Most people walking into a doctor's office with a concern about their libido or sexual function expect a prescription. They want a pill. Or maybe a cream. But when Dr. Kelly Casperson released the You Are Not Broken book, she didn't just hand out medical advice. She handed out a permission slip to stop feeling defective. It's a weirdly radical idea in a world that sells "pink Viagra" and "T-boosters" like candy.
You’re probably here because you’ve felt that nagging sense that your body isn't doing what the movies said it should. Maybe you’re bored. Maybe it’s painful. Or maybe you just feel… nothing.
The reality? Most of what we "know" about female desire is based on a male model that doesn’t even apply to half the population. Dr. Casperson, a urologist who spent years seeing patients cry in her exam room, realized the problem wasn't their hormones. It was their education.
The Big Lie of Spontaneous Desire
We’ve been sold a lie. We think desire is a lightning bolt. It strikes, you’re ready, and off you go. But for a huge chunk of women—roughly 50% or more—desire is responsive.
This is a core pillar of the You Are Not Broken book. Responsive desire means you don’t just wake up wanting sex. You start, you get comfortable, the physical sensations begin, and then the brain says, "Oh, hey, this is actually pretty great." If you’re waiting for the lightning bolt to hit before you even start, you might be waiting for a storm that never comes. That doesn’t mean you’re broken. It just means your engine needs a little more warming up than a Ferrari.
Think about it like going to the gym. You rarely want to go when you’re sitting on the couch in your pajamas. But once you’re there, ten minutes into the workout? You feel good. You’re glad you did it. Sexual desire often works the exact same way.
Why Your Doctor Might Be Wrong
Honestly, most physicians get about ten minutes of sexual health training in med school. Seriously. Ten minutes. So, when a patient says, "I don't want sex anymore," the doctor looks at a blood panel, sees "normal" testosterone, and shrugs. Or worse, they tell you it’s "just part of aging" or "stress."
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Dr. Casperson challenges this dismissive culture. She points out that we treat erectile dysfunction like a medical emergency but treat female low libido like a personality flaw. It’s a double standard that has left millions of women feeling isolated. In the book, she breaks down the actual physiology—the parts, the nerves, the blood flow—without the clinical coldness that usually makes medical texts so boring.
Navigating the Menopause Transition
We have to talk about hormones. We just do. Perimenopause and menopause are the "wild west" of women's health right now. There is so much misinformation floating around from the early 2000s—specifically the fallout from the Women's Health Initiative (WHI) study—that both doctors and patients are terrified of Estrogen.
But here is the truth: your brain, your heart, and your bones have estrogen receptors. When those levels drop, things change. It’s not just hot flashes. It’s vaginal atrophy (which is a terrible name, by the way—let’s call it genitourinary syndrome of menopause or GSM).
The You Are Not Broken book dives deep into why local estrogen is a game-changer. It’s not systemic. It doesn’t go through your whole body like a pill. It stays right where you put it to keep the tissues healthy and stretchy. If sex hurts, you aren’t going to want to do it. Your brain is smart; it avoids pain. Fix the pain, and you might find your "libido" wasn't actually missing—it was just hiding from a painful experience.
The Mental Load and the Bedroom
Let’s be real. You can’t feel sexy when you’re thinking about the pile of laundry, the school project due tomorrow, and the fact that your partner hasn't unloaded the dishwasher in three days.
Dr. Casperson talks about the "brakes" and "accelerators." This concept, popularized by researchers like Emily Nagoski (author of Come As You Are), is central to understanding sexual function. Most of us have our feet slammed on the brakes. Stress, body image issues, and resentment are heavy-duty brake pads. You can push the accelerator (candles, lingerie, wine) all you want, but if the brakes are on, the car isn't moving.
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You’ve got to address the brakes first. Sometimes that means a hard conversation about domestic labor. Sometimes it means therapy. Sometimes it just means turning off the news.
What Most People Get Wrong About This Book
People think this is a "how-to" manual for better orgasms. It’s not. Well, not just that.
It’s really a book about mindset. It’s about dismantling the "sexual scripts" we were given by religion, society, and bad rom-coms.
- Myth: Sex is for him, and endurance is for her.
- Fact: Pleasure is a birthright, not a reward for good behavior.
- Myth: If it’s not spontaneous, it’s not "real."
- Fact: Scheduled sex is actually a sign of a healthy, prioritizing relationship.
Casperson’s tone is like a blunt, slightly sweary best friend who also happens to be a surgeon. She doesn't mince words. She tells you that your clitoris is much bigger than you think (it’s mostly internal, like an iceberg). She tells you that you don't need to "fix" yourself because you weren't "broken" to begin with. You were just uninformed.
Real-World Application: Moving Past the Shame
The shame is the hardest part to kick. We carry decades of it. Shame about our bodies, shame about what we like, and shame about what we don't like.
I’ve seen people read the You Are Not Broken book and suddenly realize they’ve been faking it for twenty years. That’s a heavy realization. But it’s also the first day of the rest of their lives. Once you realize that your lack of "drive" is actually just a normal response to your current environment, you can start changing the environment instead of hating yourself.
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Actionable Steps to Take Today
You don't need to finish the whole book to start feeling better. Here is how to actually use this information:
- Check your meds. Are you on SSRIs or birth control? Both are notorious for killing libido. Talk to your doctor about alternatives, but don't just stop taking them.
- Get a mirror. Seriously. Many women have never actually looked at their own anatomy. You can't ask for what you want if you don't know the map.
- Redefine "Sex." If you think sex is only "intercourse," you’re missing out on about 90% of the fun. Broaden the definition to include any shared pleasure. This takes the pressure off "performing."
- Invest in high-quality lube. Not the stuff that smells like a cupcake from the drugstore. Get silicone-based or high-end water-based options. Friction is the enemy of fun.
- Audit your thoughts. Next time you feel "broken," ask yourself: Whose voice is that? Is it yours? Or is it your mother’s, your church’s, or a magazine’s?
The medicalization of female sexuality has done us a massive disservice by making us think we are a collection of symptoms to be managed. Dr. Kelly Casperson's work is a vital correction to that narrative. It shifts the focus from "what is wrong with you" to "what is possible for you."
If you're tired of feeling like a "low-libido" statistic, this perspective is the shift you've been looking for. It’s not about becoming a different person; it’s about finally understanding the person you already are.
Practical Next Steps for Your Journey
If this resonated with you, your next move shouldn't just be buying another book and letting it sit on the nightstand. Start by tracking your "brakes." For one week, jot down every time you feel a "turn-off." Is it a specific chore? A comment from a partner? A feeling of bloat? Identifying the brakes is 70% of the battle.
Once you see the patterns, choose one "brake" to discuss with your partner or a therapist. Don't try to fix everything at once. Just one. This isn't a race to some finish line of sexual perfection. It's about reclaiming your own body from the stories that told you it was a problem to be solved. You are the expert on your own pleasure, even if you haven't been acting like it lately. Now is a pretty good time to start.