The Impotence Epidemic: Men's Medicine and Sexual Desire in Contemporary China by Everett Yuehong Zhang (review)

Nowadays, if you stroll around cosmopolitan cities in China, you will not fail to notice the glaring advertisements for nanke (men's medicine) along streets and at public transits. Unlike the clinical flyers for sexually transmitted diseases, which appear in the marginal areas of the urban space, these advertisements display a formal and professional image. The growing publicization of men's medicine may arouse your curiosity to ask further questions: Does it imply the spread of impotence epidemic among the population? Is it a consequence of sexual liberation since the country's opening up? How do these patients define and describe their problem, and how are they perceived by their family and in the social surroundings? What kinds of medical treatment are available for these patients? To what extent does the professionalization of men's medicine contribute to the treatment, and how well are the medical suggestions being taken? Everett Yuehong Zhang's ethnography about the impotence epidemic provides rich data and insightful analysis of these important but overlooked issues, and it furthers our understanding of the complexity and dynamics of post-Mao transformation.

The book is divided into two parts. In the first part Zhang focuses on the production of desire. He reviews sexual oppression and biopolitical intervention under Maoist governance and posits how the danwei (work unit), hukou (household registration), and political class system contributed to the incidence of impotence. Then he turns to discuss the post-Mao change that people were encouraged to express their concerns about sexual desire and seek medical help if necessary. Zhang does not support the presumption that the incidence of impotence increased due to the sexual activeness fueled by the ideology of liberalization, which in his view just made impotence highly visible in the public sphere. He declares that men's sexual malfunction is not "a neurovascular event" or "a malaise of civilization" but a "social event" (100). In this sense, Zhang explores how the social transformation and bodily experiences entangled with each other in the narratives of nanke patients. Zhang lays out how intergenerational, romantic, and marital relations are inscribed in the experiences of impotence. An illuminating example from his book is the impotence of Mr. Lin (103–5), the only son of a peasant family whose suffering, in the view of Zhang, was the result of being engaged to a girl chosen by his parents. Rather than face his psychological depression, because a strong social obligation made him ignore the potential conflicts with parental dominance, Lin simply treated impotence as a physical problem and sought medication. By examining cases of impotence, Zhang reveals a complex relationship between patriarchy and masculinity, and he also presents the urgency for more gendered-neutral masculinity in the private sphere.

In the latter part of the book, Zhang finds that, on the one hand, with the withering of collectivism and asceticism, expression of the individual's sexual desire became legitimated. On the other hand, such desire was expected to be mastered with self-discipline to fend off obsession. The author explores the ways in which traditional bodily cosmology and ethical beliefs may have restrained desire. Two influential books on nanke cautioned against excessive sexual activity (140–42). People also attached ethical implications to body malfunction, such as the association between impotence and extramarital sexual activity with other women (see the case of Ms. Liao and Mr. Xiao, 142–45). Biomedical techniques (e.g., Viagra, penile implantation) were regarded as temporary and secondary means to deal with the problem. Patients view the difficulties they encounter as being twofold: the loss of "a fullness of jing (精, seminal essence), qi (气, vital energy), and shen (神, spirit)" (181); and "life's fullness, the capacity to open oneself to the world" (220). The revival of yangsheng (cultivation of life), advocating a moderate and balanced lifestyle, emphasized that people should self-regulate their desire so as to return to a healthy and...