Who Veridicts Health? Health Professional Discourses on Performance and Image-Enhancing Drugs (PIEDs), Health, and Masculinity

This article explores the ways in which Australian health professionals performatively constitute the relationships between performance and image-enhancing drugs (PIEDs), health, and masculinity. It draws on the work of Judith Butler, John Law and Bruno Latour to argue that interviews with health professionals stabilize PIEDs, somewhat paradoxically, as inherently dangerous substances that distort and damage “natural” bodies, and as important medical technologies that can reverse this damage when administered “legitimately.” On the basis of interviews with 20 Australian health professionals who, in the course of their work, encounter men who consume PIEDs, we identify some of the mechanisms through which PIED consumers are excluded from health services, and are sometimes enacted as difficult and deceitful. Rather than taking these as reflecting pre-existing truths about PIED consumers, we show how, when framed within the assumed authority of medical expertise, discourses of “the natural,” health and masculinity produce these realities. Through these entanglements, masculinity is performed as natural to the body, and self-guided, experimental and illicit consumption of drugs constitutes the consumer, his body and his masculinity as unnatural, deceptive, and inauthentic. We conclude by arguing that treating men who consume PIEDs as potential co-experts, acknowledging the uses of PIEDs, and having open discussions could improve health outcomes for this group. Such a move, we propose, might also intervene in the iterative practices that work to regulate so-called “real” and “authentic” masculinities to create more expansive possibilities for men.