“Chemical Collapse” by Astrid Lorange.

“Nature is a Slugg, and doth nothing at the sight of a Whip.”

So-called ‘female’ or ‘pink’ Viagra is a drug, recently approved by the US Food and Drug Administration, that professes to correct sexual dysfunction in women by targeting the brain. The drug company’s logic figures sexual dysfunction as a lack of desire, and understands desire, for women, as located ‘in’ the brain—the drug, we can only assume, works by alleviating more general forms of malaise for which a lack of desire is symptomatic and for which brain-targeted medication is common (depression, anxiety, melancholy). The drug is, of course, not at all like Viagra, which relaxes blood vessels and so encourages blood flow to the penis. It works like an antidepressant—or rather, it simply is one.

Pharmacological research appeals to a normative idea of functional and dysfunctional sexuality. This kind of research, we can generalise, understands there to be two discrete sexes, each with a distinct biology and psychology. It also assumes that the end goal of normative sexuality is a healthy (that is, sexually active) heterosexual relationship. Because men and women are perceived as distinct and differently motivated/conditioned, a healthy heterosexual relationship is an achievement of complementary coupling—the well-suited coming-together of opposites. Men, it is claimed, experience desire physically: desire as a force that begins in the body and then exceeds it, searching for its object in the world. Women, on the other hand, it is said, experience desire only in the form of a response: a feeling of engagement with the world, or the feeling of the other feeling back. Sexual dysfunction, in these terms, is when a man feels desire but his body doesn’t cooperate, or when a woman dissociates from the world. Healthy heterosexuality is when a man directs his desire towards a woman and the woman responds to him with positive erotic affect.

In the case of Female Viagra, or flibanserin (sold as Addyi, from Sprout Pharmaceuticals), the research cited in the long campaign for FDA approval is derived from a study of married, heterosexual women in sexually active relationships. Pointing to the upsettingly large number of women in this category that suffer from what is known as ‘Female Hypoactive Sexual Desire Disorder’—a disorder that refers, broadly speaking, to a lack of feeling towards or a lack of satisfaction from sex—flibanserin lobbyists argued on two quite different fronts. First, they argued that desire disorders as the ostensible norm is testament to the complexity, ephemerality, and frankly irrational nature of women’s sexuality (an idea with a history so familiar we rarely need to rehearse it); second, they argued in terms of equity, claiming that if men have Viagra, so too should women have a drug to enhance their sex lives. Because of this second point, the drug company found allies in women’s rights groups who perceived pharmaceutical asymmetry as a cause for feminist correction.

Commentary surrounding the drug’s appeal for approval also cited the recent phenomena of ‘Viagra wives’—women who, for the last few decades, have found it difficult to satisfy the suddenly accelerated libidos of their Viagra-taking partners. Flibanserin’s promise to even the score, so to speak, is consonant with the history of marriage as an institution of contract—a union in which conjugal sex has been assumed a matter of its own rules and laws, its own natural order. History has done a good job of assigning natural reasons for unequal appetites for sex and radically differentiated experiences of marital life. This naturalisation of marriage and the attendant mystification of women’s sexuality firms the logic that bolsters the flibanserin campaign—the way to solve marital problems and therefore to affirm gendered institutionality as a common good is to medicalise women’s sexuality for long enough that it eventually seems unremarkable that (a) most women are sexually disordered and (b) women are medicated in order that they might have more sex.

The research conducted in the name of flibanserin is obviously and treacherously erroneous. The assumption of compulsory heterosexuality, the location of sex in marriage, the perfect sex/gender essentialism, the logic of male versus female desire, the assumed good of healthy appetites for sex, the barely concealed subtext that women ought to meet expectations of sexual demand in marriage, the unexamined relationship between desire and satisfaction, the concept of gender equality as access to pharmacologically-enhanced libidos—all of it speaks to long-held and perennially reaffirmed notions of sex, gender and sexuality that derive from the naturalised, common sense of colonial-capitalist patriarchy. What’s most interesting about the research, however, is not that it is obviously shoddy (about that we ought not be surprised) but that it fails to recognise its ultimate finding—a finding which, it turns out, might be the only true insight: that sexual desire disorders might simply be a symptom of heterosexuality itself. Or, more directly, that heterosexuality causes depression in women.

Of course, they’re hardly the first to make this claim—albeit accidentally (or, in properly Freudian terms, unconsciously). Many before the flibanserin lobbyists have made the case that compulsory heterosexuality (per Adrienne Rich’s landmark 1980 essay, “Compulsory Heterosexuality and Lesbian Existence”), insofar as it prescribes a set of relations between men and women that far exceed the assumption of complementary sexual desire, functions as a kind of matrix of constraint (economic, legal, material, social, and libidinal) that come to be known via their effects (as desire disorder, perhaps, but also in an infinite variety of more general melancholies: feelings of disillusionment, disengagement, detachment, destruction and self-destruction, hopelessness, confusion, rage, envy, and so on).

Rich’s essay repurposes a list used by Kathleen Gough, who catalogued the different ways that the nuclear family unit can be conceived as a way of regulating and disciplining women’s bodies and agency. Rich’s rewrite of Gough’s list imagines enforced gender roles—and, indeed, the enforcement of gender itself—as always also enforced sexuality and the enforcement of hetero practices. After Rich, the list form has reappeared in critical writing as a device that signals the many different things that contribute to the performance of heterosexuality and its cultural paradigm, heteronormativity. Michael Warner and Lauren Berlant have a memorable list in their essay “Sex in Public” that outlines the different ways that heterosexuality is articulated beyond the sex act itself (an act which, in the context of heterosexuality, is understood as paradoxically hypervisible in media, law, policy, and so on (not to mention art, literature, pornography), and invisible because of the guiding principle that hetero sex is a private, domestic, hidden thing done by couples for the healthy maintenance of their bond and for purposes of reproduction and the cultivation of family, etc.):

The sex act shielded by the zone of privacy is the affectional nimbus that heterosexual culture protects and from which it abstracts its model of ethics, but this utopia of social belonging is also supported and extended by acts less commonly recognized as part of sexual culture: paying taxes, being disgusted, philandering, bequeathing, celebrating a holiday, investing for the future, teaching, disposing of a corpse, carrying wallet photos, buying economy size, being nepotistic, running for president, divorcing, or owning anything ‘His’ and ‘Hers.’

And, in Paul B. Preciado’s Testo Junkie, the list turns up as a way of tracking the impact of what he calls the ‘pharmacoporno­graphic’, “a term that refers to the processes of biomolecular (pharmaco) and semiotic-technical (pornographic) government of sexual subjectivity—of which ‘the Pill’ and Playboy are two paradigmatic offspring.” Preciado lists—and the whole thing is worth citing—the ways that the pharmacoporno­graphic is managed via a set of gendered practices normalised as feminine:

Little Women, a mother’s courage, the Pill, the hyperloaded cocktail of estrogens and progesterone, the honor of virgins, Sleeping Beauty, bulimia, the desire for a child, the shame of deflowering, The Little Mermaid, silence in the face of rape, Cinderella, the ultimate immorality of abortion, cakes and cookies, knowing how to give a good blowjob, bromazepam, the shame about not having done it yet, Gone with the Wind, saying no when you want to say yes, not leaving home, having small hands, Audrey Hepburn’s ballet shoes, codeine, taking care of your hair, fashion, saying yes when you want to say no, anorexia, knowing in secret that the one you’re really attracted to is your best friend, fear of growing old, the need to be on a diet constantly, the beauty imperative, kleptomania, compassion, cooking, the desperate sensuality of Marilyn Monroe, the manicure, not making any noise when you walk, not making any noise when you eat, not making any noise, the immaculate and carcinogenic cotton of Tampax, the certainty that maternity is a natural bond, not knowing how to cry, not knowing how to fight, not knowing how to kill, not knowing much or knowing a lot but not being able to say it, knowing how to wait, the subdued elegance of Lady Di, Prozac, fear of being a bitch in heat, Valium, the necessity of the G-string, knowing how to restrain yourself, letting yourself be fucked in the ass when it’s necessary, being resigned, accurate waxing of the pubes, depression, thirst, little lavender balls that smell good, the smile, the living mummification of the smooth face of youth, love before sex, breast cancer, being a kept woman, being left by your husband for a younger woman...

A list accounts for the way things are without having to summarise, paraphrase, metaphorise or moralise, and without having to lead by a single example. A list registers relationships without collapsing difference. A list implies, as well, all kinds of internal relations—some reciprocal, some not. It generally acknowledges an outside that could well be inside—I could go on. Indeed, rhetorically, the list does always go on. And because a list shows, through the accumulation of different and differently linked things, the effects of a particular concept or condition, it is a textual form that allows for the articulation of something like heterosexual culture while never affirming that ‘heterosexuality’—properly speaking—actually exists. We often find in feminist and queer critiques of sexual mainstreaming the literal listing of symptoms from which we can study the effects of the regulation and self-regulation of sexuality. Symptoms cannot be read on their own, and yet they often obscure or are obscured by their referents. In the case of heterosexual culture, the terms of reference are not only hard to define and find, they are, in every sense, unreal. That’s why sexuality is often felt as a long list of symptoms without causes—repeated, repeating reactions. And that’s why the pharmacological regulation of sexuality appears so natural—because the treatment of symptoms as though they themselves are causes is central to contemporary medicine and therapeutic culture.

In philosophical vernacular pharmakon has three simultaneous meanings: poison, remedy, and scapegoat. This busy word bears witness to the fact that there is no treatment that doesn’t inflict its own terror, no cure that it isn’t also a little curse, no drug without its side effects. And, it points to the fact that a tonic that works in two directions, or a substance with more than one result, is always going to be somewhere it isn’t expected—which means it is also likely to be praised or blamed for something it hasn’t done. So when a drug cures a migraine but makes us nauseated, we might suspect it of being the source of our neck pain. Pharmacology works on the premise of a wager: the drug will be a more effective remedy than poison; or, the remedy will distract from any damage.

Critical accounts of sex tend to posit ‘sexuality’ as a modern invention; an important concept for the development of the subject, the family, the state, and empire. Critical race theory often makes the case that, far from being often entangled or co-implicated, race and sexuality are in fact co-constitutive. Racial and sexual difference, as imagined contemporarily, exist insofar as they produce each other and exist in order to legitimise the occupation of difference as progress, civility, and reason (I am using, here, Jennifer Nash’s instructive history on this topic). Thinking of sexuality as a social dynamic that brings men and women into relations with each other is damaging not only for its presumption of heterosexuality, nor for its presumption of a sex/gender binary, nor for its presumption of naturalised roles and behaviours, but also for its refusal to acknowledge the property relations implicit in all of the above, and the way that property relations configure all social life. Reading a drug company’s research on healthy sexuality is also always a lesson in how whiteness inscribes itself as a presumed condition of hetero culture. There is no hetero culture without whiteness, and no sexuality without the racial difference on which whiteness is staked.

Flibanserin’s subject is the unmarked, unremarkable white woman ambivalent about sex with her spouse—a subject defined by her melancholy yet never understood in those terms. It registers, in some small yet elegant way, the coming collapse of hetero sex and its chemical racket.