Monday, October 5, 2015

Addyi, Desire, And The Social Control Of Women's Sexuality

This week I'm writing about Addyi, which I realize makes me like two months behind the targeted moment for writing about things, but what can I say? Speed is not the philosopher's main strong point.

Addyi, of course, is the libido pill for women, the "female Viagra." You don't need to explain why the particulars are likely to make it less than a blockbuster. As the NYT says, "In one trial, women who took the drug had an average of 4.4 “satisfying sexual experiences a month” compared with 3.7 for women given a placebo." On average it might increase the number from 2-3 per month to 3-4.

No one is more in favor of one more satisfying sexual event per month than I am, and if that were the end of the story, I'd be like, Great, knock yourselves out. But Addyi comes with serious potential side effects, including severely low blood pressure and loss of consciousness. Plus, you're not supposed to take it while drinking alcohol. And on top of everything else? You have to take it every day, at a cost -- to someone anyway -- of 400 dollars per month.

As I understand it, for some women the drug is much more effective than "one more per month" and overall it's good news that women will have the option of taking this drug. But so much about the way this drug is described, promoted, and understood is annoying.

First, there's this constant reference to "libido," "desire," and "sex drive." As is frequently pointed out, Viagra doesn't directly cause desire: it just enables more blood flow to the penis so a man can get an erection. Addyi targets the brain, the aim being to create an effect of desire. The implication is that lack of desire is the problem.

But many women don't experience sexual desire as a drive, a hunger from nowhere. They experience it in response to things. This is called "responsive desire" -- as opposed to "spontaneous desire" -- and there's nothing wrong with it at all. Unless, of course, you think the way men do things is the only appropriate way to do them.

Second, this point about desire really brings home the weirdness of measuring success in terms of "satisfying sexual encounters." In women with responsive desire, this makes it seem like the success of the drug is basically that you get to skip the activities that cause responsive desire -- like, I don't know, talking quietly, snuggling, foreplay, clean sheets, whatever -- and get straight to the action. 

This reminds me of Rachel Maines' great book The Technology of Orgasm. Maines tells an astonishing story about how vibrators were introduced as labor-saving devices for physicians to treat female hysteria: instead of having to repetitively rub their hands between a woman's legs for ever and ever -- so boring! -- doctors could use the vibrator. Voilà! Hysteria cured in minutes. I think Haines describes the vibrator as doing "the job that no one else wanted."

Speaking of vibrators, does "satisfying sexual encounters" include masturbation? I don't know.

Finally, I don't know if you read this article by Daniel Bergner in the New York Times a couple of years ago. It's about the ongoing search for the female Viagra. And much of the article fits with what I've already said: women seeking out out the drug in clinical trials describe feeling deficient because, while they have responsive desire and pleasure in sex, they don't have spontaneous desire -- that "drive" associated with the masculine pattern of lust.

Bergner has a fascinating discussion of the interplay of issues having to do with long-term monogamy and the drive of lust, pointing out that empirically, while women and men both tend to experience this drive at the start of a new relationship, that drive fades for women much faster than for men: a new partner is often something that reignites that feeling of spontaneous desire for women.

As an aside here: it kills me how these facts are not interpreted as challenging the standard socio-biology idea of women as naturally monogamous and are taken instead to prove that men's drive is just that much stronger overall. Your theory predicts P and the evidence says not-P, and you're like, Well, P anyway, just something else is going on. Obviously, social investment in the natural monogamy of women is intense.

Toward the end, Bergner talks about social views of women's sexuality, and how they affect development of these drugs. Basically, the aim is for the effects to be "good but not too good." Bergner describes one researcher being "a bit stunned by the entrenched mores that lay within what he’d heard" in discussions, concluding that "there’s a bias against -- a fear of creating the sexually aggressive woman."

One day, you're mechanizing the process of treating hysteria by rubbing women between the legs in doctors offices. A few years later you're psychopharmasizing to get the perfect female desire: not too much, not too little, not for the wrong people, and not requiring time consuming interventions like conversation, attention, and a light sense of touch.

Plus ça change.

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