On Monday, March 18th the Bates community packed the Keck Classroom for Steven Epstein’s lecture titled “Sexual Health as Buzzword: Competing Stakes and Proliferating Agendas”. Epstein is a professor of sociology and the John C. Shaffer professor in the humanities at Northwestern University. The Bates Learning Associates Committee, African American Studies, American Cultural Studies, and Women and Gender Studies co-sponsored the lecture.
Epstein’s lecture reflects the early stages of a book he is currently writing while on sabbatical from Northwestern University. More recently, his work will be featured in a journal article co-authored by Laura Mamo of San Francisco State University.
Epstein opened with the observation that the concept of “sexual health” only dates back a few decades. Yet it is on its way to becoming a “recognized medical subspecialty”. Today, “sexual health” is featured in journal titles, commemorative events (Sexual Health Day), and there is even an app devoted to sexual health. “Sexual health”, Epstein argues, has become a “buzzword”.
Epstein conceptualizes a “buzzword” as possessing two conditions: emergence and proliferation. Emergence is how a concept comes into being and proliferation refers to “buzzword” as a distinctive scholarly topic. A buzzword, Epstein explained, has a compulsory quality – it is something hard to avoid. Everyone can use buzzwords and they can use them in different ways. “We can say ‘buzzword’ has become a buzzword,” joked Epstein.
However, the transformation of sexual health into a buzzword cannot be explained by institutionalization. No single agency or organization owns the term “sexual health”.
“Sexual health now appears to be everywhere but no single meaning prevails,” noted Epstein.
Epstein argued that the multiplicity of meanings attached to sexual health defy any simple attempt to arrive at a singular definition. Sexual health, Epstein stated, has resisted being packaged and standardized in a particular way and instead, has unraveled in different threads of meaning.
Epstein is not the first to acknowledge the perplexity involved in defining sexual health. In 1975 the World Health Organization (WHO) offered a uniform definition for the concept. However, just 12 years later in 1985, the WHO decided sexual health is not definable and then in 2002 the WHO contradicted itself yet again to offer another definition.
Epstein observed that in the 1990s there was a shift in conceptualization of sexual health from emergence to proliferation. The HIV/AIDS epidemic funneled the term into public discourse – sexual health became into a respectful way of addressing health issues. Today, sexual health is everywhere but it continues to lack a singular definition.
“In contrast of any established, stable meaning, sexual health appears to be now ubiquitous but it’s practically unattainable,” stated Epstein.
A primary contribution of Epstein’s emerging work is his 12 threads argument. Epstein highlights 12 distinct sexual health “threads” in the public discourse. His first thread is “sexual health as the surveillance, prevention or treatment of sexually transmitted infections”. This, Epstein argues, is the dominant thread of sexual health.
His other threads include the second thread “sexual health as biomedical practices to treat sexual dysfunction”. This is analogous to “sexual medicine” (i.e. Viagra). This thread embodies the “better than well” philosophy regarding sexual function.
His third thread “sexual health as the management of sexual side effects of medical treatment, especially treatment of various cancers,” is the idea of returning to “sexual normalcy”. For example, correcting side effects of chemotherapy that are inhibiting sexual function.
Epstein’s sixth and seventh threads are noteworthy because they sharply contrast with his eighth thread. His sixth thread “sexual health via the marketing of toys, devices, and other products that produce pleasure,” is tied to the seventh thread, “sexual health as enabled by ‘sexual health education’.
In juxtaposition, is the eighth thread, “sexual health as a conservative discourse”. This thread emphasizes abstinence, healthy relationships, etc.
Epstein’s 12 threads exemplify the plethora of divergent meanings attached to sexual health. Epstein argues that these meanings, while shaped by biomedicine, emerge from a diversity of social actors. Furthermore, discourses about sexual health are intertwined with other discourses including sexual liberation, and reproductive rights. Epstein also points out that sexual health has a “unique cultural force” stemming from its diffusion of meanings and the ability for everyone to be an expert on it.
In his work, Epstein is primarily concerned with how sexual health holds different implications for different actors. Does altering the meaning of the term across cultures, discredit the term? Epstein states not yet but by calling it a “buzzword” we are inviting suspicion in the future. There is the possibility for too many meanings, for the term to become too convoluted, and be eventually rendered useless.
Epstein’s top priority is to study when people use the term “sexual health”, and what they mean when they use it. However, he is always aware of the broader social context – other debates on sexuality are always occurring simultaneously.
Epstein’s lecture begs the question: What really is sexual health? And how many meanings are too many meanings?