Why Medicalization? Introduction to the Special Issue on the Medicalization of Sex
Cacchioni, Thea, Tiefer, Leonore, The Journal of Sex Research
Over the past 150 years, sexual life and conduct has been exposed to increasing medical surveillance and subjected to expanding diagnostic, psychotherapeutic, psychiatric, surgical, and pharmaceutical interventions. A growing number of "health professions" are involved with sexual subjects, and "sexual health" is a common focus of media and institutional interest. The medicalization of sex is now a complex domain of personal and professional activity at the intersection of technology, culture, professional training, medicine, gender, sexuality, global capitalism, politics, and rapid social change.
This special issue of the Journal of Sex Research (JSR) features a collection of articles that critically examine historical and contemporary developments associated with diverse dimensions of sexual medical diagnosis, treatment, and surveillance, analyzing their advantages and disadvantages for social life, subjectivity, embodiment, and experience. Although both special issue co-editors have previously written about the limits medicalization imposes on sexual diversity, the development of new forms of surveillance and control, and the commercialized pursuit of profits over pleasures, there are many different ways to approach, analyze, and dissect this topic. This issue includes topics such as the medicalization and de-medicalization of sexual therapies, the pharmaceuticalization of birth control, the healthicization of "sexy" aging, the medicalization of women's sexual pain, the shift from HIV behavioral prevention to drug and surgical treatment strategies, the marketing of the human papillomavirus (HPV) vaccine, the story of the gay gene, and the sexualization of illness in popular culture.
The genesis of this special issue was an international and interdisciplinary conference on "The Medicalization of Sex" held at Simon Fraser University, Vancouver, British Columbia, in April 2011 (Cacchioni & Tiefer, 2011). The conference brought together approximately 200 both young and seasoned scholars presenting a variety of empirical and theoretical papers, and the discussions were very lively. Despite broad outreach, however, a paucity of attendance by sexologists was noted, and the idea emerged to reach out to that audience through a mainstream sexological publication. JSR was chosen as likely to reach the most interested segment of the sexological community.
The Medicalization Critique
Medicalization is an evolving conceptual framework that charts the increasing power of medical concepts, institutions, and individual figures of authority. The term medicalization has been defined in a number of ways, but it typically refers to "a process whereby non-medical problems become defined and treated as medical problems, usually in terms of illnesses or disorders" (Conrad, 1992, p. 210), or the process wherein "more and more areas of everyday life have come under medical dominion, influence, and supervision" (Zola, 1983, p. 295). Historians trace the origins of contemporary medicalization to the 19th century when the Enlightenment faith in objective, rational science reached a wide audience and physicians professionalized to distinguish themselves from midwives, "quacks," and other healers (Ehrenreich & English, 1978).
In the 1970s, feminist health research amplified sociological accounts of medicalization (Morgen, 2002). Feminist works challenged medicine as a male-dominated domain that drew on androcentric perspectives on illness and disease, maintaining women's disadvantaged position. They highlighted the exclusion of women in the early days of the professionalization of medicine, as well as ongoing negative and dismissive attitudes toward women's bodies in medical discourse and education. Medicine intervenes in women's life processes much more than in men's--for example, in the cases of menstruation (Parlee, 1973), childbearing (Martin, 1987; Oakley, 1984), and menopause (Bell, 1987). …