Medicalized Virilism under Scrutiny: expert knowledge on male sexual health in Italy

The “Viagra phenomenon” is the most visible, and most studied, expression of a broader global process of medicalization of male sexuality. Associating male health with self-control and the expression of sexual potency, this process is giving shape to a new public discourse on masculinity, taking the form of a medicalized virilism: legitimized by scientific bases, it restores the foundations of a naturalized notion of man and his sexuality. Medical discourses have a crucial part in this process, setting male sexual health as a new public issue, and thereby constructing both the masculinity to be fixed and the new forms of medical expertise legitimized to treat it. By analyzing documentary material and interviews with medical experts in Italy, this article shows, however, that medical discourses are far from being just a cog in the medicalization machine. Medical discourses work at transmitting cultural scripts which reinforce normatively gendered expressions of sex focused on a phallocentric coital imperative and on a naturalized notion of male sexual desire, assumed as always present and unproblematic. Nevertheless, they also include elements of ambivalence, tension and problematization: an indication that the medicalization process, and the interpretive frames that it implies, are an object of possible redefinition not only by end-users – patients – but also by those actors, experts in the male sexual-health field, who are supposed to be the means of propagating and legitimizing it. By focussing on the plurality of accounts experts give for their clinical experience, we discuss which forms negotiations or challenges of medicalized frames take from within the medical field.