Viagra and the coital imperative Nicola Gavey University of Aucklend Anyone encountering Viagra for the first time through direct-to-consumer promotions of the drug could be forgiven for thinking they had stumbled onto @ miraculous new elixir of relational health and wellbeing. Viagra, according to drug company advertisements, will generate not only sex, bat 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, itis implied, ofthe 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 eritcs have pointed out, the promotion of Viagra as a magic-bullet reruedy 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) itis designed to fix Most blatantly, the whole phenomenon of Viagra relies on a harl-core “coital imperative” (Jackson 1984). This is the widely shared presumption that heterosexual sex iv penis: vagina intercourse; and that anything else is either a preliminary to - or an optional extra beyond ~ real sex. 1 magazine advertisements targeted at potential consumers, notions like “satisfactory sexual activity” and “making love” are premised o the requirement of a penis erect enough for penetration that lasts (see Gavey 2005). (Hetero)sex, within the Viagra promotion industry, is penetration — ofthe vagina by the penis. And the penetrating pris, ‘must be capable of reliable and durable action 1 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 possiblity 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 charges (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 andior dismissive responses emphasizing the power of nature to determine the proper form of sexual practices and desires. From this perspective, the coital imperative might de seen as simply the way things are; as a taken-for-granted feature of human nature, However, in this chapter | argue not only thatthe coital imperative in its current fora is highly problematic, but also that is neither simply natural nor immutable, Handbook of the new sewvality studies 136 ‘The dangers of the coital imperative Feminists have long debated the symbolic meaning of intercourse, Some have portrayed itas a key site of women’s oppression (¢.g., Dworkin 1987), while others have sought to rosurrect as a viable sexual practice for heterosexual feminists (e.g., Segal 1994), However, despite these exchanges about the polities 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 sexval infections (some of which have lasting complications andlor ar 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 (eg, Petchesky 1990:189). Also, while many women report enjoying intercourse (Gee 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 1 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 {20 without regular intercourse (eg., Pots etal. 2003:706) Given the potential for intercourse 10 have serious adverse consequences for (particularly women’s) health and wellbeing, it would be reasonable to assume that it ‘migit be better eegarded 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 i coital sex with their hhusbands, in the absence of their own pleasure, and despite the painful consequences associated with unwanted pregnancies, which were difficult if not impossible 1 avoid uring the extreme pronatalist regime under Ceausescu. One woman, who had had seven illegal abortions, suid: “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 tobe fetishized above all else. Girlsand women commonly repor having. sexual intercourse even when they don’t want it and/or gain no pleasure from it (eg, Gavey 2005}, Intercourse, it would seem, is part and parcel of sex; not an item that can freely be chosen or discarded from the (hotero}sexual menu. Sanders and Reinisch (1999), for instance, found that while virtually everyone in their study regarded penile ‘vaginal intercourse as constiuting having “had sex,” 60 percent were of the view that oral-genital contact (ifit was “the most intimate behavior” they engaged in) would not,‘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 centary 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 1 noneoital 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 seen as sexvally 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 Lagueur 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 ~ atleast in theory, It seems ironic, then, that at a time when the procreative functioa 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 heyond a procreating stage of life. Yet, while the reproduetive function of coitus is no longer valorized, the particular heterosexual act for reproduction is, Apparently, in the ninewenth-century United States when the reproductive function of sex was sill of primary importance (D’Emilio and Freedman 1988), and sex was based even more narrowly around the procreative act of coitus than itis teday, it was assumod that sex between a husband and wife would gererally diminish over the course of their marriage (Seidman 1991), By the age of fy, it was thought, men’s sexual Ife would be ver: 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 produciag the kind of rigid penile aroussl required for “successful” intercourse, it is considered to be 2 sexual dysfunction (even though to some extent istically normal, asthe drug company promotions like to reassure people). Such trends might have been predicted by Jefirey Wecks’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 desites 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” paychological and relational meanings, such at intimacy and identity Handbook of the new sexuality stulies 138 (€., 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 sperative is not immutable Attentioa to the historical antecedents of our contemporary sexual norms, as we have seen, suggests that thete 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 leas!) some people do act otherwise, to embody alternative forms of (hetero)sexuality (aot to mention those who escape the strict confines of heteronormativity through lesbian, gay, or other forms of queer senuality). One example of this comes from the accounts of women aad men who hive faced erectile difficulties only to find that it enhanced their sexual relationships (Potts et «al-2004:497). Asone man who di Matter of faet ... in some ways our sex life has been, in «different way, better since... It was a matter of adapting to suit the occasion rather than aiving all away, which I suppose ... some people give it all away, but we ‘wore determined not to .. And she can get me to ¢ climax nd sort of keep me going, you know, far more than T used to before ... so in that way the sex is. different and arguably beter 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 hhcterosexual relationships, as well as for sex itself, ‘Viagea’s intervention As part of the increasing medicalization (e.g., Tiefer 1995) and commercialization of sewality, “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 Viagrs 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, itis not surprising that it can intervene within people's private sexual Ives in ways that directly (reJassert 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 noneoital sexual activities (Potts ef al, 2003:704-S) [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, Iwas trying { maintain thet this was, you know, quite an important part of making ‘Viagra and the coital imperative 139 love, so when Viagra came along the whole foreplay thing just vanished, | mean it wasn’t even a suggestion, it was: “OK, I've taken the pill, we've got about an hour, Texpect 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 hhappiness, plays with culture. It shifts the meanings of iniercourse — 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 ot not having intercourse. At the same tine, 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 ef at's research observed that the cultural pheaomenon of Viagra invelved the construction of a problem. That is it represented the invitation to understand erectile changes at pathology rather than simply a natural change of as an expression of acceptable corporeal and sexual diversity. For example, as one {60-year-old woman explained (Potts ef af. 2003.72) Yes, t 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 [think about 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 anx $0 on, in the olfer age group. Even for women and men who already do see erectile changes as 4 problem to be fired, ‘Viagra delivers ove solution (pharmaceutically restoring the ereetle capacity) with such force that other potential “solutions” are either obscured or devalued. In the ease 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 ‘ith an erect penis and coitus ar 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 restrctively, t0 clase 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 19 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 Handbook of the new sexuality studies 140 ‘who cannot, oF prefer not to, engage in sexual intercourse on every. oF even any, sexual In the midst of a Western cultural moment that is atguably open to all sorts of possibility for progressive social change around sexuslity, the Viagra phenomenoa is profoundly disappoineng. Social corstructionist perspectives (e.g, Foueauk 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-consiitution 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 fhuman sexuility might allow for shifting and less rigid norms that promote increased tolerance and an ethie 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 tbungry for new markets in which to expand profit. 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