Ian Kerner opens She Comes First by directly addressing clinical research documenting a significant and persistent orgasm gap between men and women in heterosexual sexual encounters — establishing this gap as the book's central problem to address, rather than treating it as an unavoidable or minor issue.

The research foundation Kerner presents:

• Multiple clinical studies consistently document that women in heterosexual encounters orgasm considerably less reliably than their male partners, a gap not similarly observed in women's solo sexual activity or same-sex encounters
• This gap suggests the disparity stems significantly from technique and understanding gaps rather than inherent physiological limitation, since women demonstrate reliable orgasmic capacity in other contexts
• Kerner positions this research finding as evidence of a broader, correctable knowledge and technique gap rather than an unchangeable biological given

This opening framing sets up the book's core purpose: providing the specific anatomical and technique education Kerner argues is frequently missing from typical sex education, directly targeting this documented and largely correctable disparity.