have their drug reviewed. The FDA receives a lot of funding this way, due to a shortage of funding of their own, so there is a financial incentive to approve it.

Belated 1 year anniversary!

(warning: brief talk of sexual coercion)

This was intended to be the 1-year anniversary post for this blog, which was back on the 5th, but I had been busy keeping track of, and writing about the archiving controversy between AVEN and the bloggers, and have also been busy with some other projects, but better late than never!

It was in late July last year that I got encouraged to write my own blog, and contribute to the ace blogosphere, which I started with some comments on The Asexual Agenda, though it was on August 5th that I created this blog and made my first post.

I had so much to say, but there was a lot I was holding back on due to my fears of not being understood. That still held me back despite the encouraging comments I had gotten on my blog, and some posts on The Asexual Agenda. It’s self-defeating considering why I started to blog. When asked why do we in the asexual blogging communities, write our blogs, I would’ve answered that I blog to: contribute to asexual discourse, contribute to the discourse surrounding the rejection of sex, to share my experiences, and to find others who can relate, because they also need to be reached out to.

Sharing my experiences is the most difficult part, and it still is because I know I’m an outlier in the asexual community. I’m thankful that I’ve had commenters say that it does matter that I speak up about my experiences, as isolating as it may be.

Continue reading

Archive controversy part 2: Working towards a solution

A follow-up to my last post, about the archive and copyright controversy that interrupted between AVEN, and the bloggers of the asexual community. The official thread and announcement by AVEN has escalated quite a lot, especially on the second page, but now it looks like some agreement is being reached. Some of the admins posted stating that being on good terms with content creators is more important than the completeness of the archives.

Keep in mind I’m still just speaking for myself here with this post, but I agree. I value the archives, but making them complete isn’t worth it if content creators are going to be alienated, and that would discourage us from creating more content.

Demiandproud proposed ideas for an asexuality community library as possible solutions to this problem, as something complementary to the World Watch archives, not a replacement.

This example has to do with retrocomputing and archiving old software instead, but one possible idea that comes to mind is following the approach used by World of Spectrum. Many of the other home computer systems, and game consoles from 70’s, 80’s and early 90’s have their own archives of software for them, but they fall under a legal gray area because: almost all were uploaded without the publisher’s permission, and are still under copyright, therefore it’s illegal, but the copyrights often aren’t enforced, or can’t be, hence the gray area. Some archived software are “orphaned works“, works that are still copyrighted, but the copyrights can’t be enforced. For others, the publishers or copyright holders don’t see a point in taking action if the abandonware archives aren’t profiting off of it.

With old computer software and video games, the justification used to archive it under this legal gray area is an understandable one: that physical copies of old software, and the computers themselves, aren’t expected to last long enough before the copyrights expire. Tapes, cartridges, floppy disks and CDs are all fragile formats. These “abandonware” sites exist to keep old software from vanishing off the face of the earth if there are no physical copies left that work.

Abandonware sites as a whole operate under this legal gray area, but WoS is one that stands out for operating in a fully legal manner, and shows how it’s possible: by tracking down the publishers, or current copyright holders, and asking for their permission to make copies of their software available. Most of the publishers contacted, agreed to it, and the site itself is officially endorsed by the owners of the Spectrum IP.

Under their header of “What are we after exactly?”, WoS states they want permission from the copyright holders without them having to relinquish their copyrights, and have a list of publishers and individual programmers who did or didn’t give them permission.

It’s not a perfect comparison since archiving blog posts or articles is different from archiving old software. There is a parallel in that there is an emphasis on preservation, since websites might not last long; many that go defunct either have no trace of their existence or only survive as incomplete fragments on the Wayback Machine. In general, there are challenges to preserving data, whether it’s a piece of software, or a website that partly, or completely disappears.

Archiving blog posts has its own set of concerns though, like posts that are more personal, or are edited or removed by the author for whatever reason. Another difference from the abandonware situation is that the publishers of blog posts in the asexual community can be easily found, their and our posts and blogs clearly aren’t abandoned. Many are still active bloggers, and some are actively in contact with AVEN right now. We’re here, and many of us want permission to be asked before being reposted on AVEN.

Otherwise, I think that same approach used by WoS can be taken by contacting publishers, and asking for permission, and also posting a list of publishers of asexual media, including bloggers that did or didn’t give permission for their content to be reposted on AVEN.

Archive controversy: Archival preservation vs. blogger control and limitations of fair use

Over the past few days, a controversy over copyrights erupted between AVEN and many bloggers of the asexual community, much of it documented here, because as of the past few weeks, several posts from blogs have been copied, and reposted in their entirety on AVEN’s World Watch archives.

I’m late to this issue because real life life has been getting in the way over the past few days as this issue was erupting, but I’ve been catching up. Being part of AVEN’s Project Team, but also a blogger myself, I don’t want to pick sides. This isn’t anything official, and I’m just speaking for myself here, although an official announcement from AVEN was released earlier today, and AVEN wants to work with content creators to come to a solution to this issue.

I greatly appreciate AVEN’s efforts at archiving asexual history, and I appreciate the enthusiasm of some members to find articles and posts to add. When AVEN posts articles and copies them into the WW archives, it is a good faith effort to preserve them for educational and historical purposes, because much of the asexual community’s history is online and changes so quickly. Many websites have come and gone, and copying articles is to preserve them if the article’s website goes defunct or changes URL. However, there are two more immediate concerns:

  • The impact this has on bloggers, including control over one’s own content, and how this impacts their ability to retain readers.
  • Copyright infringement, and whether AVEN’s archiving efforts fall under fair use or not.

Under the first clause of fair use, AVEN’s status as a nonprofit that archives information for nonprofit educational purposes is in its favor.

On this page that that further elaborates on what counts as fair use, it says that a project that non-commercial, and has a benefit to the public, are two points that fall in favor towards fair use, but there are limitations.

One of the points mentioned is “Nonprofit educational uses — for example, photocopying of limited portions of written works by teachers for classroom use.” This ties right into the third clause of fair use, which is “the amount and substantiality of the portion used in relation to the copyrighted work as a whole…”, which places a limitation on how much information can be copied. The guideline is usually quoting one or two paragraphs.

The fourth clause “…the effect of the use upon the potential market for or value of the copyrighted work.“, may or may not apply. Few, if any of us ace bloggers get any revenue from our blogs, but if people can just read the whole article on AVEN, then they have no incentive to click the original link, which diverts traffic away from the original blog. I haven’t been impacted by this myself, but other bloggers have. Redbeardace explained that he, and some other bloggers are dependent on traffic and visitor stats to guide them, and what they write.

Another concern is bloggers’ control over their content, especially since some of the blog posts that were reposted on AVEN were personal stories written for the author’s blog, being re-posted to a much wider audience than they may have intended, or if the blogger removed their post for whatever reason.

Personally, I think it’s fair if a couple of paragraphs are quoted, the post summarized, and linked to. That still gives someone the incentive to click the link to see the rest, and give the original blog traffic. It is also important to consider the nature of the post, respecting the difference between posts that are more about general information vs. more personal posts. Privacy should be respected.

In light of all of this, will other bloggers be stating their stances on their posts being reposted on AVEN so that this incident doesn’t happen in the future? I’d like for a balance to be struck, so that AVEN’s archives can continue to grow, while respecting bloggers’ wishes.