Pharmaceutical Patriarchy

By Wolverine de Cleyre

Filbanserin, marketed as Addyi, is a drug recently approved by the FDA to treat “hypoactive sexual desire disorder,” a disorder which does not currently exist in the Diagnostic and Statistical Manual of Mental Disorders (DSM) but is included in the International Classification of Disease. It has been referred to as the “pink pill,” likening it to Viagra for women. However, while Viagra increases blood flow to the genitals, Flibanserin purports to do something entirely different, to act on neurotransmitters in the brain to increase sexual desire. But before we get into a discussion on whether this is totally awesome or really, really creepy, let´s first look into whether or not it actually works.

Some trials of Flibanserin found no effect at all. Data averaged from the two “best” studies, which involved 5,000 women, found that Flibanserin increased the number of “sexually satisfying events” from 2.8 to 4.5 times a month. However, women receiving placebo reported also an increase of “satisfying sexual events” from 2.7 to 3.7 times a month.

Women with any sort of physical or mental health problems, or issues in their relationship, were excluded from the study group, although these restrictions will not apply to prescription of the drug.

What this boils down to is an extra .7 satisfactory bangs per month from effect of the drug. At $250 per month, that works out to $357 per bang. So, kind of a bleh aphrodisiac.

Flibanserin also has serious side effects like fatigue, dizziness, and nausea, and dangerous drug interactions with such common substances as antidepressants, hormonal contraceptives, and alcohol.

In combination with alcohol, the drug lowers blood pressure to such an extent that 1 in 5 patients lost consciousness after only two drinks. Bizarrely, these alcohol safety tests were done almost exclusively with men. It´s well documented that alcohol affects female bodies more heavily than male ones, so the actual effects are likely much stronger, but at this point unknown. Drinking a kombucha may actually make you incapable of driving. And unlike Viagra, which is taken only when you actually want a woody, Flibanserin must be taken everyday, [much more lucrative for drug companies] and effects do not show up for several weeks.

Why did the FDA decide to approve this drug? Well, they didn´t. Not the first two times at least. Flibanserin was soundly voted down by the FDA panel years ago, due to its serious side effects and lack of benefit. And yet, it passed on this third submission, despite no change to the drug or new studies demonstrating safety or efficacy.

What changed was a media campaign entitled Even the Score, funded by the drug´s owner, Sprout pharmaceuticals. It accuses the FDA of sexism, due to the fact that there are several erectile dysfunction treatments for men, and none for women. The gist is that prudish government regulators are preventing science from giving ladies the sex life we deserve. Many professionals with financial ties to the drug’s manufacturer, Sprout, have given media statements without disclosing this relationship, making the debate seem like women’s groups against the government.

This is pinkwashing at its most blatant and cynical. First off, it´s a faulty comparison, as none of the drugs for men claim to increase sexual desire, they just work on plumbing.

Its feminism is obviously shallow.

I´m really stuck by how, in both the drug company literature and physicians discussing the drug, the effect on the “relationship,” in other words, a dude, is nearly always mentioned in the same breath with the woman´s distress over her lack of sexual interest. Comments such as:

“I would point out that simply having a low sex drive should not necessarily be seen as a problem unless the woman is distressed by that or it is causing impairment in an important intimate relationship.”

So, the impatience of a woman’s spouse is what determines whether or not she has a medical condition, and this definition is being sold as feminism and equality.

The story of Flibanserin brings up a larger issue. The language of equality is easily co-opted. Equality usually means that a group of people excluded from power get integrated into the mainstream, and receive some of its benefits. What does equality mean in a system that is as fundamentally fucked up as our own? Does equality mean equal numbers of male and female police officers beating unarmed people to death? Does it mean more brown people in the military, or more queers clearcutting forests?

Do we want the “equality” to treat one’s body like a machine, to view sexual performance as a metric of manhood or womanhood or success as a human being? The “equality” to be up for fucking regardless of whether you´re exhausted from your soul-sucking job, your grey commute, or sole responsibility for your three kids?

Flibanserin is also symptomatic of the way that our society deals with its issues. A widely applied, technological solution for what is at base a social, structural problem. For example, genetically modified grains justify themselves with the promise to feed the world, but there is already enough food to feed the current population. The problem is that it´s unevenly distributed, so some people go hungry. Helicopters and drones are used to patrol the US-Mexico border and arrest immigrants, but this does not address the reasons that people want or need to migrate, or why employers choose to hire them, so people find a way through. These high-tech band-aids do not address the root of the problem, and in fact they distract us from understanding what the real problem is.

We need the time and space to know our own bodies and to cultivate our desires, and the power to choose lovers who turn us on. And sometimes, just sometimes we need freedom from sex, freedom from having to be responsible for the sexual needs of another person. What we do not need is a 250 dollar drug that makes us pass out over two beers in return for seven-tenths of a half-decent lay per month.