Review: Orgasm, Inc

by Increase M

Note: I realize this movie has been out for a while now. Many of my problems were addressed in this excellent and thorough post by the good folks at Feminists with Female Sexual Dysfunction. I wanted to focus on agency, particularly how the film minimizes the agency of women who have FSD. It is also worth pointing out at this juncture, that Canner’s documentary focuses on a very narrow definition of womanhood. There is a great deal to be said about the naturalization of cisness, hetness and whiteness both in the documentary and in the industry it is examining.

Liz Canner’s documentary begins with woman who wants to have an orgasm but is unable to.

Female sexual dysfunction, or FSD, refers to a constellation of problems surrounding female sexual response. In can encompass issues of  interest, arousal and orgasm, as well as sexual pain. According to Canner, FSD is a front diagnosis made up by pharmaceutical companies to cash in on the market hitherto available only to men and dominated by drugs like Viagra. It is a unidirectional process, first the pharmaceutical industry sees a market niche, then they make up a condition to fill that niche, finally they market this condition to women, and these women, who were previously healthy and happy, suddenly discover that they have this hitherto unknown condition that needs to be medicated. Profit$ ensue, except for the fact that the pharmaceutical industry has of yet been unable to successfully come up with a treatment for the disease that they manufactured.

In Canner’s documentary, there are two agencies that matter. First is the agency of the pharmaceutical industry. They are the ones acting, making up the disease, marketing the disease, obfuscating about their clinical trials, marketing the product, swindling women. The other agency that is respected is that heroes of the film, those scholars and activists who are pushing back against Big Pharma and its “fake diagnosis”, such as Ray Moynihan and Leonore Tiefer. They write books, give talks, picket buildings, and protest FDA hearings. Completely absent from this is any discussion of the women themselves, the women who the pharmaceutical industry is courting and that Moynihan and Tiefer are protecting. There is one women, Charlotta, the women who begins the documentary discussing how messed up she feels because she can’t orgasm, but she largely functions as a test subject for the silly sounding Orgasmatron. Her problems eventually boil down to “LOL the clitoris” and she is dispatched on her merry, healthy way. Despite the fact that women, particularly those with genital pain conditions, are largely thrilled with the legitimacy of an official diagnosis for conditions that were previously dismissed as psychosomatic, and in fact, are driving much of the commercial market for these treatments [1], Charlotta is the only patient who is given a voice. And per the cited text, I don’t want to mince words about how deeply heteronormative and biased research on sexual conditions is, because it is, but Canner isn’t doing women with FSD any favors by boxing them out of the narrative and pretending that if these ignorant women would just figure out what their clits were then Big Pharma wouldn’t have a profit motive to stand on.

Then in a coup de grace of agency minimization, Canner raises the spectre of female genital mutilation, with reference to this article from the British Medical Journal. Never mind the fact that FGM and cosmetic genital surgery are in no way, shape, or form analogous in context or practice, it’s also really… racist. African women are not a trump card in the white feminist discourse surrounding sexual dysfunction and the pharmaceutical industry.

Canner, and those she interviews, point to the fact that there is no known somatic etiology for FSD. It’s true, nobody can point to a gene, a gland or a hormone that is responsible. Canner interviews Carol Queen, owner of Good Vibrations, who offers up some kind of bullshit historical argument about how FSD is just like hysteria. I find it generally tiresome that hysteria gets punted around as the exemplar of sexist medical malpractice with very little mention of its long and complex history, but that is a topic for another post! Through establishing as a set of criteria for what constitutes a disorder far stricter then what is normally applied (take autism, fibromyalgia, lupus, all of which do not have a clear etiology), Canner again removes the agency from women, agency that she would ostensibly like to give back through better and more comprehensive sex education, to understand what is happening with their own bodies and instead places that authority with doctors and scientists. But not those doctors and scientists in the pharmaceutical industry. Again, this is not to necessarily defend Big Pharma. I agree with Canner in that industry sponsored trials are frequently poorly constructed and give inflated success rates. The FDA is underfunded, and a more robust regulatory framework would benefit everyone. But the thing is, by having a conversation almost entirely absent of the actual patients who suffer from these conditions, Canner documentary is engineering a space wherein other interested parties can talk past each other, and women will continue to suffer.

[1]. Janine Farrell and Thea Cacchioni, “The Medicalization of Women’s Sexual Pain”, Journal of Sex Research 49 (2012), 333.