Sexology and the Pharmaceutical Industry: The Threat of Co-optation

Journal of Sex Research,  August, 2000  by Leonore Tiefer

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Illustrative Example

A recent publication reported the effects of oral phentolamine on a small group of women with complaints about sexual arousal (Rosen, Phillips, Gendrano, & Ferguson, 1999). Phentolamine is an anti-adrenergic compound extensively tested and used in men with erectile complaints. The laboratory study on six women evaluated their vaginal pulse amplitude and self-reported arousal in response to erotic videotapes following medication or placebo intake. Both physiological and self-report changes following drug intake occasionally reached statistical significance but were highly variable, as is often reported in such research. It was hard to know what to conclude from this study, until one read:

   our results should be viewed with caution until replicated in a
   well-controlled, clinical trial. The purpose of this pilot study was to
   provide "proof of principle" for the concept of vasoactive drug therapy in
   the treatment of FSAD [female sexual arousal disorder]. (Rosen et al.,
   1999, p. 143)

Proof of principle is a term for a step in the FDA's drug approval process, a curiosity in a scientific publication. In other words, the purpose of the study was to demonstrate that the compound caused effects, which would then justify further research. Much drug research is like this, driven by companies needing to establish a product's viability. The science moves farther and farther away from questions and designs motivated by theories about sexuality.

Specific Conflicts Between the Pharmaceutical Industry and Sexology

In addition to general concerns about the undermining of scientific integrity as a result of relations with the pharmaceutical industry, there are at least five specific ways that sexuality research in particular would be diminished and threatened as a result of pharmaceutical industry domination. These arise in part because the goals of pharmaceutical research are ultimately pragmatic (to produce a saleable product), while those of sexology are intellectual; but more significantly, they arise because the model of sexuality used in sexology is broader, deeper, and more inclusive than the model of sexuality in industry-sponsored research.

Bypasses psychological and relational complexity of sexuality. The pharmaceutical industry approaches sex as a physical function, with adequate function of sex organs the bottom line. In typical fashion, for example, the 1989 paper on impotence defines the condition under study as "the consistent inability to achieve or sustain an erection of sufficient rigidity for sexual intercourse" (Krane et al., 1989, p. 1648). There's little attention to the person or couple attached to the penis, or recognition that relational factors might modify the meaning or importance of penile rigidity or sexual intercourse in a couple's sexual script. It would appear that industry-sponsored research wishes simply to wave away the complexities introduced by the psychosocial context of sexuality. By contrast, relationship theorists would argue that laboratory measurement of sexual organ function or self-report of organ function in the home setting offer a hopelessly incomplete sexual picture, and they would predict that drugs developed in such a bubble will be disappointing (Berscheid, 1999).