Adjusting hormones and constructing desires: new materialisations of female sexuality in Brazil

Abstract

This paper presents the findings from a study conducted in Brazil among doctors specialised in the treatment of sexual problems. Its focus is on medical treatments and approaches related to female sexuality. According to the accounts provided by professionals, the most common ‘problem’ they encountered among women was lack of sexual desire in the period around menopause. In line with current principles of sexual medicine, they concurred that this issue resulted from declining hormone production. This paper discusses how pharmaceutical treatments have facilitated the materialisation of female desire in terms of the presence or absence of testosterone, paradoxically the hormone most commonly associated with masculinity.

Résumé

Cet article présente les résultats d’une étude conduite au Brésil parmi des médecins spécialisés dans le traitement des problèmes sexuels. Il se concentre sur les traitements médicaux et les approches de la sexualité féminine. Selon ces professionnels, le « problème » le plus couramment rencontré chez les femmes est l’absence de désir sexuel à la période de la ménopause. Conformément aux principes actuels de la médecine sexuelle, ils conviennent que ce problème résulte de la baisse de la production des hormones. Cet article aborde la façon dont les traitements médicamenteux ont facilité la « matérialisation » du désir féminin, relativement à la présence ou à l’absence de testostérone, une hormone qui, paradoxalement, est le plus souvent associée à la masculinité.

Resumen

En este artículo se presentan los resultados de un estudio realizado en Brasil con médicos especializados en el tratamiento de problemas sexuales. Se presta atención a los tratamientos y los enfoques médicos relacionados con la sexualidad femenina. Según los relatos proporcionados por los profesionales, el “problema” más común que encontraron en mujeres era la falta de deseo sexual durante el periodo de la menopausia. De acuerdo con los actuales principios de la medicina sexual, coincidieron en que esta cuestión era el resultado de una reducción de la producción de hormonas. En este artículo se debate de qué modo los tratamientos farmacéuticos han facilitado la “materialización” del deseo femenino en cuanto a la presencia o ausencia de testosterona, que paradójicamente es la hormona que más se asocia con la masculinidad.

Keywords:

• Biomedicine
• materialisation
• female sexuality
• sexual problems
• hormones
• testosterone
• Brazil

Acknowledgements

I thank Claudia Fonseca, Mattijs Van de Port, Rodrigo Toniol and Emerson Giumbelli, the members of the Writing Care Group of the University of Amsterdam and the peer reviewers for their helpful comments. I am grateful to Glaucia Maricato, Juliana Loureiro, Eleonora Coelho and Karine Rodrigues for their help with field work. I am also grateful to the medical professionals who participated in this study.

Notes

1 Since the 1970s, there has been an effort in the biomedical literature to define female sexual desire as inhibited or hypoactive and/or to characterise it in terms of passivity, receptivity, responsivity and complexity. This contrasts with male desire, which is defined as more spontaneous, focused, initiatory and constant (Spurgas 2013; Faro 2016). In addition, a growing association between sexuality and organic factors, especially hormonal influences, has also occurred. In this paper, I focus on the construction of desire within these realms. A broader discussion of different understandings of desire has been initiated in the work of Van de Port (2013).

2 By means of these concepts, aspects of sexuality that hitherto had not been directly amenable to medical intervention have been (re-)conceived of and treated using according to the concepts and treatments advanced by biomedicine (Conrad 2007; Clarke et al. 2010; Williams, Martin and Gabe 2011.

3 Gewirtz-Meydan et al. (2018) have conducted a recent review of the literature that identified the complexities of the relationship between ageing and sexuality.

4 To protect anonymity and confidentiality, pseudonyms are used throughout this paper.

5 In another paper, I present the data referring to physicians in other specialties and also to doctors opposed to the use of testosterone (Rohden 2018).

6 After the interviewee's name, I indicate her/his gender (F: female; M: male) and the year in which she/he completed her/his medical degree.

7 For a discussion about the materialisation of sex with respect to genital anatomy, see Fausto-Sterling (2000). Regarding debate about clitoral size as a justification for surgery in intersex children, see Machado (2008).

Additional information

Funding

This paper presents partial findings from the ‘Processes of subjectivation, corporal transformations and gender productions through the promotion and consumption of biomedical resources’ project supported by the Brazilian National Council for Scientific and Technological Development (CNPq).