Ss2_2012.indd

Science & Technology Studies 2/2012
Enrolling Men, their Doctors, and Partners:
Individual and Collective Responses to Erectile
Dysfunction
Ericka Johnson and Cecilia Åsberg Using the Pfi zer funded Swedish informational site about erectile dysfunction (ED), www.potenslinjen.se, we examine how potential users, their partners, and medical doctors are enrolled in the process of creating the Swedish Viagra user. Contextualized against other critical work on Viagra, our analysis shows how the commercial discourse embeds the ED patient into a network of actors. Three separate actors are co-constituted and enrolled by this erectile dysfunction information discourse, comprising Viagra marketing material in a country which forbids direct to consumer advertising of prescription medication. Doctors are enrolled to produce the cultural authority of expert medical knowledge, whereas partners are given responsibility for the emotional aspects of a man’s sexuality and encouraged to direct the man toward the relationship-saving Viagra. Throughout, though, the man is the patient responsible for taking Viagra to fi x his dysfunctioning penis. We problematize this individualised solution by contrasting it with the social aspects of the discourse and examining other qualitative and historical studies of impotence. We then ask if the enrolment presented by the Swedish Viagra website could be (mis)used to expand the circle of actors involved in ED, redefi ning the ‘problem’ and opening for a wider variety of treatments.
Keywords: Viagra, enrolment, Erectile Dysfunction Introduction
the Swedish Viagra man. Our analysis builds upon existing literature about the promotion is article examines how men, their doctors, of Viagra which addresses the construction and partners are enrolled by the Pfi zer of erectile dysfunction (ED) and masculinity sponsored web site for potential Swedish in other national contexts, and we therefore e Swedish language make mention of alternative images and site www.potenslinjen.se1 (in English, readings in other contexts throughout our ‘potency hot-line’) is framed as a source of analysis. Like previous critical studies of information for lay people concerned about Viagra (Fishman & Mamo, 2001; Marshall, erectile dysfunction.2 We have examined 2006; Tiefer, 2006; Vares & Braun, 2006), how the site’s text and imagery address we are examining the construction of an diff erent audiences in the construction of ideal user of Viagra, but we also discuss the Science & Technology Studies, Vol. 25 (2012) No. 2, 46-60 Ericka Johnson and Cecilia Åsberg
way the enrolment of doctors and partners pharmaceutical solutions to ED, and lists serves to position ED in the man and defi ne the telephone number to a sexual medicine its treatment as a solitary act of taking a pill centre at a large hospital in Stockholm that while simultaneously involving the other receives undirected funds from Pfi zer. Yet, actors to help the medicine function. Our despite the DTC ban, Viagra fi gures largely contribution delineates the specifi c roles the on the website and has fi gured largely in various subjects are granted, in particular by the ‘collective psyche’ in Sweden both as a looking at the invisible work the “passive” subject of newspaper articles (some reading female partner is tasked with as she is told as if they have been taken directly from to actively guide and support her partner in the Viagra trajectory. To do this, we use debate, thanks in large part to the drawn out discussions and court cases about whether enrolment, which articulates the roles given or not Viagra would be subsidized by the to various actants as they are enrolled into Swedish health care system (Johnson, 2008; a network that discursively constructs ED as Sjögren & Johnson, 2012). Likewise, Viagra is available in Sweden, but falls outside Our research can be read against of the state subsidized pharmaceutical the framework of regulations regarding scheme, which means patients must pay direct to consumer (DTC) marketing of for the drug themselves, creating challenges pharmaceuticals. Th e legality of DTC for marketing the drug. We argue that this advertising of prescription pharmaceuticals challenge has been met in part by enrolling the man, his doctors and partner in the ways much of the critical research about Viagra and its role in the media climate (see Elliot, 2003; Loe, 2004b; Mamo & Fishman, 2001; this enrolment says about social, rather Moynihan & Cassels, 2005, Potts & Tiefer, 2006). Our study, looking at Viagra in the inspiration from early medical sociology Swedish context which bans DTC advertising for prescription drugs, confi rms the results health (Eaton & Weil, 1955) and recent of much of this work but contributes an qualitative studies of men’s responses to ED important insight to the strength and (Oliff e, 2005; 2006). By exploring alternative fl exibility of Viagra marketing in a globalized narratives of illness, we suggest that an ere is a good alternative reading of erectile dysfunction deal of harmonization between the Swedish site and other Viagra sites, yet also local Below, we delineate the interdisciplinary adaptation (see Åsberg & Johnson, 2009). conjunctions that shape our approach and And as we show here, the local adaptation provide an overview of previous critical of Viagra marketing that is not considered Viagra studies3 before detailing the enrolled DTC advertising relies on the construction subjects we have identifi ed in our material. of subjectivities for the man, his doctor, and his partner. Th Background
informational” about erectile dysfunction (though it is obviously advertising Science and Technology Studies use the Viagra) and therefore has information term enrolment within ANT to denote how explaining what sex therapy can off er men suff ering from impotence in addition to upon and woven into complicated networks Science & Technology Studies 2/2012
ough it has been discourse, erectile dysfunction has been rightly criticised for implying a heroic, articulated as a problem of arousal since entrepreneurial actor in the process of the 1970s, where ED is defi ned as a problem enrolment (Star, 1991), the concept is useful of attaining and maintaining an erection for our study because it articulates the sense that there are actors with specifi c interests Sexual response models within sex therapy (here, the pharmaceutical company have taken foremost physiology, but also Pfi zer and its marketing experts) who use specifi c methods (those described in this defi ning healthy or non-healthy sex, which article are discursive strategies) to involve coloured the term impotence pejoratively, heterogeneous constellations of human and later replaced it with the term erectile and non-human actants in the construction dysfunction. However, it was not generally of a Swedish Viagra man. We will be using a specifi c web of actants – potential users, by Pfi zer (see Marshall & Katz, 2002; Loe, medical doctors, and their partners – are 2004b; Bordo, 1998; see Johnson, 2008 for woven together by a discrete discourse to construct an identity and agenda for the narrows the defi nition of what impotence is Swedish Viagra man. from a condition of the psyche, the emotions, prescription since its approval in 1998, but, complaint (Marshall & Katz, 2002; Tiefer, like the similar drugs Cialis and Levitra, 2006; McLaren, 2007; Johnson, 2008). Pfi zer it is not covered by the national subsidy marketing has also introduced the concept programme for medicines. Th able to get a prescription for the drug, but they must pay for it out of their own pockets, & Mamo, 2001: 181; Marshall, 2002: 139) which is unusual for the Swedish consumer. playing on ‘erectile insecurity’ (Tiefer, 2006: company Pfi zer, Viagra works physically a phenomenon around which multiple in some men and in some situations by diff erent vested interests have gathered to blocking the return of blood fl owing out of sell it and construct the disease of ED, as Loe articulately shows in her examination and blood fl ow to the penis increases, of the US case (Loe, 2004b). Viagra will help keep it there and produce has reinforced the defi nition of sex as Discursively, however, Viagra does penetration, and masculinity as the ability to many other things. Viagra has, for example, achieve penetration, relying on a reworked changed our language about impotence (in e marketing previously had reserved for the female mind: around Viagra has helped to introduce the “anatomy is destiny” determinism of the the term ED (erectile dysfunction) to the naturalized body in the construction of the general public, replacing the more negative term ‘impotence’ (Bordo, 1998: 90; Potts, of male embodiment boils down to the 2004: 23). Th e term erectile dysfunction sexual (and not necessarily reproductive) performativity4 of the visible sexual organ. 1950s (McLaren, 2007: 221). In psychiatric Ericka Johnson and Cecilia Åsberg
Baglia’s (2005) study of Pfi zer promotional Materials and Methods
material in the USA has shown, sexual performance is defi ned by a narrow sexual function model starting with arousal and progressing through erection, penetration commercially produced informational and ejaculation. As long as a man can material about Viagra available in Sweden: perform this penetrative sex, his masculinity free pamphlets and booklets which can be ordered by men or their partners from Pfi zer; (or at least proves) masculinity reinforces literature for doctors and other medical the importance of penetration for both professionals; press coverage in local the sex act itself and the concept of sex-life expectancy. As sociologist Barbara Marshall notes, this concept of sex-life expectancy, about men’s health. We have, for this paper, with its calls to vigilant self-monitoring focused on the website www.potenslinjen.
of healthy practices and appropriate se for a number of reasons: it is produced sexual behaviour, relies on the disciplined by Pfi zer for a Swedish audience in the individual taking responsibility for Swedish language; it is easily accessible to managing the risks of lost masculinity (i.e. lost ability to penetrate) even before ‘old does not require interfacing with a medical age’ (Marshall, 2006: 335). Viagra connects practitioner; it focuses on impotence and this individual responsibility to the medical erectile dysfunction rather than men’s and pharmaceutical networks within which health in general; it can be accessed by and Viagra is active, which also reinforces the addresses individuals not facing impotence scientism of sex and the naturalized body, attaching both to systems of expertise while Additionally, the web site is a good example simultaneously assigning responsibility for of how Pfi zer tweaks its material to localize a global message for its global product.
In analyzing the text and images on this three step paradigm of arousal, penetration, site, we have been inspired by the critical and ejaculation, and then demands Viagra studies of Viagra mentioned above as well as as a solution to (age, stress or illness related) Foucault’s idea of an economy of discourses declining sexual performance (Plante, 2006: 380). According to this discourse, a person (or couple) can maintain a successful sex life example of an economy of discourses in an as long penetration is possible, i.e. with the attempt to articulate “the necessities of their help of Viagra, an idea which ignores, and operation, the tactics they employ [and] the tends to silence, suggestions of alternative eff ects of power which underlie them and sexual practices and a sex life that is not which they transmit” (Foucault, 1987 [1976]: dependent on penetration (Tiefer, 2006). In 68f ). We also draw inspiration from studies this narrative, emotions all but disappear. And where they do play a role, responsibility for them is given to the partner, as we will produced since the late 1970s on powerful ideological processes (cf. Merchant, 1980; Haraway, 1989; Butler, 1990; Martin, 1991; Fox Keller, 1992; McClintock, 1995; Bryld & Lykke, 2000; Franklin, Lury & Stacey, Science & Technology Studies 2/2012
ese researchers Highlighted on the welcoming fi rst page have used feminist critiques to investigate is also the accessibility of an easy and how science as a discourse and notions of comforting solution to erectile problems, in the natural are used to support dominant of disease associated with erectile diffi Enrolling Participants in
the Viagra Discourse
disease, which will be discussed below), one of the primary tools used to enrol the men is Examining the Swedish website it becomes an interactive quiz in which they are asked to apparent that three diff erent groups of fi rst rate their sexual health (by answering a human participants are enrolled by Pfi zer to series of fi ve questions), then encouraged to assist in constructing a subject position for talk to their doctor. Unlike much of the other men as potential consumers of Viagra: the text on this site, the quiz is a short version of men themselves; medical doctors; and the the International Index of Erectile Function (IIEF), and is directly translated from the the Viagra pill is also enrolled as a non- US Viagra site6. As Marshall has discussed, human actor, nearly given a hero’s identity.
this process of inviting quizzes, generous medical advice, and sexual education Enrolling Men
eff ectively creates an ostensibly benevolent Men are enrolled through the information on regime of self-surveillance on the website the pages that constructs them as potential for the individual through assisted self- monitoring and remedial action (Marshall, the fi rst page in what could be considered 2006: 356; see also Mamo & Fishman, 2001; a respectful and tactful manner: “Potency Baglia, 2005). Such a mode of address, and problems can be a sensitive issue in spite of ways of enticing and enrolling potential the fact that many men – and their partners – consumers of Viagra, can be read as part of a larger discourse, a sexual regimen of the attached to the welcome sentence, a photo of a tanned, grey-haired man in his fi fties monitoring, to borrow ideas from Foucault, is centred on male penetration at the Viagra smiling as he looks up into a blue sky that website. Given the fl ourishing market for matches his blue t-shirt, suggests a relaxed, self-health guides, books, and websites, etc., e blue colours of this mode of address is hardly surprising. clothing and sky seem to allude to the iconic is website merges the commercial aims of colour of Viagra and to Pfi zer’s logotype, a product-selling site with sexual education and health advice in a manner characteristic as has been discussed by Loe (2004b) and Baglia (2005). In the image and text, the of “edutainment” where entertaining cultural stigma of ED is mitigated by such features such as quizzes and educational a respectful yet relaxed approach. Further, imagery blend for accessible, online display the mode of address to the large number of (Åsberg, 2005). Health matters are, in such men and their partners who suff er from ED normalizes the prevalence of the problem of consumerism, as detailed in Stacey’s and works to alleviate the concern the description of self-help literature in her visitor to this site may be experiencing. cultural study of cancer (Stacey, 1997). Th Ericka Johnson and Cecilia Åsberg
Viagra consumer is enrolled into a mode of being sustained by the ideal of the self-caring and about other patients’ experiences.
subject position of a health consumer. In line with Stacey’s work on health consumerism, this also resonates with what Rose and frame to help him help himself, the website Novas termed ‘biological citizenship’ also reveals the implicit assumption of a shy (Rose & Novas, 2004: 14). Th e biological Swedish man of few words inferred by such citizen invests heavily in self-education on health matters and develops the medical is one who does not easily confi de in his literacy needed to pursue a high-quality, physician, especially not regarding sexually self-suffi cient, personally and socially related matters, and must be reassured and ‘responsible’ lifestyle (Rose & Novas, 2004: coaxed to bring up the topic during a health self-surveillance discourse redefi nes sexual health in a very specifi c, determinist way: sexual health for men is the achievement and maintenance of an erection and ability (particularly the functioning of certain parts of their anatomy) becomes their destiny.
Perhaps surprisingly, it is not a sexually surveillance and individual responsibility, it also provides the tools for individuals to take on the task of monitoring and disciplining problems. From this arises a Swedish man who is non-articulate with respect to his when asking for a Viagra prescription at interpreted as a defeat in the masculinized struggle to control the body. Importantly, on approach of Pfi zer in facilitating the Enrolling Doctors
Similarly, in a special section called the Medical doctors are also enrolled through Potency Coach, illustrated by an animated potenslinjen.se website (beyond the infamous drug rep sales techniques (see Reidy, 2005)). Part way down on the very interactive patient support that will help fi rst page, an anatomical sketch of a heart accompanies a text that reads “Potency problems – an important warning sign” and you can also fi nd information about the Science & Technology Studies 2/2012
be the fi rst “useful” sign of cardio-vascular erectile dysfunction (and, presumably, for diseases. It becomes clear that Viagra is not merely a matter of fl eshy pleasures and an improved sex life, but that it relates to serious on other national Viagra sites, also paired health issues and even has a function as a fi rst warning sign. Such medical appeals when speaking to their doctors, addressing to cardiovascular health issues as linked the fact that some men may fi nd it diffi to ED both play to the scientism of the to bring up the subject of sexual dysfunction naturalized body and work to medically during an exam. On the Swedish site, men legitimize Viagra. Swedish men seeking are told, “When you meet your doctor, she medical attention for ED are addressed as or he will probably interview you and ask upstanding citizens taking responsibility for you questions about previous illnesses and their personal overall-health, and doctors if you are currently taking any medications. are encouraged to help them with that. Try to provide as accurate information as Th is use of medical complaints other than possible, including if you still have early ED to legitimate Viagra can be read against morning erections or if your erectile ability the eff orts in Sweden to associate Viagra has disappeared suddenly or gradually. with specifi c diseases rather than lifestyle choices as part of the debate over state issues, but it is completely OK to be subsidies (Sjögren & Johnson, 2012). e medical dimension of Viagra is used to speaking about these things and further enhanced with a fi gure of authority their job is to help you.” In this way the men that confi rms both the relaxed personal and doctors are also positioned to enrol each tone and the urgency of the matter, namely other and maintain each others’ investment a headshot of a physician in scrubs with a in the Viagra-discourse. We suggest that this part of the Viagra website seems to connect the doctor creates a close proximity between biological citizenship with medical literacy medical authority and the potential Viagra consumer in another sense: the ambivalence of the picture in this setting suggests that even a medical doctor can have a use for Enrolling Partners
Viagra. Most importantly, however, this On the Swedish site partners are also small photo, emitting medical confi dence and trust-worthiness, serves a particular men as subjects for whom Viagra is the function within the website: to illustrate a solution to a waning sex life and/or issues search engine for fi nding a local, Viagra- of sexual dysfunction. Potency issues are friendly doctor. In addition to encouraging continuously addressed as a joint problem, doctors to be ‘pro-active’ in asking their for the female partner as well as for the patients about sexual function during man. In a special section of the Swedish routine exams and when taking medical web pages, partners are told about the ways histories8, Pfi zer has included a national ED can aff ect a relationship, above all by database of ‘ED aware’ doctors, or ‘affi letting coldness, distance and worry creep experts’ as Loe (2004b) calls them, which in and replace the sensitivity, nearness lets visitors to the website submit a query and trust that had been in the relationship and generates a list of doctors near them before. On the connecting pages, partners who can be consulted for information about are encouraged to be supportive of their Ericka Johnson and Cecilia Åsberg
partner, and then to let their partner know that there are treatments available for the sexual therapy. She can guide him on his way, yet he is the doer behind the deed. Th assumption about heterosexual femininity ere are medicines as sexual passivity and masculinity as sexual activity, but more importantly it also points a doctor’s visit. Apart from medical to the enormous eff ort by the woman that in treatment, sometimes sexual therapy reality lies behind achieving the “passivity” which can confi rm his active and valuable It is good for you as a relative to know about this and to be able to support and many subtle manoeuvres, enticing practices encourage your partner to seek help.
and persuasive, yet-necessarily non-direct rhetorical moves a woman must master in e partners are also encouraged to order order to achieve the right amount of sex- the free brochure, “A man’s best support inspiring passivity. Th is by his side”, published by Pfi zer with a smiling, heterosexual couple on its front masculinity.
page. Th A specifi c section of the Swedish website support the men experiencing ED plays is dedicated to the prescriptive discursive strongly on the assumption that the partner patterns available to the partner. As the is steadfastly (unrefl ectively?) consenting to reproduce certain practices and maintain suggests, she should ask herself how “Can I a supportive position within a relationship help?” to receive the answer, “Speak to and with the man (cf. Potts et. al., 2003). Th is also information about how ED makes a man feel and what sorts of ‘normal’ It is best to speak openly with your part- behaviour it can evoke in one’s partner. “Many [men with ED] distance themselves from their partners simply to avoid confl ict and to avoid situations which can lead to one fi nds a discussion about how ED and themselves in their work, or make sure they don’t go to bed at the same time as their responses build on feelings of guilt and partner in the evening. Many consciously or subconsciously even create confl icts encouraged to persevere and help their men to avoid being close to their partner.” As seek help because “When one has received implied by this quote, sexual intercourse help and solved the problem, many discover seems to be an active achievement, where that their relationship has in fact become ‘success’ needs to be granted. Moreover, the stronger.” Again, the partner’s discursive female partner has a supportive rather than a leading role in this sexual achievement eff ortless and natural attitude that avoids which combines the traditional, passive putting pressure on her partner and is recipient of penetration (waiting in the achieved by another rhetorical strategy here bed for her partner with the new hobby) provided by the Viagra site text, namely the with an active subject tasked with leading ‘we’. She can address her sexual needs and Science & Technology Studies 2/2012
his sexual problems if they are addressed as emotional health of the couple is presented a ‘we’ issue, enrolling a sexual dyad, a fi gure It is here, in the partner section, that Within the Swedish context, it is emotions and feelings are mentioned on worth noting that pre-Viagra (prior to the website with the references to coldness, 1998) medical advice about impotence distance, worry, sensitivity, nearness, trust, underlined how important it was for doctors guilt and encouragement. Physiologically, to warn their patients that merely solving a man’s ability to produce an erection aroused in the fi rst place, so partners are would not necessarily solve relationship encouraged to help achieve Viagra’s success problems (Olsson et al., 1995), something by ensuring the necessary feelings are in the Pfi zer information seems to be belying. Internationally, this assertion can be read in aspects of sex, not just the relationship, light of a Japanese study where a survey on is also eff ectively given to the partner. the level of satisfaction derived from using Partners are reminded that ED is “the man’s Viagra indicated that while the male patient symptom, the couple’s shared problem” was extremely satisfi ed, his partner was so the partner is directed to “speak to and not satisfi ed at all. Women reported their encourage” the man. She is the one that husband’s erections as troublesome, that in practice can confi rm his potency. Her they had to use supplements to increase assignment within the Viagra discourse is to vaginal lubrication and in some cases even manage this talk as she takes the emotional responsibility for discussing and refl ecting Vázquez, 2006: 123). Loe (2004a) and Potts et over the role of sex for their relationship. al. (2003) also provide examples of women’s Here, too, emotions come into the discourse responses to and concerns about Viagra use but so do the co-constitutive agencies of in the US, demonstrating a wide diversity in opinions and practices. Additional studies Viagra as embodied, chemical eff ect as well on Swedish women’s accounts of Viagra as an expectation on virile manhood giving would here be needed, but looking at the website it is clear that the female partner, are encouraged to learn about ED because, since heterosexuality becomes further “with knowledge in hand, you will fi nd it implied in the illustrative photos of both easier to speak with your partner. Together older and younger heterosexual couples that you can discuss your feelings and thoughts, frame the text, is enrolled as responsible for and give each other support, and in the end, the man’s health and for their relationship; the Viagra-empowered, potent man. At the website, her task becomes one of ensuring relationship’s well being to the female that penetrative intercourse can occur, since partner enables her to legitimately address sexual intercourse is what consolidates the problem of ED as a shared issue. Within the relationship and makes it strong. the discourse on the Viagra pages, the tool Th rough the fi gure of the sympathetic she is often given to solve the problem is the partner conjured up on the website, the little blue pill, but because of the particularly responsibility not only for the general health Swedish, legally dictated, ‘informational’ and well-being of the man but also for the role of the website, the partner is also provided with information about alternative Ericka Johnson and Cecilia Åsberg
treatments like sexual therapy (even if this of men with diff erent reasons behind their information is sparse and even as the site is branded in a very Viagra-blue). But as we involvement of partners during treatment, will discuss below, enrolling the partner in the ED discourse this way could also open for alternative solutions and alternative et al., 1995: 313). Th necessarily benign; the imagined partner was a woman in this (also) very heterosexual Discussion
discourse, and she was ascribed a narrow position in the discourse: “Men and women In our analysis, we have identifi ed three have diff erent ways of expressing themselves enrolled participants who are addressed by and therefore misunderstandings can easily the website to help create a subject position arise. Women must learn to be clearer and men to be more receptive” (Olsson et al., these is the male patient, for whom anatomy 1995: 313). Her ideal sexuality was also becomes his destiny, but who can consume Viagra to control that destiny and discipline and receptive to her male partner’s desires. it in line with youthful expectations. Th e best help for a man with disappointing second is the doctor, enrolled both to help erections is, besides his own courage to ensure the male patient is able to access Viagra and used to represent scientism, sensual partner who is sexually keen but which legitimates the use of Viagra by not demanding” (Olsson et al., 1995: 314). associating it with networks of scientifi c However, with the 1998 advent of Viagra, expertise. And thirdly, the partner of the the medical discourse in Läkartidningen patient is also enrolled in the process of narrowed the defi nition of an impotent creating a subject position for the Viagra patient to the male penis and removed the consuming man. Responsibility for his varied social and sexual backgrounds, and emotions is given to his partner, who actors, which had previously been present. simultaneously consents to supporting a Yet, in the commercial discourse, the pharmaceutical solution for the man and partner and factors like stress and tiredness e enrolment of these three participants Despite the stigma attached to impotence in the commercial discourse creates a and the common assumption that men network of actors who can perform the desire for, distribution of, and context to contribute to successful use of a pharmaceutical as a www.potenslinjen.se implies), qualitative Viagra discourse is particularly striking when one considers that they all but disappeared from the medical discourse around Viagra with their ED problems alone and in silence. when it was introduced in 1998. As Johnson (2008) has examined, the Swedish medical professionals and partners in their quest journal Läkartidningen supported a very for a solution (Grace et al., 2006; Oliff e, heterogeneous defi and impotent patients in the early 1990s, one which recognized many diff erent types their impotence (Viagra and similar drugs, Science & Technology Studies 2/2012
but also injections and vacuum pump contrast to perceiving ED as a disease of the treatments) and some men enrol their penis and the penis alone, and for which partners in both treatment therapies and responsibility to enact a solution (take a as discussion partners with whom they pill which will maintain an erection) is the can talk about their diffi man’s. As we have shown, in the Viagra alternative sexual practices (Oliff e, 2005). As discourse, the partner is enrolled to help the much current research within masculinities man see how important it is for him to take studies supports, men’s experience of Viagra. Th illness, especially a condition as related of work on her part, actively enabling the to masculinity as erectile dysfunction, man to recognize the problem as ED and is infl uenced by how the men and those the solution as Viagra. An alternative would around them, i.e. the network of actors be for partners to be enrolled as participants enrolled in defi nition and solution work, who can also defi ne alternative sexual think about and practice masculinity (cf. practices and solutions.
Marshal & Katz, 2002; Aucoin & Wessersug, new, male patients, but also their doctors suggest that some men who experience and their partners, we were reminded of an sexual dysfunction are already comfortable early study of mental health by Eaton & Weil using a network of actors to help them both (1955), which found that relatively isolated, defi ne their problem and seek treatment Anabaptist communities’ responses to options. We ask, then, how this practice and were very diff erent than the response to these enrolled actors (patients, doctors mental illness found in the wider American and partners) diff er from the enrolment we society at the time. Rather than isolating have observed on the Swedish webpage. the individual, institutionalizing him or her, Th e obvious answer, of course, is that and stigmatizing the patient, the Hutterite in the conversations detailed in Oliff e communities tried to help the individual continue to play a role in the community, pharmaceutical solutions. But we would contributing and working as best they like to suggest that the type of ‘enrolment’ could, and being cared for by their family that the men are displaying is also diff erent during the course of the illness (Eaton & eir enrolment is an Weil, 1955: 212). Reading this study today, activity which creates a community of it is obvious that it was written before the people, all of whom can help to defi ne the medical problem as medical or not and as the discourse of mental illness, and illness a problem or not. And, importantly, it is in general. Rather than talking about also a community that seems to at least patient-centred, individualized cures to tacitly recognize that the solution, when illness, the study relied on concepts of there is one, is one that needs to be acted social cohesion, social structures and group on and participated in by more than just the expectations as explanatory models and as man. In particular, these interview studies treatment options. It pays special attention would seem to highlight the partner’s need to sociological variables, the cultural and to be active in defi ning the problem, and social dimensions of health (Eaton & Weil, also the solution, as co-produced and as is is in social cohesion and mental health from Ericka Johnson and Cecilia Åsberg
1955 may be a good way to reinterpret the drug, and Viagra’s reliance on sexual erectile dysfunction. But as a reminder that desire means that the sexual partner can be our research material, our observations, important to initiate, develop or maintain and our interpretations are infl uenced by arousal. What we are asking is: If these three the paradigm within which we are working, groups of actors (men, their doctors and it is very useful. Going back to the material their partners) can be enrolled to address we have discussed in this paper, and looking at the way patients, doctors, partners and enrolled to address ED without Viagra? How pills are enrolled in the production of Viagra would a distributed response to ED place consumers, we see fi rst that these actors responsibility for dealing with the problem are enrolled to produce consumption as at the family and community level rather a treatment option. Secondly, the men than only by individual? and their partners are not discussed as ough it may seem Oliff e’s qualitative research on men with unnecessary to reintroduce the partner as the source of impotence (for a discussion of pre-Viagra treatment advice for doctors, historical, cultural and social explanations of impotence see McLaren (2007)), this to respond to a health issue does not enrolment can explain what other critical necessarily mean that the solution needs research on Viagra has shown; that its to be given to the individual, especially as existence and doctors’ participation in a pill to be swallowed. Rather, enrolling a its prescription practices have created larger network of actors can involve fi nding ED. Social structures (the medicalised and supporting alternative behaviours, framework) and group expectations (of alternative demands, and alternative lifelong sexual activity and successful aging) expectations, both by and of the ‘individual’ have contributed to the ‘epidemic’ of erectile dysfunction, and by the people around him by the enrolled actors. Only then can they be engaged as a network to (help the man) fi nd a solution. Starting from this insight, we ask: how these same human actors could be enrolled into creating a diff erent solution? 1 Accessed in October 2007, February and If Viagra was not available, what solutions could this cast of characters work together to fi nd? Who/what else could possibly be enrolled? And how would the concept of ED which is framed as an informational site readership is constructed to legally avoid traditionally been a situation that is not direct to consumer advertising of Viagra.
generally fl outed or discussed publically. 3 See the special issue of Sexualities: Th erefore we fi nd it interesting that the Viagra solution suddenly enrols a wider 4 We would like to point out that this group of actors to help the man fi nd a performativity is more directly connected these other actors; the regulatory framework discursive performativity often found in gender studies, i.e. Butler’s (1990) work.
Science & Technology Studies 2/2012
Elliott, C. (2003) Better than Well. American (New York: W.W. Norton and Company).
Fishman, J. & L. Mamo (2001) ‘What’s in a Disorder: A Cultural Analysis of Medical Franklin, S., C. Lury & J. Stacey (2000) is presented on the website http://viagra.
References
by Robert Hurley (New York: Penguin Books).
Aucion, M. & R. Wassersug (2006) ‘Th e Grace, V., A. Potts, N. Gavey, & T. Vares Viagra’, Sexualities 9(3): 295-314.
throughout history: Implications for Haraway, D. (1989) Primate Visions. Gender, modern day cancer patients’, Social Science & Medicine 63: 3162-3173.
e Viagra AdVenture. Johnson, E. (2008) ‘Chemistries of Love. of Sexual Health (New York: Peter Lang).
Viagra in Läkartidningen’, NORMA 3(1): Bordo, S. (1998) ‘Pills and Power Tools’, Men Keller, E.F. (1992) Secrets of Life, Secrets of Bryld, M. & N. Lykke (2000) Cosmodolphins. Feminist Cultural Studies of Technology, (Cambridge: Harvard University Press).
Latour, B. (1998) ‘On Recalling ANT‘, Butler, J. (1990) Gender Trouble: feminism Sociology, Lancaster University, at http:// and the subversion of identity (New York: p a p e r s / L a t o u r- R e c a l l i n g -A N T. p d f of Viagra: Gender, Dysfunction and Loe, M. (2004a.) ‘Sex and the Senior Woman: Reproduction in Japan’, Body and Society Pleasure and Danger in the Viagra Era’, Eaton, J. & R. Weil (1955) Culture and Loe, M. (2004b) Th (New York: New York University Press).
Mamo, L. & J. Fishman (2001) ‘Potency in All the Right Places: Viagra as a Technology Ericka Johnson and Cecilia Åsberg
of the Gendered Body’, Body & Society Marshall, B. & S. Katz (2002) ‘“Forever Potts, A. (2004) ‘Deleuze on Viagra (Or, Functional” Sexual fi tness and the Aging What can a ‘Viagra-Body’ Do?)’, Body & Male Body’, Body & Society 8(4): 3-70.
Marshall, B. (2002) ‘“Hard Science”: Gender Potts, A., N. Gavey, V.M. Grace, & T. Vares the “Viagra Age”’, Sexualities 5(2): 131- experiences and concerns’, Sociology of e New Virility: Potts, A. & L. Tiefer (2006) ‘Introduction’, Viagra, Male Aging and Sexual Function’, Based on Stereotypical Male-Female Rose, N. & C. Novas (2004) ‘Biological Roles’, Signs 16(3): 485-501.
Citizenship’, in A. Ong & S. Collier (eds), Global Assemblages: Technology, Politics McLaren, A. (2007) Impotence. A Cultural Feminist Analysis of Old Age, Masculinity & Sexuality (Linköping: LiU Tryck).
Sjögren, E. & E. Johnson (2012) ‘Conniving disciplining drugs. Justifying the denial of Subsidy for Viagra Use in Sweden’, in M. Moynihan, R. & A. Cassels (2005) Selling of the Swedish Welfare State (Basingstoke: turning us all into Patients (Crows Nest, Stacey, J. (1997) Teratologies. A Cultural Oliff e, J. (2005) ‘Constructions of masculinity impotence’, Social Science & Medicine Star, S. (1991) ‘Power, technology, and the 60(2005): 2249-2259.
Oliff e, J. (2006) ‘Embodied masculinity and being allergic to onions’, in J. Law (ed) A androgen deprivation therapy’, Sociology of Health & Illness 28(4): 410-432.
L. Malmberg, & J. Pedersen (1995) Tiefer, L. (2006) ‘Th ‘Är det Möjligt att bota impotens?’, Vares, T. & V. Braun (2006) ‘Spreading the and Male Sexuality in Popular Culture’, Little Blue Pill Changes Sex in America. Science & Technology Studies 2/2012
Åsberg, C. (2005) Genetiska Föreställningar: Åsberg, C. & E. Johnson (2009) ‘Viagra 581 83 Linköping, Sweden Selfhood: Pharmaceutical Advertising ericka.johnson@liu.seand the Visual Formation of Swedish Masculinity’, Health Care Analysis 17(2): Dept. of Tema, Interdisciplinary Gender StudiesLinköping University581 83 Linköping, Swedencecilia.asberg@liu.se

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