Book Report for “Come as You Are”
Part 1: Chapter Summaries
Chapter 1:
A woman called Olivia thought that she has more testosterone and is manlike due to her
likeness to masturbate, and the shape of her genitals. In response, the author, Emily corrected her
by saying there is no correlation between an adult woman’s hormone level, genital shape or size,
and sexual desire or response and told her that everyone’s genitals are made of the same parts but
in different ways. Cultures impose meanings over random biology facts and metaphorize them,
assuming what they might be instead of learning what they are. Woman’s genitals are not actually
to be ashamed of or tucked away in reality. While the penis stands out because they are bigger, the
clitoris is also at the same location, but they don’t have to be big as transporting DNA is not a
function a clitoris has to do. The female equivalent of the scrotum in males, the outer labia, is also
a similar location in the female body because the ovaries are internal, as compared to testicles in
males being external, thus scrotum are extending out. The ovaries are internal not because they are
supposed to be ashamed but because women are the ones who get pregnant.
Everyone has the same parts that came from the same biological origin but with functions
that can vary depending on the same. This is the field of biological homologue. Examples are the
penis and scrotum in males, and the clitoris and labia majora in females respectively. Both labia
majora and scrotum are places hairs grow post-puberty. Another example is nipples which are
necessary in females for human survival, males have them because, by evolution, it takes less
energy to leave them there instead of making them not exist.
Clitoris and penis are the external genitals with the most nerve endings. The visible part of
the clitoris, the glans clitoris, is at the top of the genitals, just a little away from the vagina. While
the clitoris is only one-eight the size of the penis, it has twice the nerve endings and can vary in
size, and it is an important point for erotic sensation. It has only one function: sensation while the
penis has four: sensation, penetration, urination, and ejaculation. The shaft of the penis has three
chambers: a pair of cavernous bodies (corpora cavernous) and a spongy body (corpus spongiosum),
through which the urethra passes. While the cultural understanding of the clitoris is more like “the
little nub at the top of the vulva”, the biological understanding of clitoris is more like “the farranging mostly internal anatomical structure with a head emerging at the top of the vulva”. The
respective homologues in the female’s clitoris are a pair of legs (crura), the bulbs of vestibule
homologue to both the corpora cavernous and the bulb of the penis and it is the mouth of the vagina.
The clitoris extends all the way to the vagina opening. The clitoris hood and the foreskin cover the
heads of the clitoris and the penis respectively. Another pair of homologues are the male frenulum
and the female fourchette which are very sensitive.
It is empowering to know where your clitoris is. To know, spread your labia and look at
your clitoris, or try to locate it with your fingers, maybe with a little spit, commercial lube, some
allergen-free hand cream, or olive oil.
Female inner labia (labia minora r small lips) can extend all the way beyond the big lips or
may be tucked in. It can be any color, the same, or a gradient. Regardless, it is all healthy and
normal. The male homologue of inner labia is the inner foreskin which is the skin at the top of the
shaft. The is usually a color change midway down the shaft if a male has been circumcised,
although the color change usually becomes evident after puberty. The female outer labia can also
vary it can be hairy or has very little hair, it can be puffy or flush with the body, it can be the same
or darker or lighter than the surrounding skin and it’s all normal and beautiful.
Anything taught about female hymen could have been wrong. It is rarely the main reason
for bleeding during penetration, although it can be possible; commonly it is due to lack of
lubrication. It heals if it ever breaks. Hymens can become more flexible due to regular penetration;
otherwise, regular penetration doesn’t have any effects. Because hormones change as a woman
approaches adolescence, her hymen can waste away and become unnoticeable. Hymens can also
vary a lot from some being born without one to some having imperforate, microperforate, or
septate hymens. It can be durable or fragile. It can last or disappear after menopause. They vary
because they don’t have a function and is just a byproduct of evolution, homologue to seminal
colliculus in male. Hymen is an example of how humans metaphorize anatomy. Hymens can affect
woman’s lives significantly to the extent that women can get killed if they don’t have one in the
past, not because of anatomy but because cultures put meaning over it and oppress women’s lives
with it.
Vulva refers to the entire external genitalia in females. Vagina refers to the internal
reproductive canal that leads to the uterus. The mons public refers to the triangle area where the
hair grows.
Both wetness and hardness are possible for both sexes. At both sides of vagina openings,
women have a set of glands called Bartholin’s glands which release fluid during sexual arousal,
maybe to reduce the friction of vagina penetration, or to make a healthy and fertile scene. The male
homologue of Bartholin’s glands is the Cowper’s glands, just below the prostate, and it makes preejaculate. This is what’s happening when women and men get “wet.” Women have a set of glands
at the urethra called the Skene’s glands and men’s homologue to the Skene’s glands is the prostate.
Both in men and women, they swell around the urethra so that urination is impossible during sexual
arousal. That is why, to be able to pee after orgasm, one must take deep, cleansing breaths to give
the genitals time to relax. The prostate also has another function, ejaculation which is to produce
the seminal fluid in which the sperms travel. On the other side, female ejaculation, “squirting”, can
happen to some women and is an evolution byproduct and because it is rare, it gets prized. The
genitals can get wet and can have scents sometimes. The genital secretions can change with age,
phase in the menstrual cycle, and diet.
The intersex people whose genitals are organized between the standard configurations of
male and female, also have the same parts as male and female. Due to some variation during
biochemical events before birth, they are organized just slightly differently. Unless the genitals are
causing pain or prone to infection or any other medical conditions. They are all healthy and normal
and need no medical surgeries.
Diverse portraits of the genitals, from the color, and amount of hair to skin type, and age,
are important so that everyone can understand the fact that their genitals are normal.
It is very important to learn that all human genitals are made of the same parts, just
organized differently for two reasons: it means that they are all normal and healthy, and it is the
truth for every aspect of human sexual expression from genital responses to sexual psychology,
etc. There is more difference within the groups than between the difference is meant for sex-related
concepts such as sexual preferences, and gender identity or non-sex-related concepts such as height.
Although saying ‘your genitals are healthy and beautiful’ cannot change anything if you
are uncomfortable with their genitals, there are two things you can do to change their image. One
way is to look at your vulva as said before and write down the things you only like. Repeat it and
over time, due to cognitive dissonance, the things you like will increase and not like will decrease.
Another way is to ask your partner to look at your vulva and openly discuss it from memories to
worries.
While some of us are taught the correct way about sex from the start, some have been
taught the wrong way in some parts that we have to uproot and replace with healthier ways.
Absorbing the idea that “all the same parts, organized in different ways can free you and
have you experience the ways that we are all connected.
Chapter 2:
The four-phase model of female sexual response, namely excitement, plateau, orgasm, and
resolution, developed by William Masters and Virginia Johnson became the foundation for
understanding human sexual response and the basis for defining sexual health and problems. Later,
a sex psychotherapist called Helen Singer Kaplan developed her triphasic model of sexual response.
The three phases were desire, arousal (adding excitement and plateau together), and orgasm. Her
theory would late become the foundation for diagnostic criteria in the American Psychiatric
Association’s Diagnostic and Statistical Manual. Researchers were trying to develop a pink pill
that works for women, like Viagra that gives men erections. The attempt hasn’t been successful
because of a single missing piece: the brake from the dual control model.
According to the dual control model, what is true for other aspect of the nervous system
must also be true for the brain system that coordinates sex and so, it consists of two parts: Sexual
Excitement System (SES), the acceleration and Sexual Inhibition System (SIS), the brake. By
depending on and scanning relevant sexual stimuli and threats in the environment from your 5
senses, imagination to your environmental context, SES and SIS send ‘Turn on’ and ‘Turn off’
respectively to the genitals. Scanning is happening all day unconsciously and SIS is sending ‘Turn
off ‘signal during non-sexual condition all the time. There is another break of SIS which is more
like hand break in the car while the brake mentioned earlier was like the foot break in the car. With
the hand-break, you can continue, but it is longer and less effective way to reach the goal. People
struggling with orgasm or desire is most likely due to a problem with the brake and less likely to
be because of a problem with the acceleration. Once you figure out which is it, you can make
change.
Arousal is about activating the accelerator and deactivating the brakes and it is also the
product of the sensitivities of the accelerator and the brakes to the stimuli. People are born with a
level of sensitivity, but it can change with experience. Any level of sensitivity whether for SES or
SIS is possible, but most have an average for both, and few are at extreme ends. Your sexual
response can vary a lot depending on how sensitive your SES is and how sensitive your SIS is.
Because the accelerator and the brakes are two different systems, they can be both hit at
the same time.
Although on average, men have more sensitive SES and women have more sensitive SIS,
there is more difference within each of the two groups than between those two.
The brain doesn’t know what is a relevant or irrelevant sexual stimuli by innate, but the
brain learns through the experience, the cultural environment.
The learning process is different for men and women because of the difference in genitals
and the change of hormones. Compared to boys, girls are more likely to learn what is sexual stimuli
or threat through implicit leaning, and usually start the learning process at an older age, and their
genital response and their experience of sexual arousal will probably contradict unlike boys.
Although it is hard to change the sensitivity of SES and SIS, you can change the stimuli and the
context your brain response to have a better sexual life.
Chapter 3:
Your perception of sensation is dependent on the context: the circumstance and your brain
state in the present. Acknowledging which context presents sexy to you and knowing how to
improve the context can increase your sexual satisfaction. A part of your brain responsible for all
your psychology well-being has three separate functions, namely expecting, enjoying and
eagerness. Because they are separate functions, one can work without another, for example expect
something without enjoying it and all three of them are also context dependent. The context a
woman perceive as good for sex can vary depending on age, and from individual to individual, but
generally it is the time when it is high affectionate, most erotic, and low stress.
Chapter 4:
Not just sexual, but also all the other emotional contexts, especially love and stress, can
influence what turns you on. The key to managing stress, a flight or fight or freeze response to
stressors from bills to sex life, is not by relaxing or calming but allowing the stress cycle to
complete. Flight or fight are accelerator stress responses while freeze is a brake stress response. If
you are in a bad psychological state, it is certain that you won’t enjoy sex even if you crave for it.
Because sex is not a way of personal survival, by evolution, we don’t prioritize it in a difficult time,
thus we don’t crave for it if we’re stressed except for some rare people according to the dual control
mode. We must completely complete our stress cycle, rather than shutting down our emotions due
to culture, or medication, or social normality. You should create the right context to deal with your
stress probably from self-care medications, doing exercises to affection, sleep, crying out loud.
Regardless, it is better to know which kind of social environment feels safe for you. 1 in 5 women
could have experiences of being sexual assaulted. The trauma can be from a short term or longterm event. Victims often freeze because their brains are sure that they can’t escape, nor they can
fight it off or because their bodies decide that it is the best method to survive or die painlessly.
Being sexual trauma survivor can impact your accelerator and brake. What are normally sexual
relevant stimuli will become a sign of threat for the survivors and because of the stress, sex might
be put off from the priorities for the survivors. Even after working through the trauma, the
survivors will often have tiny bits of trauma left which is okay and can be worked through 3
different methods, namely cognitive, thought-based approach, somatic approach, and mindfulnessbased approach. What is same from both myths and the biological aspect is that we love and have
attachment to become whole whether it is a parent-child, or romantic relationship. There are certain
behaviors that mark the attachment process for any relationships, and they are proximity seeking,
safe haven, emotional distress, and secure base. Because attachment is as important as survival to
us, we would do anything to not let go of the object of the attachment, even more so during distress
because it is our safe heaven even if it is the same as our object of distress. The dark side of sex
might be that we crave it more in unstable relationships than in stable relationships as a form of
distressed attachment to relief. However, eagerness and enjoyment are two different functions in
our brain. Regardless of the gender, the way we attach, securely or not, are dependent on the way
we are cared for as a child by our caregivers securely or not and is a very important factor for our
sexual or any wellbeing. Insecure attachment vary goes under two categories: avoidant or
abandonment. You can manage your attachment style by having communication, accepting,
naming, and taking responsibility for what your feel. You can’t decide to not get feel pain, you can
only trust the process and allowing it to heal and lessening the pain gradually. While connecting
with others can be a part of discharging your stress, that social context can also act in opposing
way of completing your stress cycle and even build the up more especially for women. Overall,
completing the stress cycle is the solution to not the stress interfere with your sex life.
Chapter 5:
Our culture reinforces all kinds of ideas about sex into women from our birth, and usually,
what our parents say and what the media says about what women should be like even contradicts
each other. Generally, the ideas are the moral message, the medical message, the media message,
body self-criticism, often about body image and body-shaming, and disgust, which are all proven
to affect your sexual or psychological well-being. All of these are not innate but learned,
nevertheless, they can be unlearnt and replaced with healthier thinking. When we learn to notice
our unchosen beliefs, we can decide whether we want to keep them or not. Some of us cling to
self-criticism because we believe that we are giving up if we stop doing it while the truth is, if we
let go of that idea, we might grow never like before. There is no evidence that shows that
correlation between weight and health. There are three methods to increase sex positivity for the
better of ourselves: self-compassion, cognitive dissonance, and media nutrition.
Chapter 6:
Arousal non-concordance, where the genital response doesn’t match the sexual arousal or
one’s mental state during sexual activity, can happen to everyone and is normal. When one feels
like they are aroused, and their genital response matches is 50 percent of the time for men and only
10 percent of the time for women. The pink pill doesn’t work on women like Viagra does on men
because women have a higher probability of arousal non-concordance and because genital
response only relies on a stimulus that is considered as ‘sexually relevant’. Both the genitals and
the brains of men are specific in what they respond to, but for women, their genitals are more
general in what they respond to while their brains are more context dependent. The difference
between how men and women respond is completely normal and is proof that we are humans. This
non-concordance level difference between men and women can be true for other emotional
functions too. Women have more overlap between their facial expression and their subjective
experience and men have more overlap in their skin conductance and their subjective experience.
The genital response is not equivalent to sexual arousal, desire, or enjoyment, it is simply just a
response to a ‘sexually relevant’ stimulus. Therefore, the notation that a woman’s genitalia can tell
what she likes than her mouth is very dangerously wrong. The assumption that arousal nonconcordance is a symptom of something is incorrect and the important thing is how much women’s
brakes are to the context and that the context is the reason for low desire and non-concordance.
Although a pink pill for women, which must be drunk over time intervals, has been developed and
has an estimated 10 percent of improving women’s satisfaction with sex, making changes to the
context for better could be a more effective solution. There are methods to deal with arousal nonconcordance so that one can know whether the other is having a good time: by paying attention to
breathing, muscle tension, and lastly and importantly, you can tell them with your words. You can
also improvise by using lube, and among many lubes, the silicon one is the most recommended
one. Nevertheless, it is important to understand that whether a woman is having a good time or not
is very dependent on the context they are in more than the men do.
Chapter 7:
There are different types of desires: spontaneous, responsive, or please, context dependent.
75 percent of men and 15 percent of women experience spontaneous desire and 5 percent of men
and 30 percent of woman spontaneous desire. Nothing is wrong with not having a spontaneous
desire in a healthy relationship, and it is okay to have a responsive desire. It turns out that
everyone’s desire is either responsive or context dependent. Desire occurs when the arousal is in
great context depending on the sensitivities of their accelerator and the brakes, and the context.
Sex is not a drive, not a survival mechanism pushed by an unpleasant internal state to be able to
baseline, but sex is an ‘incentive motivational state’ pulled by an attractive external stimulus which
us when you reach it. It is important to recognize that sex is not a drive, because if we acknowledge
it as one, we could be creating justifications for women being oppressed and enslaved for men to
be able to fulfill their sexual needs. Sometimes it feels like sexual desire is a drive because the
criterion velocity, which is expected effort-to-progress ratio, is not being satisfied and cause
frustration and despair. Because our culture has made us to be the least patient, we get easily
frustrated when we cannot obtain our goals. At times like that we should ask ourselves 3 questions:
are the goals right for us, are we putting proper amount of efforts, and are our expectations realistic.
Your context can influence your sexual desire more than your physiology like hormones can.
Monogamy is not directly bad for desire, however, the way we do monogamy can affect desire.
There are two general school of thoughts on strategies for how to sustain desire in long-term
monogamous relationship, namely Ester Perel school and John Gottman school. According to Ester
Perel, it simply states that for desire to occur, you need to create distance, while John Gottman
suggests that putting effort to deepen more intimacy. Although culture is a part of the context that
is partly responsible for why women have more responsive desire, it is faster to change your sex
life by changing the context rather than waiting for the culture around you to change. The issue
with having different level in desire in a relationship is not the level difference itself, but how the
couple deal with it. You can maximize your desire by increasing intensity of activation for one ring
(you can wither do it by doing that excites you or by doing meaningful challenges), or by
decreasing your brakes (by building concrete plan, or expect distractions, or connecting it with
your identity), or by desperately putting measures (such as limiting sex or taking turns for
initiating).
Chapter 8:
Orgasm is defined as a sudden, involuntary release of sexual tension and nonconcordance
can also happen during your orgasm and it is also dependent on context. Orgasm can occur
whether by stimulating clitoris, or vagina, or breasts, or from toes sucking. Like arousal, orgasm
is something that happens in the brain and not necessarily that happens to genitalia. While a third
of all women orgasm depending on the vagina penetration, others depending to a lot of other
factors, especially the clitoris stimulation. It is also not a drive necessary for survival or a product
of evolution, it is simply just a means of a pleasure. By turning off all the brakes and turning on
more of the accelerators, you can have better and more satisfactory orgasm.
Chapter 9:
The most important method to know to be able to obtain the best sex life is to accept
yourself as it is regardless of it is what you like or don’t like. Unlearning all the cultural standards
and rooting all of them out take time and effort but you can do it correcting by not judging the
emotions you take out and accept the and let them flow. By doing so, you let all you need to do
complete stress cycle and you will get a better tomorrow.
Part 2: Discussion Questions
1. Why did you specifically select this book from the list? What did you know about this
book before choosing it?
I chose this book because this book is the only one that goes into scientific insight while
others are more of philosophical. I knew nothing at first, I only chose this just by reading the book
introduction.
2. How knowledgeable were you on the specific topic of this book before reading?
I knew almost nothing before except for some common knowledge just by depending on
the surrounding and the internet and the entertainment which are of course a mixture of facts and
lies.
3. Give examples of when the author was objective and fair in covering the topic and when
the author was biased in the information presented? Explain.
I feel like all the information in this book were factual and not biased at all. While I know
nothing can be all free of bias, as far as until now, I haven’t found a part where an author is biased.
4. Give examples of the most positively and negatively impactful pieces of information you
learned from this book.
Most positive thing was that just because you are different does not mean that you are
broken. Again, this book has been nothing but helpful all the way that I can’t have anything
negative at all.
5. After reading this book, what questions do you still have on the topic?
I wonder if there are risks associated with anal sexes and why some pursue it more
specifically.
6. Did the information in your book change the way you think or feel about the topic?
Explain.
Yes. I also have incorrect ideas about sex that my culture planted into me. I’m very glad
that I gained so much knowledge from this book and it also has made me think how important the
knowledge of sex education is.
7. Has this book inspired you to pursue more information on the topic or a specific piece of
information? Explain.
In a way, yes. Reading this book make me interested how our brain and our sexual life are
correlated neurologically.
8. Are you glad you chose to read this book? Why or why not?
I am glad, it was very informative, and educating.
9. Would you recommend this book? Why or why not?
I would. This book is perfect for teenagers who has just reached puberty and has very little
knowledge of sexual world.
10. Should this book remain on the list of book report options for this class? Why or why
not?
It should. Especially because most students would probably be teenagers and it is also a
good fit to be used in a sexual biology class.