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Deleuze on Viagra (Or, What Can a ‘Viagra-Body’ Do?)
The online version of this article can be found at: http://bod.sagepub.com/cgi/content/abstract/10/1/17 can be found at:
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Deleuze on Viagra
(Or, What Can a ‘Viagra-body’ Do?)

Introduction
Recently a number of critical studies emerging from the humanities and socialsciences have examined the socio-cultural impact of the medicalization of sexu-ality and the advent and use of sexuopharmaceuticals for the treatment of so-called ‘sexual dysfunctions’. North American research in this area has focused onthe increasing influence in western societies of the biomedical model of male andfemale sexuality (Kaschak and Tiefer, 2001), and on the ways in which biomed-ical technologies such as Viagra reproduce normative notions of masculine sexu-ality (Loe, 2001; Mamo and Fishman, 2001; Marshall, 2002), and advocate thevalue for men of a life-long youthful virility fulfilled through the use of suchdrugs (Marshall and Katz, 2002). This article contributes to the critical study ofchemical sexual technologies by means of a discursive examination – informedby Deleuzian theory – of the ways in which men and women in Aotearoa NewZealand discuss their experiences of erectile difficulties and Viagra use withinrelationships.
Elsewhere I have argued that the value of a Deleuzian approach to critical studies of sexuality lies in its capacity to provide a counterpoint to prevalent, Body & Society 2004 SAGE Publications (London, Thousand Oaks and New Delhi), Vol. 10(1): 17–36DOI: 10.1177/1357034X04041759 conventional theories on sexuality and gender (see Potts, 2001, 2002). Specific-ally, Deleuzian reconfigurations of the erotic operate in contrast to understand-ings about sexuality associated with, for example, traditional psychoanalysis,orthodox sexology and biomedicine. These latter influential models of sexualitysubscribe to hierarchized, dualistic modes of ‘knowing’ about sex that are inher-ited from western metaphysics; psychoanalysis through its deployment of binaryterms such as phallic/castrated and masculine/feminine (Freud, 1986[1905]), andsexology and biomedicine through the categorizing of normal/abnormal andfunctional/dysfunctional sex (Masters and Johnson, 1966, 1970). These schoolsof thought have all sustained feminist critique related to their endorsement of ateleological and hydraulic model of normative sexuality, which is deemed to havemore in common with hegemonic masculine versions of sexual enjoyment (Tiefer,1995; Ussher, 1997). Deleuzian theory contrasts with Freudian and Lacanianviews on sexuality through its refusal to accept the notion of desire as theresponse to a need, or sense of lack or incompletion; instead, desire is positive,and associated with transformative production and experimentation. In thissense, Deleuze radicalizes Foucault’s notion of power as a ‘form of organizationof desire’ (Braidotti, 1991: 121); and hence provides, in my view, the mostproductive alternative to the most dominant field of discourse impacting uponViagra use: the biomedical normative construction of the ‘sexually functioningbody’.
I proceed in this article by expanding upon how the biomedical model of sexu- ality, within which ‘erectile dysfunction’ is constructed (and diagnosed) – andwithin which drugs like Viagra are produced and prescribed – contrasts with theDeleuzian model. I propose the emergence of a new desiring-machine in westerncultures: the Viagra-machine. This is followed by an analysis, with recourse tomaterial from interviews with research participants, of what Viagra-assisted erec-tions produce. In Deleuzian terms, this involves analysing whether the use ofViagra promotes a return (re-territorialization) of conventionally gendered andnormative sexual practices and experiences, or whether Viagra-assisted erectionssubvert (de-territorialize) habitual practices and prevalent notions of masculinity.
The final section of this article explores what occurs when Viagra doesn’t ‘work’for some men; that is, when it fails to produce erections. I argue that participants’experiences of ongoing erectile changes have the potential to facilitate eroticpleasures beyond the confines of the prevalent model of sexuality and its reifica-tion of erect penises in definitions of ‘healthy’ and ‘robust’ masculinity.
The Molar Production of ‘Erectile Function/Dysfunction’The biomedical notion of the body, within which ‘sexual capacity’ is understoodto exist largely as a biological instinct, is very different from a Deleuzian body.
The former is represented as a bounded organism, comprising various internalorganic systems and processes (digestive, reproductive, endocrine, cardiovascularand so on). Medicine assumes that ‘health’ relies on the stability (homeostasis) ofthese systems within the body; deviations are generally seen as indicatingpathologies (Birke, 1999).1 The biomedical paradigm claims to be able to deter-mine, via the scientific method of reduction, the aetiology of disturbances with/inthe body, as well as how to treat such conditions and restore the body to a stateof healthy equilibrium and predictability.
In contrast, Deleuze and (his sometime colleague) Guattari (1987: 260) assert: ‘A body is not defined by the form that determines it nor as a determinatesubstance or subject nor by the organs it possesses or the functions it fulfils.’According to this account, a body is not a coherent organism corresponding toa stable sense of self; nor is it necessarily organic. Bodies are created throughtemporary assemblages that may involve connections between the organic andinorganic. In place of the coordinated ‘mechanical’ systems of the organismadvocated by biomedicine, Deleuze proposes discontinuous, dynamic ‘machinic’assemblages running throughout and across the surfaces of bodies (Grosz, 1994).
And, in opposition to medicine’s contention that the organic body functionsthrough the monitoring and regulation of its various systems and processes,Deleuzian bodies come into being in a kind of chaotic network of habitual andnon-habitual connections, always in flux, always reassembling in different ways.
Importantly, instead of seeking to define and constrain the ‘habits’ of a body,Deleuze and Guattari are concerned with what bodies can become. The bio-medical problematic of ‘What is a body?’ (that is, the normalization of themutually constitutive relation between the body’s form and function) is replacedby ‘What [else] can a body do?’ – and what a body does is understood ‘in termsof its capacities, or affects’ (Buchanan, 1997: 86), beyond those defined by theconventions of biomedicine.
One of the models associated with biomedical conceptualizations of normal human functioning is the human sexual response cycle. Conceived in the1960sby scientists Masters and Johnson (1966), the human sexual response cycle isconstructed as a ‘biological given’, and assumed to operate within individualsregardless of cultural or historical factors (Tiefer, 2001: 78). It has been readilyaccepted within psychiatry as the definitive model of healthy and normal bodilyresponses during sexual stimulation/interaction. The human sexual responsecycle dictates that normal and healthy male and female sexual response involves a predetermined sequence of physiological events (classified as arousal, plateau,orgasm and resolution) culminating in the accomplishment of the ultimate goalof sexual activity: orgasm. Men and women are expected to progress through thiscycle in different modes: masculine sexuality focuses on penile performance,feminine sexuality on receptiveness to penile penetration. For both men andwomen several criteria are required to achieve orgasm most ‘properly’: it ispreferable for it to occur during penis–vagina sex (and therefore during penetra-tive heterosex); moreover, it should result from the correct order of events (thatis, following ‘arousal’ and before completion or ‘resolution’) (Potts, 2001).
Therefore, in the model of the human sexual response cycle, the maintenance of constancy and predictability is important; straying from the pathway signifiesa problem. For Deleuze, however, it is this very ‘deviation’ – and the consequentnovel experience(s) this produces – that are significant. Indeed, an emphasis oninnovation and change is integral to the Deleuzian notion of desire: instead ofviewing desire as a need, or the response to a lack – as has been the predominantdepiction of desire in western cultures, at least since Freud (Belsey, 1994) – desireis positive, productive, experimental and inventive; it follows no goal or direc-tion.
In order to explain the capture of desire within certain prevalent cultural meanings (such as heterosex or orgasm), Deleuze proposes three trajectoriesintervening between the individual and society: molar lines, molecular lines andlines of flight. Molar lines are the macro-forces in society that reinforce bound-aries or territories. They organize, categorize, divide and stratify. They followspecific patterns that are associated with the construction of binaries, codes, rulesand regulations. Molar lines obstruct the free flow of desire, channelling it intospecific thought regimes, practices and goals (for example, dividing desire intomasculine/feminine aspects and normal/abnormal goals). They are associatedwith authoritative discourses, ideologies and institutions such as capitalism,marriage and the nuclear family, and, with respect to sexuality, normativedomains of knowledge such as medicine, sexology and psychoanalysis. Moleculartrajectories are associated with the micro-processes in society. They operateaccording to relatively predetermined patterns and regimes connected to themolar, but they are not as structured or rigid (Deleuze and Guattari, 1987). Themost liberating trajectory, however, is the ‘line of flight’; this is the space/timewhere desire breaks from the territory of the molar and moves in another direc-tion (it de-territorializes), and manifests as something distinctly different, an‘intensity’ that defies representation and categorization. Where climax representsthe goal or objective of normative molar sexual relations (the satisfaction ofdesire), the Deleuzian–Guattarian notion of the ‘plateau’ is associated with the proliferation of desire and the production of radically different experiences of‘becoming’ (Deleuze and Guattari, 1987).
In Deleuzian terms, the human sexual response cycle can thus be viewed as the product of a molar regime, employed to organize its subjects as proper andconventional sexual beings. The cycle also operates at a molecular level, however,for there is scope for some variety of practices and pleasures as progressionthrough the sequence is accomplished (Potts, 2001). While the human sexualresponse cycle dictates the conceptual and corporeal understanding of a ‘healthy’sexual event, failure to comply with the correct progression of the cycle is likelyto result in a diagnosis of ill-health – of abnormal sexual function – termed‘dysfunction’ or ‘disorder’.
One prevalent example of the operation of the molar sexual regime is the labelling of non-erection as ‘male erectile disorder’. This ‘dysfunction’ is gener-ally defined in medical discourse as the ‘inability to attain or maintain penileerection sufficient for satisfactory sexual intercourse’ (Seidman, 2002; Steidle,2002). Such a definition demonstrates the privileging in medical discourse (as wellas a variety of other discourses, such as sexology and psychoanalysis) ofpenis–vagina sex over other forms of erotic relations, so that ‘erectile disorder’threatens the enactment of that mode of sex that best meets the cultural criteriafor normal and natural sexual relations (Marshall, 2002). It also threatens theorgasmic imperative that stipulates that the most healthy, satisfying and intimateform of orgasm occurs during coitus (or, failing that, for men at least, is producedvia an erect penis). In contrast, a Deleuzian perspective emphasizes the capacityto experience various effects: ‘those relations which ensure an open future . . .
those which promote the formation of new compounds, are considered healthy’(Buchanan, 1997: 82).
Viagra: helping to restore relationships (Pfizer advertisement, NZ Sunday StarTimes, 2000)2 Medicine seeks to treat or cure erectile disorder, to return the male body and itssexual responses to a state of order and normality. Over recent years variousmedical technologies have been employed to treat the dysfunctional penis, frommechanical devices such as vacuum pumps through to combination chemical-mechanical solutions in the form of intrapenile injections. The advent in the lastfew years of oral sexuopharmaceuticals brought about a dramatic increasein public awareness of erectile difficulties; and in New Zealand it was claimedthat the availability of Viagra precipitated an ‘unprecedented demand’ for adrug (Russell, 1998: 11). In the United States and New Zealand, where direct-to-consumer advertising is permitted, pharmaceutical company advertis-ing for Viagra promotes the drug’s capacity to restore sexual functioning tonormal pre-morbid modes. The drug is viewed as providing a panacea forerection and relationship difficulties (Mamo and Fishman, 2001).
However, in Deleuzian terms, the cultural advent of Viagra could be seen as the production of a new desiring-machine in western societies. In Deleuze andGuattari’s (1983, 1987) affirmative theory of desire, those forms of desire in circu-lation or existence constitute desiring-machines or assemblages: ‘desire achievesa certain reality in the specific productivity of an assemblage’ (Jordan, 1995: 127).
As with bodies, desiring-machines must not be interpreted according to theirmeanings or identities, but rather with reference to what they do. Indeed,traditional bodies become parts of fragments of desiring-machines and can them-selves comprise assemblages. I propose the existence of the Viagra-machine as anassemblage that comprises the drug itself, the biomedicalized (and non-biomed-icalized) bodies of those linked to it (e.g. the user and others – such as his sexualpartners, the medical professional prescribing Viagra, etc.), the Viagra-assistederect penis and its various actions and effects (as well as the extra-penile effects),the lines that traverse these various connections and presume to dictate theimpacts and outcomes of any experience associated with Viagra use, as well asthose more disruptive lines that travel between, producing unanticipated effects.
What follows is an analysis of the machinations of the Viagra-machine through the accounts of users of the drug. As previously mentioned, ideas aboutthe normal and abnormal are disturbed in Deleuzian theory: the questionbecomes ‘What can the Viagra-body do?’ And the body is evaluated more interms of ‘the things it can perform, the linkages it establishes, the transformationsit undergoes . . . and how it can proliferate its capacities’ (Grosz, 1994: 194). Suchan assessment involves asking whether the effects of Viagra are related to thereturn of bodies, desire, sexual meanings and experiences to states of molarconventionality, or whether the impact is something different. In what contexts,and under which circumstances, do the most transformative modes of sexualexperience occur? Research Details
The transcript material employed in this analysis derives from interviewsconducted throughout New Zealand in 2001 with 33 men (ages ranging from 33to 72) and 27 women (ages ranging from 33 to 68), who volunteered to take partin a national study on the social impact of drugs like Viagra.3 Participants camefrom a variety of socioeconomic backgrounds; the majority were P-akeh-a (that is, non-M-aori New Zealanders, of European descent) and heterosexual. Most hadbeen prescribed Viagra by medical professionals for the treatment of erectile diffi-culties, although a few used the drug for recreational purposes only. Participantswere interviewed individually (and in one case, as a couple) in their homes or atthe local university (a male interviewer, Philip Armstrong, conducted a third ofthe interviews with men; all other interviews were conducted by Nicola Gavey,Tiina Vares or myself). The interviews, which lasted between one and two hours,and followed a semi-structured format, focused on participants’ perspectives andexperiences of erectile difficulties and Viagra use within relationships. All inter-views were audio-taped and transcribed in full. The textual analysis involvedidentifying the various experiences and understandings that Viagra-assisted erec-tions produced in relation to sexual activities, masculinity and bodily pleasures.4 The Capacities of Viagra-bodies
It is important to note from the outset that the men and women in this studyconveyed a diversity of experiences and perspectives (Potts et al., forthcoming);this phenomenon itself contrasts with the generalizations implicit in the medicalmodel’s constitution of normative sexuality for men and women. Nonetheless,and predictably, given the pervasiveness and authority of the biomedical (molar)model of sexuality, most participants in the study did express the view that aman’s ability to achieve an erection capable of penetrative sex was integral to ahealthy and normal sex life for men and their partners. The expected effects ofViagra were therefore viewed positively by many; for example, the drug waspraised as a ‘godsend’, ‘a gift from heaven’ and ‘the best thing since peanutbutter’, especially for its capacity to restore or enhance erections, return (andstrengthen) a man’s sense of masculinity, rejuvenate sexual ability and re-estab-lish penetrative sex within relationships.
Restoring Erections, Strengthening MasculinityUntil the medical term ‘erectile dysfunction’ became popularized, the concept of‘impotence’ was more commonly used to depict the experience of erectile diffi-culties. This term infers that a man loses power through his ‘failure’ to achievean erection, and demonstrates how important a notion of ‘potency’ is inconstructions of conventional masculine sexuality. Consequently, an inability toproduce erections may be perceived as tantamount to a destruction of the maleself: Frances: I mean it must be sort of the core of a male not to have an erection, I mean, what worse thing could overcome you? Because I think it’s an important thing to most men to be able to have sex normally, and I mean if you can’t have an erection it means fora lot of them no sex . . .
Simon: [Getting an erection] has always been very important to me. It’s always been very central to me. . . . When I was going through that stage of doubtful performance, myself-esteem did go away.
Viagra was therefore viewed as beneficial for its potential to re-establish (andsecure) a sense of masculinity, especially after the devastating impact of erectiledifficulties.
Derek: [Viagra’s] been a godsend for me, absolutely, I don’t mind admitting that. I think I’d probably be in quite a depressed state if I couldn’t use it.
Martin: It’s just the extra confidence it gives you, it’s given you your manhood back again so Masculine sexuality is predominantly portrayed as ever-ready, always willing and desirous, powered by surging hormones and uncontrollable urges (Ussher,1997). Desire is not considered a problem for men; its presence is rarely ques-tioned. This construction is evident in some drug company advertising forsexuopharmaceuticals, where Viagra is represented as working closest to ‘nature’as it enables a man to match his physical ability with his assumed desire for sex(Mamo and Fishman, 2001; Potts, 2004). Likewise, in the following extract,Viagra functions as a means to enable the male body to do what it naturally(instinctively) desires.
Charles: This is why something like Viagra’s so wonderful – because it helps once again the physical ability to match the libido, and I think that’s a wonderful thing [and] a greatgift to old men.
Re-establishing Penetrative SexOne of the key incentives for most participants for seeking medical help forerectile changes, and using Viagra, was to re-establish penetrative sex withinrelationships.
For example, John considered the occurrence of regular penetrative sex to be essential for the healthy maintenance of his relationship. In the following excerpt,he employs a mechanical metaphor – ‘If you don’t use it, you lose it’ – to describethe significance of this regularity: John: We’re a married couple and intercourse . . . is part of that relationship, so I believe we should be doing it on a regular basis. It’s like anything if you stop doing it you lose theskills, you know, the old story of riding a bike . . . and it just takes time to get back onthe bike again, and I see intercourse as part of our life, and we need to be doing it on aregular basis.
Viagra was seen as beneficial because it provided a sense of security that erectionswould occur and be maintained in order to complete sexual intercourse.
Max: It gives you confidence that when you start lovemaking that it’s going to, you know, finish with satisfaction . . . so it gives you . . . peace of mind.
Perhaps not surprisingly, then, the use of Viagra was associated in some relation-ships with a reduction in non-penetrative sexual activities, and a re-prioritizationof coital sex as the primary incentive for – and mode of – sexual relations.
However, this was not necessarily viewed as one of the benefits of a man’s use ofthe drug, especially not by women: Jackie: It was such a powerful drug and it had such a powerful effect . . . [Viagra] made sex inevitable. . . . It seemed to be a given [and] it was also during a time when I was tryingto impress upon him that foreplay would be a nice thing . . . so when Viagra came alongthe whole foreplay thing just vanished . . . Rejuvenating VirilitySeveral participants commented that one of the benefits for them of Viagra wasthat it allowed men to ‘turn back the clock’, to overcome ‘nature’ and effectivelycombat the perils of ageing. This was experienced through a rejuvenated sexualability, manifesting in perceived prolonged duration and increased strength oferections.
Brendan: Viagra just restores a function that was there naturally, in younger days.
George: I mean nature proves itself, as you get older you’re not as strong as you used to be and [Viagra’s] to restore that, you know. . . . It still adds to [what you] probably havenaturally in your body. . . . [It] gives you that duration of time and a bit more, youknow, strength into it.
Although in general, the accounts of what these ‘youthful’ erections signified and were used for did not stray far from the conventional sexual path, thequantity and quality of penetrative sex may have been affected in association withan increased frequency of erections.
Gavin: [With Viagra] we can have intercourse three or four times a night [and] we will probably repeat our . . . intimacy again a couple of times in the morning.
Brad: It was so fantastic. . . . Before we had intercourse once a night possibly, and just went to sleep or whatever it was, just the usual Kiwi attitude type thing, but since we tookthis it’s [turned] into a several-hour event . . .
In these instances, Viagra-assisted erections are used to engage in frequent coitalsex over several hours. Such erections take on a superior quality; they are capableof rapidly repeated action. From a Deleuzian perspective, however, such endurance is linked to the re-establishment of a molar form of sex – in an evenmore exaggerated form. This effect is not viewed as inherently ‘healthful’ as itfails to transform conventional lines of erotic experience by fixing sexual pleasureand practice to one (repeated) modality (Buchanan, 1997).
Some men did describe gaining the confidence when using the drug to explore other erotic possibilities, but these generally culminated in penis–vagina sex atsome stage.
Nicolas: Oh, it’s the greatest sex I’ve ever had in my life. . . . I’m sort of 18 again. . . . Your erection’s just super hard, super big and you can just go on and do different thingsand there’s just no worries, it’s just great. . . . I probably experiment with a lot ofdifferent positions, but as far as sexual acts go it’s pretty conventional. . . . [laughs] Idon’t try anything that I haven’t tried before sort of thing, you know. . . . So it’s juststraight sex in any different positions and things. . . . I’m a better lover than I’ve everbeen in my life.
For Nicolas, therefore, the ‘different things’ he did as a result of Viagra-assistederections were still confined to the molar construction of masculine sexuality, andhis understanding of being a ‘better lover’ was restricted to having ‘straight sex’(coitus) in multiple positions.
‘Side Effects’In biomedical and popular depictions of Viagra use, the connection between the‘synthetic’ drug and the ‘natural’ body tends to be limited to the effects on thepenis (and the production of erections). It is explained in medical discourse thatViagra ‘works’ by increasing the effects of nitric oxide, a common body chemicalthat operates by relaxing smooth muscle and thereby promoting vascular flow tothe penis; the increased blood flow to the penis is said to enable men with erectiledifficulties to respond to sexual stimulation (Moser, 2001). Viagra is therebyportrayed as having a certain target in the body: the penis. However, like mostdrugs, it impacts on/in the body in a variety of other ways as well. Many of themen in this study had suffered from Viagra’s more recognized ‘side effects’ (forexample, headaches, indigestion, congested nose and blue vision); in some cases,severe headaches were more compelling and significant for participants than theproduction of an erection had been.5 Viagra is, therefore, not simply a drug forerections, although its effects are often represented as primarily genitally focused.
In this case, molar definitions and classifications restrict the outcome of Viagrause to penis–vagina intercourse, when, in effect, for some men the outcome mayinvolve a cold flannel across the head and a couple of aspirin. Notably, however,most of the men in this study who suffered serious headaches as a result of Viagrause persevered with penis–vagina sex despite the pain.
While the majority of male participants reported that Viagra use affected them in more predictable ways, assisting erections and promoting the completion ofcoital sex with partners, a few commented that the drug produced unanticipatedpenile effects. For example, several men had experienced ‘numb’ erections whenusing Viagra; that is, they felt the sensitivity of the penis was decreased.
Shane: I get an erection [with Viagra] but it’s almost like it’s had a little bit of local anaesthetic or something, gone a little bit numbish, which possibly doesn’t help the pleasure sideof it . . .
In contrast, several participants described how their use of Viagra facilitated a heightened physical sensitivity beyond the confines of penile sensations.
Larry: Because the blood supply is forced almost artificially – well it is artificial I suppose isn’t it? . . . The general sensation is increased. . . . If you’ve got a bad back it heightens thesensation of your back, for argument’s sake. . . . Well, the blood flow changes. . . . Soyou feel things more. . . . I mean you’re more sensitive to touch, many things.
Brad, who understood Viagra to be a ‘tool’ primarily for the purpose of promot-ing coital sex, also described how one of the unexpected benefits of the drug wasits capacity to enhance ‘romance’ in his body (this was associated with the desirefor and ability to engage in more ‘foreplay’ – that is, non-coital sex – with hispartner).
Brad: I think it changes your whole body function as well . . . you know, caressing in the build up and all the rest of it, you feel better for it, you do a lot more of that, and not just thebasic intercourse. . . . I think it builds up stronger romance, you know . . . in yourmetabolism. . . . And so it’s not a case of breaking into intercourse straight away, it’sforeplay and lots more foreplay, and all that type of thing. . . . It’s just added a wholenew dimension to your life.
Just as a ‘molar’ focus on genital sensation is somewhat disrupted in these accounts, a normative model of sexuality (and masculinity) that equates maleorgasm-via-intercourse with the successful completion of sexual relations issometimes reinforced, and sometimes displaced by Viagra. When using Viagra,men described varying effects on orgasmic experience. For some, use of the drugproduced more pronounced orgasms. Others noticed that Viagra was associatedwith a ‘suppression’ or ‘delay’ of orgasm or ejaculation (sometimes welcomed asit permitted a prolonged sexual experience). But for some men, orgasm duringViagra-assisted coital sex was not possible at all; it occurred only via mastur-bation, oral sex or manual stimulation with a partner (after taking the drug).
Nevertheless these men made it clear that they considered these activities a‘waste’ of a tablet, so they engaged in penis–vagina sex without orgasm. Theinfluence of a coital imperative was even more evident in the accounts of men who persisted in penetrative sex when this produced pain for them, or was notfacilitative of any pleasurable sensations. In these instances, the direction of thehuman sexual response cycle to its ultimate goal, orgasm, is over-ruled by theViagra-machine’s prioritization of penetration as the climax or pinnacle of sexualrelations. Erectile health (defined according to penetrative capacity) is operatinghere as the dominant molar construction, surpassing all other imperatives.
These ‘side effects’ of Viagra – extra-penile experiences, and the deferral of orgasm and/or its occurrence outside of a coital imperative (some welcomed,some not) – indicate that Viagra use does produce unanticipated outcomes, someof which challenge regular molar definitions of sex, but ultimately in limitedways. For example, even when Viagra-assisted erections permitted more varietyin sexual repertoires, sexual encounters still terminated in, and were measured inrelation to, penis–vagina sex. Indeed, the Viagra-machine may be seen to operateby firming up the link between erect penises and penis–vagina sex, by privilegingcoitus, rather than male orgasm, as the principal objective of sexual relations. Inthe next section, I explore the subversive possibilities of persistent erectilechanges – what happens when Viagra doesn’t ‘work’? The ‘Dysfunctional’ Penis and its Contents: Experimenting When Erectile
Difficulties Persist

We may be more interested in a certain line than in the others, and perhaps there is indeed onethat is, not determining, but of greater importance . . . if it is there. For some of these lines areimposed on us from the outside, at least in part. Others sprout up somewhat by chance, froma trifle, why we will never know. Others can be invented, drawn, without a model and withoutchance: we must invent our lines of flight, if we are able, and the only way we can invent themis by effectively drawing them, in our lives. (Deleuze and Guattari, 1987: 202) As discussed in the previous section, most of the participants in this study under-stood Viagra to function primarily by restoring erections and penetrative sexwithin relationships (and thereby masculine sexuality). There was little evidenceof novel or alternative approaches to erotic relations being considered as a poten-tial effect of the drug, or created inadvertently during Viagra-assisted sex. Indeed,for some men it was difficult to contemplate sex (or even life) without anerection, or without the possibility of penis–vagina sex, despite an acknowledge-ment that alternatives existed.
Simon: In terms of getting an erection, to me, I see that as the ultimate, however I’m mindful of course that there’s lots of other ways that you can have some fulfilment sexually, butI don’t really look for any other erogenous parts of me. . . . I just simply couldn’t seea life without it, in that sense.
Most men who had engaged in sexual activities other than intercourse when faced with erectile changes still continued to measure sexual performance andpleasure against the norm, penetrative sex. Other sexual activities were viewed as‘second-best’ or less satisfying, not ‘the real thing’.
Derek: Yeah, we did try [things other than intercourse] but it wasn’t a great success. . . . At the same time you got in the back of your mind you can’t use your penis and that gratesin your mind. Even . . . with it like semi-flaccid sort of thing you could still mastur-bate and still come but . . . it wasn’t the same.
In Deleuzian terms, when Viagra ‘works’ (according to its portrayal in medical/pharmacological discourse), its principal effects on penises could thus beseen to revert sex to molar patterns. However, for several participants Viagra hadsimply not worked. These men, and their partners, took part in the study in orderto discuss their experiences of sexuality and sexual relationships when erectilechanges persisted.
For example, one man for whom Viagra had little effect, and who experienced persistent erectile difficulties following prostate surgery, asserted that sex hadimproved for him since his operation. This was attributed to a focus now ondifferent modes of pleasure – as a matter of ‘necessity’ – since penis–vagina sexwas no longer an option.
Greg: Matter of fact . . . in some ways our sex life has been – in a different way – better since [the operation] because we’d developed a mutual sort of manual system beforehand[and] for the sake of a better word – refine that or fine-tune that. . . . It was a matter ofadapting to suit the occasion rather than giving all away. . . . And she can get me to aclimax and sort of keep me going, you know, far more than I used to before. More likea woman can, sort of surges, you know, and so in that way the sex is . . . different andarguably better than what it was before . . .
Interestingly, Greg’s experience of orgasm has changed now too; non-coital orgasms are experienced as distinctly different, ‘more like a woman’s’. They arecontinuous multiple ‘surges’, rather than the usual trajectory of increasing stimu-lation/arousal peaking (and terminating) with climax. While Greg conveys that he’d still like the option of having sex ‘the traditional way’, he has discovered, through his experience of erectile changes, that thismode of sex is no longer preferable for him.
Greg: We quickly regained a . . . successful sex life, admittedly not quite . . . traditional normal but we both get very good satisfaction so what else do you want? But I’d still very muchlike to be able to do it the traditional way. So the fact that Viagra doesn’t work at thisgiven time doesn’t worry me too much. . . . I wouldn’t prefer to do it the penetrativeway.
Adapting to a sex life without erections had its advantages for another participant as well. Natasha felt that sexual relations with her partner hadimproved as a result of having to work through changes together. She valued thediversity of erotic pleasures they now enjoyed, as well as the more open communi-cation between them. When her partner first experienced difficulties, they hadbeen heavily immersed in a medical model of sexuality, trying a variety of inter-ventions such as vacuum pumps, intrapenile injections and Viagra, none of whichwas particularly ‘successful’ in producing an erection for her partner and facili-tating the resumption of coital sex. She relayed that they had more or less acceptedthe long-term modifications to their sexual relationship as a result of persistenterectile difficulties, and it was merely a matter of ‘finding alternatives’.
Natasha: It’s actually probably made it better . . . because we’ve had to actually talk about it and sort of work around it and . . . make allowances and I guess, you try other thingsas well, because it’s not that easy, so you do more of other foreplay and all sorts ofthings, trying [laughs] to get there, yeah, so it actually probably has improved things,rather than not. . . . I guess we are doing different and more things than we weredoing before, more variety, you know, you stimulate each other more in lots ofdifferent ways, I guess using your hand, using your mouth, all that kind of stuff thatwe didn’t concentrate on so much before, but we do it now just for the sake of gettingpleasure . . . because we know that’s the only way we can do it. . . . I’m more keennow than I was before.
Although she is challenging a coital imperative through her endorsement of otheractivities as advantageous for their sex life (and particularly for her own enjoy-ment), Natasha appears to find it difficult to convey this without in some respectdeferring to the default model of sex. For example, she talks about how they haveto ‘make allowances’ (when erection sex is impossible), and engage in ‘otherthings . . . just for the sake of getting pleasure . . . because we know that’s the onlyway we can do it’.
Clearly, when it is difficult to conform to the molar definitions of sex, sexual repertoires may become more varied. Both Natasha and Greg discuss the benefitsof finding alternatives, but, to varying extents, their accounts remain constrictedby molar constructions of normal heterosex; it appears difficult for them to thinkor talk outside a coital imperative. In the next extract, Robert and his partner,Amanda (interviewed together), demonstrate a more radical departure. Viagrahad not facilitated erections for Robert, and coital sex had ceased completely intheir relationship; however, they were not mourning the demise of erections, butwere instead open to and enthusiastic about the possibilities of other sexual andsensual pleasures – beyond the genitals – and even beyond the body.
Robert: One positiveness in this . . . I feel more, well wouldn’t say more closer, but the thing is you actually have to rely on that extra mental closeness, if you know what I mean?Whether it has got more closer, I don’t know if that’s the case but because you rely on it. . . . It’s most probably developed more, most probably how a person loses aleg or something so therefore the other leg gets a bit stronger to compensate for it. . . yes, to a point, it could be intangible ways, emotions, that sort of thing. . . .
Whereas normally [if] you could have sex you’d most probably stop and hop on andgrind away . . . you can’t, you see, so what do you do, just keep working that way,and so you develop more touch, whereas most probably a person [who] loses theirsight developed more senses . . .
Amanda: You do get a closeness. . . . Not only that, even different things like we’ll go to a café and have a meal, and that to us it’s intimate, and there can be nobody around exceptscenery but that’s intimate. . . . Or we’ll go to the river, and just have lunch there andjust sit out there. . . . Bit like a man [who] thinks he’s going to lose his life, he’s beentold he’s terminal, and he goes out and looks at the things differently, trees, birds, hecan see them differently. I think our sexual life and our life itself is like that. We’relooking at it differently, doing different things . . .
In order to escape the discursive control imposed by the molar, Robert andAmanda reach for analogies with dimensions other than the traditionally sexual(seeing, eating, experiencing nature). The ground for these various comparisonsis a sense of loss (amputation of a leg, going blind, being told one’s life is ending):it seems some radical and involuntary loss of access to the molar is necessarybefore alternative lines of flight can be manifest, or at least before they can bedescribed in language.
Robert and Amanda explained in their interview that they had already been experimenting with different modes of erotic relations prior to the developmentof permanent erection changes. However, having been sexually adventurouspreviously, they now felt things had changed in more profound ways.
Robert: I think the reason it’s deeper now is you go deeper, whereas before you . . . might have masturbated each other, you might have rubbed each other to a level point, thenyou’ve had enough of that, and then you move into the sexual side, you know, inter-course side of it, if you understand what I mean? And you can’t do that now . . . sotherefore you just continue on, you know, think well – and I have thought, youknow – hey, if I’d have known this before I wonder what it would have been like.
But you didn’t, because see you didn’t go deeper. . . . I’ve read books where they sayfor a good sex life what you do is you have times where you basically tape yourpenis to your leg and don’t use it, you know? [small laugh] Amanda: We have done that though. . . . I mean there’s nights when I’ve said oh well – jokingly – we’re not having sex but we’re going to lie next to each other and sort of – withouteven touching – and still have that sexual feeling, and he laughed at me I think thatnight, but you could actually feel it coming on. I mean we sort of experimentedthrough life, it’s still different now, it’s gone deeper . . .
When not confined to the prevalent notion of (hetero)sex, predicated on penis–vagina intercourse (and the necessity of an erect penis), other possibilitiesemerge. This may be viewed as a break from molar norms at a molecular level; while they are still understanding their response largely in terms of a coupleimperative (two bodies) and their relationship/marriage to each other (that is, interms of a culturally sanctioned intimate relationship), they are also experiencing,as Robert describes, a dynamic appreciation of other elements, and allowing fordifferent encounters to affect them. Their description of this alternative sex lifeinvolves an intensification of embodied experience that is not confined to theorganic (or organized) body as understood by medical discourse: sexual embodi-ment expands and ‘deepens’ to include sexual feelings produced without physicaltouching, and, as in the previous extracts, assemblages between human bodies andfood (going for a meal) and nature. Their experience of erectile changes resultedin a release of taken-for-granted sexual practices and styles that, prior to erectilechanges, they had not even realized had become so habitual. Robert likens thisto adapting to becoming blind suddenly: Robert: If all of a sudden you were blind and all of a sudden you do develop these senses because you rely on them, you’re living in them, you know what I mean? . . . Yes, yougo out there and I think in many ways that’s where [the] world actually comes intoyou.
Such a release would be viewed as a ‘healthy’ capacity, from a Deleuzian perspec-tive, as it involves the decomposition of an established state in favour of some-thing novel and refreshing (Buchanan, 1997).
Indeed, Robert and Amanda’s experience of ‘becoming erotic’ resembles the Deleuzian notion of rhizomatic subjectivity. ‘The rhizome operates by variation,expansion, conquest, capture, offshoots’ (Deleuze and Guattari, 1987: 21); itconsists of plateaus, not climaxes. ‘A plateau is always in the middle, not at thebeginning or the end’ (Deleuze and Guattari, 1987: 21). Rhizomatic experienceinvolves an attention to intensities, and does not prioritize some modes or prac-tices over others – it involves a decentralization ‘that gives in to neither side, takesinto its realm the vibrations of both’ (Minh-ha, 1996: 96); it is experimental,creative and transformative.
What is at question in the rhizome is a relation to sexuality – but also to the animal, the vegetal,the world, politics, the book, things natural and artificial – that is totally different from thearborescent relation: all manner of ‘becomings’. (Deleuze and Guattari, 1987: 21) Thus rhizomatic sex follows pathways that are not pre-established, and certainly not compulsory. It produces desire, but does not trap it in preconcep-tions or habitual practices (for example, the ‘naturalized’ or oedipalizedneed/desire of a male body – penis – to connect or ‘unite’ with a female body –vagina – and vice versa); instead desire – released from conditions and definitions – is fundamentally productive. Such desire constitutes lines of flight from theViagra-machine.
What Can a Viagra-body Do?
In this article I have not set out to present a case for or against the use of Viagra;I have not argued that Viagra is good or bad. In fact, the drug itself is not inher-ently positive or negative; it is, arguably, neutral.6 A Deleuzian analysis proposes,however, that when such a chemical technology is employed by – or capturedwithin – a molar paradigm, when its purpose is understood according to pre-determined behaviours and goals, and its effects are confined to the usual experi-ences, then the production of positive difference and innovation is curbed, anddesire becomes constrained by conventional (habitual) styles and practices.
I have suggested that the Viagra-machine operates predominantly along molar lines, reducing experiences of erectile changes and Viagra use to the tenets ofauthoritative institutions such as biomedicine and sexology. For most of theparticipants in this study Viagra certainly functioned as a molar medicine; itseffects were understood in terms of the drug’s capacity to resurrect erections,repair damaged masculinity and restore penis–vagina sex in relationships. In somecases, the perceived restorative outcomes of Viagra use took on even more exag-gerated or entrenched forms: for example, penile erections were experienced asstronger, more enduring, more masculine; the resumption of sex incorporatingerections was accompanied by an increased focus on and frequency of penetra-tive sex, sometimes at the expense of other non-coital practices and pleasures.7 However, there were also accounts of Viagra use within relationships prompt- ing changes in previous sexual perspectives and routines; several participantscommented that the ‘stamina’ of Viagra-assisted erections facilitated an engage-ment in different forms of sex (other than coitus) for longer periods of time, a‘side effect’ that was generally welcomed. In some cases, the effects of Viagrainadvertently disrupted the very regime within which the drug is employed (andprescribed); for example, some men forfeited an essential stage of the normalhuman sexual response cycle – orgasm – in order to perform Viagra-assistedpenis–vagina sex (that is, when this mode of sex did not induce orgasm for them).
In this respect, and at least for those participants in heterosexual relationships,the Viagra-machine may be viewed as displacing the primacy of (male) orgasmthrough a reconstitution of coital sex as the objective (the climax or pinnacle) ofsexual relations.8 Subverting the Viagra-machineFrom a Deleuzian perspective, the most rhizomatic stories in this study werethose that departed from the molar trajectories of the Viagra-machine; that is, theaccounts of those for whom the drug did not work, and who continued to experi-ence erectile changes. These participants described how adjusting to a sex lifewithout erections had produced positive transformations in erotic relations.9(Perhaps not surprisingly, however, the predominance of conventional modes ofconceptualizing sex impacted on how several of these people could express thecreative aspects of dealing with such bodily changes; it appeared difficult toescape or ‘think outside’ the more authoritative definitions of normal sex and itsrequirements for erections and penis–vagina intercourse.) According to Deleuze,the most ‘healthy’ outcome arises not from erections per se, therefore, nor fromtheir absence necessarily, but from challenging the taken-for-granted habitualpositioning of erections as normal, natural and essential for male (and hetero-sexual female) erotic pleasure. This necessarily involves the decomposition ofprevious representations, styles and practices in the formation of new self-inven-tions: ‘the body must increase its capacity to be affected, not decrease it’(Buchanan, 1997: 88). In opposition to the biomedical ‘healthy’ body that desiresan enduring capacity to maintain predictability (the mundane) and stability(homeostasis), the Deleuzian ‘healthy’ body craves extra-ordinary capacities toexperiment and create novel affects and relations (Buchanan, 1997). Such un-usual transformations in the realm of the erotic may or may not involve an erectpenis; however, this certainly is not a precondition for the production of desireor the experience of positive erotic relations. While the molar model of mascu-line sexuality and normative sexual relations marginalizes the pleasures associatedwith semi-erect or flaccid penises (and with non-genital sex) (Potts, 2002), theexperience of those for whom Viagra was not effective in reproducing erectionsand re-installing conventional sex demonstrates the creative potential of explor-ing other modes of relating erotically.
I am immensely grateful to the participants in this study, and to the Health Research Council of NewZealand for funding the project. My thanks also to the other interviewers, the transcribers (RoxaneVosper and Sharon McFarlane), and to Philip Armstrong and the three reviewers for their valuablecomments on an earlier draft. This article is dedicated to my aunt and friend, Rita Russell (1907–2003).
1. See, however, Emily Martin’s (1999) theorizing of a cultural shift to view ‘flexible’ bodies as more desirable in western societies.
2. Pfizer is the pharmaceutical company that manufactures sildenafil (Viagra).
3. This analysis is part of a larger national project involving my colleagues, Victoria Grace, Nicola 4. When presenting extracts from interviews in this report, word repetitions and speech hesitations have been omitted. The presence of three consecutive dots [. . .] indicates that a portion of speech hasbeen cut. Italicized portions of transcript material indicate where a participant has emphasized a wordor phrase in speech. All names used are pseudonyms.
5. One other ‘side effect’ of Viagra use described by these participants was priapism – the poten- tially dangerous condition of a persistent erection that requires medical intervention to reduce.
6. By ‘neutral’, I mean in this context that the chemical compound itself does not have specific predetermined and guaranteed positive or negative effects. However, as a reviewer of an earlier draftof this article pointed out, the ‘capturing’ of a drug by molar systems has in a sense always alreadybegun prior to a consumer’s use of this biotechnology, through, for example, the sets of assumptionsand interests central to the conceptualization, design, manufacture and marketing of any drug. This isnowhere better exemplified than in the current race to develop so-called ‘pink Viagra’ for women (seeTiefer, 2003).
7. My reading of these men’s heightened sense of masculinity and ‘potency’ following Viagra use somewhat challenges the predictions of psychoanalytic theorist, Slavoj Žižek (1999: 383), who, antici-pating the impact of Viagra on male sexuality and masculine identity during the early days of the drug’savailability, commented: ‘Viagra is the ultimate agent of castration’ and ‘this turning of erection intoa mechanical procedure will simply desexualize the act of copulation’. These contentions are not wellsupported by Nicholas’s experience of sex using Viagra, where he claims ‘I’m a better lover than I’veever been in my life’, for example. Although Žižek’s argument may be compatible with the experienceof some men, responses are more diverse and complex than a single psychoanalytic interpretationwould allow; elsewhere I have analysed the varying responses of men, and their partners, to reconsti-tution as ‘Viagra cyborgs’ (Potts, 2004).
8. It should also be noted that Viagra use may, of course, precipitate more radically different experiences than the accounts in this study indicate; as Mamo and Fishman (2001) point out, the drugis already being used outside its designated market (e.g. by women, for homosexual sex, for recre-ational use).
9. Such experiences have been noted in other studies of men affected by erectile difficulties (see References
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Annie Potts teaches critical sexuality studies at the University of Canterbury, Christchurch, Aotearoa
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(Routledge, 2002).

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Best Practice & Research Clinical GastroenterologyIstituto Allergologico Lombardo, Piazza Monsignor Moneta 1, 20090 Cesano Boscone, Milan, ItalyS.C. Allergology and Clinical Immunology, Niguarda ‘Ca’ Granda’ Hospital, Piazza Ospedale Maggiore, 3, 20162 Milan, ItalyAdverse reactions to foods, aside from those considered toxic, are caused by a particularindividual intolerance toward

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GINA SONG UNC Eshelman School of Pharmacy ♦ (919)966-1622 ♦ gsong@email.unc.edu EDUCATION  University of North Carolina , Chapel Hill, NC  Present Eshelman School of Pharmacy Division of Pharmacotherapy and Experimental Therapeutics Ph.D. student  University of Minnesota , Minneapolis, MN  May 2005 – May 2008  Ewha Women’s University, Seoul, Republ

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