Bodies in Transition in the Health Humanities

Representations of Corporeality

Lisa M Detora, Stephanie Mathilde Hilger

• Publisher: Routledge
• Year: 2019
• ISBN:
  9781351128728
• Edition: 1
• Topic: Social Sciences
• Subtopic: Popular Culture
• Index: Social Sciences

In recent years, the transitioning body has become the subject of increasing scholarly, medical, and political interest. This interdisciplinary collection seeks to enable productive dialogue about bodily transformation and its many potential meanings and possibilities.

Recent high-profile sex transitions, such as Bruce Jenner's transformation into Caitlyn, have contributed to a proliferation of public and private debates about the boundaries of personal identity and the politics of gender. Sexual transition is only one possible type of bodily transformation, and bodies that change forms vex many binaries that underpin daily life such as male/female, gay/straight, well/unhealthy, able/disabled, beautiful/ugly, or adult/child. When transformations and transitions involve trauma, illness, injury, surgery or death, bodies can become culturally and socially illegible and enter the realm of abjection or even horror. Health humanities, a recent revision of medical humanities that includes patients and other nonphysicians, provides an interdisciplinary lens through which to read such bodily transformation and its representation in public culture. The authors of the essays in the present volume situate their work in this interdisciplinary space to enable productive dialogue about bodily transformation and its meanings in artistic, literary, visual, and health discourses. The essays in this volume discuss non-normative bodies from eighteenth-century France to present-day Iran and investigate narratives of cancer, aging, anorexia, AIDS, intersexuality, transsexuality, viruses, bacteria, and vaccinations.

This collection will be of key interest to faculty and students in women' studies/gender studies, cultural studies, studies of visual and material culture, medical/health humanities, disability studies, and rhetorics of science, health and medicine, and will be a useful resource for scholars across interdisciplinary fields of study.

1 Introduction

Bodies and Transitions in the Health Humanities

Lisa M. DeTora and Stephanie M. Hilger

During the United States bicentennial year, 1976, Bruce Jenner won the decathlon, reclaiming national athletic superiority at a significant juncture of Cold War politics: the Montreal Olympic Games, one of the few sites in which democratic and communist forms of government could claim victories. These sites of victory took place over bodies, the bodies of athletes as they transitioned to fame, broke world records, or succumbed to defeat. Jenner, later accorded the honor of adorning the Wheaties box in 1978, won his decathlon at a critical time, in the midst of a Space Race in which the U.S.A. was regularly outpaced by the Soviet Union. His intensive training program transformed his body from amateur to professional athlete and marked the first time a U.S. athlete trained to the level of state-sponsored Soviet counterparts (Carothers). Nearly forty years later, in 2015, Jenner marked another groundbreaking transition, from a transgendered man into a woman, Caitlyn—the first Olympic gold medalist to undertake such a transition (Brockes). Jenner’s transitioning body has contributed to the proliferation of debates about the boundaries of personal identity and the politics of gender in popular culture and in scholarship.

Theoretical Approaches to Questions of Embodiment

One of the most essential questions underpinning lived experience is the implicit need to conform to gendered social expectations. In fact, gender binaries inform an understanding not only of personal lived experiences, but also of how we express those experiences in visual and cultural artifacts; thus, questions about the relationship of certain types of bodies and consequent identity occur in many registers. While highly politicized statements, such as the suggestion that gender is immutably fixed at birth (Green et al.), inform current public debates, more subtle questions also warrant close examination.

Recent psychological studies, such as the ones by Lauren Spinner and Laura Zimmermann, have found that children’s toys send important messages about gender:

Looking at how children play with toys that fall into gender stereotypes gives us a window on children’s developing sense of what goes along with being a boy or a girl. But it can also be an important indicator of what skills young children are acquiring as they play, and of whether their academic and professional horizons are comparatively wide—or whether they are already starting to rule things out for themselves.

(Klass n.p.)

In their studies, children’s ideas about the fixity of gender norms were found to depend not merely on what toys they preferred, but also on how these choices were presented. In other words, children were less likely to see apparent gender identity and toy preferences as natural if they were offered different kinds of social messages. Significantly, the reporter who covered the story, Perri Klass, is a pediatrician whose reflective work situates her at an important intersection of humanistic and scientific understanding of embodied experiences. Although Klass’ coverage suggests that these recent studies were scientific breakthroughs, they in fact build on a large body of existing knowledge.

Studies of the human body as a necessarily gendered entity entered scholarly, medical, and political discourse in the late twentieth century. Much of this attention grew out of feminist scholarship in the seventies and attendant studies of the epistemological significance of gender and its relationship to embodiment and corporeality. In the following decades, scholarly interest in the question of embodiment grew as can be seen in Anne Fausto-Sterling’s Myths of Gender: Biological Theories about Women and Men (1985), Elaine Scarry’s The Body in Pain: The Making and Unmaking of the World (1985), Judith Butler’s Bodies that Matter: On the Discursive Limits of Sex (1993), Elisabeth Grosz’ Volatile Bodies: Toward a Corporeal Feminism (1994), and Katie Conboy, Nadia Medina, and Sarah Stanbury’s anthology, Writing on the Body: Female Embodiment and Feminist Theory (1997). These groundbreaking studies questioned a Western medical tradition that normalized the young man’s body as a site of reference and thereby paved the way for the current understanding of gender in general and sexual transition in particular.

While sexual transition has become a crucial site for scholarly attention, it is only one possible type of bodily transformation. Debates about transgender persons’ access to restroom facilities, for example, also foster discussions about broader questions concerning the human body and its place in society, such as issues of citizenship, morality, and the ethics of inclusivity and diversity. Bodies that change forms vex many binaries that underpin a common understanding of quotidian life: male/female, gay/straight, well/unhealthy, able/disabled, beautiful/ugly, and adult/child.

Butler’s Bodies that Matter, in particular, posits a nuanced understanding of corporeal transformations and transitions that involve trauma, illness, injury, surgery, or death, in the context of gender as a fundamentally flawed binary. For Butler, trauma and illness can render bodily experiences both culturally and socially unrepresentable, unspeakable, thereby entering the realm of abjection or even horror. Butler comments on “abject, unliveable” bodies (3) that haunt the edges of representation, defying attempts to render their experiences into language. If we, like Butler, accept a Foucauldian construction of knowledge, one that assumes that knowledge only exists once it can be rendered into language, then a major challenge of current studies of the body is to account for the realm of abjection and the possibility for making such experiences meaningful.

The scholars who contributed to this volume examine debates on the body in different cultural, national, religious, and historical contexts and do so from a variety of perspectives: women’s and gender studies, cultural studies, visual and material culture, health humanities, disability studies, and the rhetorics of science, health, and medicine. While subjective experiences of trauma and illness may appear to be of primarily personal significance, limited to the realm of psychological adjustment, the necessity for representing sickness, disability, and difference informs social interactions and the realm of medical practice.

Health Humanities

Medical humanities, a field of study that emerged in the 1970s and emphasized the moral dimension of medicine by seeking to bridge disciplinary divides, provides an interpretive lens through which to read representations of physical transformations due to trauma, illness, injury, surgery, or death. Scholars and teachers of medical humanities explore a wide range of interrelated topics: narrative medicine (the analysis of the narrative dimension of patients’ and doctors’ stories), the therapeutic uses of reading and writing literature (biblio- and scriptotherapy), writing about disease (pathography), the pedagogical uses of literature courses in the medical curriculum, the role of doctor-writers, the representation of the medical encounter in literary texts, the medical case history as a literary genre, changing literary depictions of disease, and the history of medicine, just to name a few of the most prevalent areas of inquiry. K. Danner Clouser, who was the very first full-time medical humanities faculty member, identified the goals of medical humanities as follows: that medicine draw on the humanities while the humanities examine the practices of medicine. In recent years, the term “health humanities” has gradually replaced “medical humanities” to address the reality that medicine affects more people than just physicians (Jones et al.). This semantic shift highlights the fact of multiple stakeholders in healthcare settings, including nonphysician healthcare professionals, patients, and relatives. In the past decade, as noted by Luca Chiapperino and Giovanni Boniolo, the pace of scientific discovery and technologically-informed practices has far outstripped that of considered philosophical, moral, and ethical approaches to biomedicine. A humanities-based intervention has therefore become more necessary than ever to recover the human in the practice of medicine and reflect on its treatments of bodies, especially those that vex received understandings of corporeality. The present collection expands on the work of existing volumes on health and medical humanities such as Ronald Carson and colleagues’ Practicing the Medical Humanities: Engaging Physicians and Patients (2003), Thomas Cole and colleagues’ Medical Humanities: An Introduction (2015), and Therese Jones and colleagues’ Health Humanities Reader (2014). Unlike these more general collections, however, the authors in the present volume study one particular question: How the body is rendered representable or unrepresentable in various cultural contexts. We hope this volume will be a valuable resource in undergraduate and graduate curricula as well as for scholars across various interdisciplinary fields of study.

By casting health humanities as a site for critical thinking about bodily transformation and its representation in public culture, we can create room for the possibility raised by Gillie Bolton that mutual pressure might strengthen both medicine and the humanities. This type of inquiry necessarily leverages interdisciplinary practices, bridging not only biomedical sciences and the arts, but also varied theoretical and disciplinary approaches within the arts and letters. Thus, interdisciplinary approaches such as disability studies, cultural studies, or the history and rhetorics of science and biomedicine also underpin this growing discourse, allowing for an interrogation of the very terms that make certain bodies meaningful within the context of transition. The authors of the chapters in the present volume situate their work in this interdisciplinary space to enable productive dialogue about bodily transformation and its meanings within a context of scholarship that can accommodate various ways of making the body meaningful. Central to this discussion is the notion that bodily states and transformations cannot enter into the realm of knowledge unless they are rendered intellectually or socially intelligible at the margins of artistic, literary, visual, and health discourses.

In her foreword to the volume, Rebecca Garden describes her path to the health humanities by reflecting on the embodied experience of illness from the patient’s perspective. She argues for the role that the humanities can play as a critical supplement to healthcare pedagogy and practice. Recuperating patients’ perspectives through narrative medicine challenges the norms and hierarchies of medicine and healthcare. Garden’s reflections frame the ethical issues raised by the chapters in this volume, which are grouped under three headings, each of which addresses a specific form of embodiment: modes of charting or mapping the body as a gendered entity, means of protecting the body from infection or invasion, and ways we document the body in the transition between life and death.

Charting Bodily Norms in Official and Educational Discourses

The first section, “Medical Models, Charts, and Institutional Narratives,” considers medical and legal modes of describing people and bodies, particularly those that defy gender expectations, in official or public documents. The authors in this section examine the development of biomedical case studies and charting as well as ongoing critiques of those official discourses. Ultimately, these authors assert that the close examination and mapping of bodies that defied gender expectations formed the basis for our current understanding of gendered norms.

Angelika Vybiral examines the exhibition of female wax models in the historical-anatomical collection of the Viennese Josephinum, the Austrian medical academy, founded in 1784. Because early anatomical wax models were primarily male, the rarity of female forms in this medium makes them particularly significant for understanding debates regarding gender norms in the eighteenth century and beyond. Yet these norms hinged not so much on the existence of unequivocal gender binaries as on descriptions of bodies that called such binaries into question.

Gender norms and the eighteenth-century medical discourse on gender also stand at the center of Stephanie Hilger’s essay on medical case studies about Michel-Anne Drouart, a so-called hermaphrodite. Drouart’s case, like that of other sexually ambiguous people who served as medical models, appeared in court documents as well as the news media of the day. In the context of the Enlightenment’s empirical endeavor to elucidate all mysteries of the natural world, scientists carefully examined, measured, and recorded all the details of Drouart’s sexually ambiguous body. Yet this body, like that of other persons of ambiguous gender, thwarted scientific efforts to elucidate its workings. The failure to establish firm gender binaries contributed to a profound sense of epistemological anxiety that emerged from profound shifts in eighteenth-century structures of knowledge.

The medicalization of sexually ambiguous bodies continues today, as discussed in Katelyn Dykstra’s essay on present-day intersex life narratives, published in the 2015 issue of the journal Narrative Inquiry in Bioethics. For Dykstra, these narratives resist medical discourse as represented by and established in the medical chart as an accepted and official documentation genre. Access to the medical chart permits persons whose gender does not neatly fit into binary categories to reclaim agency and form an activist community around the collective memorializing of their medical trauma.

The trauma caused by the medical treatment of non-normative bodies is also the focus of Najmeh Moradiyan Rizi’s reading of Be Like Others (2008), a documentary on transsexuality in Iran. The author challenges the film’s reductive approach to this issue, which aligns it with homosexuality, and highlights instead the complexities and particularities of sex change in the country. By questioning neo-Orientalist discourses, this essay foregrounds the complexity of the formation of transsexual identity in post-Revolutionary Iran, where gender, sexual, and cultural norms are constantly being negotiated and contested.

The connection between activism, gender expectations, and medical trauma is not limited to sexual transition or gender ambiguity. Resistance to the trauma caused by medical intervention is also the topic of Barbara Grüning’s chapter on Italian anorexia sufferers’ autobiographical narratives, which question the institutionalized spaces of centers for eating disorders and hospitals. The chapter explores the social and cultural environments of southern and northern Italian cities, the influence of Italian Catholic culture on gender roles, the authors’ social status, and the historical context as central agents that shape both the women’s spatial experience of their body and the ways this experience is narrated.

Infection, Invasion, and Protection

Section two, “Invasive Influences and Corporeal Integrity,” considers representations of the body as a site of illness, infection, and transition in medical discourses, specifically in microbiology. While the primary transition of interest in these essays is between illness and health, representations of the body as a site of bacterial invasion or microbiological activities provide a second unifying theme.

The desire to reclaim control over a non-normative body informs Lisa DeTora’s discussion of what she terms “the meningococcal body.” Typical stories of meningococcal disease highlight disability, especially disfiguration among young women, and focus on vaccination as a preventative measure. DeTora juxtaposes this public health ...

Table of contents

• Cover
• Half Title
• Title Page
• Copyright Page
• Table of Contents
• List of figures
• List of contributors
• Acknowledgements
• Foreword
• 1. Introduction: Bodies and Transitions in the Health Humanities
• PART I: Medical Models, Charts, and Institutional Narratives
• PART II: Invasive Influences and Corporeal Integrity
• PART III: Aging, Decline, and Death
• Index