How do we understand sexual pleasure in this age of ‘consent’?

Debates about the kind of sex that we should be having are focused on the issue of individual choice and sexual autonomy. We are living, it seems, in the age of consent.

Societies tell us a lot about themselves by how they struggle over sex. Different places and generations have distinct sexual battlegrounds. From anti-miscegenation laws to criminal prohibitions of same-sex intimacy and sex work, these contests address with whom we can have sex, when, and under what conditions. At present, debates about the kind of sex that we should be having are focused on the issue of individual choice and sexual autonomy. We are living, it seems, in the age of consent.

The idea that consent to sexual activity should be the benchmark for deciding what constitutes legally permissible and socially desirable sex is far from obvious. This is in part because sex means very different things in different moments. Paid sex might indeed be conducive to transactional, negotiated terms in which the parties bargain and consent to specific acts for a set price. But not all sex can be – or should be – reduced to an atomistic meeting of the minds of two individuals. Sometimes what we want is not fully known to us in advance. The details of desire and satisfaction are often discovered, and produced, in the sexual moment. Rather than a question of individual will, sexual autonomy can be expressed through the interaction of two (or more) partners. Sex can be a uniquely utopian experience, in that the act of sexually relating creates novel ways of being together socially.

Women’s sexual pleasure is often viewed as more complicated and less predictable than men’s. Historically, this assumption has contributed to the over-regulation of female sexual and reproductive capacities. Rather than the exception, ambiguity about exactly what is desired, and how that desire should be expressed, is the sexual norm. Women’s emancipatory projects should therefore focus on ways of incorporating this fact, rather than shunning it.

The actualisation of the sexual self can happen at the same time that degrees of fear, repulsion and uncertainty – as well as excitement and intrigue – are present on both sides. In these moments, allowing ourselves to engage in intense personal vulnerability can make space for the production of liminal trust. This trust is based not on consent, but on a shared commitment to embrace the fact that sexual pleasure and danger often occupy the same space. Although sexual liminality encompasses the risk that conduct can cross over into the realm of bad sex, it can also be empowering because it acknowledges the potential for sexual encounters to change us, to recreate us, in unplanned ways.

Like informed consent to medical procedures, sexual consent is a contested legal construct that has evolved over time. It is a concept that the law uses to distinguish between criminal and non-criminal sex. But how do we determine whether consent is present or absent? Even the most affirmative consent-based sexual-assault jurisdictions, where consent is understood as the subjective product of the complainant’s mind at the time of the alleged assault, rely on judicial constructs of consent. Outside emphatic ‘yes’ or ‘no’ situations, complainant testimony is combined with other kinds of evidence, including the verbal and non-verbal behaviour of both parties throughout the encounter. The judge must then decide whether, on the whole, both the claim of non-consent is believable, and whether the accused knew, or should have known, that consent was not present or had been withdrawn. From beginning to end, the law relies on different kinds of evidence and signs, direct and indirect, to build a construct of consent.

What this means is that consent is not a thing-in-itself, out there to be found, either by a sexual partner or by a judge or jury. Consent is no more, or less, than an indicator of how a given society understands particular sexual behaviour. We declare consent to be absent at the point where we decide that sexual conduct crosses the threshold of what we consider a culturally acceptable level of coercion, compromise and risk.

Many feminists will respond that the problem is not with the nature of consent, but that the law does not go far enough. The law, in other words, should be adapted to track the cultural shifts demanded by #MeToo. Proponents of affirmative consent argue that sexual partners should actively seek clear signs of consent throughout a sexual encounter. ‘Consent is sexy,’ we are told. When a woman alleges an assault, we should believe her. The burden should shift to the defendant to show that he took reasonable steps in the circumstances to ascertain her consent. Changing our sexual behaviour to fit these expectations, we are told, will make for both a safer and sexier culture. What feminist in her right mind could disagree with that?

There are two major problems with this logic. First, as both conservative and ‘pro-sex’ feminists have long acknowledged, the binary on/off approach present in consent discourse does not reflect sexual reality in either a cultural or a legal sense. ‘Consent’ weaves in and out of sexual encounters in complex and unpredictable ways. The same sexual encounter, taken as a whole, can be variously humiliating yet titillating, disgusting yet intriguing, frightening and yet compelling. What is more, consensual sex is not the same thing as wanted sex; conversely, non-consensual sex is not the same as unwanted sex. Equating consent with unambiguous desire significantly alters the sort of sex that society deems permissible in troubling, namely regressive, directions.

The ‘enthusiastic’ consent frame advanced by other feminists, including Robin West, accounts for these difficulties by going even further. Highlighting the conditions of female oppression under which ‘normal’, heterosexual relations take place, including within marriage, these feminists argue for the criminalisation of any sex – whether consensual or not – that is the product of coercion. Law, and society, should endorse only genuinely desired sex.

However, there is no reason to believe that even truly wanted sexual encounters correlate with good sex. Unwanted, or partially wanted, sex can still be sexy and transformative. Experimenting with pain or fear can shift previously anticipated sexual boundaries precisely because it engages vulnerable states of being. One can imagine that the appeal of choking, for example, resides at least partly in the genuineness of the fear that it provokes.

This is not to say that there are no limits in sex, but rather to propose that we devise limits that align with the erotic potential of the sexual encounter. Liminal trust is a space in which partners can explore the value of sexual experiences precisely because they directly engage the line between permissibility and impermissiblity. Both affirmative and enthusiastic consent cast this kind of sexuality as deviant and criminal. That is a mistake.

#MeToo explicitly relies on patriarchy as both cultural context and target. It sees women as objects of sexualised male domination. Men, we are told, have an interest in furthering, or at least maintaining, misogynistic forms of social control over women. They are assumed to want to go ‘as far’ as they can before being confronted with a woman’s expression of non-consent to sex. This picture provides, at best, an idiosyncratic and regressive picture of human sexuality. At worst, it encourages us to police sexuality in conservative ways. The real promise of the contemporary sex debate is that it opens up a new space in which to theorise the limits of truly adventurous and fulfilling sex.

Heidi Matthews

This article was originally published at Aeon and has been republished under Creative Commons.

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Upstreamism advocate Rishi Manchanda calls us to understand health not as a "personal responsibility" but a "common good."

Sponsored by Northwell Health
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Yale scientists restore brain function to 32 clinically dead pigs

Researchers hope the technology will further our understanding of the brain, but lawmakers may not be ready for the ethical challenges.

Still from John Stephenson's 1999 rendition of Animal Farm.
Surprising Science
  • Researchers at the Yale School of Medicine successfully restored some functions to pig brains that had been dead for hours.
  • They hope the technology will advance our understanding of the brain, potentially developing new treatments for debilitating diseases and disorders.
  • The research raises many ethical questions and puts to the test our current understanding of death.

The image of an undead brain coming back to live again is the stuff of science fiction. Not just any science fiction, specifically B-grade sci fi. What instantly springs to mind is the black-and-white horrors of films like Fiend Without a Face. Bad acting. Plastic monstrosities. Visible strings. And a spinal cord that, for some reason, is also a tentacle?

But like any good science fiction, it's only a matter of time before some manner of it seeps into our reality. This week's Nature published the findings of researchers who managed to restore function to pigs' brains that were clinically dead. At least, what we once thought of as dead.

What's dead may never die, it seems

The researchers did not hail from House Greyjoy — "What is dead may never die" — but came largely from the Yale School of Medicine. They connected 32 pig brains to a system called BrainEx. BrainEx is an artificial perfusion system — that is, a system that takes over the functions normally regulated by the organ. The pigs had been killed four hours earlier at a U.S. Department of Agriculture slaughterhouse; their brains completely removed from the skulls.

BrainEx pumped an experiment solution into the brain that essentially mimic blood flow. It brought oxygen and nutrients to the tissues, giving brain cells the resources to begin many normal functions. The cells began consuming and metabolizing sugars. The brains' immune systems kicked in. Neuron samples could carry an electrical signal. Some brain cells even responded to drugs.

The researchers have managed to keep some brains alive for up to 36 hours, and currently do not know if BrainEx can have sustained the brains longer. "It is conceivable we are just preventing the inevitable, and the brain won't be able to recover," said Nenad Sestan, Yale neuroscientist and the lead researcher.

As a control, other brains received either a fake solution or no solution at all. None revived brain activity and deteriorated as normal.

The researchers hope the technology can enhance our ability to study the brain and its cellular functions. One of the main avenues of such studies would be brain disorders and diseases. This could point the way to developing new of treatments for the likes of brain injuries, Alzheimer's, Huntington's, and neurodegenerative conditions.

"This is an extraordinary and very promising breakthrough for neuroscience. It immediately offers a much better model for studying the human brain, which is extraordinarily important, given the vast amount of human suffering from diseases of the mind [and] brain," Nita Farahany, the bioethicists at the Duke University School of Law who wrote the study's commentary, told National Geographic.

An ethical gray matter

Before anyone gets an Island of Dr. Moreau vibe, it's worth noting that the brains did not approach neural activity anywhere near consciousness.

The BrainEx solution contained chemicals that prevented neurons from firing. To be extra cautious, the researchers also monitored the brains for any such activity and were prepared to administer an anesthetic should they have seen signs of consciousness.

Even so, the research signals a massive debate to come regarding medical ethics and our definition of death.

Most countries define death, clinically speaking, as the irreversible loss of brain or circulatory function. This definition was already at odds with some folk- and value-centric understandings, but where do we go if it becomes possible to reverse clinical death with artificial perfusion?

"This is wild," Jonathan Moreno, a bioethicist at the University of Pennsylvania, told the New York Times. "If ever there was an issue that merited big public deliberation on the ethics of science and medicine, this is one."

One possible consequence involves organ donations. Some European countries require emergency responders to use a process that preserves organs when they cannot resuscitate a person. They continue to pump blood throughout the body, but use a "thoracic aortic occlusion balloon" to prevent that blood from reaching the brain.

The system is already controversial because it raises concerns about what caused the patient's death. But what happens when brain death becomes readily reversible? Stuart Younger, a bioethicist at Case Western Reserve University, told Nature that if BrainEx were to become widely available, it could shrink the pool of eligible donors.

"There's a potential conflict here between the interests of potential donors — who might not even be donors — and people who are waiting for organs," he said.

It will be a while before such experiments go anywhere near human subjects. A more immediate ethical question relates to how such experiments harm animal subjects.

Ethical review boards evaluate research protocols and can reject any that causes undue pain, suffering, or distress. Since dead animals feel no pain, suffer no trauma, they are typically approved as subjects. But how do such boards make a judgement regarding the suffering of a "cellularly active" brain? The distress of a partially alive brain?

The dilemma is unprecedented.

Setting new boundaries

Another science fiction story that comes to mind when discussing this story is, of course, Frankenstein. As Farahany told National Geographic: "It is definitely has [sic] a good science-fiction element to it, and it is restoring cellular function where we previously thought impossible. But to have Frankenstein, you need some degree of consciousness, some 'there' there. [The researchers] did not recover any form of consciousness in this study, and it is still unclear if we ever could. But we are one step closer to that possibility."

She's right. The researchers undertook their research for the betterment of humanity, and we may one day reap some unimaginable medical benefits from it. The ethical questions, however, remain as unsettling as the stories they remind us of.

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