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Making appropriation 'stick': Stabilizing politics in an 'inherently feminist' tool
Abstract
This article examines how feminist politics are made to 'stick' to appropriated technologies in the context of a contemporary feminist women's health clinic in the US. Feminist clinics such as 'FemHealth', founded as part of 1970s women's health movements, put medical tools and knowledge into lay women's hands, making the appropriation of medical technologies a centerpiece of their political project. In the process, they rejected the authority of physicians and gave new politicized meanings to the tools they claimed as their own. As lay healthworkers at FemHealth continued the project of appropriation, they also continued to negotiate their dependence on physicians to perform tasks that required a medical license. Drawing on participant observation and interviews with healthworkers, I argue that struggles over the role and authority of physicians in this clinic play out through debates over two similar and competing tools used in the abortion procedure: the single-tooth tenaculum and the cervical stabilizer. Many healthworkers invested in the stabilizer as 'inherently feminist' in hopes that it would maintain its politics even when passed into physicians' hands. While appropriation depends on the ability of users to alter a technology's meanings, actors may feel invested in the new politics taken on by appropriated tools and work towards making those meanings persist, or 'stick'.
Intermediary spaces between health social movements and biomedicine have proliferated since the 1970s and have typically been analyzed through the lenses of co-optation or hybridization. In this article, we present data from two separate empirical projects (teaching and learning the pelvic exam in medical schools and feminist anti-violence counseling programs) in order to theorize what we call “counter-clinical spaces.” Counter-clinical spaces are medicalized sites of knowledge production and practice that are produced through social movements’ contestations with biomedicine. Other examples include sexual assault nurse examiner programs, LGBT health centers, and sexual health clinics. Counter-clinical spaces are “counter” and “clinical” in several ways. First, these spaces are distinctly clinical in that they intervene in the health of the body. Second, these spaces are counter-clinical in that they are organized in critique of dominant medical practices. Crucially, counter-clinical spaces engage the clinical encounter as a site of transformation: social movement actors target clinicians’ deployment of medical power, especially in their interactions with marginalized persons. We thus attend to the scale upon which social movements make a change in and against medicine, and we highlight how social movement logics can and do change practices even when they are unable to shift structures.
This article provides a critical analysis of the evolution and impact of hospital-sponsored women's health centers. Using original data gathered from interviews, participant observation, and content analysis of documents and brochures, the authors describe the development of four models of hospital-sponsored women's health centers and illustrate three specific mechanisms of the co-optation process. They show how many elements of feminist health care were used for the purpose of marketing and revenue production rather than for empowering women and transforming the delivery of care. Following Stratigaki's notion of negative countereffect, the authors show how the key feminist concepts of women-centered care and empowerment ended up contradicting their original meaning and purpose. Rather than being the subject of care, women became the object of treatment and revenue production.
In social studies of technology, as in many other scientific disciplines, highly persuasive similes are at work: pious stories, seemingly reaped from research, suggesting certain general theoretical insights. Variously adapted, they are handed down: in the process, they acquire almost doctrinal unassailability. One such parable, which has been retold in technology and urban studies for a long time, is the story of Robert Moses' low bridges, preventing the poor and the black of New York from gaining access to Long Island resorts and beaches. The story turns out to be counterfactual, but even if a small myth is disenchanted, it serves a purpose: to resituate positions in the old debate about the control of social processes via buildings and other technical artifacts -or, more generally, about material form and social content.
Beginning by reading a 1992 feminist appropriation of Michelangelo's Creation of Adam - in a cartoon in which the finger of a nude Adamic woman touches a computer keyboard, while the god-like VDT screen shows a disembodied fetus - 'Virtual Speculum' argues for a broader conception of 'new reproductive technologies' in order to foreground justice and freedom projects for differently situated women in the New World Order. Broadly conceptualized reproductive practices must be central to social theory in general, and to technoscience studies in particular. Tying together the politics of self help and women's health movements in the United States in the 1970s with positions on reproductive freedom articulated within the Legal Defense and Educational Fund of the NAACP in the 1990s, the paper examines recent work in feminist science studies in several disciplinary and activist locations. Statistical analysis and ethnography emerge as critical feminist technologies for producing convincing representations of the reproduction of inequality. Untangling the semiotic and political-economic dialectics of invisibility and hypervisibility, 'Virtual Speculum' concludes by linking the well-surveyed amniotic fluid of on-screen fetuses and the off-frame diarrhea of uncounted and underfed infants in regimes of flexible accumulation and structural adjustment.
It is a routine teaching day. The advanced level course in science and technology studies (S&TS) is holding its fourth weekly class of the semester. The students dutifully indulge the professor in his incantation of one of the iconic case studies of the field: Langdon Winner’s well-known
analysis of Moses’ bridges. Winner claims that the bridges built by Moses on Long Island are an example of a technology which has political qualities: by this he means that the bridges were designed (consciously or unconsciously) to have a particular social effect.
This study explores the role feminist ideology played in long-term structural changes in feminist organizations. The vehicle for this exploration was a comparative case study of 14 feminist women's health centers that were started in the 1970s and were still in existence in the early 1990s. Drawing on interviews and site visits, the author describes the early collectivist structures, highlights some of the crises these organizations faced, and describes three structural ideal types that emerged in the 1990s. The analysis suggests three ideological issues that directed structural change: the importance of maintaining a system for the equitable distribution of power, the importance of growth versus autonomy, and the importance of feminism as an organizational outcome or internal process.
In a path-breaking essay, ‘The Virtual Speculum in the New World Order (1999),’ Donna Haraway links Our Bodies, Ourselves (the book and the slogan) to a critique of the US women’s health movement, claiming that both draw implicitly upon colonialist metaphors of discovery and acquisition of territory. Haraway’s critique does not stand alone, but belongs to a broader discussion within poststructuralist feminist theory which has been concerned with denaturalizing the female body, with the rejection of ‘experience’ as basis for feminist knowledge projects, and with deconstructing women’s position as autonomous epistemic agents. Given the popularity of this much-cited and often reprinted essay, as well as Haraway’s enormous influence on feminist (body) theory, feminist epistemology and technoscience politics, I will use her essay to consider the gap between contemporary poststructuralist feminist theory and women’s health activism. On the basis of alternative feminist theoretical (phenomenological) perspectives on women’s bodies and embodiment, I conclude that Haraway’s critique, while provocative, has little to offer as an epistemological foundation for feminist health activism.
I examine the process of cooptation in a feminist health clinic, focusing on how the State shapes and absorbs the challenges of grassroots health activism. A familiar picture of of organizational change accompanies the clinic's decision to secure State funding: the erosion of collective decision-making, an immersion in service delivery to the exclusion of other activities, and a dependency on continued funding which decreases the political autonomy of the organization. Using Gramsci's analysis of hegemony, I demonstrate how the State's effect on this organization stemmed from both direct pressures for particular changes and the influence of dominant ideology and social relations in structuring the clinic staff's response to those pressures. Additionally, I explore the factors that laid the groundwork for a reversal of cooptive patterns and a revitalization of the clinic's social movement orientation and political goals.
Abortion represents a particularly interesting subject for a social movements analysis of healthcare issues because of the involvement of both feminist pro-choice activists and a segment of the medical profession. Although both groups have long shared the same general goal of legal abortion, the alliance has over time been an uneasy one, and in many ways a contradictory one. This paper traces points of convergence as well as points of contention between the two groups, specifically: highlighting the tensions between the feminist view of abortion as a women-centred service, with a limited, 'technical' role for the physicians, and the abortion-providing physicians' logic of further medicalization/professional upgrading of abortion services as a response to the longstanding marginality and stigmatisation of abortion providers. Only by noting the evolving relationships between these two crucial sets of actors can one fully understand the contemporary abortion rights movement. We conclude by speculating about similar patterns in medical/lay relationships in other health social movements where 'dissident doctors' and lay activists are similarly seeking recognition for medical services that are controversial.