Medicalisation of sex and pleasure Flashcards
Describe changing attitudes to sex over history
- From policing to enabling
- ### Fourteenth CFemale sexuality
- Simultaneously libidinous and passive empty vessel
- Life expectancy: 29 years: largely due to risk of death from childbirth and disease
Male sexuality
- Risk of disease
- Sexual pleasure acknowledged but religious constraints
Overall
*Sexual pleasure morally dangerous for men
*Medicine had policing function (mostly advisory)
*Church and state defined proper sexual conduct, medicine served advisory role
Nineteenth century
Female sexuality
- Idealised woman sexually withdrawn
- “Civilisation is syphilisation”: represents risk of death
- Risk of death in childbirth still high
- Some advancement: Goodyear and the vulcanised rubber condom 1844, beginnings of separation of reproduction and sexual pleasure (not completely)
Male sexuality:
- appreciated as complex
- Freud: “Where they love they do not desire, and where they desire they cannot love.”: separation of the concepts of desire and love
- Ejaculatory loss and loss of vigour: anti-masturbation attitudes
Krafft-Ebing Psychopathia Sexualis (1882)
The beginnings of scientific study of sex and pathologies
Note a focus on pathology, and not a study of pleasure.
Overall
*Doctors played a **policing function (but also an enabling function in some cases)
- taking over from the church in policing
*Krafft-Ebing defined abnormality
*General belief in female sexual atrophy
*Freud began to develop scheme for mapping normal sexual desire
- Kinsey and surveys of sexual behaviour in U.S.
- Sexual Behaviour and the Human Male (1948)
- Sexual Behaviour and the Human Female (1953)
Critiques: informant bias (interviewed people in jail, paedophiles over-represented), leading to moral concerns about data
First study to point to breadth of sexual experience among American men and women, and did good work in normalising homosexuality, and extramarital sex.
Also Masters and Johnson: discovering pleasure, demonstrating different responses of men and women in sex, and highlighting the diversity of women’s experience and women’s anatomy.
1970s Overall
*Medicine had explicit enabling function – reproductive
*Sexual orthodoxy around experimentation
*Diverse modes of sexual being: homosexuality voted out of the DSM
*Incendiary debates within the medical profession about failure to police sexuality: usually religiously framed arguments against contraception and supposed encouragement of promiscuity
Historically
*Male sexuality assumed to be “natural” – defined in relation to problematic female sexuality (because anatomy not fully described)
*Anatomy of female sexual organs not described fully 1998-2006
21st century
Female sexuality
- Desire a desired state
- Reproductive freedom
Male sexuality
- Sexual performance preserved across life (viagra/sildenafil)
- Ejaculatory loss leads to personal and interpersonal renewal
In 2023
*Drug company led dominance of medicine in determining the forms of sexual pleasure
*Normalises genital view of sexuality. Notion of sexual rights (women also advertised to: menopause medications designed to improve sexual performance)
*Implicitly, sexual performance (and desure) is modifiable through medicine
Describe the medicalisation of male and female pleasure
e.g. of sexual pleasure for men requires
*Something that is biologically plausible (sildenafil and mechanism of action)
*Something that speaks to a current preoccupation
*An authority voice within medicine (Sex therapists, urologists etc.)
*A method of diagnosis (self-reported)
*An acceptable treatment (pill as opposed to previous treatments: pump, injection)
e.g. of women:
*Sexual pleasure is (sort of) biologically measurable and reportable
*Preoccupation: Lifelong access to sexual pleasure
*Authority voices
*Method of diagnosis
*Acceptable therapies: Sildenafil, Testosterone, other hormones – less effective in women
Describe future directions and modern day FGM
Future directions
- shortening of the refractory period
- policing of ‘wring desire’: how medicine should get involved e.g. paedophilia
- cosmetic surgery
(not more on new slides, not yet uploaded)
Modern day FGM
*http://www.labialibrary.org.au/
*Better Health Cosmetic Genital Surgery
*Impact of aesthetic surgery on sexual function is not mentioned
*Parallels between FGM (illegal) and labiaplasty and phalloplasty (legal) avoided
Note also
The asexual community and refutation of medicalisation
Describe attitudes towards sex in the 14th century
Fourteenth C
Female sexuality
- Simultaneously libidinous and passive empty vessel
- Life expectancy: 29 years: largely due to risk of death from childbirth and disease
Male sexuality
- Risk of disease
- Sexual pleasure acknowledged but religious constraints
Sex and danger
This explains why women were considered inherently libidinous
- “all women are inherently libidinous (as conception can occur after rape”
- older women particularly dangerous
- all women of reproductive age considered dangerous
Overall
*Sexual pleasure morally dangerous for men
*Medicine had policing function (mostly advisory)
*Church and state defined proper sexual conduct, medicine served advisory role
Describe attitudes towards sex in the 19th century
Nineteenth century
Female sexuality
- Idealised woman sexually withdrawn
- “Civilisation is syphilisation”: represents risk of death
- Risk of death in childbirth still high
- Some advancement: Goodyear and the vulcanised rubber condom 1844, beginnings of separation of reproduction and sexual pleasure (not completely)
Male sexuality:
- appreciated as complex
- Freud: “Where they love they do not desire, and where they desire they cannot love.”: separation of the concepts of desire and love
- Ejaculatory loss and loss of vigour: anti-masturbation attitudes
Sex and danger
Krafft-Ebing Psychopathia Sexualis (1882)
The beginnings of scientific study of sex and pathologies
Note a focus on pathology, and not a study of pleasure
*“paradoxias” – desire at the wrong time
*“anaesthetics” – absence of desire at the right time
*“hyperaesthetics” – excess desire at any time
*“paraesthesias” – desire for the wrong object
Describe attitudes towards sex in the 1950s
Scientific study of sex
- Kinsey and surveys of sexual behaviour in U.S.
- Sexual Behaviour and the Human Male (1948)
- Sexual Behaviour and the Human Female (1953)
Critiques: informant bias (interviewed people in jail, paedophiles over-represented), leading to moral concerns about data
First study to point to breadth of sexual experience among American men and women, and did good work in normalising homosexuality, and extramarital sex.
Also Masters and Johnson: discovering pleasure, demonstrating different responses of men and women in sex, and highlighting the diversity of women’s experience and women’s anatomy.
Describe attitudes towards sex in the 1970s
1970s
Female sexuality:
- Reproductive freedom(the pill: represented a proper decoupling of reproduction and sexual pleasure )
- Ideology of sexual experimentation
- Perceived freedom from sexually transmitted diseases
- “Frigidity” a new problem
Male sexuality:
- Idealised male sexually aggressive and young
-
Overall
*Medicine had explicit enabling function – reproductive
*Sexual orthodoxy around experimentation
*Diverse modes of sexual being: homosexuality voted out of the DSM
*Incendiary debates within the medical profession about failure to police sexuality: usually religiously framed arguments against contraception and supposed encouragement of promiscuity
Describe attitudes towards sex in the 21st century and this year
Historically
*Male sexuality assumed to be “natural” – defined in relation to problematic female sexuality (because anatomy not fully described)
*Anatomy of female sexual organs not described fully 1998-2006
21st century
Female sexuality
- Desire a desired state
- Reproductive freedom
Male sexuality
- Sexual performance preserved across life (viagra/sildenafil)
- Ejaculatory loss leads to personal and interpersonal renewal
In 2023
*Drug company led dominance of medicine in determining the forms of sexual pleasure
*Normalises genital view of sexuality. Notion of sexual rights (women also advertised to: menopause medications designed to improve sexual performance)
*Implicitly, sexual performance (and desure) is modifiable through medicine
Compare and contrast the role of biomedicine in relation to sexual pleasure through masturbation in the eighteenth and nineteenth century and sexual pleasure through sexual intercourse in the late twentieth century and early twenty-first century.
Biomedicine played a “policing” role in relation to masturbation (termed “self-abuse” or “peripheral excitement” for women) in the eighteenth and nineteenth century. The practice was medicalised in that it was felt that it was physically enervating, and would lead to physical ill-effects, including death. Medical practitioners wrote books in which they detailed the medical consequences of masturbation, and in some cases performed surgery to treat it. So we had a condition thought to be biologically based, which concerned a lot of people, has authority experts within medicine, a mode of diagnosis (observation or self-report) and some pretty brutal, but widely used, tretments.
The role of biomedicine in the latter half of the twentieth century has been to view sexual pleasure as something to be enabled, beginning with the work of sexologists, reinforced by the development of the oral contraceptive pill, and culminating in the development of the first medication that was consciously designed and approved to enhance sexual function: sildenafil (Viagra).
What was the significance of the Kinsey report?
It mapped the degree and diversity of sexual experience among Americans .
Other answers are wrong because:
A. The Kinsey reports are often used to support the argument that 10% of the population is homosexual, but Kinsey was interested in experience rather than identity, and would have seen the use of a simple number as a glossing of the diversity of sexual experience and orientation.
His report stated 10% of men were exclusively homosexual in orientation for three years between the ages of 16 and 55.
C. The populations in his reports do over-sample prisoners and male prostitutes, but when the data are reanalysed leaving out outliers the results do not substantially change.
D. Some people were uncomfortable that Kinsey included sex offenders among his population, but this is not the reason the reports are significant.
The oral contraceptive pill is generally regarded as one of the most important medical technologies of the twentieth century. Reasons for this are
It allowed sex and reproduction to be decoupled. It became a tool to support the evolving autonomy of middle-class women.
Sildenafil (Viagra) is a key enabling technology in relation to sexual pleasure in the early 21st century. Outline some potential negative consequences of the widespread use of Viagra (apart from side-effects for the over-enthusiastic user).
- Defines sexuality as exclusively genital
- Defines sex as performative
- Creates new markets (not bad in itself, but some of these markets may be vulnerable – the highest rise in the incidence of HIV in southern USA is among the elderly who, with the aid of Viagra, are becoming sexually active, and believe they have no need for condoms. The ratio of men: women in retirement homes means that one man with Viagra has many potential partners – the Captain Condo phenomenon)
Who discovered the clitoris and its function, and when?
The clitoris has of course always been there, but all these people have laid claim to describing the clitoris for the first time. The Taoist literature clearly indicates that they knew that it was for pleasure, and Columbus (not THE Columbus) claimed this was new discovered territory when he wrote of it. The Boston Women’s Health Collective encouraged all women to understand their own anatomy and described in some detail the function of the clitoris. Helen O’Connell has made a major contribution by describing for the first time the vast neurological connections of the clitoris, which is critical in understanding the implications of gynaecological surgery.
