The Rise of Viagra: How the Little Blue Pill Changed Sex in America
http://www.100md.com
《新英格兰医药杂志》
Sex is by definition a social business — the basic design presumes two. But the marketers of Viagra (sildenafil) would have us believe that sex is an individualist, male pursuit. Meika Loe's core argument is that the unprecedented success of Viagra in America is not the result of an exciting scientific breakthrough bringing relief to the desperate or dying. Rather, commercial interests have created a socially desirable but medically limited product — ironically, by denying the fundamentally social nature of sex. By reducing sex to penile performance, then equating penile performance with masculine identity, a man's self-worth and social worth are reduced to the hardness and sustainability of his erections. To use Loe's example, Senator Bob Dole just had to pop a blue pill and all would turn out right at night — except that no one asked Elizabeth.
(Figure)
Making Viagra in Egypt, 2002.
By permission of AP/Wide World Photos. Photograph by Amr Nabil.
Loe's "institutional ethnography" sets this right. She weaves together excerpts from interviews with Viagra users and their partners and friends with commentaries and illustrations of how Viagra is sold in the popular press and discussed in academic journals and at conferences. The real success of her approach is the juxtaposition of glimpses into people's intimate lives with analyses of the inner workings of large corporate institutions. Viewed through the lens of her interviews, particularly those with elderly women, Loe's analysis of the Boston Forum and its role in the search for a female Viagra is especially compelling. She concludes that this time the marketers struggled. Perhaps women's sexuality is just too complicated, or perhaps the well-honed feminist critique of the medicalization of women's bodies is too strong. Whereas American men have bought the message wholesale, women have not.
Viagra is an example of the growing phenomenon that Loe calls the medicalizing of discontent. Ritalin (methylphenidate) and Prozac (fluoxetine), she suggests, are others. It involves reinventing complex sociopsychological problems as simple medical conditions. To create the market for Viagra, impotence is reinvented as erectile dysfunction and frigidity as female sexual dysfunction. In each case, the identified problem is shorn of its social, cultural, emotional, and psychological elements, leaving a core physiological dysfunction that is intrinsic to the individual and independent of society. This can be "cured" with a specific medical treatment. In short, the problem is designed to fit the treatment, not the reverse. In the case of Viagra, this "cure" actually exacerbates the wider problem, cynically ensuring the continuing growth of the condition, the treatment, and the profits from drug sales. Loe shows how in America, this medicalizing of discontent has been facilitated by the passage of legislation permitting direct-to-consumer drug advertising, online drug sales, and the entanglement (even merger) of health professionals and drug marketers. The central argument gains pace through the book, becoming increasingly compelling as the ominous implications of Viagra for American society unfold.
Yvonne Marshall, Ph.D.
University of Southampton
Southampton SO18 1LJ, United Kingdom
ymm@soton.ac.uk(Meika Loe. 289 pp., illus)
(Figure)
Making Viagra in Egypt, 2002.
By permission of AP/Wide World Photos. Photograph by Amr Nabil.
Loe's "institutional ethnography" sets this right. She weaves together excerpts from interviews with Viagra users and their partners and friends with commentaries and illustrations of how Viagra is sold in the popular press and discussed in academic journals and at conferences. The real success of her approach is the juxtaposition of glimpses into people's intimate lives with analyses of the inner workings of large corporate institutions. Viewed through the lens of her interviews, particularly those with elderly women, Loe's analysis of the Boston Forum and its role in the search for a female Viagra is especially compelling. She concludes that this time the marketers struggled. Perhaps women's sexuality is just too complicated, or perhaps the well-honed feminist critique of the medicalization of women's bodies is too strong. Whereas American men have bought the message wholesale, women have not.
Viagra is an example of the growing phenomenon that Loe calls the medicalizing of discontent. Ritalin (methylphenidate) and Prozac (fluoxetine), she suggests, are others. It involves reinventing complex sociopsychological problems as simple medical conditions. To create the market for Viagra, impotence is reinvented as erectile dysfunction and frigidity as female sexual dysfunction. In each case, the identified problem is shorn of its social, cultural, emotional, and psychological elements, leaving a core physiological dysfunction that is intrinsic to the individual and independent of society. This can be "cured" with a specific medical treatment. In short, the problem is designed to fit the treatment, not the reverse. In the case of Viagra, this "cure" actually exacerbates the wider problem, cynically ensuring the continuing growth of the condition, the treatment, and the profits from drug sales. Loe shows how in America, this medicalizing of discontent has been facilitated by the passage of legislation permitting direct-to-consumer drug advertising, online drug sales, and the entanglement (even merger) of health professionals and drug marketers. The central argument gains pace through the book, becoming increasingly compelling as the ominous implications of Viagra for American society unfold.
Yvonne Marshall, Ph.D.
University of Southampton
Southampton SO18 1LJ, United Kingdom
ymm@soton.ac.uk(Meika Loe. 289 pp., illus)