Story of Ohh

If there’s one thing Liz Canner knows, it’s orgasms.
Lucky lady, right? But, before you make assumptions about her personal life, consider that the 41-year-old filmmaker acquired her encyclopedic knowledge of the big O almost accidentally. After years of making documentaries about social justice and human rights issues, Canner needed a break from the heavy stuff. So, rather than focusing her camera lens on pain, she set out to learn about pleasure.

But not the pleasure that comes from helping an elderly person across the street or teaching a child to read. The pleasure she wanted to explore was of a more primitive, carnal variety — the female orgasm. To that end, Canner, who just finished an appointment as Visionary-in-Residence at Dartmouth College [1], accepted a job at a pharmaceutical company making erotic videos for clinical trials of a drug designed to be the first Viagra for women. In essence, she became a scientific pornographer.

That was nine years ago. What emerged from Canner’s work in pharmaceuticals is a near-exhaustive and often hilarious account of the science of female pleasure and the race to create a drug that will help women achieve the ultimate release. Her new film, Orgasm, Inc. [2], explores Big Pharma’s stranglehold on women’s sexuality and the lengths to which its players will go to help women get off with pills, creams, patches or even surgically implanted electrodes.

It might be a subject people don’t want to talk about, but health care professionals who have seen the film, including Dartmouth Medical School instructors who have screened it for their students, say Canner’s work is a positive step toward opening up the dialogue about female sexuality. Many of them share Canner’s concerns that the pharmaceutical industry — a $300-plus billion industry in the U.S. — is far too influential when it comes to women’s sexual health. And it’s not just a concern in this country; Orgasm, Inc. is slated to run on public television around Canada, Finland, Israel and Brazil. The film opens for a limited run at Burlington’s Roxy Theatre this Friday, and will be screened September 12 at the Savoy in Montpelier.

The film’s debut at the Hot Docs Film Festival [3]in Toronto in May garnered rave reviews from the Toronto Star [4] and Variety [5], which called the movie “buzzworthy.” Shortly after the film was released in the spring, Canner screened it at Dartmouth’s Center for Women and Gender [6]. The standing-room-only crowd was shocked to learn about some of the procedures available to women and the lengths that pharmaceutical companies go to develop and market a product. The film was so popular, Canner had to show it eight more times. The reception has been overwhelming, she says.

Canner, a 1991 Brown University graduate, is no stranger to the documentary process. A number of her films have been broadcast on PBS and on public television around the world. She has screened films at the New York Film Festival and the Human Rights Watch International Film Festival, among others. Canner was recently named one of the “top 10 independent filmmakers to watch” by The Independent magazine, a journal of independent filmmaking. Prior to her stint at Dartmouth, Canner was a fellow at the Radcliffe Institute for Advanced Study [7] at Harvard University, an honor held by former Vermont Governor Madeline Kunin [8]in 1992.

When Canner, whose studio is currently located in White River Junction, began her work with Vivus [9], a pharmaceutical company based in Mountain View, Calif., she never anticipated she’d be exposing the seedy side of the drug industry. “I thought this would be a film on women and pleasure,” Canner says in a telephone interview. “But when I started learning more, I saw there was something strange going on.”

What she saw was an industry that appears to have helped create a disorder so it could market a drug to cure it. According to data proffered by pharmaceutical companies looking to turn a profit on problems in the sack, “female sexual dysfunction” [10] afflicts 43 percent of American women. Oprah Winfrey, the venerable expert on all things female, called FSD a “secret epidemic” — so secret women didn’t even know they suffered from it. When she tried to get to the bottom of this diagnosis, Canner found little more than bunk science to back up claims that nearly half of American women live with this disorder.

After a naughty teaser, the film’s narrative begins with Canner at Vivus explaining her job — creating erotic films for female test subjects participating in clinical trials of the company’s orgasm cream, Alista. For the project, Canner teamed up with Kim Airs, the motorcycle-riding sex maven and owner of Boston erotica emporium Grand Opening! [11], to create porn that female testers would find stimulating.

Surprisingly, Vivus was completely open to Canner documenting her work on film, and the company offered her unprecedented access to the process of creating a drug for the open market. In one of many candid interviews, Vivus’ bow-tied founder, Virgil Place, explains how his firm got into the business of sexual dysfunction. “Our objective was to put life back into dead penises,” Place says earnestly.

His was the first company to come out with a drug to aid men with erectile dysfunction. But, shortly after Vivus won FDA approval, Pfizer, a much larger company with an advertising budget greater than the GDP of some third-world nations, introduced Viagra to the market, and the little blue pill took off. Vivus had a drug that would work for men with erectile dysfunction, but it no longer had a market.

Ideally, the executives reasoned, their erectile-dysfunction drug would work for women as well. During a television interview, one of them suggested this, and immediately the price of Vivus’ stocks shot up. The company couldn’t disappoint shareholders, so it had to move forward with development of a drug that hadn’t been part of the original plan.

At this point in the movie’s narrative, Canner’s skill as a journalistic filmmaker shines through. She managed to get the company’s manager of clinical research, Darby Stephens, to admit that Vivus had a drug, but no “disease entity” that it was meant to cure. “In order for us to develop drugs, we need to better and more clearly define what the disease is,” Stephens says in the film. It’s apparent from her shifty eyes and nervous laughter that she’s not entirely comfortable with that back-door approach.

Throughout the film, it’s clear that the evidence for female sexual dysfunction is wishy-washy at best. FSD is a collection of symptoms born largely from observational studies and surveys such as the Kinsey Reports and the work of Masters and Johnson, pioneers of human sexuality research.

Dr. Alessandra Rellini, director of the Sexual Health Research Clinic [12] at the University of Vermont — who is not in the film — concurs that the origin of FSD is murky. But, she says, so is the origin of many other psychological disorders. “The scary thing is that every single disorder comes about like this,” Rellini says, explaining how a grouping of symptoms becomes a bona fide “disorder” recognized in the Diagnostic and Statistical Manual of Mental Disorders.

As a case study in this process, Canner’s film is enlightening. It moves along at a steady clip, focusing heavily on the work of Dr. Leonore Tiefer, an associate clinical professor of psychiatry at New York University School of Medicine and Albert Einstein College of Medicine. A staunch opponent of the medicalization of sexuality and so-called “disease-mongering,” Tiefer has waged what she calls a New View Campaign [13]. In interviews with Canner, she advocates against “the distorted and oversimplified messages about sexuality that the pharmaceutical industry relies on” to develop and market new drugs. Tiefer believes sexuality is far more complicated than we realize, and there’s no one-size-fits-all fix for women with sexual difficulty. Rather than a catchall term like “female sexual dysfunction,” she proposes a new classification system that takes into account issues such as inhibition and individual distress within the context of relationships and culture.

UVM’s Rellini, whose work is not funded by the pharmaceutical industry, points out that popping a pill is easier than the often-messy business of mental health therapy. She doesn’t discount that medication could be useful for some women who are not as libidinous as they’d like to be. Many of those she sees at her clinic are survivors of sexual abuse and would benefit from a pharmaceutical aid, she says.

Ideally, though, Rellini would like to see drugs used in concert with psychotherapy. The problem, she says, is that public funding for research on human sexuality is nearly impossible to find. The behavioral side of sexuality is largely ignored by conventional sources of funding such as the National Institutes of Health. “There’s a rush to create a drug because there are very few behavioral approaches to address these issues,” Rellini says.

Throughout Orgasm, Inc., Canner tracks the progress of so-called arousal drugs through the use of clever animation. Patches and pills race toward a finish line that stays just barely out of reach.

Gale H. Golden, a Burlington-based clinical social worker who specializes in clinical sexology, has her own theory about why no pharmaceutical company has developed a drug that works better than a placebo in clinical trials. From time immemorial, humans have sought the key to sexual desire, using everything from antiquated aphrodisiacs such as rhinoceros horn and tiger penis to Viagra. But, while such drugs produce physical arousal, the less easily definable quantity of “desire” remains elusive. “Viagra does not address desire,” Golden says. “Desire is the holy grail of the pharmaceutical houses. They’re trying to address it, but so far it ain’t working.”

Golden, like Rellini, believes it’s important to take a balanced view of female sexuality and the role of medicine in treating sexual problems. She thinks drugs may be useful to women who are perimenopausal or menopausal, have had surgery such as a hysterectomy or are taking other medication. But the key, Golden posits, is to recognize that there is no “normal” when it comes to sexual functioning. Porn narratives aren’t normal, and neither are the stories told in the pages of Cosmopolitan. “How people define what sex is is terribly important. For a million people there are a million definitions,” Golden says. “It’s important that people don’t have unrealistic expectations. People aren’t going to get the sex lives of their twenties back.”

These experts agree that, to help women move beyond the shame and frustration associated with sexual problems, health care professionals must recognize that desire is just as much part of the sexuality equation as physical arousal. The physiological and the psychological component cannot be teased apart, says Rellini, who believes that male and female sexuality are equally complicated.

Nancy Mosher, president and CEO of Planned Parenthood of Northern New England [14], says that “fear-based” education is one way in which our culture inhibits women’s sexual desire. Through research conducted in 2008, Planned Parenthood learned that young women see negative and shameful messages about female sexuality as pervasive. “We need to help young people be sexual in a positive way,” Mosher says. “We need to help them understand that if they’re not orgasmic every time, well, neither are most women.”

Canner’s film suggests part of the problem is that women are told there’s something wrong with them if they’re not writhing in ecstasy every time they have sex. She chronicles one patient’s search to find out what’s wrong with her lady bits. Charletta, a middle-aged married woman, has never had an orgasm during penetrative sex and seeks the help of researcher Dr. Stuart Meloy, inventor of the Orgasmatron [15], to give her the O of her life. The doctor was perhaps unaware of the phone-booth-sized device of the same name in Woody Allen’s 1973 hit, Sleeper [16].

Meloy’s Orgasmatron seeks to stimulate women’s sexual organs using electrodes implanted in the patient’s spine. Instead of having a mind-blowing orgasm, though, Charletta ends up with a jittery leg and an electrode dangling out of her back. Once the device is removed, Charletta realizes there was nothing wrong with her to begin with. “The heck with all that disease stuff,” she proclaims.

Canner also documents the disturbing trend of laser vaginal rejuvenation [17], designer laser vaginoplasty and other surgical procedures aimed at enhancing women’s sexual experiences. In the film, Dr. Susan Bennett, an assistant professor at Harvard Medical School, goes after doctors who do these procedures and women who think they’re necessary. “Any kind of cosmetic surgery to external genitalia is a form of genital mutilation. I can’t think of any rational reason for it,” she says.

After the movie was released in May, Canner and others in the Dartmouth community founded SHEBOP — Sexual Health Education: Bring on Pleasure. The loosely organized group tracks doctors who offer to create “designer” vaginas for patients. Canner wants women to know that these couture cooters come with a high price tag: The operations can result in infection, scarring, nerve damage and loss of sensation.

The movie traces the race for a “cure” for FSD, but Canner’s point is that it doesn’t really matter who wins. Within the next year, she says, women will probably have their own Viagra. But, like many of the men who are prescribed the pill, they’ll come to realize that pharmaceuticals alone don’t make them want to have sex.

Canner says her disagreement is not so much with the idea of a drug to help women achieve orgasm as with the assumptions drug purveyors seem to make about who and what women are. “How these issues are being framed is the problem,” she says. “Doctors don’t have time to sit you down and talk about this, and they’re not really taught about sexuality anyway. It’s a perfect setup for an easy pill prescription.”