1. Diffusion of Expert Language Related to Erectile (Dys)Function: Focus Group Study of Slovak Middle Aged Men Rado MASARYK, School of Education Comenius University Bratislava Magda PETRJÁNOŠOVÁ, School of Arts Comenius University Bratislava

2. Why erectile dysfunction? Arrival of oral treatment – breakthrough in sexology, campaigns by pharmaceutical companies New paradigm in medicine – healing pain vs. improving quality of life Charging perception of erectile function Issues regarding erection and male identity

3. Initial observation 1 – jokes that exaggerate effects of Viagra

4. Initial observation 2 – Real men don't need Viagra

5. Theoretical sources Evolutionary paradigm Margaret Mead – social interactions and culture Elain Morgan – alternative evolutionary theory Michel Foucault - historical, social and cultural discourses Feminist authors

6. Erectile dysfunction - expert definition National Institutes of Health Conference (1992) replaced the hitherto used term “impotence” with the aim of eliminating pejorative implications Defines it as “inability of the male to achieve an erect penis as part of the overall multifaceted process of male sexual function” However, „its various aspects remain poorly understood by the general population and by most health care professionals“

7. More expert knowledge... Belongs to the most common sexual dysfunctions in males (Wagner & Saenz de Tejada, 1998) Its prevalence in the group of men aged 40 to 70 years is estimated at 52% (Feldman et al., 1994) Only 10% of men seek medical help (ISIR/MORI International Survey on Men’s Attitudes toward ED,1998)

8. The research - methodological framework Serge Moscovici (2001) – concepts of anchoring and objectification Denise Jodelet (1989/1991) - expert knowledge on psychiatric conditions vs. practical thinking of people about „the mad“

9. Research method Principal method 8 Focus Groups (FG) Questionnaires Total number of participants N=70 Average age was 49 (40 to 64) 6 largest cities of Slovakia Semistructured scenarios Transcript of discussions Manual coding and Atlas.ti

10. Diffusion of Expert Language Related to Erectile (Dys)Function: Focus Group Study of Slovak Middle Aged Men Results

11. Point 1 – economical and social situation As seen in previous research (Masaryk & Máthé, 2001) No identification with the concept of erectile dysfunction Seemingly contradictory story - sexuality alright, performance is superior, yet there is decline (it is a natural process) and sexuality is highly valued

12. Extract NRM23: „Economical and social security, and from this unrolls wellbeing of the family at home, I can buy myself what children feel like having, I can [buy] lunch, I can [buy] shoes, I can take my car and go for a ride, I can on Saturday, Sunday go out for some kind of cultural activity – or we can’t. And that’s the way it goes, be it friendship, family, wife and overall relationship. Some are having high times, and others are all the way down, and the one in the middle, what used to be in socialism that kind of being in the middle, [everyone] more-less equal, kind of amplitudes knocked together - it does not exist anymore, and now it’s just the question of in which extreme does one end up...“

13. Point 2 – expert vs. lay knowledge What experts refer to as “erectile dysfunctions” was understood by our men as: Decline caused by age Lost of erectile function in very high age Accident, disease (in younger men) Aging man with younger partner Childlessness (in younger men)

14. Point 3 – how does it affect sex lives?

15. Point 4 – what does that tell us about using focus groups? Relatively low openness and interaction within groups “Quest for an expert“ Challenge to present a total and complex solution, not a chance to refine their opinions

16. Conclusions and outcomes Financial conditions and insecurity Social representations of erectile dysfunction. Cultural and social norms of gender related behavior Participants refuse medicalization and problematization of their sexuality, welcome the “qualify of life” paradigm in healthcare Practical outcomes - recommendations for physicians and psychologists, seminars for physicians and media

17. Thank you for your attention... Rado MASARYK, School of Education Comenius University Bratislava Magda PETRJÁNOŠOVÁ, School of Arts Comenius University Bratislava