We appreciate the thoughtful and insightful commentaries by Basson (2018), Bogaert, Skorska, and Modica (2018), Calogero and Siegel (2018), Nichols (2019), Schick and Baldwin (2018), Tolman and Chmielewski (2018), and Velotta and Schwartz (2018) to our Target Article “The Relational and Bodily Experiences Theory (RBET) of Sexual Desire in Women” (Cherkasskaya & Rosario, 2018). While each commentary makes important points, we address recurring themes throughout the commentaries. Specifically, our response considers (1) the commentators’ critique of RBET as overly parsimonious and the suggestion to expand and augment the model in a number of different ways; (2) the claim that RBET is missing the vital construct of sociocultural forces in shaping women’s sexual desire; (3) the critique that RBET unduly privileges attachment over other potential constructs; and (4) the limitations of existing measures of desire, which impeded our ability to assess all the facets of our definition of sexual desire, as well as other methodological restrictions imposed by the literature. As concluded by Basson (2018) and apparent throughout the commentaries, RBET emphasizes the importance of continuing our inquiry into the many facets of sexual desire in women.

The Parsimony of Relational and Bodily Experiences Theory

Our goal in developing RBET was to present a parsimonious model that would include the smallest number of essential constructs to explain sexual desire in women. We therefore intentionally left out other potential constructs (e.g., biological, romantic relationship satisfaction, mood and psychopathology) that were reviewed in the article and previously have been found to be implicated in women’s difficulties with their sexual desire. Our concern in including additional constructs is the potential for overlap between the variables, indicating coverage of similar information about sexual desire.

We value the importance of studying the constructs that were raised by the commentators such as Tolman and Chmielewski (2018), Bogaert et al. (2018), and Schick and Baldwin (2018) to the understanding of sexual desire in women. Future research investigators might assume the task of expanding RBET in the ways that were suggested. However, we caution researchers in this endeavor and suggest that the benefits of including more constructs be balanced against what is uniquely learned by the additional constructs. The overlap of such constructs with those of RBET would undermine the model and diminish our understanding of sexual desire. For example, Bogaert et al. suggested integrating the Object of Desire Self-Consciousness theory (Bogaert & Brotto, 2014) with RBET. ODSC is a valuable contribution to our understanding of women’s sexual function and the fusion of RBET and ODSC may be of interest to some. However, we argue against it because ODSC is subsumed by RBET. The former concerns the perception that one is sexually desirable to an object, which is a component of our definition of sexual desire.

Tolman and Chmielewski (2018) posited an interesting hypothesis that RBET may involve bidirectional relations between the constructs of sexual desire and sexual bodily self-representations (SBSR), which is not accounted for by our model as it currently stands. RBET is a recursive model and, as such, the relations are unidirectional. Longitudinal data are necessary to examine non-recursive paths and consider the different ways in which desire and SBSR are related.

Schick and Baldwin (2018) suggest including sexual motives as distinct from the experience of desire in our model. While we appreciate such a nuanced approach to the phenomenology of desire, we suggest that one’s motives are implicated in one’s experience of desire. Again, we argue for the value of a parsimonious model.

Velotta and Schwartz (2018) raised the important distinction between hypersexuality and high sexual desire and question the absence of control over one’s sexuality in RBET. As explained in the Target Article, hypersexuality is a form of dysregulated sexuality (Carvalho, Stulhofer, Vieira, & Jurin, 2015); contrary to the commentators’ suggestion, it is not high sexual desire. Consequently, hypersexuality is not included in the model. Velotta and Schwartz also questioned how the relational and bodily constructs are weighted, suggesting that we do not explain the relative significance of either construct in understanding sexual desire in women. Relatedly, they call for the weighting of the components of each latent construct. The reason the weighting of the constructs is not addressed in the model is that we do not privilege the relational over the bodily or vice versa but, rather, affirm that both components are essential to understanding sexual desire in women. Similarly, we do not support deconstructing the latent variables to determine which of the observed variables carries a greater weight, given that each latent construct is defined by all of its observed variables. Again, our aim was to develop a parsimonious model and we therefore chose the latent and observed variables that we deemed most robust and vital to explaining sexual desire in women.

In summary, expanding/augmenting and integrating RBET with other constructs can be tackled in future research, but we would be wary of moving in that direction. Including additional constructs carries theoretical and statistical tolls that may undermine the validity of the model. Theoretically, we, paradoxically, gain more understanding of a phenomenon with fewer constructs. The issue is which constructs to include? Our response is RBET. Statistically, redundancy among actual and potential constructs must be minimized to enhance prediction. In short, less is more.

Sociocultural Context in Relational and Bodily Experiences Theory

Multiple commentaries highlighted the problematic absence of sociocultural forces in our model of sexual desire in women. We certainly agree with Schick and Baldwin (2018), Tolman and Chmielewski (2018), and Velotta and Schwartz (2018) about the importance of identifying and understanding sociocultural forces that may undermine or enhance women’s sexual functioning, including in the realm of desire. However, we disagree that this is missing in our model or that sociocultural influences are “distal factors” in RBET, as suggested by Schick and Baldwin. The sexual body self-representation construct is a register of sociocultural exigencies that women experience, which are embedded in the model’s mediators, consisting of sexual subjectivity (Horne & Zimmer-Gembeck, 2005), self-objectification (Fredrickson & Roberts, 1997), and genital self-image (Schick, Calabrese, Rima, & Zucker, 2010). As suggested by the theories underlying these constructs, women’s experiences and perceptions of their bodies are greatly impacted by the way the female body is treated and portrayed in one’s sociocultural milieu. The sexual body self-representation construct reflects how women integrate and metabolize the social messages regarding their bodies.

A related issue emerged in Calogero and Siegel’s (2018) commentary, which challenged one facet of our definition of sexual desire: “the want to be an object of and submit to another’s desire.” The issue here is one of semantics as Calogero and Siegel seem to be misunderstanding our use of the phrase “object of desire.” We did not intend to suggest that in experiencing sexual desire, women wish to take on the role of object as defined by Nussbaum (1995): to be deprived of autonomy, agency, subjectivity, and a voice and to be used as a tool and reduced to a body that can be owned, silenced, and violated. Rather, we are suggesting that one aspect of sexual desire is the wish to be desired—to be on the receiving end of another’s desire. When we talk about the experience of shifting between object and subject, we are describing one’s capacity to occupy both positions of desiring and desired, active and passive, subject and object in a way that does not compromise one’s sense of agency or subjectivity. We certainly agree that objectification is incredibly damaging to women’s well-being, including their sexual function, which explain why sexual subjectivity, self-objectification, and genital self-image are included in the model.

In sum, we agree with the commentators’ position that examining sociocultural influences is essential to understanding sexual desire in women. We believe that these factors are contained in the sexual body self-representation construct. Specifically, each of the observed variables (sexual subjectivity, self-objectification, genital self-image) of this latent construct is based on a theory concerning the sociocultural exigencies faced by women in society.

Significance of Attachment

Another critique of RBET by multiple commentators is that we overvalue attachment over other potential psychological mechanisms that shape women’s sexual desire. We agree that we do privilege attachment but stand by this choice. A vast literature exists on the importance of attachment for multiple areas of functioning, including in the relational and sexual domains (Mikulincer & Shaver, 2007). Assessment of attachment style captures one’s internalized working models of self and other that remain stable from childhood into adulthood. While some research has not supported the stability of attachment as pointed out by Nichols (2019), it is quite possible that this is an issue of measurement error and research design, given that we use very different measures in childhood and adulthood and longitudinal studies are complicated to conduct. In this way, the continuity of attachment patterns is challenging to accurately assess. In RBET, we stay true to the attachment theory posited by Bowlby (1969, 1973) who suggested that one’s attachment style that develops in the context of the early parent–child relationship remains relatively stable, albeit malleable, and sets the template for adult romantic and sexual relationships.

Multiple commentators, including Schick and Baldwin (2018), Tolman and Chmielewski (2018), and Velotta and Schwartz (2018), questioned the importance of attachment and suggest that sociocultural forces should be privileged above women’s early relational experiences. While we do agree that the sociocultural milieu has a powerful effect on women’s sexuality, we believe that positive parent–child relationships provide women with an armor that protects them against the forces that thwart sexual agency. In her commentary, Nichols (2019) similarly critiqued RBET for its emphasis on attachment in understanding sexual desire difficulties. Nichols cites her clinical experience, arguing that focusing on one’s early relational history in addressing sexual problems is dated and that therapeutic approaches that focus on non-sexual problems do not ameliorate sexual functioning. We suggest that one issue in this observation is the clinician’s illusion as sex therapists may see only the patients who are not helped by other kinds of interventions. In contrast, we agree with Basson’s (2018) recommendation to assess women’s developmental history, including attachment style, especially when sexual issues are lifelong. We appreciate Nichols’ suggestion that perhaps attachment plays an important role when attachment security is absent but is less important when it is present, which would be an important question for future research. Further, we appreciate Nichols’ referencing emotionally focused therapy for couples (Johnson, Hunsley, Greenberg, & Schindler, 2006), which emphasizes attachment-related needs in treating relationship difficulties across all domains, including sexual functioning (Johnson, 2017).

In summary, we agree with the commentators’ observation that we privilege attachment over other potential constructs. We stand by this decision because we maintain that women’s early parental relationships as captured by their attachment style are vital to consider in identifying the psychological processes that shape sexual desire in adulthood.

Limitations of Existing Measures, Definitions, and Operationalizations

Multiple commentators expressed concerns that stem from the limitations of existing literature. For example, Tolman and Chmielewski (2018) pointed out that our assessment of desire in the empirical paper testing RBET (Cherkasskaya & Rosario, 2017) did not capture our multidimensional definition of desire. We agree. Unfortunately, we were limited by the existing measures. Development of measures is necessary to address this gap in the literature. Velotta and Schwartz (2018) questioned the operationalization of sexual subjectivity and self-objectification. Again, these concepts and their operationalization are based on the existing literature, which has certain limitations. Sexual subjectivity has been mostly studied in adolescent girls (Horne & Zimmer-Gembeck, 2005, 2006; Zimmer-Gembeck, Ducat, & Boislard-Pepin, 2011) rather than in adult women, and thus, some of its components require evaluation for their generalizability to adult women. Schick and Baldwin (2018) highlighted the limits to the generalizability of RBET as it can be applied to sexual minority women and gender-diverse individuals. This is an area that requires further research given that most studies on women’s sexual desire focus on heterosexual cisgender women and penile–vaginal intercourse. We look forward to assessing and seeing RBET assessed across sexual and gender identities.

Some commentators considered the empirical paper that tested RBET (Cherkasskaya & Rosario, 2017), highlighting other concerns. Schick and Baldwin (2018) pointed out that when the model was tested, the fit of the model was reasonable rather than a good fit to the data. They attributed such findings to potential flaws in the theory. However, we consider the problem to be methodological, including lacking more robust measures of desire and attachment and participant bias associated with Internet-based recruitment. Replication studies are needed to continue to evaluate RBET. As previously mentioned, the self-report of adult attachment is not an ideal assessment of one’s attachment style and the existing measures of desire do not capture the multiple facets of our definition of sexual desire.

In sum, the development of RBET and a study evaluating its fit were limited by the existing literature and other methodological restrictions. Replication studies of RBET and development of more comprehensive measures of desire and attachment are needed to adequately test RBET and consider its applicability to different populations of women.

Conclusion

The commentaries aptly raised some very important and complicated issues in both RBET and the literature on women’s sexuality. Schick and Baldwin (2018) questioned whether RBET is meant to identify women with low versus high desire or whether the model aims to identify the factors that may inhibit women’s experience of desire. The aim of RBET is to explain the full spectrum of sexual desire in women parsimoniously with the most essential psychological and contextual influences. While we appreciate the commentators’ emphasis on sociocultural context, we believe that women’s relational histories as encapsulated by attachment and the sociocultural exigencies that are encountered by women in society are essential to understanding desire. The latter is captured in the sexual body self-representation construct of RBET. The recurring theme of expanding our model reflects the many factors that may be necessary to consider when addressing sexual desire in women in both empirical investigations and clinical interventions; however, such concerns require tests that compare RBET with the alternative perspective(s). Basson’s (2018) commentary touched on the many questions that require attention in order to continue to deepen and expand our understanding of the full spectrum of sexual desire in women. As Basson concludes, RBET highlights how much there is still to learn about women’s desires in order to effectively help women with their sexual concerns.