Taking a Biological Turn: The Push for a "Female Viagra" and the Medicalization of Women's Sexual Problems

Article excerpt

Sex is a topic of perennial interest for feminists, with ever-changing opportunities for scholarship and activism. Somewhat unexpectedly, the turn of the 21st century finds a major resurgence of biomedical thinking about women's sexuality in popular media and professional research. Since the U.S. Food and Drug Administration (FDA), in 1998, approved Viagra, an oral medication manufactured by Pfizer, Incorporated, that treats men's erection problems, print and electronic media of all sorts have focused on women's "comparable" problems with orgasms or arousal. "Where is the Viagra for women?" is asked in women's magazines and newspapers (e.g., Hitt, 2000). Extensive public discussion of women's sexual experiences could be noteworthy and have many benefits, but it seems that the focus is almost entirely on seeing women's sexual problems as treatable, largely biomedical conditions.

Scholars of women's studies have long observed that sexuality, especially but not exclusively women's sexuality, is as much a matter of politics as biology (Snitow, Stansell, & Thompson, 1983; Vance, 1984). In all parts of the world, sexual expectations, patterns of sexual behavior, standards of sexual attractiveness, and other normative matters are shaped by religion, socioeconomic context, and gender regime. Cultural and religious traditions, historically dominated by gender inequality, have molded women's sexuality on both individual and institutional levels (e.g., Ehrenreich, Hess, & Jacobs, 1986; Fine, 1988; Rich, 1980; Tiefer, 1995; Tolman & Higgins, 1996; Ussher & Baker, 1993).

As second-wave feminist scholarship analyzed the multiple determinants of women's sexuality, recommendations emerged for reform and reconceptualization. These included foregrounding sexual diversity, promoting individual empowerment through education and masturbation experience, and illuminating the role and impact of sexual abuse and violence (see bibliography in Tiefer, 1991). Women's health texts embraced these new sexual discourses. Beginning in 1971, for example, the Boston Women's Health Book Collective devoted substantial parts of each edition of its best-selling text, Our Bodies, Ourselves, to women's sexuality; raising awareness of the destructive impact of violence and inequality on sexual life; portraying positive lesbian experiences; and calling attention to menstrual, reproductive, and menopausal health as part of women's sexuality. A small amount of feminist sex therapy literature in the 1970s and 1980s stressed issues such as the role of the clitoris in sexual pleasure, the need for women to be sexually assertive, and the importance of positive body image (Cole & Rothblum, 1988; Daniluk, 1998; Ellison, 2000; Hall, 1996; McCormick, 1994).

However, in recent years, primarily since the FDA's approval of Viagra, a phase of medicalizing sexuality and sexual problems has gathered speed, with important implications for individuals' and couples' sexual lives. The process of medicalizing men's sexuality occurred over a 15-year period of research and public relations, but in the case of women, such medicalization appears to be occurring more rapidly (Tiefer, 1995, 2000b, 2001b, c).

The social and cultural contexts for this new phase of medicalization include shifts in medical research funding, demographic changes, new profitability of lifestyle drugs, and dramatic deregulation of the FDA (Tiefer, 2000b). Direct-to-consumer (DTC) advertising of prescription-only drugs, a phenomenon prohibited in most of the industrialized world, was newly permitted by the FDA in 1997 and plays an important role in the current trends (Washburn, 2001). Market analysts now predict "a marketing war . . . that could make impotence drugs the nation's most heavily advertised category of pharmaceuticals" (Gillis, 2001, p. 1). A wide variety of male-directed by-prescription pills, injections, creams, patches, inhalants, and mechanical devices are currently in development or undergoing clinical trials, and similar drugs are under development and being tested for treating the newly identified "female sexual dysfunction" (FSD). …