There appears to be a nationwide obsession with female reproductive health and, by extension, women’s sexual performance, and its relationship to the state. Women’s access to reproductive health services and the means to exercise full sexual autonomy (which, for heterosexual women, means birth control, including the option of abortion) has been regulated and, in some states, denied under both public and private insurance plans. Meanwhile, lawmakers have chosen to ensure that male sexual performance and the pleasure it brings is available even to those men who are on Medicare. Earlier this year, female lawmakers across the country, fed up with this sexual double standard, began introducing legislation targeting male sexual and reproductive health.
In my home state of Ohio, the charge was led by Senator Nina Turner, the Democratic minority whip, who proposed Senate Bill 307 mandating thorough physical and psychological screenings, including a visit to a sex counselor, a cardiogram, and a colonoscopy, before a man who claimed to be suffering from impotence could get a prescription for Viagra© or any other medicine intended to treat erectile dysfunction from his health care provider. Mimicking language used by politicians in regulating women’s health, Turner stated, “We must advocate for the traditional family, protect the sanctity of procreation, and ensure that all men using PDE-5 inhibitors are healthy, stable, and educated about their options – including celibacy as a viable life choice.”
This language resonated with me. It is nearly identical to the language used by American medical professionals throughout the 1950s and much of the 1960s to justify an invasive and obsessive concern over the sexual behavior of American citizens, both male and female. Much like the presidents and policymakers who banned gays and lesbians from federal employment, or the law enforcement personnel who arranged sting operations to entrap gay men in sexually compromising situations, or the school boards that expelled pregnant teenagers, physicians believed that controlling sexual behavior and containing it within the confines of a heterosexual marriage was essential to the well-being of both the local and national community. As a psychiatrist wrote in the Journal of the American Medical Association, “That basic unit without which few societies can survive – the family – depends upon discipline and control of sexual behavior. Without such control, the family soon breaks down, and soon thereafter the whole society comes crashing down – like the mighty Roman Empire, which is no more.” As I discussed in my book, the American medical profession had no intention of letting the United States follow the same ill-fated path as the Roman Empire. Instead, they determined to use whatever heroic measures were necessary to ensure that Americans were engaging in sexual practices that were healthy and would contribute to the stability of their marriages. This, in their view, would also ensure the stability of the state. Families were the building blocks of the nation; thus, if families were decaying due to individual maladjustments, sexual dysfunction, and divorce, then so too would the nation. The opposite was also true: healthy families = a healthy state.
What this meant in practical terms was that it was very important for married couples to have satisfying sex lives. Thus, it was essential for a man to be able to get and maintain an erection, as an erection was necessary for men to achieve the end-game of intercourse: arousal, penetration, pleasure, orgasm, and release. Of course, ejaculation not only marks the climax of male sexual pleasure, it also makes reproduction possible, making it very difficult to distinguish between male sexual health and male reproductive health. In the ‘50s and ‘60s, medical professionals went to great lengths to restore male erections if there was a failure to launch, so to speak. There were implants and exercises, surgery, and some (failed) attempts at hormonal therapy, but for the most part, efforts centered on encouraging men to feel manlier and insisting that their wives be more passive. Her sexual pleasure was at stake, too, as the only acceptable female orgasm was one that resulted from deep penile penetration during intercourse. Anything else (in other words, an orgasm as a result of clitoral stimulation by hand, mouth, or object) was problematic as it could be both a symptom and the source of female sexual dysfunction. Any orgasms women were having that were not potentially procreative were out (although using contraceptives temporarily for family planning was okay). Meanwhile, the male erection was thought necessary for male sexual health, for female sexual health, and for reproduction. In my book, I argue that the epicenter of healthy heterosexuality was the vaginal orgasm, but due to recent events, I’m beginning to think it was and always will be all about the penis.
I don’t want to overstretch the connection between definitions of male sexual health a half-century ago and contemporary political debates. The language Senator Turner and others have used in this proposed legislation is clearly steeped in irony intended to expose the hypocrisy of efforts to regulate female healthcare. Even so, the issue niggles at me. While we talk far more about female sexual behavior and reproductive roles, we actually prioritize making sure that men get off as nature/God/Pfizer intended. We never discuss alternatives for ensuring male sexual pleasure other than the ability to penetrate and ejaculate (i.e., options that would avoid potential insemination). We never debate if a man actually needs to have an erection if he and his partner aren’t trying to conceive. We never suggest that male heterosexual function is a lifestyle choice and therefore not something that private or public insurance companies are obligated to provide as health care. We gloss over the myriad causes of impotence, focusing on the ‘quick fix’ of the little blue pill. Forget the problems; let’s jump to the solution. Impotence, as a former presidential candidate, an all-star athlete, and a fictional polygamist have reassured us, is normal – something that happens to most men at some point in their lives. While it is still necessary to see a doctor for a prescription, the advertising done by the multi-billion dollar pharmaceutical industry naturalizes the condition, reassuring men that sexual dysfunction is most certainly not a reflection of their failed masculinity. On the one hand, this is good. ED is not about not being man enough. On the other hand, it doesn’t really resolve its underlying causes. Whether physical or psychological, they remain hidden, shameful, undisclosed. At the same time, the naturalization of male sexual dysfunction and the widespread advertising for pharmaceutical treatments have also asserted sexual function and pleasure as something to which all men are entitled. Sexual pleasure is, in this sense, a basic right, one that the medical profession and the pharmaceutical industry are eager to protect and that lawmakers have shown no genuine interest in regulating.
Of course, we cannot say the same for women, can we? Without being able to control their bodies’ ability to reproduce, heterosexual women cannot exercise full command over their sexuality. We thought that an earlier pill provided by doctors and proudly sold by the pharmaceutical industry had offered reproductive self-determination and sexual freedom to women half a century ago. Now, (predominantly, but not exclusively, white, male, heterosexual) legislators are obsessed with regulating women’s bodies and what they do with them. Female lawmakers have been censured and silenced – as happened quite literally in Michigan last month – for protesting against this assault on their and their female constituents’ lives and bodies. While the media focused on the silencing of Representative Lisa Brown for using the word ‘vagina’ and her subsequent reading of The Vagina Monologues on the steps of the Michigan state capitol, few have considered the simultaneous censure of her colleague, Representative Barb Byrum, who stood at a podium while the Speaker of the House ignored her waving arm. She was attempting to introduce an amendment to an abortion bill that would place similar restrictions on men seeking a vasectomy. Regulating female reproductive function is the province of these lawmakers; regulating male reproductive function isn’t even open for discussion. While this ostensibly is about reproduction and preserving life (or the potential for it), the refusal in Michigan and elsewhere to give serious attention to male reproductive function reveals the underlying truth: this is not about limiting unplanned pregnancies and abortion; this is really about sex and who gets to have it and under what circumstances.
Like medical practitioners a century ago, these lawmakers are trying to confine female sexual behavior within the parameters of a heterosexual, procreative marriage. I say female sexual behavior because, let’s be honest, as a society we still believe that men need sex, think about sex, want sex, have sex, far more than women do, despite all evidence to the contrary. We expect men to engage in non-marital, non-procreative sexual behavior. After all, boys will be boys, and they aren’t going to buy the cow if they can get it for free.
The consequence of this is that we expect there to be restrictions on female sexual behavior as a means of controlling men. And since no one dares to pass laws that prohibit unwed women from having sexual intercourse, reproductive function is the only clear target. Making it next to impossible for women to avoid pregnancy if they engage in intercourse (or so the logic goes) will discourage women from doing so and will punish those who do. Men, meanwhile, can keep on doing what they have always done. And if they can’t, the state will be there to make sure that even the poorest among them will have access to the health services to make the magic happen.
This blog originated in a talk I delivered at the Contemporary History Institute at Ohio University in May.