soc

Medicalization of Sexuality: A Historical Analysis

What is Medicalization?

There are two inter-related processes

1. Certain behavior or conditions are defined in terms of health and illness

2. Medical practice becomes a vehicle for eliminating or controlling “deviant” experiences – for ensuring adherence to social norms.

Can you think how medicine and “diseases” can be used for social control?

Lobotomy, a surgical procedure of removing the prefrontal cortex, was used in the past to treat a wide range of “mental illness” ranging from clinical depression, to even behavioral “abnormalities”. Of course, as you can guess what is defined as “abnormal” changes overtime so we had people who we would now label as homosexuals, feminists, rebels, all being subjected to lobotomy. How many of you have seen the movie “One Flew over the Cuckoo’s nest”? This film portrays how patients were treated in mental institutions back then, and tells the story of Jack Nicholson, a man who desperately wanted to break out, to rebel, to change things, for himself and for the others. And what happens to him at the end? He is subjected to lobotomy.

Perhaps, lobotomy is an extreme example, it doesn’t really happen anymore. But think of the use of tranquilizers to curb anxiety or hyper active behavior, Ritalin to cure ADD. All these are just instances of how certain behavior types get classified as “abnormal” and medicine is used to “curb” that kind of undesirable behavior.

There are usually three steps in the process of medicalizing a behavior:

1. Conceptual: A medical vocabulary is used to define a problem, so excessive sexual desire is labeled as “sex addiction”

2. Institutional: Physicians legitimate a problem. Have you heard of this book called the Diagnostic and Statistical Manual (DSM)?

Diagnostic and Statistical Manual of Mental Disorders is published by the American Psychiatric Association, used most often in diagnosing mental disorders in the United States. The DSM covers over 300 “mental diseases” ranging from shyness to addiction to video games. New diseases are added all the time – some are deleted.

The criteria that determine what qualifies as a “disease”, change over time and differs from country to country. For example, before a psychiatric plebiscite in 1973, homosexuality was listed in the DSM as a diagnosable mental illness.

3. Interactional: When actual diagnosis and treatment of a “problem” occurs (Doctor-patient interaction). So I go to a doctor with a concern, say I shake my legs too often. And the doctor tells me, “Oh yes, that is a disease. It’s called the Restless leg Syndrome. A lot of people have it. It’s not good for your career. And the doctor prescribes me a medicine to “cure’ it.

But how is medicalization used as a mechanism of social control?

Recall from the first module the two types of social control: formal and informal.

Informal: Sex addiction didn’t exist as a problem till 1970s. Before medicine, it was controlled by informal mechanism like stigma – calling people “nympho” or “slut”.

But then came the formal mechanisms of social control – the Church. With the rise of the Catholic Church (1100 AD), the Church became a formal institution of social control and it labeled homosexuality as “sin”. What other forms of social control can you think of? Yes, the police, the legal system and doctors – over time each of these institutions have labeled homosexuality as “abnormal”, something that needs to be cured either because it is a disease or a crime.

If you are interested, there are a couple of very interesting videos available on youtube.

1950s public information video about how to protect oneself from the “disease” of homosexuality.

http://video.google.com/videoplay?docid=7366196067315057571

A reaction to a Doctor’s statement on Fox News that homosexuals can’t have a family

http://video.google.com/videoplay?docid=-4353648393929664638&q=homosexuality

Let us connect all this back to our topic of social construction; how certain diseases are actually socially constructed, in certain cultures, at a particular point in time. Thus science is used to classify certain behaviors as illness.

For example in the 1920s, science was used to demonstrate that women have smaller brains, cannot be rational, they were too emotional. What did that legitimize? It justified why women should stay at home, not be paid equal wages, not be allowed to vote, not be allowed to be leaders.

As late as the 1960s science was also used to legitimize racist beliefs. There were articles in reputed scientific journals on the genetic basis of intelligence, namely the different makeup of African American brain makes them suitable for domination. What did this do? It justified slavery, discrimination, blacks not being given the right to vote, etc.

Let’s reflect a little bit on what we have thought about till now.

What should science study? It’s not based on just objective conditions. There is a social agenda embedded in the choices made – when scientists study the brain size by gender or race, they are trying to find biological roots for gender roles and racial discrimination.

And this process of putting all behavior under medical scrutiny, involves individualization, complex processes are reduced to narrow cause-effect relationships.

When a couple goes to doctor to discuss the low sex drive of the wife and the doctor prescribes a medicine, what is the harm? The problem is that it is a quick fix, an individual solution for something which is probably much bigger. Perhaps the wife doesn’t want to have sex because she is tired after looking after the children and simultaneously working out of the house. Perhaps she doesn’t want to have sex because her partner is really bad in bed! But all that gets pushed under the carpet because she is prescribed a pill.

Conclusion: What are the consequences of Medicalization?

· Creates new socio-sexual categories: For example, sex addiction versus inhibited libido, but how do we know how much sex is too much and how much is too little. Why is the doctor given all the power to decide?

· Creates new types of people: Sex addicts, homosexuals.

· Creates new ways of judging self

· Constructs new moral boundaries

· Creates new interventions and commercialization: Think of how much the pharmaceutical companies gain from increased sale in anti depressants and tranquilizers.

Question: Can you think of examples of different ways that sexuality has been medicalized in the readings and examples in your life? How does medicalization of sexuality work as a form of social control?