Book Review: Big Pharma, Women, and the Labour of Love

Big Pharma, Women, and the Labour of Love. Thea Cacchioni, 2015. University of Toronto Press: Toronto, Buffalo, London. 167 pages (including index) $26.00 (paperback on Amazon) In August 2015, the United States Food and Drug Administration (USFDA) approved the pink Viagra or female Viagra with the trade name of Addyi (Flibanserin is the name of the medication). Prior to its approval in 2015, the FDA had denied the pharmaceutical company's application twice before, because of the concerns raised around issues of safety and efficacy of the drug based on the data collected. One of these denials happened after a FDA hearing in 2010, a hearing at which Thea Cacchioni testified against Flibanserin. Thus, then this book Big Pharma, Women, and the Labour of Love by Thea Cacchioni is a joy to read as it allows the reader direct access to a historical moment--a moment that Cacchioni is not only writing about, but also participating in by being involved with the hearings. Her experiences, her depth of knowledge about Female Sexual Dysfunction and its mis/classification within the medical establishment, her empirical work with women suffering from sexual pain and her effort to view this critically through the theoretical paradigms of bio-medicalization and heteronormativity makes this an engaging read. The book, while concerned with issues of pharmaceutical interventions in women's sexual lives and choices, extends the analysis to work with women who have experienced physical pain, displeasure, and even marginalization because of not being able to participate in heteronormative sexual behavior (penetration followed by orgasm). Here Cacchioni looks at women's articulations of their sexual problems, how they address them, what factors influence their perceptions and choices, what coping strategies they employ, and above all what this tells us about medicalization of sexual pain, FSD, and heterosexual norms. She concludes, [...] that despite sophisticated efforts, drug companies and sexual medicine physicians so far have failed in their vision to create a market of pill-popping women diagnosed with Female Sexual Dysfunction (FSD) (pg. 4). Thus this book creates a new critical mode of analysis that looks beyond the first layer of critique of the marketization of under neoliberal regimens, and uncovers the complexities of sexual medicalization by focusing on women who do suffer from sexual pain and who desperately seek to live lives beyond this pain and discomfort. However, the cohort of women that made up the research in this book upend any simplistic analysis, and instead of promoting or encouraging pharmaceutical interventions offer transgressive and sometimes subversive solutions to achieving more fulfilling lives--sexual and otherwise. From refusing to be normal in terms of hetero sex, to seeking alternative relationships that were based on non-sexual pleasure, these women refused to participate in sex work. The book is divided into six chapters, an introduction, and an epilogue, with each section being a comprehensive analysis and conclusion that the author builds towards. This is particularly helpful, if this book is to be used in upper level undergraduate or graduate classes. The Introductory Chapter and Chapter One lay out the author's main argument about the need to look beyond medicalization of women's sexual lives and looking at their socio-economics to truly enhance their sexual and everyday lives. Chapter One, in particular is a through and fascinating read as the author brings into focus the myriad ways corporate, medical, and pharmaceutical interest coalesce to create a market for FSD, as a per-cursor to any launch for a medical intervention. The readers would appreciate the details in which she lays out the academic and professional (profitably so) journeys of Dr. Irwin Goldstein and Dr. Jennifer Berman (and her sister), the leading experts who worked through public media and academic publications to create and promote the idea of FSD and its possible cure being limited to pharmaceutical interventions. …

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