J Med Humanit (2013) 34:261268

DOI 10.1007/s10912-013-9226-8

The Geriatric Clinic: Dry and Limp: Aging Queers,

Zombies, and Sexual Reanimation
Shaka McGlotten & Lisa Jean Moore

Published online: 7 March 2013

# Springer Science+Business Media New York 2013

Abstract This essay looks to the omission of aging queer bodies from new medical
technologies of sex. We extend the Foucauldian space of the clinic to the mediascape, a
space not only of representations but where the imagination is conditioned and different
worlds dreamed into being. We specifically examine the relationship between aging queers
and the marketing of technologies of sexual function. We highlight the ways queers are
excluded from the spaces of the clinic, specifically the heternormative sexual scripts that
organize biomedical care. Finally, using recent zombie theory, we gesture toward both the
constraints and possibilities of queer inclusion within the discourses and practices that aim to
reanimate sexual function. We suggest that zombies usefully frame extant articulations of
aging queers with sex and the dangerous lure of medical treatments that promise revitalized,
but normative, sexual function at the cost of other, perhaps queerer intimacies.
Keywords Aging . Human sexuality . LGBTQ health . Zombie theory
In Western cultures, aging bodies are missing bodies, subject to stigma and forms of social
exclusion (Casper and Moore 2009). Yet the invisibility of aging bodies is rapidly changing, as
diverse biopolitical actorsfrom politicians to social activists and most especially medical
enterprisestake a focused interest in the economic power an increasingly aging population
wields. A key site for such interest is in those practices and organs normatively associated with
life, with reproduction and sex. Treatments for an array of sexual disorders have become more
available and visible; they have also generated new medical treatment subfields and enormous
profits for pharmaceutical companies. Older sexual bodies are big business.i
For older people, sexual dysfunction treatments promise to reanimate their bodies and
lives. This reanimation calls forth the uncanny life of the zombie. Zombie theory, which cuts
across disciplines like computer science, philosophy, and cultural studies, usefully frames
S. McGlotten (*) : L. J. Moore
Purchase College, SUNY, Purchase, NY, USA
e-mail: Shaka.McGlotten@purchase.edu
L. J. Moore
e-mail: lisa-jean.moore@purchase.edu

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the limits of consciousness and embodiment, limits acutely experienced by older people and
reproduced in images of them as doddering, shambling shadows of their former selves.
Treatments for sexual dysfunction promise a vital expansion of intimacies,
supporting their spontaneous expression and buttressing their durable forms. With
these drugs and treatments, older people can have sex whenever they want; they
can come back to life. But how do biomedical fixes specifically address the needs of
aging queer bodies? Aging LGBT populations face challenges distinct from their
straight counterpartsthey tend to suffer from higher rates of chronic illnesses,
disabilities, and mental illness (Fredriksen-Goldsen et al. 2011). In addition, trans
persons must navigate the social and economic costs of hormone therapy and surgery.
Gay men continue to suffer the highest rate of infection of HIV. Lesbian womens
specific sexual health needs go under-examined because their sexual health is almost
exclusively linked to reproduction. These health issues are tied to and exacerbated by
isolation, stigma, overt discrimination and the dearth of culturally competent service
providers equipped to meet their specific needs.
Our essay looks to the omission of aging queer bodies from new medical technologies of
sex. We extend the Foucauldian space of the clinic to the mediascape (Appadurai 1991), a
space not only of representations but also where the imagination is conditioned and different
worlds dreamed into being. In the mediascape, multi-million dollar advertising campaigns
focusing largely on erectile dysfunction, for example, exclude aging gay men. Ads addressing the specific needs of women, including vaginal dryness, are almost entirely absent.
Here we speculate about the relationship between aging queers and the marketing of
technologies of sexual function. We highlight the ways queers are excluded from the spaces
of the clinic, specifically the heternormative sexual scripts that organize biomedical care.
Finally, using recent zombie theory, we gesture toward both the constraints and possibilities
of queer inclusion within the discourses and practices that aim to reanimate sexual function.
We suggest that zombies usefully frame extant articulations of aging queers with sex and the
dangerous lure of medical treatments that promise revitalized, but normative, sexual function
at the cost of other, perhaps queerer intimacies.

Sex and the aging body

Inevitably, our bodies succumb to the disease of aging. The medicalization of agingthe
processes by which aging is subjected to the material, discursive, institutional and technological power of modern biomedicinepromises a range of solutions (Katz 2011). Most
focus on reanimating those bodily sites predominantly associated with human vitality: the
sexual organs. Vaginal dryness can be treated through topical creams, drugs, or surgery,
while vaginal rejuvenation surgeries promises a younger, toned vagina (Braun 2010).
Likewise, decreases in testicular mass or erectile dysfunction can be combated with an array
of pharmacological and other interventions (Loe 2004; Joyce and Loe 2010).
Importantly, what counts as sexual function is constrained by heteronormative and
patriarchal ideologies that frame sexual activity as penetrative sexual encounters loosely
based on a model of sexual reproduction. Hence the entire framing of sexual health is
limited by a focus on insertive penis-vagina sex with reproduction figured as both threat and
aspiration. There are, of course, many other forms of sexual exchange including masturbation, oral sex, anal sex, fingering, rimming, and fisting. As among many queers, sex between
older persons often happens outside of the reproductive imperative. Their sexual intimacies are not necessarily governed by the logic of penetration; thus, they pose problems for

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dominant configurations of sex and sexual identity. Old bodies cant reproduce, and they
cant always have sex in ways that are recognized as sex.
Although our culture celebrates youthfulness, equating it with sexual desirability, many
older people remain sexually active, challenging assumptions that sex is the purview of the
young. In a 2007 study, more than half of those 6574 and a quarter of those 7585 reported
sexual activity (Lindau et al. 2007). Still, many older people report sexual dysfunction, and
while they often find it difficult to speak about sex with their physicians, they nonetheless
draw on a panoply of treatments (Lindau et al. 2007). Unsurprisingly, older gays and
lesbians also continue to have sex. More than half of aging LGBT people have been sexually
active in the last year (Fredriksen-Goldsen et al. 2011).

Sexual dysfunction and the aging queer body

From the array of sexual problems, which are part of the increasing and profitable
medicalization enterprises, we have chosen to address two specific sexual concerns,
erection and lubrication. These are sexual concerns that affect male and female bodies
regardless of sexual orientation. Among men, the most common diagnosed sexual
dysfunction is the inability to achieve or maintain an erection. Although the likelihood
of experiencing erectile dysfunction (ED) increases as a man ages, men of any age
can experience ED. Circulation problems resulting from some illnesses such as
cardiovascular disease or diabetes can inhibit the physical processes of erection in
which spongy tissue in the penis becomes engorged with blood. Fear and anxiety can
also play a role.
Vaginal dryness is one problem older women face as the result of menopause or other
hormonal changes. Again, physical causes can include a range of illness and medications,
and psychological factors play an important role. Women with vaginal atrophy experience a
thinning of the vaginal walls, which can make sex painful and also affect the plasma
discharge that contributes to vaginal lubrication. Vaginal dryness and atrophy are often
treated with topical estrogen. Women are also recommended to use water-based lubrication
to ease intercourse. In recent years, vaginal rejuvenation has also become a popular medical
treatment. It refers to a range of surgical procedures used to alter real or perceived deformity
or injury to the labia. Older women sometimes undergo the procedure to tone and tighten the
vagina after childbirth or other changes that come with aging.
What makes these issues matter specifically for older queers?
On a very basic level, older LGBT people encounter difficulties specific to their sexual
orientation, including social stigma and isolation, related fears of disclosure, and financial
insecurity. Studies point to significant health disparities including higher rates of disability,
mental distress, substance abuse, and some illnesses (Fredriksen-Goldsen et al. 2011). Aging
queers also express fears about being able to access healthcare because of their sexual
orientation and also report being denied service or receiving inadequate care because of their
sexual identities. Older transgender persons experience these challenges more intensely:
22 % could not see doctors because of cost, and 40 % have been denied care or provided
with inferior care (Fredriksen-Goldsen et al. 2011).
Insofar as sex is a key practice that contributes to a queer sense of difference as well to
more general sense of liveliness, sexual activity among older LGBT persons can contribute
to a sense of connection and well-being. Of course, it can also be accompanied, especially
among older gay men, with particular risks related to HIV and other STIs. All of this is to say
that there is no one size fits all approach to dry vaginas and limp penises.

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The distributed clinic

Queer people have been central to the history of medicalizing sexual anatomies, sexual
activities and sexual identities, and in key ways, they continue to be pathologized today as
deviations from some statistically imagined norm. Michel Foucaults famous work on the
clinic examined the ways the disciplinary formation of modern medicine produced new
forms of knowledge and new expressions of power. What we take as particularly salient in
Foucaults work is an interpretation of power that is not necessarily located in particular
social actors or institutional sites but distributed across social institutions and agents. In this
way, we might think of the clinic through the lens of Gilles Deleuzes and Felix Guattaris
(1987) concept of the assemblage. An assemblage is something made up of many parts,
typically in non-hierarchical or rhizomatic ways; assemblages produce effectssocial,
affective, aesthetic. To take one example, CAT scans index an array of interlocking technologies (of vision and imaging), social and material conditions (cost, access, insurance
codes), and feelings (the experience of being still, the fear of what might be found).
Thus, the modern clinic is not limited to particular sites but located across multiple planes
or strata; it is a heterogeneous multiplicity. The medical gaze of the clinic is evident in the
management, regulation, and analysis of bodies as well as in the surgical or pharmacological
interventions to these bodies. Most dramatically, these practices take place in hospitals and
research facilities. But they are also more subtly evident in governmental or security
biosurveillance practices like biobanking, gait signatures, finger-printing or retinal scans.
What often goes unnoticed are the more mundane ways in which the medical gaze operates
through ordinary talk about the body, its fleshiness and failures. These banal complaints and
commiserations at the pharmacy or supermarket, between strangers or intimates, in the
classroom and in the bedroom, work to create a more ubiquitous medical gaze that
disciplines all of social life. The mediascape is part of what counts as a commons under
late capitalism and a key site through which this distributed clinic circulates.
After a significant change in regulation of medical advertisements, since the mid-1990s,
Direct To Consumer Advertising of drugs on television in the U.S. has proliferated, and
erectile dysfunction drugs are now among the many drugs sold over the airwaves. Aimed
toward men, but especially older men, ED commercials can treat their subject lightly or
seriously. Here a descriptive array of ED commercials provide some of the texture of ads in
the media landscape.
In a Viagra commercial from 2008, exceedingly average older men celebrate in the
streets, leaping and dancing to the music of Queen; evidently theyve had some very recent
conjugal success. In more recent Viagra ads, independent and rugged men overcome
challenges on their own, like repairing a broken line while sailing. The gravelly voiceover
announces, With every age comes responsibility, and Youve reached the age when you
wont back down from a challenge. The ads are motored by the cultural links established
between erections and masculinityerections signify assertive and confident masculinity.
ED is just another challenge to overcome.
Do these ads hail aging gay men as well as straight ones? While the ads do not overtly
address gay men or represent men that might be easily read as gay (through gay styles or
mannerisms, for instance), several are amenable to queer readings. In an ad from Viagras
Viva Viagra campaign, a group of bandmates sing about boners, an example par excellence of bromantic homosociality. Even the hegemonically masculine Viagra campaign we
describe abovea white, tough, well-to-do guys guy who knows how to get things done
is open to interpretation. At the end of each of the commercials, the problem-solving loner
arrives at a stereotypically American suburban split-level. As he pulls into the driveway, a

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light flashes on. Someone is awaiting his arrival and looking forward the benefits of the blue
pill he has taken on his way home. But we never see that someone. That someone could be a
man.
While ED ads abound, we were unable to find televisual ads specifically addressing
vaginal dryness treatments. Post-menopausal women suffering from sexual dysfunction are
difficult to find within the mediascape. While there are vaginal estrogens available for
treatment of vaginal atrophy and dryness, we are not aware of any popular media representations of Estring or Vagifem, two of the treatments. There are no readily available video
clips from Superbowl commercials or klatches on The View. Instead, the use of testimonials
on websites and online forums coalesce into a sly marketers dream of user ratings deployed
for intimate persuasion. One product, Replens, is available over the counter and trickles into
womens consciousness through the more concealed networks of feminine communication.
These real testimonials are accompanied by images of modelsattractive white women in
their late 40s50s who recline in self-satisfied poses with the tag line: Discover long-lasting
relief of vaginal dryness with Replens (http://www.replens.com/Main/Default.aspx).
Clearly part of the heterosexual script of sexual satisfaction, many women specifically
signal their male partners as also appreciating the newly moistened vagina in online
testimonials.
Love your products!! It literally made my marriage better. HAD severe problem with
vaginal dryness. Thank you for Replens.
I love your products and tell all my female friends how much I have been helped by
using these products. I encourage my friends to not hesitate to buy your products in the
event they ever experience the need. I wish I had known about Replens years ago!
Using your products has greatly helped my husband and I.
Thank you.
Fascinatingly, this limited focus is exclusively about the vagina literally dwarfing the
clitoris as integral to sexual pleasure. Clitoral aging is invisible in the popular mediascapes
of aging sexual bodies. Vaginas are understood as receptacles and keeping them moist is a
phallic prerogative that undergirds lifelong heteronormative performances. The absence of
significant images of aging womens sexual health speaks, we believe, both to the ways that
ED is privileged in a culture that values mens over womens pleasure and health, as well as
to the simple fact that big pharma has not yet effectively monetized this particular dysfunction (especially when lube does so well). In the few materials we did find, industry infomercials, the women describing their experiences and treatments are explicitly identified
as heterosexual. Aging lesbians are, however, having sex, penetrative and otherwise, as well
as no doubt being treated for vaginal atrophy. However, aging lesbians are largely invisible
in the medical gaze of advertising. And they do not fare much better in a more paradigmatic
site of the clinic, the doctors office.

Old and queer in the doctors office

In the clinic, what does the aging body communicate to the doctor? How does the doctor,
ostensibly straight, read a body differently once it is identified as queer? Is a queer identity
revealed through disclosure of sexual practices or through non-normative gender embodiments? In recent studies on aging LGBT populations, fear looms large. Aging LGBTs fear
discrimination by doctors and healthcare staff, and many report having experienced discriminationin the form of the refusal of care or receiving inadequate care. 15 % fear accessing

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care outside the LGBT community (Fredriksen-Goldsen et al. 2011). In the doctors office,
what does an older queer adult find? Those with economic, social, and cultural capital find a
service provider there to answer questions and provide care. But how equipped are doctors
with the cultural competencies necessary to address aging queer populations? Given the
heteronormative character of American social institutions, doctors often assume their patients are straight, unless they self-disclose. But for those without such forms of capital,
especially racial minorities for whom relationships with doctors and healthcare systems are
particularly fraught, disclosure may be especially difficult. Yet absent this information,
doctors may miss particular risk factors or caregiving options.
Then theres sexual activity. Although many aging queer adults have sex, do they discuss
the sex they have with their doctors? As we outline above, LGBT populations face health
disparities that might shape sexual dysfunction diagnoses and treatments. If queer folks
dont disclose to their doctors, however, and if doctors presume their elderly patients are
straight (just as many of the treatments options outlined above do), then how well will their
needs be met? How does sexual dysfunction articulate with the particular contours of aging
queer socialitywith loneliness and isolation, with risk factors related to HIV transmission,
or incidences of breast and ovarian cancer? How equipped are doctors to address the specific
structures of sexual opportunity gay men possess, or to extended chosen families of lesbians,
or of the legal or insurance challenges transgender people face? We cannot answer all of
these questions here. What we wish to emphasize are the ways aging queer bodies are
missing within both the distributed clinic in the mediated public sphere and the ways the
burden of disclosing their sexual identity falls largely on them within the space of the
doctors office, a space that is rarely welcoming to queer differences.

Necropolitics, zombies, and aging queers

In this final section, we look to the figure of the zombie to frame our contribution. Theorist
Achille Mbembe (2003, 40) offers necropolitics as a notion that can help us to understand
the ways contemporary death-worlds have turned people into the living dead. As Mbembe
argues, excess mortality shapes the lives and deaths of groups that rank low on systems of
social stratification. Queers have historically been located on the low end of these systems,
and, in key ways, continue to be. Recent theorizations of the zombie (Boluk and Lenz 2011;
Lauro and Embry 2008) likewise explore a range of necropolitical events and contexts that
shape the precariousness of contemporary life. The figure of the zombie can allegorize the
excess and failures of capitalism and of the security state. Zombies also evoke racial histories
and revolutionary uprisings. And they usefully frame questions about agency, consciousness, and a widespread affective disposition that mixes numbness with an insatiable hunger
whether for consumer goods, power, or simple human connection.
Zombie theory can also aid in our understanding of the medicalization of sex and aging
queer bodies. Aging queers are situated in an awkward limn between life and death: some,
especially white gay men, enjoy relative power, while others, especially lesbians and queers
of color, remain the unimaginable excess. They are located at a paradoxical site where decay
and deterioration come together with vitality and vigor. The closer aging bodies resemble the
empowered aging heterosexual through their racial, ethnic, class, physical markers, the more
intelligible these bodies are to the biomedical industrial complex, and hence the more likely
they are to be served through medical diagnoses and cures.
For aging queers, the call of medical fixes for their sexual health may exert an even more
powerful appeal. Biomedicine promises to repair and renew their desiring bodies; it

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promises to reanimate those organs and activities that mass culture and medical discourses
alike would have us believe are most central to our being. Treating that which makes us
legible as living beings further normalizes us and raises the probability of more biomedical
intervention. Put differently, if queers are to be seen and treated for sexual dysfunction, they
must capitulate to a pharma fix that is engineered for different users. In becoming medicalized, these queers through their penises and vaginas are able to be useful again, but only in
the standard limited heteronormative ways of fashioning an active sex life, that is, one in
which hard cocks go into wet vaginas.
The zombie metaphor is powerfully ambivalent. On the one hand, it evokes the ways that
medical treatments of all aging bodies might produce mindless rutting automatons: ever
ready, ageless hard penises fucking pink, wet, tight pussiesconsuming drugs and other
bodies with disregard for less dominant, and potentially dominating, forms of intimacy. On
the other hand, zombie theory also suggests some of the extant and emergent potential of
queer socialities (McGlotten 2011). Queers are already like zombies: our desires are
organized around bad objects, we spread by contagion (imagined or real), and we form an
array of improper intimacies (from anonymous sex among men, to the complex affective
entanglements of some lesbian communities). We are also, like zombies, abjected in and
through our desires and vulnerable embodiments. Sometimes this abjection is the result of
homophobic violence, but other times, we choose to embrace our difference and its
destructive potential (Dean 2009; Edelman 2004).
Queers are already the living deadwe do not reproduce by genital means but nonetheless shape social life, even if through the fear of a menacing homosexual horde. (The fear of
a queer planet looks a lot like the fear of a zombie planet.) Aging queers acutely conjure the
death-in life of queerness. What liveliness they once possessed, a sense of vital difference
organized in and through their deviant sex, has dissipated and, according to normative
medical models, they can only aspire to but never achieve the reanimation medical fixes for
sexual dysfunction promise their straight counterparts. It seems to us that all old sex
becomes queer sex.
But zombies and aging queers also provide theoretical traction for rethinking individual
agency and collective socialities. After all, not having a coherent self might not be such a bad
thing; and checking out of mundane desires for success or skinniness or youth represents a
sort of freedom. Zombies, like some of our forgetful elders, are obligated to nothing other
than their own immediate needs, like hunger.
Older queers have contributed to a vast repertoire of forms of belonging and collectivity.
On a collective level, aging queers also represent an as yet largely inchoate force. Whether or
not they answer the reanimating call of the new medical technologies of sex, they invite us to
consider the powerful capacities of a queerness not yoked to normative demands to
reproduce, or to get hard, or to stay wet. They remind us that inventing intimacies is part
of their living legacy.

Note
i.

As life expectancies change over time and age cohort ranks swell due to variable birth
rates, the notion of an older body cannot be firmly fixed to a chronological age.
Furthermore, different cultural groups conceived of as cohesive clusters such as gay
men, lesbians, or understood as intersectional groups such as black gay men, or Latina
lesbians, have different aggregate life expectancies and shared cultural norms about what
it means to be older. So whereas someone might be considered older at the age of 50,

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other intra-group evaluations might see older as over 65. We primarily mean to refer to
older sexual bodies as those who are determined to be open for diagnosis and medical
interventiontypically over 55 years of age.
Acknowledgements Thanks to Mary Kosut, Matthew Immergut, Lara Rodriguez, Monica Casper, and
Paisley Currah for their helpful comments.

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