Sex Is More Than Performance, Says Israeli Psychologist Mia Lavie-Ajayi

Prof. Mia Lavie-Ajayi, a critical medical psychologist and head of the interdisciplinary studies department at Ben-Gurion University, argues that society wrongly treats sexuality as a checklist of functions. In an interview about her essay, “Medicalization of Sexual Difficulties,” published in the new book “Body of Your Own,” she says the common model focuses too much on erection, penetration, orgasm, ejaculation, and a clear ending to sex.

Lavie-Ajayi says this narrow framework reduces sexuality to performance and ignores emotional, relational, and social dimensions. “Sexuality is not only what the body does,” she says. “It is also connected to communication, self-confidence, education, the relationship, feelings and a sense of comfort.” She says this especially harms women, many of whom feel something is wrong with them if they do not experience spontaneous desire, even though reactive desire can arise from closeness, touch and intimacy.

She warns that a lack of desire or orgasm does not automatically mean there is a sexual problem. It may reflect a difficult period, relationship tension, poor communication, fatigue, stress or low confidence, factors the medical model often misses because it looks mainly at the body and function. “Much of the difficulty does not come from sexuality itself but from the social expectation we have in our heads,” she says.

Citing studies on what people mean by good sex, Lavie-Ajayi says the answers are usually broader than intercourse, erection or orgasm, and often emphasize connection, intimacy, pleasure and closeness. She calls for a wider, more curious approach to sexuality that changes over time and between people, and advises women not to start with why they cannot orgasm, but with what feels good, interesting and pleasurable. “Do not focus on the goal, but on exploring what feels good to you,” she says.