For Some Men, Erectile Dysfunction Is Totally Chill
In the US, there is an expectation for men to become erect and have penetrative sex throughout their lives. One study finds that, elsewhere in the world, men are happy to be rid of their hard-ons.
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Recent research by Emily Wentzell, an associate professor of anthropology at the University of Iowa, examines the way that erectile dysfunction's (ED) designation as a medical problem is a consequence of culture and profit-motivated industries. "Ideas about what counts as good and manly sex are cultural, not natural or universal," Wentzell explains in an interview with Broadly. "There is money to be made off promoting the idea that manly men should have life-long penetrative sex, by selling pharmaceuticals—hence the widespread marketing of ED drugs."
In the United States today, it is generally taken for granted today that penises which cannot become stiff enough to penetrate others are failures of health, belonging to men who qualify for medical treatment. Wentzell's study points out something that may seem obvious: Erectile function is tied to conceptions of masculinity and social standing. However, as Wentzell once wrote in an older article about impotence in America, "this way of understanding non-normative erections is culturally and historically contingent," meaning the reasons we view "less than ideal erections" as medical problems are dependent upon social norms, and not some innate truth about the human body or the function of men.
"Focus on penetrative sex as the ideal kind of sexuality to engage in throughout the life course represents US cultural ideas about virility and of the male body as, ideally, a machine that never stops functioning the same way, despite illness or aging," Wentzell says. There are many different justifications given for erectile dysfunction. Today, these range from deeming it a behavioral-based issue to a psychological problem to something purely biomedical. But there are older accounts. Ages ago, Wentzell explains, it was surmised that witchcraft could account for limp dicks. Modern interpretations on the so-called problem, Wentzell says, have been motivated by industries with financial interests.
"The medicalization of impotence and the emphasis on casting phallocentric sex as the natural and healthy sexual ideal have been promoted worldwide through ED drug marketing," Wentzell writes in her study. "While ED drugs can bring real relief for men who want to—but have difficulty—having penetrative sex, they also promote problematically narrow cultural norms for masculinity and sexuality," says Wentzell.
"For drugs to sell, people first need to be sold on the idea that something is 'wrong' enough with them, that they require medical treatment," says Tristan Bridges, a masculinity scholar and a professor of sociology at the College at Brockport State University of New York. Bridges points out that there has been a recent shift in medical language around erectile performance; it is "more commonly referred to as 'erectile quality' rather than 'erectile dysfunction' by medical professionals and in drug marketing material," he says.
This focus on penetration as the most manly, real, and best kind of sex can be harmful
Wentzell says that, by labeling men on degrees of impotence, we have affected their views of themselves along the spectrum of masculinity, impacting their lives. Men have been "marked" as "deviant" to varying degrees because their penises cannot always become erect, and various medical industries have, perhaps cruelly, "provided hope for attaining ideal erection and masculinity to some men while denying it to others."
And Bridges believes this problem is only worsening through the broadening of medical marketing language around erectile function. "Referring to the 'problem' as erectile quality as opposed to dysfunction is a powerful illustration of a piece of the problem: While not all men might perceive themselves as have a sexual 'dysfunction,' the discourse of 'erectile quality' is one on which almost any man can be sold," Bridges said.
In her study, Wentzell plots out alternatives, citing work by her colleagues, who found that "some men using ED drugs to embrace and conform to ideals of lifelong penetrative sexuality, while other men and women critique the 'mechanized' feel of drug-assisted erections or express desires for a widening range of non penetrative practices as they age."
Bridges points out that many ideals of masculinity, such as penetrative sex throughout the life cycle, are marketed "as if they should be achievable by all men." However, this view is not universal; men in other countries view their sexual function differently. "This focus on penetration as the most manly, real, and best kind of sex can be harmful since people often report wanting different kinds of sex and intimacy as they age," Wentzell adds.
Wentzell conducted her study through "open-ended interviews with over 250 men" in Mexico, who were currently receiving treatment "for a variety of urological problems." For 10 months, Wentzell observed "daily life in the hospital's urology clinic." Her findings highlight cultural gender differences and the that the pathologizing of nonfunctioning penises is a choice.
According to her study, the working-class men that she interviewed in Mexico interpreted changes in the functionality of their genitalia in positive ways, forgetting the importance of penetrative sex to maintain an idea of manhood. Such men "came to appreciate decreased erectile function as an aid for living out culturally appropriate older masculinity," Wentzell writes. She tells Broadly that "when those men began to experience erectile difficulty, they understood it as an aid for being a different, better kind of man, more focused on home and family than extramarital sex. They did not want ED drugs, which they saw as socially inappropriate."
Moving forward, Wentzell believes it would be helpful to stop considering changes in erectile function as somehow bad or negative. Giving up on the ideal of penetrative sex, or its role in making so-called real men, "can do social good," Wentzell says. "People would likely be happier with themselves and their partners if think more broadly about what counts as enjoyable sex and see men's changing bodies and desires over the life course as normal rather than pathological."