Biomedicine and gendered bodies: committed articulation as a feminist methodology

by S. García Dauder, Carmen Romero-Bachiller, Pablo Santoro

We present the research trajectory and current projects of the Science, Technology and Gender research group of Madrid, an interdisciplinary team composed of philosophers of science, sociologists, social psychologists, historians, nurses and anthropologists, most of them women. Focusing on biomedicine and its relationships to bodies, gender and activism, the group has opened a line of research based on feminist studies and STS which was practically absent from Spanish academia.

The challenge of building a feminist and interdisciplinary STS team

In contrast to other countries, STS studies in Spain have had scarce institutional support. Recognition is even more limited if STS Studies include the term “feminism”. For this reason our team was not organised by a university department or an already existing STS institution. Rather on the contrary: the very trajectory of the team has  contributed to the creation of one: the Science, Technology and Society department in CSIC -the Spanish National Research Council, which is the main state research institution. The Science, Technology and Gender research group in Madrid emerged more as a personal and risky endeavour carried out by Eulalia Pérez-Sedeño (CSIC Research Professor), along with some other feminist researchers, to develop a Science, Technology and Gender field in Spain. Despite this lack of support and informality, the group has enjoyed greater flexibility and interdisciplinarity, as it has never been tied to narrow disciplinary boundaries.

Fig. 1: Eulalia Pérez-Sedeño y S. García-Dauder.

Although membership has varied over the years, the group is formed of philosophers of science, sociologists, social psychologists, historians, nurses and anthropologists, most of them women. The team brings together scholars from different institutions, particularly from the STS department at the Institute of Philosophy-CSIC, the department of Social Theory at the Complutense University and the area of Social Psychology at Rey Juan Carlos University, but also from other institutional and non-institutional locations. The original meeting ground for the group, which started to function around 2004, was a feminist epistemological proposal: that a more democratic and inclusive scientific community would result in fairer and more objective science (González-García  and Pérez-Sedeño, 2002; Romero-Bachiller and García-Dauder, 2006). Research carried out by the team is characterised by the confluence of feminist epistemologies, STS, anthropology of the body and social studies of biosciences, with a particular orientation towards Science, Technology and Gender issues. Our investigations have always maintained an empirical connection to the context of Spain,  building links with diverse social actors, from activist groups to scholars from other areas or biomedical professionals.

Research trajectory

Since 2004, our team has been awarded several STS and STG-related competitive projects, funded by the Spanish Public R+D Plan, which have functioned as a way of connecting individual research and the interests of the team members. The first three projects carried out by the group, STS Interactions in Biosocial Sciences and Medical Technologies (2004-2007,  I+D+I 29/03); Sciences and Technologies of the Body from an STS Perspective (2007-2010, HUM2006-06327/FISO); and Cartographies of the Body: Biopolitics of Science and Technology (2010-2013, FFI2009-07138), featured Eulalia Pérez-Sedeño as the main researcher. The evolution of the careers of the team’s junior members led to a subsequent coordinated project, Visions and Versions of Medical Biotechnologies (2013-2016), with two subprojects: Governance, Public Understanding and Hidden Innovations, led by Pérez-Sedeño (FFI2012-38912-C02-01), and Analysis of the Production and Circulation of Lay/Expert Knowledges in Biomedical Practices, led by García-Dauder (FFI2012-38912-C02-02). Since 2016 we have been carrying out two different but coordinated projects: Multiple Voices, Plural Knowledges and Biomedical Technologies (2016-2019), led by Pérez-Sedeño, and  Feminist Epistemologies and Health Activisms: Emergent Practices, Care and Knowledges in Biomedical Contexts (2017-2020, FEM2016-76797-R), led by Romero-Bachiller.

These funds have served as umbrella projects for our team members’ empirical research, teaching, seminars and academic supervision, allowing for the consolidation of a line of research which had been practically absent from Spanish academia. All of these activities carried out by the group have culminated in many papers, presentations and articles, several PhD dissertations and two edited collections, Cuerpos y Diferencias (Pérez-Sedeño and Ibáñez, 2012) and Cartografías del cuerpo. Biopolíticas de la ciencia y la tecnología (Pérez-Sedeño and Ortega, 2014). Since 2005 the group has also annually organised an international workshop in Madrid where Spanish and Latin American researchers, along with scholars from other geographic origins, can present their research, share their interests and discuss current issues related to the complex intersections between science and gender. Throughout our history we have formed ties with many other research groups, both in Spain and internationally, and we have received visits from various STS, STG and gender studies scholars. Some members of the team have also been active in different STS networks, such as Redes-CTS (the Spanish-Portuguese STS Network) or EASST.

Fig. 2: S. García-Dauder and Nuria Gregory, “Multidisciplinarity and psychosocial turn in the management of intersex”, presentation at the X International Workshop Science, Technology and Gender: Visions and Versions of Biomedical Technologies, Medialab Prado Madrid (23rd-25th March, 2015).
Fig. 3: Anne Fausto-Sterling and Carmen Romero-Bachiller, Anne Fausto-Sterling “Gender as Process, Not Trait: dynamic systems approaches to the origins of difference in infancy“, invited conference, XII International Workshop Science, Technology and Gender: Knowledges, practices and activism from feminist epistemologies, Centro de Ciencias Humanas y Sociales, CSIC, Madrid (21st-23rd June, 2017). Photographs taken by a team member.

As the names of our projects suggest, our group maintained a special focus on bodies during the first few years, analysing how biomedical practices and discourses result in the production of particular types of bodies, and especially how they act upon women’s bodies and re/produce boundaries between sexed bodies. Different empirical case studies were addressed by the team, allowing for a comparative perspective between specific biomedical technologies: from reproductive technologies or plastic surgery to sex-assignment procedures and food technologies. The comparison of these diverse technoscientific fields, with their focus always coming from the context of Spanish reality, gave way to the development of several analytic perspectives and questions, such as: How are bodies materially and semiotically produced? How are bodies gendered? What is “the human”? How do norms and differences function in biomedicine? How are logics of care and choice put to play?

We would like to highlight the critical work done by the team in its initial years on the lack of representation of women’s bodies in assisted reproductive technology discourses and practices (Pérez-Sedeño, 2004; Sánchez, 2004). We also consider noteworthy the pioneering work on the situation of psycho-medical regulation of sex/gender dualisms in the treatment of intersex conditions in Spain (Gregori, 2006; García-Dauder, Romero-Bachiller and Ortega, 2007). In later works we analyse how the “human” and “individuality” are made -the “individual patient”- in reproductive technologies. Whereas those technologies are deeply connected with women’s bodies, the center of attention tends to be displaced towards the “couple”, the “embryo”, or some other parts of the women’s body that become externalized (Ruiz and Romero-Bachiller, 2010; Bergmann, 2014; Pérez-Sedeño and Sánchez, 2014). In the case of therapeutic technologies, “molecular biopolitics” fragments bodies into transferable tissues that can be separated from their original settings, mobilised by clinics and reused in other bodies -cord blood banking and ova donation- (Santoro, 2009; Miranda, 2014). We have also analysed how bodies can be perfected and regulated through food, as is the case with cholesterol control and eating disorders (Ibáñez and Santoro, 2012; González Aguado, 2014), and other aesthetic medical practices, such as mammary implants (Pérez Sedeño, 2012, 2014). We additionally consider how bodies are surgically fixed as humanly livable through the medical assignation of a single sex within the sexual dichotomy, e.g., in intersex conditions (García-Dauder, 2014; Gregori, 2014).

Committed articulation as a way of doing research in STS/STG

Given the proximity that many of our projects have had with social movements and feminist and LGBT activist groups, a characteristic trend that has emerged throughout the different projects of our group is a way of doing research we refer to as “committed articulation”. Initially, the team employed mostly qualitative methodologies based on critical discourse and representation analysis -employing “classical techniques” such as semi-structured in-depth interviews, focus groups and discursive analysis of media or on-line productions. Later on, seeking to highlight how bodies are made in biomedical contexts, an ethnographic approach on these practices was favoured. Over the years, and with more than a decade of committed research on trans and intersex medical interventions working in, with, and alongside collectives, using Jay Ruby’s (1991) terminology, our methodological stance has adopted the form of a committed support rather than a detached extraction of information. This has allowed for emergent and more participatory methodologies to be constructed alongside collectives, whose goals very often go beyond “research” as such. We have named such an approach “committed articulation”. It is a methodology of processes, with a strong embodied and activist commitment (Esteban, 2011), anchored in standpoint feminist epistemologies and consciously aware of their political implications. A methodological stance where researchers are situated in an assemblage of relations along with different actors and voices articulated around a particular phenomenon. Research is, therefore, part of the assemblage itself. Thus, the impact of such a relation is part of a collective learning process, and the given results are never detached or aseptic. Yet, recognising co-production does not eliminate power relations altogether, and these need to be accounted for in any particular intervention. We may talk, then, of hybrid practices of research, activism, social transformation and teaching. An approach that is allowing us to recognise and bring to the fore knowledges emanated from health activism, participating in their processes of expertization, “getting undone science done” and acting as “epistemic correctives” (Hess, 2009).

Current research

Starting in 2013, our more recent research has been dedicated to two projects. In the project Visions and Versions of Medical Biotechnologies (2013-2016), our focus was not so much centered around how diverse biomedical technologies shape “the body multiple” (Mol, 2002), but around the different forms of public participation in the production of biomedical knowledge. We were also especially focused on how expert knowledge is constituted, in processes of expertification (Epstein, 1996), and, -questioning this dichotomy- “lay/expert” knowledge interchanges. In most cases, we aimed our attention at controversy analysis -in nosology, diagnosis, etiology, treatment and bioethical issues- and how a democratic re-articulation of knowledge is produced in a context of digital citizenship and citizen participation in health (García-Dauder and Romero-Bachiller, 2012; Romero-Bachiller, Ibáñez and Ortega, 2014; García-Dauder, Gregori and Hurtado, 2015; Hurtado, 2017).

We have been particularly interested in the figure of the “expert patient” or the “lay expert” and their hybrid experiential/activist/expert knowledge (Akrich, 2010; Akrich, O’Donovan and Rabeharisoa, 2015). Thus, we have addressed different cases of “epistemic communities”: patient organizations and online collectives constituted around a concrete health condition, that move from serving as a counseling and emotional support role within the community, to spreading and disclosing knowledge to the outside, to their own production of knowledge. Concretely, both the International Campaign for Trans Depathologization, and some intersex collectives, such as GRAPSIA -a Spanish support group for relatives and people with Insensitivity Androgynous Syndrome-  are paradigmatic examples of “epistemic correctives” in health, identifying undone science and producing activism-based evidence, inverting the concept of “evidence-based activism” as defined by Akrich, O’Donovan y Rabeharisoa (2013)  (Ortega, García-Dauder, Gregori and Pérez Sedeño, 2017).

Stemming from that work, the current project of the team, Feminist Epistemologies and Health Activisms, investigates emergent knowledges -including how-knowledge, caring practices and experiential knowledge- produced by feminist activism in health. Our objective is to analyse examples in the context of Spain of what Nancy Tuana (2006) has identified as the move from “epistemologies of ignorance” to “epistemologies of resistance”. In this project we are also introducing innovative methodologies that try to connect STS/STG research, health professionals and health activism with formal and informal teaching and learning procedures, and with more horizontal and inclusive formats to favour open conversations.

Teaching profile and research training

Our group members have multiple institutional assignments, which increases interdisciplinarity, and also multiplies our teaching participation in various university programmes and institutions, some of them directed towards health professionals. Currently, team members teach Sociology and Anthropology for the Nursing degree programme at both the Complutense University and University Rey Juan Carlos, and Sociology of Science for the Sociology programme at the Complutense University. Our members have also been participating in several innovative teaching projects, such as “Salud y sociedad” (Health and Society), lead by Elena Casado Aparicio, Pablo Santoro and Pablo Messeguer, which aims to go beyond the biomedical paradigm in nursing by promoting a socio-practical knowledge based on collaboration, tinkering and caring.

In addition, the team is highly committed to training researchers, which we do by extending our teaching to postgraduate M.A. courses at different institutions: the M.A. of Science, Technology and Society (CSIC); the M.A. of Health and Gender (URJC) and the M.A. of Sociocultural Analysis (UCM). Throughout the years, our group’s research development has also opened the way for varying promotions for its members. Some of them have completed their PhDs in its framework (Miranda, 2013; Ibáñez, 2014; Ortega, 2014; Gregori, 2015; Ruiz Marcos, 2015) and some have gained seniority and are now leading research projects and tutoring PhDs themselves. New members have joined the team as well, and their presence has contributed a revitalizing and renewing effect to the group, allowing for its expansion and maturation.

To conclude, the Science Technology and Gender research team of Madrid has contributed to the development and recognition of STS/STG Studies within the Spanish context, working from  a perspective of commited articulation between research, activism and teaching.

References

Akrich, Madeleine (2010). From communities of practice to epistemic communities: health mobilizations on the internet. Sociological Research Online, 15(2): 10.

Akrich, Madeleine; O‘Donovan, Orla; Rabeharisoa, Volona (2015). The entanglement of scientific and political claims: towards a new form of patients’ activism. In P. Wehling; W. Viehöver y S. Koenen (ed.), The Public Shaping of Medical Research. London: Routledge.

Bergmann, Sven (2014). La genética es como la masa de la pizza. El matching y la clasificación del fenotipo como práctica y decisión cultural en las clínicas de reproducción asistida. In Pérez-Sedeño, Eulalia; Ortega, Esther (eds.). Cartografías del cuerpo: biopolíticas de la ciencia y la tecnología (307-352). Madrid, Cátedra.

Callon, Michel; Rabeharisoa, Volona (2003). Research “in the wild” and the shaping of new social identities. Technology in Society, 25: 193-204.

Epstein, Steven (1996). Impure Science: AIDS, Activism, and the Politics of Knowledge. Berkeley: University of California Press.

Esteban, M. Luz (2011). Crítica al pensamiento amoroso. Barcelona: Bellaterra.

García-Dauder, S. (2014). La regulación tecnológica del dualismo sexual y el diseño de cuerpos normativos. In Pérez-Sedeño, Eulalia; Ortega, Esther (eds.). Cartografías del cuerpo: biopolíticas de la ciencia y la tecnología (469-520). Madrid: Cátedra.

García-Dauder, S.; Romero-Bachiller, Carmen (2012). Los desplazamientos políticos de las categorías médicas: actores, discursos y relaciones en la controversia “alteraciones del desarrollo sexual” versus “Intersexualidad”. In Pérez-Sedeño, Eulalia; Ibáñez, Rebeca (eds.). Cuerpos y diferencias (213- 240). Madrid, Plaza y Valdés.

García-Dauder, S.; Romero-Bachiller, Carmen; Ortega, Esther (2007). Cossos  insubmissos i mutilació genital: La regulació tecno-mèdica dels cossos sexuats. In Armengol, Josep M. (ed.). Masculinitats per al segle XXI (35-45). Barcelona: CEDIC.

García-Dauder, S.; Gregori, Nuria; Hurtado, Inmaculada (2015). Usos de lo psicosocial en la investigación y tratamiento de las intersexualidades/DSD. Universitas psychologica, 14(5): 1649-1666.

González, María (2014). Las caras ocultas de la anorexia: diferencias relacionales de lo bello, lo bueno y lo blanco. In Pérez-Sedeño, Eulalia; Ortega, Esther (eds.). Cartografías del cuerpo: biopolíticas de la ciencia y la tecnología (133-191). Madrid: Cátedra.

González, Marta. I.; Pérez-Sedeño, Eulalia (2002). Ciencia, tecnología y género. Revista Iberoamericana de Ciencia, Tecnología, sociedad e innovación, 2. Disponible en http://www.oei.es/historico/revistactsi/numero2/varios2.htm

Gregori, Nuria (2006). Los cuerpos ficticios de la biomedicina. El proceso de construcción del género en los protocolos médicos de asignación de sexo en bebés intersexuales. AIBR. Revista de Antropología Iberoamericana, 1(1).Disponible en: http://www.redalyc.org/html/623/62310108/

Gregori, Nuria (2014). “Llegar a ser” mujer/hombre desde un diagnóstico de intersexualidad o ADS. In Pérez-Sedeño, Eulalia; Ortega, Esther (eds.). Cartografías del cuerpo: biopolíticas de la ciencia y la tecnología (423-468). Madrid: Cátedra.

Gregori, Nuria (2015). Encuentros y des-encuentros en torno a las intersexualidades/DSD: narrativas, procesos y emergencias. Tesis doctoral, Universidad de Valencia.

Hurtado, Inmaculada (2017). Asociaciones y disociaciones: agentes, discursos y controversias en torno a la hiperactividad infantil. Salud Colectiva, 13, 321-335.

Ibáñez, Rebeca (2014). Bad to eat? Empirical explorations of fat. Tesis doctoral, Universidad de Salamanca.

Ibáñez, Rebeca; Santoro, Pablo (2012). Elecciones inciertas en tiempos inciertos: «elección informada» en el almacenamiento de células embrionarias de cordón umbilical y los alimentos funcionales. In Pérez-Sedeño, Eulalia; Ibáñez, Rebeca (eds.). Cuerpos y diferencias (179-193). Madrid: Plaza y Valdés.

Miranda, Mª José (2013). Fenomenología de las agencialidades materiales en la investigación con células troncales. Tesis doctoral, Universidad de Santiago de Compostela.

Miranda, Mª José (2014). Medicina regenerativa y terapia celular: turismos, patentes y feminismos. In Pérez-Sedeño, Eulalia; Ortega, Esther (eds.). Cartografías del cuerpo: biopolíticas de la ciencia y la tecnología (353-389). Madrid: Cátedra.

Mol, Annemarie (2002). The Body Multiple. Ontology in Medical Practice. Durham: Duke University Press.

Ortega, Esther (2014). La cuestión del sexo/género en medicina: tecnologías de reasignación de sexo y valores de género en España. Tesis doctoral, Universidad de Santiago de Compostela.

Ortega, Esther; Romero-Bachiller, Carmen; Ibáñez, Rebeca (2014). Discurso activista y estatus médico de lo trans: hacia una reconfiguración de cuidados y diagnósticos. In Pérez Sedeño, Eulalia; Ortega, Esther (eds.). Cartografías del cuerpo: biopolíticas de la ciencia y la tecnología (521-572). Madrid: Cátedra.

Ortega, Esther; García-Dauder, S.; Gregori, Nuria; Pérez-Sedeño, Eulalia (2018). Practices and knowledge: philosophy of biomedicine, governance and citizen participation. In Belén Laspra; José A. López Cerezo (ed.), Spanish Philosophy of Technology – Contemporary Work from the Spanish Speaking Community. Springe.

Pérez-Sedeño, Eulalia (2004). Sociedad, cultura y tecnologías reproductivas. In Actas del IV Congreso de la Sociedad de Lógica, Metodología y Filosofía de la Ciencia en España  (pp. 438-441). Valladolid: Universidad de Valladolid.

Pérez-Sedeño, Eulalia (2012). Ciencias y tecnologías del cuerpo: la práctica de la tecnología de los implantes mamarios. In Pérez-Sedeño, Eulalia; Ibáñez, Rebeca (eds.). Cuerpos y diferencias (131-152). Madrid: Plaza y Valdés.

Pérez-Sedeño, Eulalia (2014). Feminismo, ética y cirugía estética. In Pérez-Sedeño, Eulalia; Ortega, Esther (eds.). Cartografías del cuerpo: biopolíticas de la ciencia y la tecnología (91-132). Madrid: Cátedra.

Pérez-Sedeño, Eulalia; Ibáñez, Rebeca (eds.) (2012). Cuerpos y Diferencias. Madrid: Plaza y Valdés.

Pérez-Sedeño, Eulalia; Ortega, Esther (eds.) (2014). Cartografías del cuerpo: biopolíticas de la ciencia y la tecnología. Madrid: Cátedra.

Pérez-Sedeño, Eulalia; Sánchez, Ana (2014). Asimetrías y olvidos en las tecnologías de reproducción asistida. In Pérez-Sedeño, Eulalia; Ortega, Esther (eds.). Cartografías del cuerpo: biopolíticas de la ciencia y la tecnología (195-244). Madrid: Cátedra.

Romero-Bachiller, Carmen; García-Dauder, S. (2006). Epistemologías feministas y democracia radical. In Eulalia Pérez-Sedeño (ed.), Ciencia, tecnología y género en Iberoamérica (263-271). Madrid: CSIC.

Ruby, Jay (1991). Speaking For, Speaking About, Speaking With, or Speaking Alongside- An Anthropological and Documentary Dilemma. Visual Anthropology Review.  7(2), 50-67.

Ruiz-Marcos, Lorena (2015). Cuando la memoria pasa por la piel. Escenarios del cuidado en la enfermedad de Alzheimer. Tesis doctoral, Universidad Complutense de Madrid.

Ruiz-Marcos, Lorena; Romero-Bachiller, Carmen (2010). Embriones, no nacidos y otras especies. una coreografía de los límites de la vida humana. Athenea Digital. Revista de pensamiento e investigación social, (19), 29-50.

Sánchez, Ana (2004). La investigación en células germinales embrionarias. In Actas del IV Congreso de la Sociedad de Lógica, Metodología y Filosofía de la Ciencia en España  (pp. 442-446). Valladolid: Universidad de Valladolid.

Santoro, Pablo (2009). From (public?) waste to (private?) value. The regulation of private cord blood banking in Spain. Science Studies, 22(1), 3-24.

Santoro, Pablo y Romero-Bachiller, Carmen (2017). Thinking (the bioeconomies) through care. Patients› engagement with the bioeconomies of parenting. In V. Pavone y J. Goven (ed.), Bioeconomies: Life, Technology and Capital in the 21st century. London: Palgrave Macmillan.

Tuana, Nancy (2006). The speculum of ignorance: The women›s health movement and epistemologies of ignorance. Hypatia, 21(3): 1-19.

MerkenMerken