Everett Zhang’s The Impotence Epidemic is an unprecedented in-depth examination of men’s changing sexuality in modern China and a powerful deconstruction of impotence as mere biological dysfunction. Zhang was drawn to the topic in the late 1990s, when nanke (men’s medicine) had established itself in hospitals across the country, and both men and women increasingly expressed their (or their husband’s) inadequacies of virility, whether in private or public venues. Why was impotence, at that particular moment, suddenly an issue of seemingly epidemic proportions? Standard psychological and biomedical explanations, which approach the body as a machine-like system and impotence as a “neurovascular event”, fall short of clarification, as the emergence of an impotence discourse in China did not equate to a demonstrated increase in erectile dysfunction per se, but clearly had something to do with wider social changes of the post-Mao reform era. Neither did it seem that this development was comparable to the 1970s “impotence boom” in America that associated declining masculine capacities with feminist demands for sexual equality and satisfaction (5). Further illustrating this incommensurability of cases is the relative failure of America’s wonder-drug Viagra in the Chinese market after its highly anticipated introduction in 2000. To understand more precisely the complex relationship between impotence and the Chinese social body, Zhang conducted fieldwork in biomedical nanke and TCM (Traditional Chinese Medicine) clinics in both Beijing and Chengdu, interviewing hundreds of male patients as well as their partners and doctors. He found that patients’ stories about impotence were inevitably stories about how to live in a rapidly transforming society, and that concerns about impotence far exceeded (sometimes, had nothing to do with) sex itself, yet could be matters of life and death.
Zhang divides the book into two parts. In the first, “Society and the State”, he tackles the shifting social context of impotence, applying Deleuze and Guattari’s notion of “desiring production” to highlight how, in post-Mao China, impotence is a “positive sign” of reemergence from repression (13). Although many men also experienced erectile dysfunction during the Mao era, it was only in the 1980s, after the establishment of nanke and encouragement of individual desire, that impotence could reemerge as a recognizable medical problem from which men suffered. Under socialism, men instead suffered from excesses of desire, in some cases even choosing castration or death rather than to act upon their stigmatized impulses. These shifts in what Zhang calls “moral symptomatology” are clearly more than biological or psychological processes, but are intimately tied institutional legitimation and structural changes (32). Zhang argues that the hukou registration system and organization of danwei work units were exercises of biopower that disrupted lives and produced impotence. Keeping working married couples geographically separated prevented them from establishing sexual relationships and reproducing. Prejudices that formed around the class and rural-urban social stratification of socialist living further limited many individuals’ prospects in love and marriage. Even now in an age of new freedoms, impotence experiences reveal how histories of family obligation, class conflict, hunger and violence, surveillance, restrictive political policy, a lack of sex education, lay-offs in early postsocialism, and the shock or pressures of a new consumerist culture persist to thwart the desires of men and women today.
In part two, “Potency and Life”, Zhang unpacks complex relationships and seemingly contradictory ethics between the resurgence of yangsheng (a reinvented ancient notion of wellness, or “cultivation of life”), the loss of jing (“seminal essence”), and the biomedical turn. Although the so-called epidemic is a positive expression of the liberation of desire, it co-occurs with the revival of traditional notions of wellness that warn against a lifestyle of desire and indulgence. Yangsheng in particular recommends moderation and restraint. The loss of jing, or potency, that occurs in an impotent individual is therefore inescapably a moral issue. In order to make sense of the contradiction between legitimized sexual desire in the new society and a persistent ethic of restraint, Zhang identifies a transformation in the ethics of being that allows men to take control of their lives in an age of new cosmopolitan freedoms. Meanwhile, even as the rise of biomedicine in China downplays the holistic or moral aspects of impotence (as in loss of jing), there is a limit to how far Chinese men are willing to understand their erectile failure mechanistically. Doctors and patients frequently follow a pattern of hybridization, utilizing both herbal treatments and Viagra. To rely completely on Western medicine for this kind of disorder would constitute an ethical imbalance. Hybridization and movement between two medical systems or perspectives creates a cosmopolitan ethos among doctors and patients Zhang observed.
The author’s skill in straightforward application of theory and gifted narration of a wide range of case studies complement each other to show that sexuality is necessarily intercorporeal, always already about one’s relations to others and being-in-the-world. The “epidemic” not only reflects, but also provides new insights into transformations in China’s political economy from the Confucian state to intensifying collectivism under Mao, to the desire-affirming consumerist culture of reform-era China. Zhang presents his informants’ personal stories with care and provides necessary socio-historical contextualizations without losing his guiding lines to overdetail. In short, this was a meticulously crafted book, and a thoroughly enjoyable read. Potential readers worried that they have no connection to or interest in the topic should rest assured—The Impotence Epidemic is about everything behind and beyond the impotence itself, which is exactly its point, its ethnographic value.
This book speaks to a larger literature on the social psychology of desire in contemporary China, ethnographies of Chinese medicine, and scholarship on gender and embodiment. However, I believe the work will not only be of interest to scholars in these fields, but also to those looking for an engaging introduction to medical anthropology, as the work repeatedly and clearly illustrates the shortcomings of universalist disease categorizations and purely bio-scientific approaches to understanding health and bodies. It is important to mention that the author also includes women’s experiences and perspectives in this book, although this material raises many questions that lie outside of the work’s scope and which will hopefully prompt further research on women’s sexuality in the coming years.
Mollie Gossage is a PhD student of cultural anthropology at the University of Wisconsin-Madison. She is interested in morality and spirituality in China, as well as tourism, visual culture, and the globalization of Buddhism.