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‘Sex for life’? Men’s counter-stories on ‘erectile dysfunction’, male sexuality and ageing
Annie Potts, Victoria M. Grace, Tiina Vares, Nicola GaveyFirst published: 27 March 2006 https://doi.org/10.1111/j.1467-9566.2006.00494.xCitations: 80Address for correspondence: Annie Potts, School of Culture, Literature and Society, University of Canterbury, Private Bag 4800, Christchurch, New Zealand e-mail: email@example.comSECTIONSPDFTOOLSSHARE
Discourse on male sexuality in mid-to-later life has exploded in recent years (Gullette 1998). Attention to this topic has been spurred by the advent of (highly profitable) sexuopharmaceutical ‘solutions’ to erectile changes affecting older men. ‘Success’ stories abound in the media and in medical literature related to the restoration of faulty erections and ailing sex lives through drugs such as Viagra (sildenafil citrate), Uprima (apomorphine) and Cialis (tadalafil). In this paper we explore some of the ways in which notions about ageing and male sexuality are changing in popular cultural and medical texts in response to the advent of Viagra and the increasing authority of biomedicine in this area. We also demonstrate how the recent biomedical endorsement of ‘sex for life’ (the imperative to maintain an active youthful masculine [hetero]sexuality – defined in terms of male orgasm through penetrative sex) may be challenged by the very accounts of older men who are, or have been, affected by erectile difficulties and have used drugs like Viagra themselves. We present the perspectives of mid-to-late life heterosexual men in New Zealand whose stories question the contemporary biomedical privileging of erections and intercourse ‘at any cost and at any age’. We argue that the current push to identify and treat so-called erectile dysfunction (and restore erections and penetrative sex to relationships) neglects some men’s own experiences of alternative modes of relating sexually that they identify as ‘normal’, ‘healthy’, ‘enjoyable’ and ‘satisfying’ for them and their partners; and undermines their understanding of such changes as positive outcomes of ageing, experience and maturity.
In 1998 Margaret Morganroth Gullette identified a ‘midlife decline narrative’ operating in Western cultures, in which changes associated with getting older are constructed in negative terms through tropes of ‘diminishment’ and ‘reduction’. The ‘decline narrative’, she proposed, is associated with nostalgia for youth; many men (and women) are influenced by this idea and it profoundly affects their relationships and lives in general. In relation to sex, as Gullette (1998: 28) points out, this discourse portrays male sexuality and pleasure as ‘waning’ with age: ‘Men who hold this view go by the numbers, as they were taught in their youth. Counting and contrasting, they note that they have sex less often or more slowly, and that this is awful and could not be felt or be understood otherwise’. Moreover, this authoritative discourse purports to ‘know’ best about the outcomes of ageing: ‘Taking “the truth about aging” as its domain, decline discourse relegates other assertions to the subordinate and defensive realm of counter-discourse’ (Gullette 1998: 7). It is, however, this counter-discourse that we focus on in this paper, particularly as it relates to male heterosexuality. The experience of ageing (and of erectile changes) may give some men opportunities to experiment with alternative sexual lifestyles. Men who take advantage of these opportunities often report that sex in mid-to-later life does not change in quality for the worse, and in fact they are ‘doing more of the kind of sex they want. They are more considerate to women; they are more competent at giving pleasure’ (Gullette 1998: 29, citing the Janus report). Men in this group tell what Gullette terms a ‘progress story’, rather than a ‘decline narrative’; youthful sex as they remember it (or imagine it) may still be their reference point when discussing sexuality, but they relay an account of sex improving with age and experience.
Gullette was writing before what Barbara Marshall (2002) has termed ‘the Viagra era’, and while these narratives of decline or progress are still evident in contemporary culture, we would argue that they are also being modified or revised as a result of the recent focus on the so-called ‘epidemic’ of male erectile disorder (shortened to MED in medical discourse), and the advent of treatments to correct this ‘disorder’. The corollary of constituting erectile changes for men in later life in terms of MED is the new imperative of ‘sex for life’ understood as erectile ‘function’ for penetration (Marshall and Katz 2002).
In this paper we explore the ways in which some men in mid-to-later life, who have themselves experienced erectile difficulties and used Viagra, are challenging this new imperative of ‘sex for life’, and how they are responding to the various ‘decline’ and ‘progress’ narratives.
The current research does focus on the experiential narratives of men experiencing erectile difficulties. But because this research does not attend to the doctor-patient relationship but rather to that of the ‘consumer’ resistant to the knowledges embedded in a medically-marketed product, our theoretical framing of the question of modalities of resistance in the context of the medicalisation critique is brought into focus with greater salience through consideration of Clarke et al.‘s notion of ‘biomedicalisation’ (2003).
Our focus here is on men’s counter-rhetoric on erectile dysfunction, which we explore in the context of perspectives on male sexuality and ageing found in some popular self-help and medical texts over the past decade with a particular interest in the shifting employment of ‘progress’ or ‘decline’ narratives in pre- and post-Viagra era texts.
Changing perspectives on male sexuality and ageing
According to the ‘decline narrative’ men’s sexuality diminishes with age; this is an inevitable ‘negative’ outcome of getting older, accompanied by a sense of loss for the youthful capacities and escapades of the past; Gullette (1998: 17) terms this ‘the invention of (sexual) nostalgia’. In the ‘progress narrative’, while men may still use ‘youth’ or adolescent sexuality as a reference point, male sexuality is viewed as changing in more positive ways with age; men adapt accordingly, and sexual experiences may expand, and take on new meanings and different modes. Both the ‘decline narrative’ and the ‘progress narrative’ are evident in various kinds of literature on male sexuality and ageing. One way of demonstrating the difference in ageing narratives pre- and post- the Viagra era is to compare representations of male sexuality and ageing in popular cultural and medical texts over the past 10 years.
Popular sexual and lifecourse self-help texts
Popular sexual self-help texts preceding the Viagra era may be seen to stress the ‘naturalness’ of changes in sexuality associated with ageing, and endorse such changes as positive and normal. This is typical in pre-Viagra texts on so-called ‘milestones’ in men’s lives, such as the ‘male menopause’ (also referred to as the manopause, andropause and viropause). For example, in Male Menopause, Jed Diamond (1997: 5) contends that:
The greatest concern most men have as they enter the Menopause Passage is the loss of sexual functioning. Many men cling to memories of the rock-hard-fire-hose penis of their youth. They are unprepared for the normal changes associated with Second Adulthood . . . Male menopause forces men to confront their changing sexuality. Rather than being a time where sexuality drops off, it can be a time where sexuality expands and takes on new dimensions.
In the 1990s, Gail Sheehy’s (1995, 1999) books on lifecourse psychology were extremely popular in the United States and other Western countries. In Understanding Men’s Passages: Discovering the New Map of Men’s Lives, Sheehy (1999) outlines her version of ‘the male sexual life cycle’. This cycle, not to be confused with Masters and Johnson’s (1966, 1970) ‘male sexual response cycle’, consists of several stages: ‘Racing car sex’ (ages 15–30), which is characterised by narcissistic attitudes to sexual pleasure involving ‘instant gratification’; ‘Dutiful sex’ (30–40), when ‘sex becomes powerfully linked to procreation’; ‘Masters Tournament sex’ (40–55), defined as ‘the virtuoso peak of a man’s sexual life cycle [when] his sexual responses slow enough for him to control, choreograph, prolong and savor each erotic encounter’; ‘Surfing sex’ (55–70), when erectile changes are most noticeable; and ‘Snuggling sex’ (ages 70 onwards) when touching and tenderness are important (Sheehy 1999: 181–4)1.
Sheehy (1999: 184) states: ‘It is normal for a man, after 50, occasionally to have a partial erection . . . A clever man will educate himself to graduate from adolescent “racing car sex” to “surfing sex”’. It is worth focusing some more on this stage she calls ‘surfing sex’ as most of the men we interviewed were in this age range. Sheehy elaborates:
The surfer won’t exhaust all his sexual energy in a frenetic effort to reach full erection and orgasm . . . Instead he will ride the waves of erotic love, gliding up with the swells of pleasure [and] down with the ebbs of intensity, when stroking and intimacy can be enjoyed . . . He will learn the ways his partner likes to be pleasured, with hands or tongue, in between their couplings . . . He will enjoy receiving pleasure from his partner’s touch . . . (1999: 184)
While the various stages of the male sexual life cycle speak of the advantages of sexual pleasures and practices diversifying with age, Sheehy (1999: 199) also reinforces Masters and Johnson’s adage, ‘use it or lose it’, and thereby supports an imperative to maintain sexual activity for as long as possible or else risk losing the ability altogether.
These two sexual self-help texts, Male Menopause and Understanding Men’s Passages, provide examples of pre-Viagra narratives associated with male sexuality and ageing. While male sexual capacity may be described according to negative tropes of degeneration (‘dropping off’) and deceleration (‘slowing down’), male sexual experience in mid-to-later life is considered to have the potential to ‘expand’ and ‘take on new dimensions’. The pleasures of mutuality in sexual relations become more significant; the importance of non-penetrative and even non-genital sexual pleasures is acknowledged; and men are encouraged to expect, accept and adapt to ‘natural’ changes in sexuality associated with growing older.
In contrast, some popular sexual self-help texts following the advent of Viagra (and here we have specifically selected those which focus on the use of Viagra as a sexual self-help measure) argue that erectile changes are not a normal feature of ageing:
Many people believe ED is a natural consequence of aging. This just isn’t true! (Viagra and the Quest for Potency, Drew 1998: 12).
In the past, people assumed that as men grew older, their sexual function would automatically slow down and finally fail . . . We now know that the inability to function sexually has very little to do with age (Viagra: The Wonder Drug for Peak Performance, Whitehead and Malloy 1999: 10).
Post-Viagra self-help texts may ‘reinvent’ changes in erectile capacity in older men as adverse and abnormal (there is no ‘natural’ shift in ‘sexual function’ linked to ageing); they may advocate that any reduction in sexual ability can be countered; in any case, ‘decline’ is viewed as a pernicious force –‘the enemy’– which men must combat (with the help of biomedicine and ‘virility remedies’):
For the first time, it is possible to restore optimal sexual function to nearly every man who desires it. [Viagra] will put to rest the myth that ED is an irreversible function of aging. In a matter of minutes, the new oral medications can: allow a man to have firmer erections to ensure fulfilling sexual intercourse; renew and strengthen an existing – or even dormant – sex life; . . . offer joy in the sexual arena, where little or none had been felt for years . . . (The Virility Solution, Lamm and Couzens 1998: 11).
The post-Viagra self-help texts dismiss the inevitability of erectile difficulties associated with ageing. A modified version of the ‘decline narrative’ is employed within these texts – no longer is a man to accept bodily and erectile changes, whether they are associated with ageing or any other process, event or condition; changes in sexual capacity in mid-to-later life must be resisted and overcome, and ‘premorbid’ sexuality restored. They also relay a ‘revised progress narrative’, which espouses the revitalisation of ‘potency’, the ‘restoration’ of sexual relationships to prior states, or even the ‘strengthening’ of sex lives beyond the scope of previous sexual pleasure. ‘Progress’ is measured in terms of the ability to ‘turn back the clock’ and maintain ‘functional sex’ for as long as possible. Functional sex – and sexual performance – in these books generally equates with penetrative sex, which is viewed as essential to concepts of masculine identity and potency. These texts re-establish and reinforce the primacy of firm and enduring erections – capable of penetrative sex – in constructions of healthy male heterosexuality, and in all stages of life. They argue that there is no need to accept change with age; indeed, men can – and should – enjoy ‘sex for life’ (by which they clearly mean one