Medicalizing Desire

Andrew Sullivan —  Apr 15 2012 @ 9:08am

by Zack Beauchamp

Katrien Devolder puzzles the ethics of prescribing libido-reducing anti-depressants to those who have religious objections to sex:

Perhaps one could say that helping people adhere to religious norms falls outside of the psychiatrist’s sphere of duty, and that, as a consequence, psychiatrists do not have to provide such ‘treatment’ even if requested by the patient. However, the aim of the drug could be described in several ways: to help maintain the Haredi community, or to increase people’s wellbeing, for example, by increasing their authenticity, or by reducing anxiety and depression. The latter clearly falls within the professional responsibility of psychiatrists. So should a psychiatrist then provide such treatment? Many psychiatrists may feel uncomfortable at this thought.

Iain Brassington compares this case to its opposite, prescribing libido-enhancing medication:

In both cases – of being under-stimulated and being over-stimulated – there’s room to wonder whether the real problem is a rigid (pfffft!) view of what sexuality entails and demands.  The man who wants oxytocin in order to have sex may simply be buying into a narrative about how sex – and masculinity – involves getting it up, hopefully quite often, and wanting to get it up.  Haim is at the receiving end of a narrative about how he should avoid wanting to get it up nearly as much as he does.

The distress caused by the failure to meet the demands of these narratives could well be genuine.  But if the problem is with the narratives, then prescribing drugs in an attempt to solve them might miss something rather important.