The Impotence Epidemic: Men’s Medicine and Sexual Desire in Contemporary China (Critical Global Health: Evidence, Efficacy, Ethnography)

By | April 2, 2018
The Impotence Epidemic: Men's Medicine and Sexual Desire in Contemporary China (Critical Global Health: Evidence, Efficacy, Ethnography)

Since the 1990s China has seen a dramatic increase in the number of men seeking treatment for impotence. Everett Yuehong Zhang argues in The Impotence Epidemic that this trend represents changing public attitudes about sexuality in an increasingly globalized China. In this ethnography he shifts discussions of impotence as a purely neurovascular phenomenon to a social one. Zhang contextualizes impotence within the social changes brought by recent economic reform and through the production of various desires in post-Maoist China. Based on interviews with 350 men and their partners from Beijing and Chengdu, and concerned with de-mystifying and de-stigmatizing impotence, Zhang suggests that the impotence epidemic represents not just trauma and suffering, but also a contagion of individualized desire and an affirmation for living a full life. For Zhang, studying male impotence in China is one way to comprehend the unique experience of Chinese modernity.

One thought on “The Impotence Epidemic: Men’s Medicine and Sexual Desire in Contemporary China (Critical Global Health: Evidence, Efficacy, Ethnography)

  1. Etienne RP
    6 of 6 people found the following review helpful
    5.0 out of 5 stars
    Getting It Up in China, April 4, 2015
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    This review is from: The Impotence Epidemic: Men’s Medicine and Sexual Desire in Contemporary China (Critical Global Health: Evidence, Efficacy, Ethnography) (Paperback)

    Everett Zhang was conducting fieldwork in two Chinese hospitals, documenting the reasons why men sought medical help for sexual impotence, when Viagra was first introduced into China’s market in 2000. He therefore had a unique perspective on what the media often referred to as the “impotence epidemic”, designating both the increased social visibility of male sexual dysfunction and the growing number of patients seeking treatment in nanke (men’s medicine) or urological hospital departments. At the time of Viagra’s release, Pfizer, its manufacturer, envisaged a market of more than 100 million men as potential users of “Weige” (Great Brother) and hoped to turn China into its first consumer market in the world. Its sales projections were based on reasonable assumptions. The number of patients complaining from some degree of sexual impotence was clearly on the rise, reflecting demographic trends but also changing attitudes and values. There was a new openness in addressing sexual issues and a willingness by both men and women to experience sexually fulfilling lives, putting higher expectations on men’s potency. Renewed attention to men’s health issues since the 1980s had led to the creation of specialized units in both biomedical hospitals and TCM (traditional Chinese medicine) clinics. There was no real competitor to Pfizer’s Viagra, as traditional herbal medicine or folk recipes clearly had less immediate effects in enabling sexual intercourse.

    And yet Viagra sold much less than expected. In hospitals and health clinics, Chinese patients were reluctant to accept a full prescription. Instead, they requested one or two single pills, as if to avoid dependence. The drug was expensively priced, and customers were unwilling to sacrifice other expenses to make room in their budget. In addition, Viagra did not substitute for traditional remedies, but rather developed in tandem with them as people switched between Viagra and herbal medicine, taking both for seemingly compelling reasons. Viagra addressed the issue of erectile dysfunction, and its bodily effects were clearly experienced by Chinese men who reacted to it in much the same way as male subjects elsewhere. But it did not bring an end to the “impotence epidemic”, which continued to be framed as more than a health issue by the Chinese media. Viagra did not “cure” impotence or restored men’s potency because it was unable to do so. Pfizer’s projected sales figures had been based on false assumptions, and the Chinese market proved more resistant than initially envisaged.

    Zhang proposes a compelling theory of why it was so, thereby demonstrating the value of a fieldwork-based anthropological study as distinct from other types of scholarly explanations. In contrast to the dominant biomedical paradigm, he rejects the notion that male potency can be reduced to the simple ability to achieve an erection. Impotence is much more than a bodily dysfunction or a “neuromuscular event”: witness, as Zhang did, the despair of men who complain of having lost their “reason to live”, or the frustration of women who accuse their companion of having become “less than a man”. But impotence is not only a metaphor, as some cultural critics would have it. Impotence is often presented as the symbol of a masculinity in crisis or as a sign of the “end of men” and the rise of women in postsocialist China. But these generalizations do not reflect the practical experiences of impotent men, nor do they explain why the demand for more and better sex resulted in anxiety for some men, leading to impotence. “In fact, notes the author, none of the discussions surrounding Chinese masculine crises was either soundly conceptualized or empirically supported.”

    Zhang’s fieldwork confirmed the rise of women’s desire or increased people’s longing to enjoy sex throughout their adult life, but did not go as far as to validate the claim of an “impotence epidemic” or to testify to a “new type of impotence”. During the Maoist period, people were discouraged from seeing doctors about impotence, as sexuality was repressed and the desire for individual sexual pleasure was regarded as antithetical to the collective ethos of revolution. If anything, patients came to consultations to complain about nocturnal emissions (yijing), a complaint that more or less disappeared in the post-Maoist era. When men’s health clinics or nanke departments emerged in the new era, they medicalized impotence and established it as a legitimate “disease” warranting medical attention. Private selves emerged when the overall ethos of sacrifice and asceticism gave way to the exaltation of romantic love and then to the justification of sexual desire and pleasure. But structural impediments to sexual desire did not disappear overnight, such as the physical separation of married couples and other constraints on…

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