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JOURNAL OF SEX RESEARCH, 49(4), 344–352, 2012

Copyright # The Society for the Scientific Study of Sexuality
ISSN: 0022-4499 print=1559-8519 online
DOI: 10.1080/00224499.2011.644598

From Desire to Disease: Human Papillomavirus (HPV) and the Medicalization
of Nascent Female Sexuality
Jessica C. Polzer and Susan M. Knabe
Department of Women’s Studies and Feminist Research, The University of Western Ontario

This article critically examines the proliferation of information on the human papillomavirus
(HPV) vaccination as integral to contemporary processes of medicalization that take the
young female body and her nascent sexuality as its primary object and target. We suggest
that the recent introduction of voluntary HPV vaccination for girls, in North America and
elsewhere, constitutes a form of neomedicalization (Batt & Lippman, 2010) that links risks
for future disease (cervical cancer) with the transmission of a common, sexually transmitted
infection (HPV). Informed by findings from a critical discourse analysis of Canadian English
newspapers, magazines, and public information about HPV vaccination, our interest is on how
the emergence of sexual relationships becomes constructed as a time fraught with risks to
future health, and that must be managed through biotechnological intervention (vaccination).
We suggest that this configuration of medicalization, rather than demarcate a new category of
abnormality that can be treated with pharmaceutical or medical intervention, positions the
emergence of sexuality itself as the basis of risk and pathologization. The article concludes
by considering the implications of this form of medicalization for constructions of female
sexuality and sexual health education.

Vaccination against human papillomavirus (HPV), available information about HPV is nothing short of
often described as the world’s most common sexually staggering. Whereas as recently as five years ago the
transmitted infection (STI), has swiftly emerged as a term HPV would have been recognized only by medical
public health priority in North America and elsewhere. researchers and practitioners in the field of sexual
In Canada, voluntary, school-based immunization pro- health, today this term has gained a lively presence in
grams are free of charge for all girls aged 9 to 13, and popular culture and the public’s imagination. This
have been implemented in each of Canada’s provinces spread of awareness about HPV is due in large part to
and territories. The rationale for initiating the the aggressive marketing of HPV vaccines Gardasil
three-dose vaccine within this age range is based on evi- and the more recently approved Cervarix1 by pharma-
dence suggesting that efficacy is greatest prior to onset ceutical giants Merck & Co., Inc. and GlaxoSmithKline,
of sexual relations (National Advisory Committee on respectively. As well, both before and following the
Immunization [NACI], 2007). Gardasil1, the first Health Canada approval of Gardasil, many news and
HPV vaccine approved by Health Canada in July magazine articles reported on the vaccine, with many
2006, protects against four types of HPV, two of which hailing it as a medical breakthrough (e.g., CanWest
are associated with the development of approximately News Service, 2006) and milestone in public and
70% of cases of cervical cancer (Types 16 & 18) and women’s health (e.g., Richwine & Heavey, 2006), and
two of which are associated with the development of some raising concerns about the vaccine (e.g., Gulli,
approximately 90% of cases of genital warts (Types 6 George, & Intini, 2007; Picard, 2007). In addition to
& 11; NACI, 2007). news and magazine articles, a number of organizations
Accompanying this institutionalization of the HPV actively promote the uptake of vaccination against
vaccination for girls, the recent proliferation of broadly HPV on their Web sites and in print brochures. These
include national and provincial health authorities (e.g.,
Ontario’s Ministry of Health and Long-Term Care
We gratefully acknowledge Laura Cayen for her assistance on this [MOHLTC]), cancer agencies (e.g., the Canadian
project, and the anonymous reviewers for their helpful suggestions. Cancer Society [CCS]), and local public health authori-
Correspondence should be addressed to Jessica C. Polzer, Depart- ties, which implement the school-based vaccination pro-
ment of Women’s Studies and Feminist Research, The University of
Western Ontario, 3237 Lawson Hall, London, Ontario, Canada
grams. The Society of Obstetricians and Gynecologists
N6A 5B8. E-mail: jpolzer@uwo.ca

Inc. which produces Gardasil (Merck. lung and breast cancer account for opportunities to develop and market new drugs and 25. 2003) and who vaccine’’ (e. and treatment of female 2009). 2000). risks. ‘‘increase the Gardasil through its ‘‘Make the Connection’’ and ‘‘Tell arc through which the biomedical language and perspec- Someone’’ campaigns (Wolfe. which are then managed or cer disease. alcoholism) or natural Although there are over 100 types of HPV. usually in terms of illnesses. NACI. Morgan. According to and populations.. p. American medicine in the context of an increasingly vical cancer incidence and mortality were drastically technologized landscape of health and health care reduced when access to screening became universally (Clarke. through which nonmedical problems. which. Similar to this biomedicalization Canadian cancer statistics. 2010). Fosket. Among all cancer deaths among women companies) transform risks for future disease into (N ¼ 36. 2009. Shimmin. following the initial Health Canada & English. Cervical cancer ranked as the 20th deadliest use the term neomedicalization to consider how cancer. or subsequent implementation of school-based vaccination processes. undetected.. 1990. conceived as social problems (e.300 new cases of cervical theory (Clarke et al. 1998. Such conflations obscure evidence that ‘‘treated’’ using medical technologies or expertise HPV is carried by both males and females and is easily (Conrad. as evidenced by numerous headlines and refer. stakes in the support or refusal of such naming and fram- vical cancer. and name and frame things in biomedical terms and.. 2007). rather than to control the spread of STIs ing. & Tsui. & Stryker. with the largest reductions on the optimization and enhancement of health through observed among women in the lowest income groups the identification and surveillance of risk in individuals (Ng.S. Not the Disease’’ campaign The rapid implementation of HPV vaccination pro- (www. to that cervical cancer results when infection with HPV is bring them under medical control and surveillance (Zola. constructed through Merck & Co. or disease. that most cases lization focused on the power of the medical profession to of HPV are transient and spontaneously cleared. lar entity and conflate HPV infection with cervical can. usually programs. medicalization describes the process. & Boscoe. research funders. and persistent (Lippman. characterized by an emphasis gram in the early 1970s.g. continuing medi- fully cultivated public awareness of the linkage between cal education organizers. Mamo. accounting for 370 out of 76. whereas cervical cancer technologies that purport to help women manage these accounts for 1% (CCS. MEDICALIZATION OF NASCENT FEMALE SEXUALITY of Canada (SOGC. 2010.. licensing of in providing press coverage of key events. Habel.’s ‘‘disease pharmaceutical companies. aging and childbirth). 2007).. the term biomedicalization has been cancer control strategy in Canada is interesting. and has been financially supported grams as a public health strategy to prevent cervical can- in these efforts by educational grants from Merck & cer. disorders. and the proliferation of awareness about HPV and Co. Fishman. more recent feminist accounts emphasize how Melnychuk. but more specific in its cri- cancer were diagnosed in 2010. HPV and cervical cancer prior to the U. & Shim. Gunson. transformed by processes of medicalization (Ehrenreich and young women.g. Urquhart. approval for females aged 9 to 26 years and the Traditionally. 1992). 2007) has been a major player in Background and Conceptual Framework promoting the uptake of the HPV vaccination through its ‘‘Spread the Word. This prioritization of cervical cancer was initially sexual dysfunction (FSD) involves experts (urologists). of medicalization includes patient groups and women flation. Nelson. 2003). actively negotiate health-related risks and decisions in 2006. Fung... Whereas many early accounts of medica- transmitted between sexual partners.ca).hpvinfo. 2010). 2007).200). Calloway. government agencies.g. cer. Inc. HPV vaccines have been marketed to girls networks that involve various groups with different and young women primarily as a means to prevent cer. Wilkins. girls. 1972). the classification. are symptomatic of the ways in which Page. themselves. For example. This more complex picture media have also played a role in perpetuating this con. become defined and representations tend to speak about the virus as a singu. thus. 2009. medicalization operates through dynamic processes and Despite this. Neomedicalization poses particular threats to 345 . Riessman. 2006). The introduction of a mass HPV vaccination as a More recently. 45).g. 2007. respectively. Polzer & Knabe.. 2004). Talaga. awareness efforts’’ (Herskovits. university researchers. who participate in and stand to benefit from ences to Gardasil as the world’s first ‘‘cervical cancer processes of medicalization (Riessman. & Clark. transformation is. 2010. Batt and Lippman (2010) women. Jorensen. given proposed to describe a major transformation of the success of cervical cancer screening. Robertson. The popular tive are disseminated’’ (p. This available under Canada’s national health insurance pro.8%. To date. 2004. diagnosis. 2010. 1. understood in medical terms. in part. specific contexts of medicalization (e. & Berthelot. Saraiya. Hartley and Tiefer (2003) showed how (Mamo. which purpose. 2009.8% and 14. untreated. the majority of these education= women’s bodies and lives have been subjected to and marketing efforts have been targeted at parents. In Canada. as well as the mass media. Liddon. popular processes (e. HPV vaccines.200 total cancer corporate-driven efforts (usually by pharmaceutical deaths. making cervical cancer tique of the effects of neoliberalism on public health the 13th most commonly diagnosed cancer among policy and women’s health. 2010). Mancuso & Polzer. 60).

& Dennhardt. and as we go 2011) and privilege particular ways of being. However. Roy (2007) used discourse analysis methods they narrowly focus on individual and biological traits. 123). 1980)—a view that sees health as a moral suffering. POLZER AND KNABE women’s health because the feminist health principles of We locate this work within feminist scholarship that has empowerment and autonomy are easily co-opted by the examined the various ways in which women’s bodies are increased ‘‘choices’’ that these new drugs and technolo. thus. and management in health drugs and devices. thus. processes of neo. 1995.. implicated in the regulation of makes being ‘‘at-risk’’ a disease state and frames the healthy populations (Lupton. and sexuality (e. self-surveillance. of women’s health risks and medicalization. and technologi- transform health from a public good into a commodity cal intervention (e. are symptomatic of neoliberal poli. Moynihan & Mintzes. tion of the media content (e. Morgan. the ‘‘passing through a normal life stage from childhood possibility of developing future cancer. the mass media consti- tute a rich site to examine current cultural constructions Like other forms of medicalization.g. popular media.’’ Current emphasis on risk and self-surveillance and the purchase of particular identification. 2006. tation construct and convey particular ideas about gen- typically does not result in cervical cancer. these risk-based approaches multiply problem and the use of some drug or device to manage opportunities for surveillance and preemptive inter- this risk. neomedicalization vention. this pathologization Gardasil in the United States. (Batt & Lippman. As a primary vehicle for the dissemination of not become reality. scientific. which (e. but rather through a cancer link. p. or improve- cies that aim to stimulate the biotechnology sector and ment through pharmaceutical. In particular. and resource for economic growth. Hartley & Tiefer.. to illustrate how English–Canadian women’s magaz- thus obscuring the social determinants and processes ines reinforce a prevailing ideology of ‘‘healthism’’ that produce inequitable distributions of disease and (Crawford. individual as responsible for ensuring that the risk does 1996). analysis to illustrate how the advertising campaign for cent female sexuality. In one sense. 346 . and other modes of represen- acquiring HPV is normal: HPV is easily transmitted. der.g. Such approaches to textual In this article. 2009.. the established epidemiological link are morally obligated to take responsibility for their between some forms of HPV and cervical cancer makes health and the health of their children. monitoring.. course conveys particular notions of nascent female Habel et al. 1998. Huot. For example. are structured to frame health issues in particular ways. 2010). Crossly. neously clears in most cases. 2010. For medicalization depoliticize the causes of ill health as example. Roy identified HPV vaccination discourse within the broader socio. (2010) used discourse through vaccination. Clarke. health. Processes of neomedicalization. This linking of risk. 2009) to examine how media messages sexuality and parental responsibilities for sexual health. 2003. interdisciplinary analysis of health representations go beyond a descrip- perspective to illuminate how HPV vaccination dis.. or subjec- on to suggest.g. Petersen & Lupton. treatment. biomedical approaches to gies claim to offer. promotion and public health expands the scope of med- and individual responsibility for health is a key feature icalization by linking everyday life events and behaviors of neomedicalization. cularly relevant in the Canadian context to understand Drawing on Batt and Lippman’s (2010) notion of neo- how neoliberal policies effect shifts in public health medicalization. surgical. Mamo et al.. we are particularly interested in how priorities such that increasing emphasis is placed on HPV vaccination extends processes of medicalization individual citizens who are expected to minimize their into the lives and bodies of girls and young women exposure to risks for disease through increased medical through the concept of ‘‘risk. pathologized by reductionist. 2007. to adulthood’’ (p. by linking the universally construct all girls as inevitably ‘‘at risk’’ for emergence of a typical life experience (sexual relations) cervical cancer as a result of their being on the cusp of with the possibility of acquiring HPV and. through which the politics of risks to health merge with Such textual analysis methods are useful to show how the medicalization of female sexuality. and are. Calloway et al. we take a feminist. J. eating and sexual activity) with the potential for negative health outcomes in the future. responsibility and goal that is achieved through individ- The concept of neomedicalization is helpful to situate ual effort and enterprise. and its associated occurs not through the designation or classification of a non-branded awareness campaigns of the HPV–cervical sexual abnormality or dysfunction. has the effect of pathologizing nas. Gupta.. As we argue. and sponta. specifically. the possibility that HPV may lead to cer.g. and the possibility of foreclosing this risk 2009). displace concerns about HPV as an STI and pathologization of the normal—that is. Indeed. This concept is parti. Batt health and constructed as objects that require medical and Lippman argue. In its most expansive form. within this genre as rhetorical strategies to reinforce ary expressions of the medicalization of female the prevailing cultural attitude that women. how cautionary tales and inspirational stories are used political matrix and to consider its effects on contempor. assessment.g. Even when emphasizes an individual’s supposed risk of developing a well-intended. tivities (e. 50) ideas about health and sexuality. vical cancer. Laliberte-Rudman. consumption. sexuality. or suffer the HPV vaccination a unique and interesting case study consequences.

2009. question how advertising and awareness campaigns Consistent with CDA. mission is effected through repeated descriptions of the Chatelaine and Cosmopolitan). multiple close readings to elucidate the meanings and nation as the ‘‘right tool’’ for cervical cancer prevention. [sexually transmitted disease] like herpes or human papil- tial effects of such framings. which can cause both genital warts and mere reflections of reality (i. discourses are not lomavirus (HPV). 1142). and the poten. J04]). we identified two broad themes that character- ted on the ways in which industry advertising sets up ized our media sample. images. 2007. for diversity and included gender-neutral magazines The de-stigmatization of HPV acquisition and trans- (e. framing effects they convey through the use of meta- Focusing on the Canadian context. and the ways in pendent review of a subset of the magazine and which such constructions function to incite particular newspaper articles. mak- by explicating the links that are made among girlhood.. Discourses are both enabling and con.hpvinfo. p. (Califano. All news and magazine virus itself as ubiquitous and easily spread. p.ca) and the SOGC’s Studies suggest 10% to 29% of women in Canada are ‘‘Spread the Word. 241) place boundaries on what comes to be viewed and accepted as legitimate knowledge (i. as they construct campaign. 2004). (Kirkey. Thus. 2004. Our sam- The view of nascent female sexuality that emerges in ple includes 180 newspaper articles and 48 magazine our sample of media representations is produced through articles. we analyzed our texts using render girls’ bodies as inevitably risky and HPV vacci. 1999. 2007b. use of statistics: we focus on brochures produced by Ontario’s MOHLTC (www... we present findings from a critical Results discourse analysis (CDA) of Canadian magazine and newspaper articles and selected brochures about HPV Pathologizing Nascent Female Sexuality vaccination published in the English language. although the majority of the including the use of globalizing statements (‘‘HPV is articles in both text domains were published during the most common sexually transmitted infection in the 2006 (when the vaccine was approved) and 2007 (when world’’ [Cherry. Through this iterative health. Brochures were also reviewed to see how these themes were reflected in HPV awareness campaigns. allergies and the common cold). To facilitate this interpretive pro- tions of HPV vaccination around the time that cess. In this article..hpvontario. but are ways dangerous cervical lesions. Method In this article. evoked in relation to this construction. As well. ing them appear reasonable and justifiable while alterna- risk for future disease. and vaccination. For example. . Magazines were selected infection is simultaneously de-stigmatized and amplified. In the news- articles were identified using the search term HPV. This paper and magazine articles. comparisons of HPV with the first provincial vaccination programs were imple- mundane conditions that are not sexually transmitted mented). problems in ways that naturalize some responses.e. Not the Disease’’ sense.g. transmitted infection in the country. 2009). . which commen. Mamo et al. Not the Disease’’ HPV awareness infected with HPV. de-stigmatization is term first appeared in our sample of newspapers in 1986 accomplished through various rhetorical strategies. That makes viral STDs of thinking and speaking about a phenomenon that more common than allergies. The first theme focuses on a con- sexually active young women as having to make deci. discourse analysis goes beyond a description of specific issues reported in the 1 in 3 Americans is now living with an incurable STD media to focus on how issues are framed.ca). Maclean’s) and gender-specific magazines (e.g. tic strategies (Cheek. Newspapers and magazines were selected on a productive tension in which the risk posed by HPV the basis of readership levels. truth or facts. privileged by HPV vaccination discourse. ments that it is easily transmitted through all forms of straining ‘‘in that they allow for certain ways of thinking sexual contact. and in magazines in 1996. The second hensive and easily accessible information (Polzer & theme describes the parental responsibilities that are Knabe. For example. In this chures used in the ‘‘Spread the Word. tive responses are rendered illogical and less legitimate. p.. we use a similar phors. in print and online bro- about reality while excluding others’’ (p. A1) From our critical perspective. HPV is further de-stigmatized through repeated state- Cheek. ality that are privileged by popular media representa. and through the that promote the uptake of vaccination. . Laliberte-Rudman et al. what is). making it the most common sexually campaigns (www.e. MEDICALIZATION OF NASCENT FEMALE SEXUALITY and the discursive effects of such framings. Lupton. HPV is described as a ‘‘highly contagious’’ 347 . and other rhetorical devices and linguis- approach to identify the constructions of female sexu. 1992).. which was then refined by applying expectations and responsibilities regarding sexual the template to new sets of data.g. they have framing effects. struction of pathologized nascent female sexuality that is sions about HPV vaccination in the absence of compre. process. This extends our previous work. we developed a coding template based on our inde- Gardasil was approved in Canada. we collected a number of brochures (e.

vaccination is highlights this insufficiency by juxtaposing it with presented to parents as the reasonable and responsible national and global cervical cancer mortality statistics: decision to ‘‘protect’’ their daughters from cervical can- cer. teens are depicted as ease of transmission. absolute.000 women worldwide. safe sex and preventive health practices: (Hutsul. and frame cervical cancer as a fatal disease. of sexual relations. (Morse. p. underlying these differences. and as likely to be unreliable risk managers. (Downton. 2006. 21) HPV and cervical cancer. A8]). it is accompany their nascent sexual activity. [T]here is no such associated with the possibility of acquiring HPV and. Rarely do these articles mention that cervical women and teens as particularly vulnerable to STIs. potentially deadly has the paradoxical effect of ‘‘Annually.to 290. D04) At Planned Parenthood . but HPV—often misunderstood as merely warts and grouped with crab As well. cancer incidence and mortality have been declining. ‘‘Every nine. but not encounter even without penetration’’ (SOGC. is characterized by a tension in which Communicating Responsibility HPV is simultaneously constructed as potentially deadly. 2007). the construction of HPV as common but incidence and mortality statistics are reiterated (e. 2003.400 women are diagnosed with it de-stigmatizing this STI just as it pathologizes the onset in Canada and about 400 die of it’’ [Bridges. 2007. but also through and newspaper articles as a reason why condoms are skin-to-skin contact’’ [Kirkey. The second theme refers to the parental responsibil- yet ubiquitous and easily spread through all forms of sex. a picture and that cervical cancer is the 13th most commonly is painted of a population that cannot be trusted to pro- diagnosed cancer among Canadian women (CCS. . While HPV is de-stigmatized through its ubiquity and In both magazines and newspapers.g. cervical cancer. protection. Young women were our media sample through the consistent and selective unreliable about getting their Paps. cervical cancer statistics also fre. we also knew that our young The potential deadliness of HPV is also emphasized in patients were notoriously immortal. . 2007a. Moreover. we consider how their parents quently appear in the news media with infrequent are called on to respond to and manage this risky nas- attempts to distinguish these from Canadian statistics cent sexuality through biotechnological intervention (which are much lower) or to discuss the reasons (vaccination). future cancer. including about 400 in 13-year-old girl in the country should be vaccinated 348 . teens are described as failing to exercise proper lice and other low-impact STDs—lurks in the shadows.g. . . provincial and national In summary.. Because any form of sexual contact insufficient protection against HPV. The ease of transmission is often cited in the magazine ted not just through sexual intercourse. p. Chlamydia and 14. by constructing young A02]). POLZER AND KNABE virus that can ‘‘infect anyone who has ever had a sexual Canada each year. HPV vaccination discourse. This unable to provide full protection against HPV: emphasis on the ease of HPV transmission and acqui- sition is significant because behaviors that may have [W]e have learned at least one frightening thing about once been regarded as sexual exploration and innocent the disease: HPV is spread through skin-to-skin contact messing around become reframed as risky activities of genitals and their surrounding areas. 2007b. 2002. p. In news articles. . p. despite its deadly potential. 2006. (Talaga. its potentially deadly consequences particularly vulnerable to the health risks that are simultaneously emphasized. (Kirkey. p. close to 1.to 17-year-olds has found. Thus. In the following section. thus. the risk of acquiring HPV is gized construction of nascent female sexuality amplified by repeated warnings that condoms provide described earlier. 2010). These depic- through its epidemiological association with cervical tions are supported by drawing on studies that describe cancer that HPV has been framed as a serious STI teens as lacking the knowledge and ability to appropri- worthy of public attention. as represented in our media sample. A1) Spreading HPV through non-penetrative sexual contact also features in newspaper accounts (‘‘HPV is contrac. Condoms provide some. an online survey of big-time profile afforded to other STDs. ities that are communicated in relation to the patholo- ual contact. tect themselves against HPV and. Worldwide. p. just as they were presentation of statistics that reinforce the link between about using condoms. 41) thus. A16) herpes have had their names in lights. The following quote is deemed likely to expose girls to HPV. This duty to protect through vaccination is directly HPV causes almost all cervical cancers. which are described as more widely recognized and consequential: Canadian teens know little about sexually transmitted infections and are participating in risky behavior that The virus. Furthermore. This is accomplished by ately judge their vulnerability to such risks: comparing HPV with other STIs. In the news media. p. killing about stated in some newspaper accounts (e. has never had the could be hazardous to their health. thing as safe sex. so condoms don’t always protect against it..

‘‘We encourage parents to get the facts accompanied by the phrase. It’s the right thing Centre. who is situated as both political leader and tales. particularly in the way that they juxtapose their father. which again features on its cover of Screening of Cancer Care Ontario. 2007. . p. both smiling she said. ‘‘Love alone won’t protect and discuss the HPV vaccine with their children’’ (p. But. ‘‘Every year in Ontario about 550 compared to just the grief and distress women have with women are diagnosed with cervical cancer and 150 die. This rhetorical framing of the HPV vaccination demon- she did not hesitate for an instant.’’ On the inside flap. 16. p. Similar representations accompaniments to their sexual development. . A4) cancer for women aged 20 to 44. the follow. (vaccination) can preempt risk for cervical cancer and cal cancer’’ [Kirkey. When the family doctor recommended to Anna Janes (MOHLTC. In this In the newspaper articles. preserve their daughters’ future health: nicated through the use of personal stories and testimonials. personal testimonials from excerpt. 2007. in particular. 2007b. and they do die from this disease. . he recommends it because She didn’t mind spending a total of nearly $400 for three the sexually transmitted virus causes genital warts and injections for her daughter Allie. This vaccine pre. it’s an easy equation .’’ followed by. experiences having and treating cervical cancer with nation in moral terms as the ‘‘right’’ decision. I couldn’t imagine who wouldn’t want from harm are mobilized to present vaccination as an their daughter protected. finished with. nate as straightforward. p. with families and This duty to protect is reflected in print brochures mothers. disseminated as part of Ontario’s eighth-grade vacci. ever want anyone to go through what I YOUR DAUGHTER FROM CERVICAL CAN. which present parental decisions to vacci. ‘‘If anybody is against this. ‘‘This I do for MY about the costs of not vaccinating: DAUGHTER. . chief of obstetrics at Sunnybrook Health Sciences it saves lives. .’’ (Ferguson. Cervical cancer is the 2nd most deadly cancer in women. and that active steps daughters. p. with Ontario’s Grade 8 vaccination program you can help protect your daughter from this deadly disease. A11) the inside of the brochure. . the vaccine is further described as a special investment that parents— In addition to encouraging parents to vaccinate their mothers.’’ (Picard. did because of a stupid little virus. One of parental obligation to protect are evident in the 2009 ‘‘Letter to the Editor. cervical cancer. ‘‘This is when we see women at the peak of their careers. not to vaccinate (Roy. nation programs for girls in eighth grade. and to overcome any discomfort they may 349 . given the established link Its main cause is the Human Papillomavirus (HPV). for example. Similarly. (Picard. one abnormal Pap smear. including vaccination’’ holding her daughter close to her chest. which can cause cervical cancer. 2009) that her 16-year-old daughter be vaccinated against human papillomavirus. offering this to our girls in Grade 8 because Blake. ‘‘physician and mother. which func- nicated in news reporting about the controversies tions to warn parents what might happen if they choose surrounding Ontario’s decision to implement vacci. On a visit to the cancer ward. 2007. . is particularly persuasive as he describes vacci.’’ by Verna Mai (2007). as a father. deadly cancer’’) acts as a cautionary tale. . 2007.’’ in an article that appeared on the eve of the provincial decision to Premier Dalton McGuinty said it’s up to parents and cover vaccination for eighth-grade girls: their daughters to decide whether to get the optional vaccinations. strates how parental love and desire to protect daughters vents cancer. this cervical cancer survivor warned readers nation presented the headline. said cervical cancer is the second most common to do. The fram- ing of cervical cancer as highly lethal (‘‘the 2nd most The parental responsibility to vaccinate is also commu. these media messages encourage parents to imagery—can make in their daughters’ futures (‘‘This become actively involved in the process of communicating protection is truly something special you can do for to their daughters risks that are framed as inevitable your daughter’s future health’’). ’’ We are . . Director MOHLTC brochure. Dalton patients and doctors similarly function as cautionary McGuinty. the image of a mother holding her daughter. The 2007 MOHLTC brochure that accompanied Ontario’s first rollout of the HPV vacci. both for the decision to vaccinate. p.’’ Below this is a close-up image of a mother ever we can to protect people.’’ (Talaga. MEDICALIZATION OF NASCENT FEMALE SEXUALITY against the sexually transmitted virus that causes cervi. The HPV vaccine is also presented as an opport- ing excerpt reminds parents of the potentially unity for parents to initiate discussions about sex with deadly consequences of HPV. A1]) and is also commu. AA07). 2007). We should do what- CER. A11) obligation to ensure a child’s health and life. ‘‘ONTARIO’S GRADE 8 HPV VACCINATIONS TO HELP YOU PROTECT ‘‘I would never. ‘‘For the money. the voice of Ontario’s premier. . between HPV and cervical cancer: Now. as suggested by the visual daughters. Consider the following story the government of Ontario and for parents: of Jenny Blake. I’ll take them for and looking out to meet the gaze of the viewer. your grade 8 daughter. It’s a simple reason. A18) nation program. .

2007). 2007. our analy- ‘‘It certainly isn’t carte blanche to participate in any sis considers how constructions of nascent female sexu- kind of activity that they want. thus. but nological solutions to sexually transmitted health risks. As the following passage suggests. and specifies parental responsibilities Furthermore. campaigns in the United States. but also invoke particular responsibilities to manage these ‘‘risky’’ bodies. which primarily focuses part in the proliferation of discourse about HPV and on the time around the approval of Gardasil for girls HPV vaccination and. its links to cervical cancer. and the benefits responsibility for sexual health. such as HPV vac- industry strategies that intentionally capitalize on exist. boys. the imperative expressed by media mes- to manage this risk both through vaccination and com. is et al. Drawing on the awareness about HPV and HPV vaccination raises notion of neomedicalization. However. of vaccination can be communicated and deployed. cervical cancer). and youth sponsored advertising for Gardasil and HPV awareness a chance to talk openly about sex and its consequences. 1998). The linking of 350 . potentially deadly). More specifically. These relationships are specified by the dis. 2009). In addition. appeals to ‘‘open’’ communication between logical link between certain types of HPV infection and friends are made in the ‘‘Spread the Word. tify the need for such technologies. However. and constructions of topic of HPV vaccination may be helpful to some par- responsibilities (both to vaccinate and communicate ents who use it as a convenient entry point into broader risks associated with HPV). usually harmless. Rather. cines. in the process of and young women and the development of the HPV vac- pathologizing nascent female sexuality. However. but also for establishing new requirements and course privileges a particular view of nascent female standards for responsible parenting and citizenship.’’ (Gulli. talking pathologization by designating the onset of sexual rela- ‘‘openly’’ about sex is driven by considerations of risk tions as a time when sexuality must be considered and management: negotiated in terms of future disease. Our analysis is limited to the time HPV vaccination discourse encourages parents to take period of our sampling frame. 37). This making the topic of sex more palatable is an assumption configuration of medicalization does not demarcate a that requires empirical investigation. and older women alters reporting on course as important vehicles through which messages HPV and shapes media constructions of sexuality and about HPV. we question the ways Disease’’ campaign (SOGC. who found similar trends in industry- that the HPV shot will give parents. new category of sexual abnormality that can be treated gesting HPV vaccination as a convenient entry point into with pharmaceutical or medical intervention. ultimately. (2010). biotech- tions of HPV (as easily spread. This has implications not only for individual vaccination deci- In conclusion. 2006. are shaped in relation to economically driven. sexuality as risky. important questions about the insidious ways in which vious descriptive media analyses of the HPV vaccination responsibilities for sexual health and cancer prevention to consider the symbiotic relationship between construc. We do not claim to provide a com- prehensive account of the specific issues addressed in What we draw attention to here is the way in which our media sample. Not the risk for cervical cancer. In this sense. sex necessarily becomes framed as case with FSD. The HPV and. and health-related risks rely on and perpetuate longstanding their ‘‘natural inclinations as talkers and sharers’’ pathologized representations of female bodies and sexu- (Herskovits.’’ says Davis. cination programs in 2006 and 2007. nation discourse constitutes a particular form of medica. Such representations not only jus- HPV and its link with cervical cancer (Wolfe. our analysis extends pre. Such appeals reflect in which the marketing of products. We suggest that HPV vacci. teachers. we question how the framing of nas- cent female sexuality as risky legitimizes some actions Discussion (vaccinating) over others (not vaccinating). POLZER AND KNABE have instigating these conversations. the idea that HPVvaccination will have the lization that takes the young female body and her effect of ‘‘opening’’ parent–child communication by nascent sexuality as its primary object and target. para. 52) Canadian context. that purport to help girls and women manage their ing female relations (with family and friends). We are not contesting the clearly established epidemio- Similarly. ‘‘But it is ality as risky and in need of protection are perpetuated an opportunity to discuss options and give them the in mass media and public health information in the information that they need to continue with a safe and healthy sex life in the future. Our interpretations are supported by those of Mamo Another benefit. as is the discussions about sex. discourses on HPV vaccination ‘‘risky’’ and as in need of management to ensure future position the emergence of sexuality as the basis of health. by sug. constructions of female sexuality Our concern is not that parents are encouraged to dis- (as pathologized through its inevitable association with cuss matters of sexual health with their children. p. we suggest that HPV vaccination dis. says Davis [President of the SOGC]. sages for parents to participate in the proliferation of munication of health risk information. to create awareness of ality (Morgan. young men. discussions with their children about sexual health. sions. Further research this form of medicalization operates through familial should examine how the approval of the vaccine for relations.

come (starting tonight). race. What is at stake is expertise do not lend themselves to offering concrete not only the commodification of women’s health. do to help make these forces once again visible in raising questions about HPV vaccination. J. November). A. 15. & Lippman.. Journal of Women’s Health. Saibil (Eds. Our theoretical orientation and tions of sexual health and sexuality.. newspapers. July 19). U. June 9). (2010). which tend to con. (2010). (2009). but also and prescriptive recommendations. among other things. health and illness in the U. T. cleared in most cases) with the risk for cervical cancer. along lines of class.. family. Canadian . cuss sexual health? To what extent does framing National Post. worry and fear: The portrayal of pathologize female sexuality? sexuality and sexual health in US magazines for teenage and 351 . Cosmopolitan. we offer the commodification of their intimacy: friends. A. not only for parents who might be judged ings of sexual health been rendered invisible by as being irresponsible for not getting their children processes of neomedicalization? What might we vaccinated. Mamo. A. that unsettle powerful discourses that tend to Clarke. starting point for parents and practitioners to Clarke. & Shim. we hope to promote to promote healthy skepticism and remain vigilant in our critical reflection among practitioners and researchers considerations of how to benefit from medical and tech- who have a vested interest in contributing to and compli- nological advances without allowing powerful economic cating discourses on sexuality. Women’s work. Jorensen. To what extent does framing cervical cancer when implemented as part of comprehensive sexual prevention in terms of HPV vaccination obscure health programs that include. and cultural influences on prevailing understand- cult to resist. Sexually communication between parents and their chil. that mark their sexuality as risky and frame sexual January 2002–June 2005. to be shaped by these pharmaceutical interventions Calloway. Canadian Cancer Society. CanWest News Service. economic. gies. J. A content analysis of news coverage of the HPV vaccine by U. Qualitative Health Research. in relation to health decision making and sexual tions as a medically mediated event. 14(8). Saraiya. We hope that our analysis will contribute to ongoing These questions have implications that extend beyond the feminist efforts that aim to de-medicalize female sexuality case of HPV vaccination. N. At the margins? Discourse analysis and qualitative communication about sexual health in terms of research. dren? How can the ubiquity of HPV provide a Toronto Star.. sexual health. Although by no means an exhaustive list. Nevertheless. gender. MEDICALIZATION OF NASCENT FEMALE SEXUALITY sexual health to cancer prevention undoubtedly alters . initiate broader discussions about sexual health Durham. and so forth? By linking the onset of sexual relations to risk for future . such as HPV vaccines. transmitted disease thought to cause 70% of cervical cancers. what does this Our analysis challenges the ways in which HPV vac.S. but also for researchers and activists who.. HPV vaccination and risk prevention truly ‘‘open’’ Cherry. (2004). this form of neomedicalization is diffi. (2006. How will young women’s first sexual experiences. How to protect your sexual health and their imaginings of these experiences. A02. Toronto: Women’s Press. and sexually interests to dominate public discussions and representa- transmitted health risks. (2006. Toronto. cancer statistics 2010. Vaccination may expression? prove beneficial for some individuals and populations . C. pharmaceutical companies stand policy responses to redress such inequalities? Will to gain from media representations. 803–809. January 18). ter critical reflection and interdisciplinary dialogue. To the extent that processes of neomedicalization the very nature of such discussions. & Tsui. 47–66). Rochon Ford & D. we feel that such questions are important given the power of the phar- maceutical industry and the media to frame sexual health References concerns and the very nature of female sexuality: Batt. the benefits of HPV vaccines also be distributed flate the risk of HPV infection (which is spontaneously differentially. onset as a risk to their future health? Canadian Cancer Society’s Steering Committee. A6.. and may narrow co-opt feminist critiques by appealing to notions the range of issues addressed. of self-empowerment and choice. Preventing disease: Are pills the . thus. To what extent have the political. Biomedicalization: Technoscience. How is the scope and character of sexual health answer? In A. such as Pap cancer morbidity and mortality and the need for smears.). As well. approves first vaccine to prevent through the concept of risk? cervical cancer. social. S. NC: Duke University Press. Fishman. (2007. J.S. What are the consequences of using new technolo. J. contestable? charged with being anti-women’s health. Cervical cancer vaccine hailed. (1999. Toronto Star. Such discussions are necessary and women’s sexual health. J. Califano. .S. J04. Fosket. L.. The push to pre- and sexual health education shaped by pharmaceu. 240–245. 227. C. J. However. J. as opportunities to dis. 1140–1150. mean for how young women develop autonomy cination marks the time of one’s entry into sexual rela. tical interests that expand their niche markets Bridges. may be and. cervical cancer. scribe: Women and Canadian drug policy (pp. the following questions on the basis of our analysis to fos- and nascent sexuality and desire. Cheek. public awareness of the inequalities in cervical well-established screening procedures. (2010). (2006). Vaccine fights cancer virus..

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