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In addition to the healthcare industry, Leonore Tiefer adds that mass media also advocates for the medicalization of sexuality? The language of science sells sexual health subject matter in a way that legitimates the newsworthiness df newspaper and magazine articles and television and radio news reports.

It is not necessary to argue that the United States is an advocate for the continued rhedicalization of sexual health. The ongoing struggle for universalized medical care in the United States presupposes that our current system is working for the stakeholders for whom power means more than consis tent erections. Rather, I argue that the medicalization of men’s sexual health - and, in particular the production of Viagra - preserves a privileged masculinity. I Lynne Segal writes, “However familiar we may be with competing biologidal and clinical narratives of male impotence and sexual dysfunction, it is these myths of penile prowess which we need relentlessly to expose in our rethinking of heterosexuality”.

In Louis Althusser’s parlance, the U.S. medical system is an ideological state apparatus (ISA) - a structure - that interpellates the citizen.72 When the ISA calls ou!t “Hey you!” the citizen knows that he/she is being summoned and turns tJ acknowledge the source. Moya Lloyd writes, From the dly we are born we are interpellated as gendered beings, and we continue to be gendered throughout our lives in a variety of ways. Morebver, we understand ourselves as gendered beings. Filling in forms, reacting to Jolfwhisties in the street: in a multiplicity of ways gender impinges upon us andl encodes us.73

In Foucauldian terms, our turning around to meet the voice signi1fies the way in which we police ourselves. Gender and, more specifically, masculinity are frequently overlooked variables in how the complex U.S. healthcare system is made more complex by relationships of power. For many men,i health and sexuality are properties of a privileged masculinity that must be endured over the life course. As a result, the deconstruction of phallocentrisl11 is delayed.

When Pfizer Pharmaceuticals tells us that erectile dysfunction is physiological (rather than relational or psychological), there is something in the male psyche that is counted on to turn around without exercising the power of agency that might otherwise question the summons. But I must question it and risk

being accused of violating the complicity that maintains the power structure.

To question the ideology beneath Pfizer’s marketing - that men must have erections and penetrative sex to be men - is to be caught in one of Radway’s ideological seams. Men must balance the agency that comes with choice. Complicity with Pfizer’s agenda/ideology purchases the possibility for erectile control and traditional definitions of what it is to be a man. Questioning the benefits of ordering viagra requires the exercising of individual agency and creates the possibility of structural improvisation - that is, new and better definitions of what it is to be a man.