Abstract
The medicalization of the human condition is well understood within the sociological literature, and women’s bodies have been particularly ripe targets for therapeutic treatment. Indeed, the medicalization of childbirth, menstruation, and even hysteria, are common examples of how normal functions have developed into medical events and, in recent years, the pharmaceutical industry has played an exceedingly larger role in this process.
Enter the relatively new terrain of Female Sexual Dysfunction (FSD) as a problem, and “pink” Viagra as a therapy. Cacchioni and others have studied big pharma’s attempt to develop and market a drug to address sexual problems—this time for women—in hopes of creating a new blockbuster. This literature has examined the tactics and rhetoric of creating the new disorder. What has not been studied in depth, and what this book addresses, is how women view and manage their sexual problems independent of the pharmaceutical industry. Interviewing a sample of mostly white, mostly middle class Canadian women—a population targeted for the new pink pill—and a handful of practitioners specializing in treating women with sexual difficulties, this book explores the ways in which both groups perceive women’s sexual difficulties and their strategies for addressing them.
Her findings underscore the contradictions between the ways in which many women understand their sexuality, and their ability to act on their perceptions. A number in her sample believe that their sexual activity and feelings are evaluated—read judged—in narrow terms that they do not necessarily embrace; nevertheless, they strive to master the normative sexual script that views success through the lens of desire, arousal, and heterosexual climax.
Cacchioni frames the process of attempting to achieve “normalcy” in the concept of “the labor of love,” which she sees as work that women do in monitoring and managing the sexual part of their relationships. Ultimately, much of this energy is aimed at changing a women’s sexual response to conform to expected practice. While pointing out that this is the goal of most types of sexual therapies, be them part of the formal health care system or developed by grassroots groups, she reminds us that “sex work” does not have to be paid; rather it also occurs in the realm of the personal and it is women who are charged with this labor.
A corresponding point developed nicely in the book is the heteronormativity of sexual requirements. She notes that this is at the heart of big pharma’s medicalization of sex, which defines traditional male–female relations as the gold standard. She also reminds us that this predates the development of FSD; the norm of heterosexuality is the foundation for the institutions that organize sexuality and it is also what marks queer as other. Achieving this norm can also be very hard (sex) work. Moreover, she finds that heteronormativity is not confined to relationships between men and women, but the expectations of sexuality for LGBTQ subjects are also organized around traditional assumptions about sexual desire and fulfillment.
These major points are tied together by a series of arguments and ideas that frame the labor of love and the pressure to conform in the larger context of gender requirements, particularly in a neoliberal society. She points to the disciplinary beauty and body practices expected of straight women, for example, to demonstrate the pressures for gender conformity and heterosexuality that are so very common. At the same time, however, she points to transgression; to those women who have opted out of the (hetero)sexuality imperative, although she notes that there are consequences for this path. But perhaps the hope for a broader definition of sexual agency that she delivers is the understanding of many of her sample that, in the words of the sociologist, hegemonic sexuality is socially constructed. That is a beginning, at least, and it is where she sees an opening for challenging hegemonic practices. We can only hope that she is correct.
And, by the way, since the book’s publication, “pink” Viagra has been approved for sale in the United States and this has occurred in the name of both feminism and women’s empowerment. Now, what is left to be seen is whether the drug industry and its helpers will be able to create the market that they envision.