The Rise of Viagra: How The Little Blue Pill Changed Sex in America (review)

Recently several qualitative monographs have demonstrated the cracks in the structural edifice of the monolithic patriarchy (Faludi 2000, Inhorn 2003, Lucia 2005). Meika Loe's qualitative grounded theory adds to the literature in a significant and highly original fashion. The book would be the most useful addition in the libraries of sociologists, anthropologists and historians of science, medicine and technology, sex and gender studies and masculinity studies scholars, and qualitative researchers.

Her work queries: How can we interpret the "stories told about Viagra" to better understand the implications of phallic malfunction in both micro- and macro-sociological contexts? Her answers embedded in The Rise of Viagra aptly investigate the little blue pill through the critical reformulation of patriarchal domination as heterogeneous, in flux and self-protecting. Social processes of medicalization and the technological imperative are prominently featured in the analysis of robust and extensive data sources. Loe begins her book by laying out the argument that Viagra emerged due to five social circumstances:

1. 1. medical expansion

2. 2. science and technology innovation

3. 3. pharmaceutical deregulation and expansion

4. 4. cultural and demographic shifts in gender and aging

5. 5. increased scientific and popular attention on sexuality and sexual dissatisfaction

Using the theoretical backdrop of symbolic interaction and ethnomethodology, Loe takes seriously the meaning making of individuals about identities, selves, interactions and objects while interrogating the construction of the normal. For example, her work, in the spirit of Doing Gender (West and Zimmerman 1987), deconstructs the institutional scaffolding of the Viagra pharmaceutical nexus. As illustrated in her data, gender is perpetually accomplished through the creation, distribution and consumption of the drug.

Qualitative monographs are only as good as the methodological rigor evidenced in the authenticity of the researcher's voice and trustworthiness of methods of data collection and analysis. For this reason, I began this book with the appendix. Her method design encompasses grounded theory, ethnography and content analysis of triangulated data from 70 in-depth interviews, 60 surveys, hundreds of hours of participant observation, and context analysis of mass media and promotional materials about Viagra. Frankly, it is often a great disappointment to read methodological appendices as they are written as a post script without many interesting or revealing tales from the field. This is not the case with Loe's. From her skilful reflexive vantage point, she shares her recruitment challenges, concerns of going native (a footnote about urges to take the medication should have been expanded), and abandonment of detached neutrality toward an activist scholar method. The consequences of methodological choices are considered in particular the challenges to maintaining entrée to certain informants and sites. And because she seductively alludes to it, perhaps other readers would also be curious about more methodological reflexivity concerning Dr. Loe's "young-looking and female" identity as it relates to her data collection and analysis.

After an introductory chapter that lays the groundwork for the book, Chapter two is a historical account of how erectile dysfunction was transformed from an endemic state to an epidemic. In true interactionist form, Loe employs a "definition of the situation" analysis as she interprets the construction of the normal innovation of treatments and evaluation of effectiveness. Of particular interest is her analysis of the branding of erectile dysfunction.

Chapter three explores the complex processes of how doctors and patients co-produce of the normal male body. Instead of erectile dysfunction becoming an opportunity to reassess the unattainable standards of normality masculine bodies, Loe argues that Viagra has been used to reinforce and perpetuate ideally functioning male bodies.

At its best, qualitative feminist research's expertise is its focus on the voices of those who are underrepresented and silenced in cultures. By interpreting her data of interviews with older women (65- 86), Loe provides us with insight into the lives of the often unacknowledged. Chapter four reminds us that these women's voices and lives are rich with valuable sociological insights into...