Nicola Gavey University of Auckland
Anyone encountering Viagra for the first time through direct-to-consumer promotions of the drug could be forgiven for thinking they had stumbled onto a miraculous new elixir of relational health and wellbeing. Viagra, according to drug company advertisements, will generate not only sex, but also the restoration of closeness, romance, love and intimacy. It will, in fact, protect against the very breakup of relationships threatened by “distance” – a distance born, it is implied, of the ailing self-esteem and crumbling masculinity caused by
“failure to admit” and therefore to overcome the condition of “erectile dysfunction” (see Gavey 2005). And what is the route to such happiness and harmony? It is the biotechnological production of a penile erection with all the qualities – of firmness and duration – required for vaginal penetration and “successful” intercourse.
As critics have pointed out, the promotion of Viagra as a magic-bullet remedy to this host of personal and relational troubles relies on a whole array of contemporary assumptions about sex and gender. So too, of course, does the construction of the very problem (erectile dysfunction) it is designed to fix. Most blatantly, the whole phenomenon of Viagra relies on a hard-core “coital imperative” (Jackson 1984). This is the widely shared presumption that heterosexual sex is penis–vagina intercourse; and that anything else is either a preliminary to – or an optional extra beyond – real sex.
In magazine advertisements targeted at potential consumers, notions like “satisfactory sexual activity” and “making love” are premised on the requirement of a penis erect enough for penetration that lasts (see Gavey 2005). (Hetero)sex, within the Viagra promotion industry, is penetration – of the vagina by the penis. And the penetrating penis must be capable of reliable and durable action to avoid pathologization. According to a
“sexual health inventory” on the drug company’s website, even the man who reports he is able to maintain an erection that is firm enough and lasts long enough for “satisfactory”
intercourse “most times” and reports “high” confidence in his ability to “get and keep an erection” scores the advice that he “may be showing signs of erection problems” (see Gavey 2005). The possibility that sexual activity or making love could happen without penile penetration of the vagina – which conceivably might be an option that some heterosexual men with erectile changes (as well as some without), and their partners, might otherwise consider – is completely obscured within the promotional advice.
Of course drug companies did not invent the coital imperative. Contemporary culture is thoroughly saturated with the commonsense assumption that (hetero)sex is coitus. In fact, to question that mature heterosexual sex could be otherwise – that it might not require intercourse – is likely to generate bemused and/or dismissive responses emphasizing the power of nature to determine the proper form of sexual practices and desires. From this perspective, the coital imperative might be seen as simply the way things are; as a taken-for-granted feature of human nature. However, in this chapter I argue not only that the coital imperative in its current form is highly problematic, but also that it is neither simply natural nor immutable.
The dangers of the coital imperative
Feminists have long debated the symbolic meaning of intercourse. Some have portrayed it as a key site of women’s oppression (e.g., Dworkin 1987), while others have sought to resurrect it as a viable sexual practice for heterosexual feminists (e.g., Segal 1994).
However, despite these exchanges about the politics of coitus, the coital imperative which casts intercourse as an essential part of heterosexual sex, unquestionably has a downside – for women in particular. Heterosexual intercourse is a sexual practice that has life-changing implications, in particular pregnancy and the transmission of sexual infections (some of which have lasting complications and/or are life-threatening). While a myriad of techniques and technologies exist for circumventing potential consequences like an unwanted pregnancy or an STI, they are widely perceived and/or experienced as difficult or adverse in their own right. For example, the most technically effective methods of birth control, such as oral contraceptives and IUDs (intrauterine devices), are well known for their “dangerous or troubling side effects” that lead many women to discontinue use (e.g., Petchesky 1990:189). Also, while many women report enjoying intercourse (see Segal 1994), others go through with it in the absence of their own desire or pleasure (e.g., Gavey 2005) because of the assumption it is normal and, therefore, required. Some women continue to have intercourse even despite routinely experiencing outright pain and discomfort. One 51-year-old woman, for instance, said she was sometimes unable to
“disguise how much discomfort” she experienced during intercourse due to her own advanced illness; yet she persisted because of her belief that it was not good for men to go without regular intercourse (e.g., Potts et al. 2003:706).
Given the potential for intercourse to have serious adverse consequences for (particularly women’s) health and wellbeing, it would be reasonable to assume that it might be better regarded as a choice within sex rather than as a taken-for-granted act if
“sex”is to occur. However, by and large this is not the case. Elsewhere I have discussed the poignant case of Romanian women who continued to engage in coital sex with their husbands, in the absence of their own pleasure, and despite the painful consequences associated with unwanted pregnancies, which were difficult if not impossible to avoid during the extreme pronatalist regime under Ceausescu. One woman, who had had seven illegal abortions, said: “When I was asked by my husband to make love with him I began to feel pains in my stomach because of fear” (cited in Gavey 2005:123). Despite the especially harsh social conditions these women were living under, which exacerbated the stakes of engaging in unwanted intercourse, the fantasy of sexual and reproductive choice does not necessarily play out fully even in neo-liberal societies in which the notion of choice seems to be fetishized above all else. Girls and women commonly report having sexual intercourse even when they don’t want it and/or gain no pleasure from it (e.g., Gavey 2005). Intercourse, it would seem, is part and parcel of sex; not an item that can freely be chosen or discarded from the (hetero)sexual menu. Sanders and Reinisch (1999), for instance, found that while virtually everyone in their study regarded penile–
vaginal intercourse as constituting having “had sex,” 60 percent were of the view that oral–genital contact (if it was “the most intimate behavior” they engaged in) would not.
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The coital imperative is not natural
One of the interesting insights gained from historical studies of sex is the finding that some of the assumptions that currently operate as taken-for-granted truths about (hetero)sexuality are not in fact historically constant. For instance, historians write of a
“sexual revolution” in the eighteenth century during which the whole nature of what heterosexual sex was changed radically. According to Tim Hitchcock (2002), drawing on data from England and Western Europe, it became increasingly phallocentric at this time, moving away from a set of practices that encompassed mutual masturbation, kissing and fondling, mutual touching, and so on. Instead, “putting a penis in a vagina became the dominant sexual activity” (Hitchcock 2002:191). By the nineteenth century, “proper”
marital sex in the United States not only centered on the act of coitus, but reference to noncoital sex was rare in publications of the era, and when it was mentioned it was always associated with prohibitions (Seidman 1991). Perceptions of women’s sexuality also changed markedly over this period. From being seen as sexually aggressive (Hitchcock 2002), women came to be seen as sexually passive. Their pleasure during sex, and their orgasm in particular, became increasingly less important (see also Laqueur 1990). More recent changes over the twentieth century include the shift away from seeing (hetero)sex in primarily procreative terms. Through the “sexual revolution” of the mid-to-late twentieth century, women’s sexual pleasure has come back onto the agenda – at least in theory.
It seems ironic, then, that at a time when the procreative function of sex has perhaps never been less important, the sexual act “designed for” procreation has not only persisted as the defining feature of hetero(sex); but, with the Viagra moment, it is increasingly being stretched across the lifespan. Most men using Viagra and similar products are beyond a procreating stage of life. Yet, while the reproductive function of coitus is no longer valorized, the particular heterosexual act for reproduction is.
Apparently, in the nineteenth-century United States when the reproductive function of sex was still of primary importance (D’Emilio and Freedman 1988), and sex was based even more narrowly around the procreative act of coitus than it is today, it was assumed that sex between a husband and wife would generally diminish over the course of their marriage (Seidman 1991). By the age of fifty, it was thought, men’s sexual life would be over: the “sex drive” being “either absent by that age or enfeebled to a point where it would have little significance in the marriage” (Seidman 1991:25). Today, when men’s bodies give up on producing the kind of rigid penile arousal required for “successful”
intercourse, it is considered to be a sexual dysfunction (even though to some extent statistically normal, as the drug company promotions like to reassure people). Such trends might have been predicted by Jeffrey Weeks’s (1985) diagnosis of the colonization of sex by capitalism since the beginning of the twentieth century. As part of a more general
“commoditisation and commercialisation of social life,” Weeks (1985:22, 23, 24) pointed to an “expansion of perceived sexual needs, particularly among men.” This was fertile ground for the “proliferation of new desires as the pursuit of pleasure became an end in itself.” Not only the pursuit of pleasure; for sex has become increasingly entangled with all sorts of “higher” psychological and relational meanings, such as intimacy and identity
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(e.g., Seidman 1989). Intercourse is practiced not simply as a (possible) means to physical pleasure, but as an expression and/or confirmation of love and closeness (e.g., Gavey et al. 1999).
The coital imperative is not immutable
Attention to the historical antecedents of our contemporary sexual norms, as we have seen, suggests that there are no single cultural or biological determinants of human sexual behavior that are rigidly prescriptive over time and place. Further support for this contention exists in contemporary evidence that (at least) some people do act otherwise, to embody alternative forms of (hetero)sexuality (not to mention those who escape the strict confines of heteronormativity through lesbian, gay, or other forms of queer sexuality). One example of this comes from the accounts of women and men who have faced erectile difficulties only to find that it enhanced their sexual relationships (Potts et al. 2004:497). As one man who did not have erections commented:
Matter of fact … in some ways our sex life has been, in a different way, better since … It was a matter of adapting to suit the occasion rather than giving all away, which I suppose … some people give it all away, but we were determined not to … And she can get me to a climax and sort of keep me going, you know, far more than I used to before … so in that way the sex is … different and arguably better than what it was before.
Stories such as this – and there were more – disrupt the pharmaceutical company’s unidimensional hype about the devastation that erectile difficulties (necessarily) cause for heterosexual relationships, as well as for sex itself.
Viagra’s intervention
As part of the increasing medicalization (e.g., Tiefer 1995) and commercialization of sexuality, “Viagra” is a cultural phenomenon rather than simply a (set of) biotechnological products; a phenomenon that relies on, reinforces, and extends existing sociocultural norms. The impact of Viagra can be felt at several different levels, from the intimate lives of individual women and men to the broader public domain of popular culture. Given that the promotion, and presumably the appeal, of Viagra trades on the coital imperative, it is not surprising that it can intervene within people’s private sexual lives in ways that directly (re)assert this imperative. For instance, a 48-year-old woman described how Viagra enforced the coital imperative within her sexual relationship, with the unwelcome extinction of noncoital sexual activities (Potts et al. 2003:704–5):
[Viagra use began] during a time when I was trying to impress upon him that foreplay would be a nice thing. After twenty-odd years of marriage, foreplay is one of those things that goes by the way; however, I was trying to maintain that this was, you know, quite an important part of making
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love, so when Viagra came along the whole foreplay thing just vanished, I mean it wasn’t even a suggestion, it was: “OK, I’ve taken the pill, we’ve got about an hour, I expect you in that time to be acquiescent.”
Not only does Viagra intervene in men’s bodies, minds, and sexuality (and, therefore, in women’s experience of heterosex and in relationships between men and women), but the Viagra phenomenon intervenes in culture itself. This phenomenon is more than just the chemical compound sildenafil citrate. It is the potent mix of the drug itself (as well as newer similar drugs) and their promotion within drug company marketing, professional endorsements, and various popular cultural representations. The promotion of Viagra as a biotechnological miracle for restoring men’s potency, and with it personal and relational happiness, plays with culture. It shifts the meanings of intercourse – not by inventing new meanings, but by reinforcing and intensifying existing ones in ways that move to squeeze out any comfortable spaces for alternative meanings around having or not having intercourse. At the same time, it prescribes new norms for coitus by extending normative expectations for its place in the lives of aging men, and those with health conditions that threaten erectile reliability. In these ways the Viagra phenomenon shifts the cultural conditions of possibility for (hetero)sex, in ways that are both prescriptive and restrictive.
Some of the interviewees in Potts et al.’s research observed that the cultural phenomenon of Viagra involved the construction of a problem. That is, it represented the invitation to understand erectile changes as pathology rather than simply a natural change or as an expression of acceptable corporeal and sexual diversity. For example, as one 60-year-old woman explained (Potts et al. 2003:712):
Yes, it would definitely be different for everybody, I guess, but I think you’d probably find that … a large percentage of women in my age group would say that … the desire decreases as you get older and … Possibly, if I think about it, it’ll come up because Viagra has been brought up, right?
Because I think Viagra has made a lot of people feel inadequate … everybody’s on the defensive about how often they have sex and so on, in the older age group.
Even for women and men who already do see erectile changes as a problem to be fixed, Viagra delivers one solution (pharmaceutically restoring the erectile capacity) with such force that other potential “solutions” are either obscured or devalued. In the case of men for whom Viagra poses a serious health risk (e.g., those taking nitrates in medication prescribed for angina or those using recreational drugs that contain nitrates), this fixation with an erect penis and coitus as sex is potentially fatal. In these ways, we can see how the Viagra phenomenon works both prescriptively, to install new needs for intercourse, and at the same time restrictively, to close down other legitimate possibilities for sexuality.
In this chapter I have argued that the Viagra phenomenon reinforces and hardens the coital imperative. Not only does it potently work to re-naturalize and re-normalize the centrality of intercourse to heterosexual sex, but it extends its reach to areas of society that previously were able to slip it by (that is, men and women beyond middle age, and those with certain health conditions). And, on the way, it pathologizes bodies and people
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who cannot, or prefer not to, engage in sexual intercourse on every, or even any, sexual occasion.
In the midst of a Western cultural moment that is arguably open to all sorts of possibility for progressive social change around sexuality, the Viagra phenomenon is profoundly disappointing. Social constructionist perspectives (e.g., Foucault 1981; Tiefer 1995) which draw attention to the shifting and contextual nature of human behavior and experience have become highly influential within sexuality studies. Moreover, even recent trends within biology emphasize the co-constitution of organisms and their environments (see Gavey 2005). The convergence of these constructionist perspectives from biology, social science and history permits a cautious optimism that the plasticity of human sexuality might allow for shifting and less rigid norms that promote increased tolerance and an ethic attentive to difference and power. It is just possible that these trends within the academy, as well as within the queer margins of culture, might have signalled broader movements towards new cultural understandings and practices. Were such an ethic brought to bear on questions relating to health, wellbeing, and equality, the coital imperative would surely be due for some wider critical scrutiny. Instead, such potentially radical cultural shifts have arguably been stalled by the escalating medicalization of sexuality within the corporate thrust of pharmaceutical companies hungry for new markets in which to expand profit. Through their prominent cooption of the coital imperative, which is strategically necessary in order to create a new market for a costly erectile fix, the disappointing spin-off is that many men and women are likely to be deprived of the cultural conditions for realizing diverse sexual and reproductive choices that might have enhanced their health and wellbeing.
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