Revisioning Women, Health and Healing

Feminist, Cultural and Technoscience Perspectives

Adele E. Clarke, Virginia Olesen

• Publisher: Routledge
• Year: 2013
• ISBN:
  9781317795438
• Edition: 1
• Topic: Social Sciences
• Subtopic: Feminism & Feminist Theory
• Index: Social Sciences

This engaging collection examines the implications and representations of race, class and gender in health care offering new approaches to women's health care. Subjects covered range from reproductive issues to AIDS.

Feminist Revisioning

Theoretical Speculations and Interventions

Revising, Diffracting, Acting

ADELE E. CLARKE AND VIRGINIA L. OLESEN

About Revisioning

Diffraction patterns record the history of interaction, interference, reinforcement, difference. Diffraction is about heterogeneous history, not about originals.… Diffraction is a narrative, graphic, psychological, spiritual, and political technology for making consequential meanings. (Haraway 1997: 273)

Despite decades of feminist research and theorizing in the social sciences, humanities, nursing, and related sites on the problematics of women’s health and embodiment, probably the most common operant framing today in both the academy and society remains the biomedical model. This model centers on concepts of health status, health behaviors, and technoscience interventions. Gendered, cultured, historicized, classed, raced, and otherwise situated, women are routinely silenced or erased as actors in the production of health, in both the provision and receipt of health care per se as well as in health politics and policy.¹

Yet a theoretical sea change has been occuring across many if not most segments of the social sciences and humanities in terms of fresh ways of conceptualizing multiplicities, multiculturalisms, cultural critiques, bodies, identities, marginalities, differences, women, subjects, objects, gender, communities, practices, and an array of other elements linked to modernity and postmodernity. This book draws deeply on these new approaches. We seek to again rupture increasingly biomedicalized frameworks of women’s health, as feminists have notably ruptured these in the past, and to revision—and thus to retheorize—women, health and healing. Revisioning means letting go of how we have seen in order to construct new perceptions.

In many ways, the women’s health movements of the last decades of the twentieth century in the United States have been exceptionally successful. There is considerably increased attention to women’s health, increased attention to women in scientific and clinical biomedical research, an increase in women as providers of care, and even improved inclusion of women as consumers of health care in policy venues.

Yet at the same time, we also suffer from the increased biomedicalization of women’s—and other people’s—health, and increased co-optation of earlier feminist interventions now shorn of their feminist roots and epistemological and even ontological processes. Many of us share a painfully increased understanding that essentializing “women” and “men” often creates false universals that then work to erase significant differences within groups rather than address them seriously in health policy, practices, and caregiving. Moreover, “old” problems of access to care have been twisted and torqued by “managed care” and “health care reform” but remain ever with us, however unstable in their details.

We therefore see this historical moment as one beset by dilemmas, paradoxes, and contradictions—in both feminist theorizing and women’s health situations—which cannot be ignored. We are reminded of the pointed comment made by Gloria Steinem in an early film on the women’s movement that “feminism is not an unmixed blessing.” Nor is the “success” of a social movement such as women’s health. Our successes in both feminist theorizing and in women’s health have themselves produced new problems—anticipated and unanticipated—which we are calling “complications.” In this book, we set out many of these complications, seeking to place the dilemmas, paradoxes, and contradictions on the table for consideration and reflection.

What we hope to provide here is an occasion for rethinking the conceptual foundations of women’s health, and perhaps troubling the concept itself. We want to provoke a retheorizing of women’s health premised afresh upon the differences and complexities of women’s knowledges, bodies, experiences, and situations, which the full range of feminist scholarship has been very busy revealing over the past two decades. We are no longer theoretically or politically naive—or at least, not in the same ways we were years ago. Our understandings are now considerably more nuanced both because we have paid profound attention to theory/theorizing and because we have lived through—or, perhaps more accurately, been battered by—the contradictions and the pseudo-privileging of “women’s” agendas, the places and spaces where rhetoric has replaced action and activism, process and practice, deleting and diluting feminisms.

Our quest here is for fresh approaches and cross-disciplinary pathways rather than exploration of the many critical substantive topics in women’s health (for example, breast cancer and violence). We in fact boldly argue that the destabilized methods and disruptive agendas generated here can be applied in pursuit of the substantive. This is not a dodge to get around the complexities in the topics of women’s health (see Ruzek, Olesen, and Clarke 1997), but rather an argument for new conceptual and theoretical interventions found in the contributors’ multiple approaches. Here, feminist theory writ large and women’s health and healing writ large meet. We are decentering women, health, and healing from its long-standing cage in biomedicine, a process already begun in earlier feminist analyses (e.g., Arditti et al. 1985; Fisher 1986; McClain 1989; Ratcliffe 1989; West 1984; Lewin and Olesen 1985), and resituating it at the intersection of new theoretical frames that open new vistas, new horizons and—needless to say—new problems as well.

Our guiding metaphor for this project of revisioning women, health, and healing is Donna Haraway’s concept of diffractions. Drawing from the optical metaphors and instruments so common in Western culture and technoscience, the concept of diffractions includes but goes beyond reflexivity as a critical practice because “reflexivity, like reflection, only displaces the same elsewhere, setting up the worries about copy and original and the search for the authentic and really real.” Diffraction adds action after reflection: “Diffraction is an optical metaphor for the effort to make a difference in the world … a device for considering how to make the end [of the millenium] swerve” (Haraway 1997: 16).

We take diffractions as close to what Blumer (1969) called “sensitizing concepts”—ideas to guide us toward fresh ideas and understandings. These are working concepts, pragmatically flexible to allow multipurpose use.² Diffractions allow us to attempt to see from multiple standpoints simultaneously, taking advantage of the poststructural deconstruction of woman/women into multiple lived subject positions through which differently situated knowledges, needs, and desires have been, are, and will continue to be constructed and articulated. Though we use the metaphor of re-visioning as path to the future, voice and other senses are, of course, also of importance. We need to hear multiple voices to see what to diffract. But voice, like vision, is not perfect. Contra Habermas, voice cannot necessarily carry a subject’s meaning(s) or intention(s) unmediated. We must grapple with the inherently problematic politics and practices of representation.

Diffractions can allow tensions to be held simultaneously rather than “resolve” them—because they may not be “resolvable.” Such tensions may instead be paradoxes and contradictions within which we must dwell. Such tensions are especially common around the difficult powers of bodies and embodiment, key sites where feminisms meet the world—including all kinds of sciences through all kinds of cultures. But again, and most important, diffractions are intended to provoke actions.

Thus we seek here to diffract new theoretical lenses through which fresh agendas and practices in women’s health and healing can be forged. We do this because we believe now is the time for such reframing. Agendas of twenty-five years ago have been accomplished, discarded, co-opted, and/or now seem more than a little outdated. But laundry lists of women’s health topics and issues will not suffice—though they are absolutely requisite as each issue has its own specificities.³ The profound revolutions in feminist theorizing of women’s extremely heterogeneous situations, identities, and desires absolutely must be taken into account if we are not to merely end up with more of the same defeminized and dehumanized biomedicalizations of women’s health.

The theoretical lenses we draw upon for diffracting and revisioning women, health, and healing are feminist theory, cultural studies, and technoscience studies perspectives. We start by asking what has changed over the past quarter century in these areas and how these changes potentially relate to revisioning women, health, and healing. When second-wave women’s health movements were gaining momentum in the early 1970s, feminist theory and women’s studies were in their infancy, often simplistic, categorical, and universalizing. Then centered exclusively on women, feminist theory largely sought to explain women’s oppressed positions in various social structures. Early theory produced three or four “kinds” of feminists: liberal, cultural, socialist, and/or Marxist, which could and did lead to different modes of political activism around women’s health (e.g., Fee 1983). We often arrogantly thought we knew what liberation meant. Today the shelves of books and journals of feminist theory are overflowing. Almost nothing of our earlier understandings has gone uninterrogated and reframed, especially by the poststructural turn, but also by new feminist state theorizing, feminist legal theory, and often agonized yet highly productive and invaluable “global” confrontations. Gender studies are increasingly valued, if problematic and problematized.⁴ It is through these theoretical “complications,” described a bit more below, that revisioning women’s health needs to occur.

In the 1970s, cultural studies as a field was largely confined to Britain. It sharpened its focus on popular cultural phenomena, from music to dress to movies and other especially visual cultures, examining these “bottom-up” phenomena through an array of critical means (Grossberg, Nelson, and Treichler 1992). Not necessarily feminist, early cultural studies also fixed its sites of study on education and labor (Gordon 1995; McNeil and Franklin 1991). Feminists working inside that approach then began challenging the male biases and the lack of gendered and raced analyses—including the limited choices of research topics.⁵ Today cultural studies are quite global, vital, contentious, and productive of valuable understandings that can and should inform the future of women, health, and healing.

Technoscience studies barely existed before 1980. The term refers to the transdisciplinary field focused on examining the social and cultural interactions and consequences of sciences, technologies, and medicines. Like feminist theory and women’s/gender studies, it includes scholars from sociology, history, anthropology, rhetoric, languages, communications, political science, cultural studies, and even literature (e.g., Hess 1997; Traweek 1993; Jasanoff et al. 1995). The term itself challenges traditional notions that “basic” scientific research produces “applied” technologies in a unidirectional fashion. Instead, the two are loosely viewed as coconstituitive, as hybrid (Latour 1987). The term also has a “specific historical meaning for fields where knowledge, and practice and the economy were intimately related,” where science involves “the creation and sale of knowledge products”—technoscience (Pickstone 1993: 438).

Over the past decade, exciting new work has been done in all three of these fields and, perhaps more important, they have begun to intersect with each other quite deeply. As we have come to examine the heterogeneities of women’s lives and experiences, we have drawn increasingly upon understandings based on social and cultural frameworks. And we have been making increasingly explicit the relations among women, cultures, sciences, technologies, and medicines of many kinds. Women dwell in deeply technoscientific situations, not only but perhaps most intensely vis-à-vis health and healing. The work done through these perspectives and their intersections over the past decade provides new theoretical repertoires and resources for reinterpreting and revisioning women’s health issues and, based upon thoughtful theorizing, setting new agendas for the next millennium. The substantive focus of this volume is largely on the United States, but many of the contributors have articulated transnational patterns and concerns. The goal of retheorizing is to think in ways complicated enough to cross all kinds of boundaries. The saliences or lack of saliences of nation-states in the health and healing practices of women are questions to be explored rather than taken as given.

In the remainder of this introduction, we first elaborate what we see as the complications, the problematics that provoked us to have the conference that led to this book. We try to do this thoroughly enough to contextualize the papers that follow, but it is ultimately those papers which revision the future of women, health and healing. They reconceptualize our current situations in ways that we hope can help us move beyond the complications, providing new angles of vision—diffractions—and modes of action and reaction. They seek to build unique and important transdisciplinary bridges among the social sciences, humanities, and health professions—what Foucault (1975) termed the human sciences—to create fresh meeting sites where new futures can be considered and created.

We are concerned here with two sets of complications of situated knowledges: those that have occurred around feminist theory and those that have occurred around women’s health and healing in the past twenty years or so.

Feminist Theoretical Complications

Challenging the material-semiotic practices of technoscience is in the interests of a deeper, broader and more open scientific literacy, which this book will call situated knowledges (Haraway 1997: 11).

The need to destabilize ...

Table of contents

• Cover Page
• Half Title page
• Title Page
• Copyright Page
• Dedication
• Contents
• Acknowledgments
• Feminist Revisioning: Theoretical Speculations and Interventions
• Destabilizing Methods
• (Re)Constructing Experience: Searching the Self
• Challenging New World Reproductive Orders
• Revised and Disruptive Agendas for Women's Health
• Index