It is open season on erectile dysfunction. First, a politician in South Carolina introduced a bill to make it hard to get Viagra and then a politician in Kentucky. If the bills pass, they will hold patients with erectile dysfunction hostage to unrelated agendas. You might think that erections would be as politically untouchable as guns. After all, erections are nearly as popular as they are common. So how can erectile dysfunction be politically impotent?
Our society has a bipolar relationship to erections. It is so extremely bipolar that it leaves little room for authentic conversation: Real men, who are neither studs nor eunuchs, talking authentically about real dysfunction. At one pole, our society glorifies erections. Just look at the prevalence of gentlemen’s clubs and pornography, which very poorly represent the real lives of common men. At the other pole, our formal structures, including the work environment, permit no mention of erections, libido, or anything else remotely sexual. The overall message to common men is that they need to be Casanova, which most men are not, or silent, which most men are.
As a related problem, the doctors that men see when they have erectile dysfunction are generally busy typing into EMRs, learning ICD-10, and churning patients. They may be too distracted to attend to what many may see a transient issue (i.e., erections needed for momentary sex). That is like conceiving that breasts are needed merely for serving food to babies. The fact is that many physical dysfunctions and deformities have long lasting and potentially very profound ill effects on mood and social functions. They can bring on social isolation, melancholia, and depression. And in the case of erectile dysfunction, it can be a sentinel of diabetes, hypertension, and heart disease. Erectile function can be the busy doctor’s most useful and efficiently informative sign of health, yet it is roundly ignored.
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