Rosemary Basson: why desire can show up along the way, and why that’s normal

Who is Rosemary Basson?

Rosemary Basson was a physician trained at the University of London, where she graduated in 1971, and she spent most of her career in Canada. She joined the psychiatry department at the University of British Columbia (UBC) in Vancouver in 1988 and ran its sexual medicine program for nearly twenty years. There she saw women, and couples, referred for difficulties with desire, arousal, or pain.

It was this clinical work that led her to question the prevailing models. She published more than a hundred articles, including reviews in The Lancet and the New England Journal of Medicine, and served as vice-chair at the 2003 and 2009 international consultations on sexual dysfunction, which shaped how doctors define these problems. She retired at the end of 2020 with the title of clinical professor emerita, and died in April 2026, at 78.

Why she matters for your couple: Basson is the person who gave a name, and clinical legitimacy, to something many people lived with in silence. Not feeling spontaneous desire, yet having a satisfying intimate life once you’re engaged, is not an anomaly. It’s a way of working.

The central idea

The classic model, inherited from Masters and Johnson (1966) and later extended by Helen Singer Kaplan (1979), describes a straight line: desire comes first, arousal follows, then the rest. It describes the early days of a relationship well, and what comes after often poorly. In 2000, and again in 2001, Basson proposed something else: a circle. You can enter it from a neutral state, with no prior wish, for reasons of intimacy: feeling close, pleasing your partner, sharing a moment. If the context is good and the touch is pleasant, arousal arrives, and desire switches on along the way. The satisfaction that follows, emotional as much as physical, feeds the motivation to do it again.

Basson doesn’t deny spontaneous desire: it exists, especially at the start of relationships and, for some people, all their lives. What she says is that in established relationships, particularly among the women she saw, responsive desire is often the main path, and that it is just as legitimate as the other.

The key concepts

Responsive desire

It’s the appetite that comes while eating. The wish isn’t the starting point, it’s a response to what is happening: closeness, tenderness, relaxation, a safe context. Basson describes the drift, over the years, from spontaneous desire toward responsive desire as a way of working, not a breakdown. And believing the opposite creates exactly what she fears: if you watch for your wish, you start monitoring it, and the monitoring turns into pressure.

Chosen willingness

The entry point to the circle isn’t desire, it’s a deliberate openness: agreeing to step into a pleasant moment without knowing where it will lead, and without any obligation that it lead anywhere. The word matters: it is a willingness you choose, never an obligation. “No” and “not now” are complete answers, and Basson insists on the motivation of the person themselves, not on that of their partner.

A circle that can break at any step

The clinical value of the model is that it shows where things get stuck. The circle can break at the entry (no reason to go there: an unresolved conflict, resentment, exhaustion), during (a setting that doesn’t allow you to relax, unsuitable touch, pain), or at the exit (a disappointing outcome that lowers the motivation for next time). When pain is part of the circle, or when a treatment, an illness, or a hormonal upheaval has come into play, the first person to call is a doctor, not a couple’s exercise.

A model for established relationships, men included

Basson first wrote for women, based on her practice. But as early as 2001, in “Human sex-response cycles,” she presented a model that holds for both sexes, noting that many men in long relationships also recognize a desire that arrives along the way. Later surveys confirmed that neither “women” nor “men” fit a single pattern.

What the research says

Basson’s model is first of all a clinical model, built from consultations. It was then tested with questionnaires that ask people which pattern they recognize themselves in. Here is what that work shows.

• Basson (2001) used her circle with 47 women referred for low desire: all of them recognized themselves in it and could place breaks at several points in the cycle. Useful in a clinic, but it’s a small clinical sample with no comparison group.
• Sand and Fisher (2007), with a sample of nurses, found that roughly as many women recognize themselves in each of the three models (Masters and Johnson, Kaplan, Basson). Those with sexual difficulties more often recognize themselves in Basson’s.
• Giles and McCabe (2009) agree: the linear model describes women without difficulties better, while the circular model describes women with difficulties better.
• Giraldi, Kristensen, and Sand (2015), in a Danish survey of men and women ages 20 to 65, conclude that no single model describes everyone, and that most people who are satisfied with their intimate life recognize themselves in the linear models.
• In 2013, the DSM-5 merged desire disorder and arousal disorder in women into a single diagnosis, and responsive desire appears among its criteria. Brotto and Graham (2021) point out, however, that no single model served as the framework for that revision.

The honest reading: Basson’s circle is very useful for understanding a difficulty, and less so for describing “the” female or male sexuality in general. Its real contribution is to have widened the range of what counts as normal.

Limits and criticisms

The first criticism comes from the research itself: the model describes people with difficulties better than everyone else. Some clinicians concluded that it risks normalizing an absence of desire that may be a signal worth listening to: a relationship going badly, health faltering, a treatment weighing on you. A public debate took place in 2021 in the Journal of Sex & Marital Therapy, between those who consider the model outdated and those who point out that it remains validated, alongside others.

The second limit is methodological. The validations rest on self-report questionnaires that ask people to recognize themselves in a drawn pattern, with samples that are often Western and mostly heterosexual. Men were little studied until the 2010s, and the original circle fit them poorly without adaptation.

The third limit is a risk in how it gets used, and it’s the most important one for a couple. “Desire comes along the way” can turn into “just get in anyway, you’ll see.” That is a serious misreading: Basson talks about chosen willingness and personal motivation, never about pushing. If the model is used to pressure someone, it is no longer good for anything, and it damages the safety that responsive desire needs.

How MyLoveLab uses it

In the Intimacy and desire dimension, level 2 (“How your desire works”) rests on her work: the myth of the spark, the two paths of desire, the circle rather than the straight line, and two profiles under the same roof. Level 9 (“Crossing the deserts”) takes up the idea that a season without desire is not a verdict. The test never measures a frequency: it looks at whether you can talk about desire without embarrassment or pressure, and at what happens when one of you isn’t in the mood. And the program keeps Basson’s rule in its strictest form: nothing gets forced, and any pain or lasting drop in desire is a matter for a doctor.

Further reading

• The female sexual response: A different model · Article, 2000The founding article, in the Journal of Sex & Marital Therapy: the circle, responsive desire, chosen willingness.
• Human sex-response cycles · Article, 2001The version of the model for both sexes, with the idea that intimacy can be the reason to step in.
• Using a different model for female sexual response to address women’s problematic low sexual desire · Article, 2001The model applied to 47 women in consultation: where the circle breaks and how to work on it.
• Women’s sexual dysfunction: revised and expanded definitions · Article, 2005In the CMAJ: how her model led to a redefinition of desire disorders in women.
• Sexual desire and arousal disorders in women · Article, 2006A clinical review in the New England Journal of Medicine, built around a case: the family doctor version of her approach.

Frequently asked questions

References

1. Basson, R. (2000). The female sexual response: A different model. Journal of Sex & Marital Therapy, 26(1), 51-65.
2. Basson, R. (2001). Human sex-response cycles. Journal of Sex & Marital Therapy, 27(1), 33-43.
3. Basson, R. (2001). Using a different model for female sexual response to address women’s problematic low sexual desire. Journal of Sex & Marital Therapy, 27(5), 395-403.
4. Basson, R. (2006). Sexual desire and arousal disorders in women. New England Journal of Medicine, 354(14), 1497-1506.
5. Sand, M. & Fisher, W. A. (2007). Women’s endorsement of models of female sexual response: The nurses’ sexuality study. Journal of Sexual Medicine, 4(3), 708-719.
6. Giles, K. R. & McCabe, M. P. (2009). Conceptualizing women’s sexual function: Linear vs. circular models of sexual response. Journal of Sexual Medicine, 6(10), 2761-2771.
7. Giraldi, A., Kristensen, E. & Sand, M. (2015). Endorsement of models describing sexual response of men and women with a sexual partner: An online survey in a population sample of Danish adults ages 20-65 years. Journal of Sexual Medicine, 12(1), 116-128.
8. Brotto, L. A. & Graham, C. A. (2022). Is Basson’s model of sexual response relevant? Yes, and so are other validated models of sexual response: A commentary on Balon (2021). Journal of Sex & Marital Therapy, 48(1), 13-16.

See the full bibliography