Which returns us again to the problem of basing sex advice on a model of sexuality that is not about women’s sexual pleasure but about women’s sexual subordination. While sex therapy has long afforded pornography some form of legitimacy, the processes of pornification seem to have fuelled this to a point where porn stars are now becoming understood as the ultimate sex experts. As pornography and sex therapy continue to provide mutually reinforcing understandings of what sex should be, it makes it increasingly difficult for women to step outside this model and make claims to a sexuality which is based on equality and respect, one that fundamentally rejects pornography as an authority on sex. But while it may be increasingly difficult to challenge this model, it is also increasingly important that we try.
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Renate Klein
Big Porn + Big Pharma: Where the Pornography Industry Meets the Ideology of Medicalisation
1
Introduction
As the pornification of culture continues to engulf our daily lives, so too does the normalisation of medicalisation. Increasingly, all aspects of our health are deemed in need of medical scrutiny and ‘personalised’ attention. We are checked, screened and tested from before birth to old age and when (invariably) found deficient and straying from the ‘holy’ average (which, in fact, changes quite frequently), we are plied with a bewildering array of ever more tests, drugs and procedures. In 2006, global revenues for ‘Big Porn’ were reported to be approaching US$100 billion, and ‘Big Pharma’ has projected profits of US$1000 billion (1 trillion) by 2013.
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These 2 industries are linked in many ways and it is some of these connections that I will examine in this article. I include the cosmetic and reprogenetic industries under the rubric of Big Pharma and will discuss the medicalisation of (porn)sex, the need for bodies to conform to pornsex, the medical hazards of pornsex, reproporn, and lastly, what to make of the new disease ‘porn addiction’.
1 The Medicalisation of (Porn)Sex
Pornsex portrays women as horny ‘hos’ with an insatiable appetite for oral, anal and vaginal penetration, and men as domineering studs whose erections need
to be bigger and ‘last longer’
3
so as to fill female orifices and spill their ‘cum’. These portraits create anxieties for many ‘ordinary’ women and men who feel ill-equipped to live up to porn industry standards.
‘Luckily’, Big Pharma has come to their rescue by, first, creating new diseases of sexual dysfunction and, second, offering a cure for them. For men with less than pornsex erections in size and duration, Viagra (meaning ‘tiger’ in Sanskrit) brings salvation. Initially prescribed for ‘erectile dysfunction’ – but now also used as an ‘enhancement drug’ easily available online for any man who wants more prowess in his ordinary, pornographic, or prostitution sex – Pfizer’s little blue pill has raked in close to US$2 billion since 1998.
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Viagra works by increasing blood flow to the penis, but carries the short-term risk of possibly fatal stroke and heart attack.
5
Diagnosing – and ‘curing’ – female sexual dysfunction (FSD) has proven a far greater challenge for Big Pharma. To repeat the commercial success of blue Viagra for men, pink Viagra, and later Cialis (manufactured by Eli Lily), seemed a lucrative answer. But in order to attract female customers, women first had to be convinced they suffered from FSD. The republication of earlier findings in a 1999 article in the
Journal of the American Medical Association
did just that (Laumann et al., 1999). Seven survey questions were asked of a group of 1500 US women, including: did they lack interest in sex? did they not have an orgasm? were they anxious about their sexual performance? – even if it was only
once
in the past year. A ‘yes’ response to just one of these questions branded the respondent as suffering from FSD. Adding up these one-time events, the researchers concluded that a whopping 43% of US women suffered from female sexual dysfunction.
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Viagra, Cialis, testosterone patches, and more recently, the fast-acting anti-depressant Flibanserin, were all Big Pharma dreams to cure FSD (and one of its
sub-disorders, hypoactive sexual desire disorder or HSDD). But unfortunately for Big Pharma, female sexuality does not follow the male hydraulic model. Pumping blood into women’s genitals does not do the trick. Even research projects sponsored by pharmaceutical companies did not come up with increased sexual satisfaction when compared with placebos.
Moreover, since 2000, well-publicised grassroots activism against pornsex by New York University feminist psychiatrist and sex therapist, Leonore Tiefer, is gaining ground. Tiefer argues that the ‘corporate-backed idea of sex-as-function’ needs to be replaced with a ‘humanistic vision’ of sexuality which she puts forward in her New View Campaign
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(Kaschak and Tiefer, 2002; see also Moynihan, 2010, p. 148). In a similar way, the 2011 film
Orgasm Inc.: The Strange Science of Female Pleasure
, directed by Liz Canner, reveals the manufacturing of the ‘disease’ FSD by profit-hungry pharmaceutical companies (see Laureano, 2011). Nevertheless, encouraging as these critiques of Big Pharma’s union with Big Porn are, it would be naïve to conclude that the pharmaceutical quest for a miracle pill or patch for this elusive ‘disease’ has come to an end; new drugs are in the pipeline and the magic number ‘43%’ continues to haunt women and to ‘normalise’ FSD.
2 Pornsex Needs Pornready Bodies
The continuing hypersexualisation of women and girls demands that their bodies fit the ideology of pornsex and a male-centred model of sexual activity. Their breasts need to be augmented, any real or imaginary wrinkles Botoxed, and their hairless labia and vaginas surgically redesigned. ‘Pornochic’ has become the norm of the beauty industry.
Injuries and death from breast augmentation have long been noted by feminist writers.
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Adverse effects from silicone breast implants have led to hundreds of product liability litigation cases (Cohen, 1994). Notwithstanding such documented
damage, the pornification of women’s lives has normalised breast augmentation surgery as a way to attain the required ‘ho’ look.
A case in point is the death of German porn star, Carolin Berger, during her 6th breast enhancement surgery at age 23 in January, 2011. Her heart stopped during the operation and she sustained severe brain damage. Bloggers expressed sadness over Carolin’s death on the Website
JustBreastImplants.com
which describes itself as a ‘Breast augmentation patient education resource’ where you can locate a surgeon. One post reads: “Oh how sad! My heart goes out to her loved ones” followed, however, by the same woman writing “5’1 almost at 5’2, 103lbs, 350 mod+ saline, started as 34aa, now a 34c or a 32d!!!!” Other bloggers post their own revealing photos with augmented breasts and a full list of enhanced body parts, followed by the name of their cosmetic surgeon. The postmodern ideology of bodies-as-text, here to be inscribed, meets the demands of a pornified society for medically enhanced women’s bodies.
The same ideology was reflected in a 2009 Channel 4 TV Program in the UK. Four hundred teenagers from 14 to 17 had been surveyed. A group of boys from Sheringham High School in Norfolk was shown photographs of 10 pairs of breasts. All said that the most attractive breasts were those that had been surgically enhanced. As TV presenter, Anna Richardson, commented: “Alarmingly, a posse of their female classmates says the same thing. Both sexes are unimpressed with normal breasts, which – unlike porn stars’ silicone-boosted chests – are often not symmetrical and sit down, not up.” And 45% of girls from Sheringham High School were unhappy with their own breasts, and almost a third said they might consider surgery (
The Guardian
, 30 March, 2009).
The Guardian
report continues:
When the programme makers show boys and girls a woman opening her legs to reveal hair, there are gasps, some born of disgust. In porn, females are always shaved down below. Girls admit that they are starting to shave their lower regions and that boys expect them to do so. The pupils’ reaction shows how their expectations of what bodies should look like are framed by watching porn. Freakish ideas of physicality are mainstream.
Indeed, there is now a seemingly non-negotiable demand to be hairless and ‘pert’ in the vaginal department. Unruly vaginal lips and body hair are frowned upon by men who like their (porn) women to look like little girls: clean, and definitely hairless. Hence the commercial success of celebrity surgeon David Matlock’s trademarked procedures at his Institute in Los Angeles: the ‘Designer Laser Vaginoplasty
®
’ (“for the aesthetic enhancement of the vulvar structures”) and ‘Laser Vaginal Rejuvenation
®
’ (“for the enhancement of sexual gratification, vaginal tightening”). Other must-have surgeries include ‘Brazilian Butt Augmentation’
demonstrated by Dr Matlock himself in a video on his Website to, as he puts it, “artistically enhance your buttocks to give it a more rounded, toned, lifted, athletic look that compels people to look and admire” (<
http://www.drmatlock.com/
>).
Leonore Tiefer and colleagues call such procedures FGCS (Female Genital Cosmetic Surgery) and compare them to FGM (female genital mutilation, see <
http://www.newviewcampaign.org/video.asp
>). They decry the increasing lack of diversity in women’s bodies – including labia of all sizes and shapes – as creating a monoculture of pornsex bodies. Retail medicine and global medical tourism offer a plethora of exotic places where women can submit their bodies to FGCS: from Australia’s Gold Coast to Bangkok or Florida.
As pornography critic, Gail Dines, observes:
Something has shifted so profoundly in our society that the idealized, pop culture image of women in today’s pornified world is no longer a Stepford Wife but rather a plasticized, scripted, hypersexualized, surgically enhanced young woman. The media world we live in today has replaced the stereotyped Stepford Wife with the equally limiting and controlling stereotype of a Stepford Slut (in Rivers, 2010. See also her comment on ‘sluts’ in Griffin, 2011).
3 Medical Hazards of Pornsex
In addition to the damage from cosmetic surgery, there are daily health risks from engaging in increasingly violent pornography acts – be it as paid ‘porn stars’ or as Stepford Sluts in the privacy of millions of homes. For potential porn recruits the Website of the Adult Industry Medical (AIM) Healthcare Foundation (<
http://www.aim-med.org/
>) with 2 clinics in Los Angeles, acts as a Health Care provider, and will tell you all there is to know about starting your ‘career’ in ‘the Industry’. In the video
Porn 101
, you are guided by Sharon Mitchell (Dr Mitch) who introduces herself as having been “an actress and a producer, director, stripper and just about anything else you can possibly think of in the Adult Entertainment Industry for over 21 years” (such as waging a battle with drug addiction for 18 years, as she tells viewers in
Porn 102
). The potential porn ‘professional’ is introduced to the Pornography Industry in a matter-of-fact, friendly and non-threatening way. The most important message is to be tested for sexually transmitted infections (STIs) before you start performing, and to be re-tested every 30 days. Easy – and just what you would do in any other ‘job’.
Joined by an equally friendly and non-threatening male doctor, the pair then goes through some of the 25 sexually transmitted infections (STIs) that awaits you in your new ‘profession’ including chlamydia, syphilis, gonorrhea (including of the throat), hepatitis A, B and C (A is transmitted by faeces from anal to
mouth). You are told to avoid sharing razors, and also needles, with others, to avoid hepatitis C. HIV is another infection you might contract during your professional porn performances, and Dr Mitch particularly cautions about HIV in breast milk “for those milk movies.” Genital warts are talked about at length – where to spot them, how to treat them – and novices are instructed to have regular pap smears. Women as well as men are strongly urged to get the 3-shot HPV vaccine Gardasil at $400 – without any warnings as to its serious adverse effects.
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The idea is created that if you follow this health advice, life in the pornography industry is without danger to your health. Indeed, ‘the Industry’ is depicted as so safe that you are admonished to watch your private sex life so you won’t infect your fellow ‘clean’ porn performers.
Condom use is encouraged (“switch condoms for every hole”) but ‘unprotected sex’ is mentioned so frequently that it is clear that condom use is wishful thinking rather than daily reality. The follow-up video,
Porn 102
, is interspersed with short video clips that show how exciting porn shoots are, while Dr Mitch and Nurse Nina – a jolly blond woman and former porn performer too – instruct you, with lots of laughs, how to start working in the Industry. Their advice includes: “don’t do anything you haven’t already tried out with your partner”, “don’t fuck under water, very bad for your tender parts.” Some of what they say sounds eminently sensible: “you can say no”; “[y]ou are in charge of your career”; and “make sure you get paid properly.” You are also advised to bring “some knitting, puzzles, a robe, slippers … because you will have to wait a lot on the set.” If, despite these precautions, you get sick, AIM promises plenty of drugs they can treat you with. The clear message is that ongoing medical supervision and treatment is part of your life in the porn industry: medicalisation and pornification joined at the hip (pocket).
Ultimately, despite – or precisely because of – the easy camaraderie between Dr Mitch, Nurse Nina and other ex-porn stars in
Porn 101
and
Porn 102
, the AIM Website acts as a grooming site for inexperienced girls and women who are attracted to the promise of stardom and big money. The health care aspect normalises the Porn Industry, with potential porn performers being reassured repeatedly that it is a lucrative ‘job’ and that they will be in charge (“your pussy is
your business – are you going to incorporate?”). In spite of all of this down-to-earth talk, we must remember that only sex industry ‘jobs’ accept dangerous STIs, as well as violence through rough handling and vaginal, anal and throat tears, as part of their ‘regular’ occupational health and safety (OHS) requirements. Add to these dangers the well-documented problems of substantial drug and alcohol abuse to cope with the demands of the ‘job’. Unintended pregnancies are not mentioned on the AIM Website, but the Australian Sex Worker Outreach Project (SWOP) recommends the use of the morning-after pill after unprotected sex or condom breakage. If used on a regular basis, the morning-after pill can adversely affect a woman’s health (see Sullivan, 2007, pp. 298–299).
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