A response

A fake (menstrual) period? As I began exploring potential fieldsites, I rapidly came across the phenomenon of menstrual suppression which featured widely in global media in the mid-2000s. While the Financial Times evaluated the economic burden of menstruation on the economy (but had little to say about the surplus value menstrual suppression generates for the pharmaceutical industry), women’s magazines featured enthusiastic neo-feminist editorials lauding the benefits of freeing oneself of the biological obligation to menstruate. The periods induced by the oral contraceptive pill’s 7-day interval were rebranded as “fake.” Some, most notably the Bahian gynaecologist Elsimar Coutinho, pushed the rationale further, arguing that menstruation is unnatural and “useless,” the product of civilization which reduces the intervals between pregnancies and the duration of lactation (Coutinho, 1999).

My objective had initially been to remedy what I saw as a dearth of ethnographies that dealt with women’s experiences of menstruation. The ethnographic record is full of analyses of menstrual symbolism, but there was less, if anything – beyond Emily Martin’s (2001) seminal[1] The Woman in the Body – on how women experience and manage their bleeding. In the course of fieldwork, the question of menstruation gave way to that of pharmaceutical sex hormones and their repackaging, as women are increasingly proposed contraceptives to manage, interrupt or reduce their periods. As I began to follow hormones, fieldwork led me to places I had not initially foreseen: a blood donation centre, the operating theatre where vasectomies and tubal ligations are conducted, the weekly meetings of the Bahian Association of Travestis, the state of Bahia’s health secretariat’s IT services or a compounding pharmacy where vats of imported powdered hormones are handcrafted into subdermal hormonal implants. Salvador da Bahia is an exuberant and generous city (or at least it was). Decades of clinical trials for hormonal treatments – including many of those that eventually led to the FDA approval of the highly controversial Depo-Provera three-monthly contraceptive injection – made it an ideal place to carry out ethnographic fieldwork around these questions and to link them to broader issues of modernization, changing labour and gender relations, situating them within stratified biopolitical projects.

To make sense of menstruation and its hormonal transformation, it became clear that I needed to situate this within a wider economy of bodily plasticity in Brazil, from plastic surgery (Edmonds, 2010; Emonds & Sanabria, 2014) to the epidemic of c-section births (McCallum, 2005). This placed plasticity and the policing of the boundary between nature and artifice at the core of the inquiry. The book thus stemmed from a concern that arose as I thought about bodies – women’s bodies in particular – from rather than in Brazil. Through a decade of fieldwork and engagements with colleagues and friends in Brazil I came to better understand certain implicit assumptions I inherited about bodily norms and to identify more clearly the bodily norms that pervade our analytics. This book is an attempt to render some of this in a manner that does not reduce it to a difference between here/there but rather explores the variegated contingencies and normativities through which bodies come into being and take shape.

As I worked against naturalizing assumptions about what bodies are, seeking to reveal ethnographically how they are made to be what they become, it gradually became clearer that my central question was really about how the body’s capacities are moulded, manifested or policed, and to what ends. When I began this work, the literature I encountered often presented the body as a kind of blank canvas, differentially inscribed by “culture.” Fieldwork challenged this idea profoundly. Bodies, it appeared, not only receive new form and content from their environments, but are plastic. That is, they give themselves (new) form through such transactions, while enduring. Such a statement is of course the luxury of hindsight, and of having had the chance to think through these issues over time. The central concern with boundaries and hygiene that organised the dissertation evolved into a reflection on plasticity and the tension between change and endurance, between what is given and fixed and what is transformable.

I first discovered Anita Hardon’s inspiring work on pharmaceuticals and contraceptives in Portuguese translation during my first visit to Brazil and still have the battered and much annotated photocopy! This work was incredibly useful in setting about fieldwork – its own precursor in multi-sited ethnography – and provided a fabulous place from which to probe the intermingling and entwinement of pharmaceutical effects. To have the opportunity to work through these questions with her has been a rare privilege, not least thanks to the immensely generous and enthusiastic approach she cultivates. Chapter 5, in particular, owes much to the extended conversation Anita and I have had, drawing on this to explore in detail the materiality and “thingines” of hormonal drugs – beyond their pharmaceutical compositions. I use this case to suggest that pharmaceuticals – and hormones in particular – have a great deal to contribute to feminist theorizations of materiality. Through this case and in the work I have been pursuing since alongside Anita in the ChemicalYouth program (https://chemicalyouth.org) I have been thinking through materialsemiotic entanglements in ways that do not purport to know before the ethnographic inquiry where things are situated along material-semiotic continuums. In our forthcoming review (Hardon & Sanabria, 2017), we ask which of the potential pharmaceutical efficacies a drug has are actualized out of the myriad possible local iterations of pharmaceutical action. We explore the political, economic and regulatory labour that goes into facilitating or blocking certain efficacies over others.

Daniela Manica picks up the “paleofantasy” theme that runs through the tautological idea of returning the female reproductive organs to their purported natural state through artifice (synthetic sex hormones). While this idea may seem strange to readers in the US or Europe, it has a certain immediacy in Brazil on account of the relatively recent reduction in birth rates. One nursing auxiliary I interviewed had been using Depo-Provera for twelve years to suppress menstruation because of painful periods. During a conversation we had over coffee, after a busy morning attending patients in a health post on Salvador’s periphery, she explained: “Woman was made to procreate, not menstruate. It is only with modernity that woman had to leave the household and take charge of her own life. This is what made her menstruate.” This idea was reiterated time and time again in my encounters in Salvador. These are accounts of the social making the biological. As such, they invert the common idiom of the social being “after nature” (Strathern, 1992) while paradoxically appealing to a real, original biology.

Writing a book like Plastic Bodies was an ambiguous endeavour. Part of this stems from the ambiguity inherent in Bahian social life, a point that Elena Calvo Gonzalez highlights in her review. Anything one writes about Salvador can be unwritten or contradicted. In this sense, Daniela Manica and Elena Calvo Gonzalez’s reviews matter immensely to me, as doing justice and conveying accurately something of the reality I observed in Brazil raised substantial anxiety. Beyond this productive anxiety, it became an opportunity to reflect on location and my own relation to Bahia as a place from which I was thinking. This was further complicated by the fact that Bahia, while partaking in something distinctively recognisable as a modernist agenda, almost deliberately challenges the categorical distinctions upon which such agendas are constructed (or at least analysed within academic discourse), preferring what van de Port (2011) aptly sees as a Baroque aesthetic which is inclined to mixing and troubling totalizing narratives. So rather than highlight the plasticity “there,” so to speak, the text attempts to underwrite from Bahia the implicit assumptions concerning fixity and essence that continue to pervade the analytics and conceptual tools of academic discourse.

That the reviews assembled here come from colleagues located in Brazil and the Netherlands is meaningful with regard to this point, for much as I sought to problematize the “there” of fieldwork, I also sought to trouble the implicit “here” from which I was writing, inspired by the work colleagues in these places are producing as they unwrite the implicit placedness of theory (Mol, 2014; Yates-Doerr, 2015). Indeed, being based in France, writing about and from Brazil for a North American Press posed more than linguistic challenges – a point I have been fortunate to discuss at length over the course of an immensely productive conversation with colleagues at the University of Amsterdam, in particular Emily Yates-Doerr. The passage she describes as “exquisite” is deeply informed by the inspiring conversations we’ve had about place, theory and writing. The question she poses in her review, namely where the difference between my Bahian-inflected commitment to multiplicity or insistence on staying with the trouble of contradiction (before we were given such an apt turn of phrase by Haraway to name what we were trying to do) and the insatiable horizon of capitalist growth lies. It’s a challenging provocation, and the line between the two, as she rightly notes, is a treacherously thin one. My answer is that the book was an attempt to respond to multiplicity and contradiction with a “both, and” as an alternative to the categorical work of differentiation that theory oftentimes operates in counter-posing or contrasting with “either, or.” This (“both, and”) is a small, but I feel significant difference to “and, and, and”. Moving back to the conceptual language of the book, the difference between “both, and” and “and, and, and” is precisely the difference that Malabou leverages between plasticity and flexibility. And it is in that small space of difference that we may perhaps have most to hope for.

This ties into the questions that Daniela Manica poses in her review, namely what the notion of bodily plasticity might entail politically. “Should our bodies be less plastic, and more closed?” she asks while pointing to the issue of hormonal “excess” and proliferation as a politically ambiguous zone when unleashed from its natural referent. In Plastic Bodies, I argued that the distinction between nature/culture is not the place to ground our political response. Grounding a feminist resistance in women’s anatomy is deeply problematic. It relies on an apolitical understanding of biology that is blind to race, trans-, queer- and non-reproductive personhood. In her response to the book, Daniela Manica thus asks how to we address a politics that takes advantage of bodily plasticity? While we – as feminist scholars – may welcome this move away from the natural it is not without a valid concern for what can unwittingly come meddled with this. The excess agency of hormones that is put to work emancipatorily by travestis, as Daniela Manica astutely notes, is the very same agency that is also used to reinscribe sex binaries and normativities. The answer for me is again in the distinction between plasticity and flexibility. The oppressive or exploitative politics that Daniela Manica refers to is one that exploits flexibility’s infinite extendability, not plasticity. For to recognize plasticity, politically, would mean to recognize not just one pole of plasticity (the capacity to change and receive form) but also – and crucially – simultaneously, the capacity to endure, to yield a constraint to such demands. The promise of plasticity thus defined is that it has this “both, and” capacity to bring together two otherwise opposed meanings: that of necessity or determination of form and that of liberty or capacity to become otherwise. The tension between them is what constitutes the force of this concept and, I believe, its political promise within the rich repertoire of feminist responses to neoconservative orderings and categorical differentiations.

 

Emilia Sanabria is Assistant Professor of Anthropology at the Ecole Normale Supérieure de Lyon, France and Senior Research Fellow in the Chemical Youth Advanced Grant ERC project based at the University of Amsterdam (https://chemicalyouth.org). She has a sustained interest in anthropological theories of the body and materiality and her research has examined how the relationships between substances and bodies are conceptualized across a range of contexts. Her new project “Healing Encounters” centers on the psychedelic science renaissance and the new therapeutic uses of the psychoactive Amazonian brew ayahuasca.

 

References

Coutinho, E. (1999). Is Menstruation Obsolete? How suppressing menstruation can help women who suffer from anemia, endometriosis, or PMS. Oxford: Oxford University Press.

Edmonds, A. (2010). Pretty Modern: Beauty, Sex, and Plastic Surgery in Brazil. Durham, N.C.: Duke University Press.

Hardon, A., & Sanabria, E. (2017). Fluid Drugs: Pharmaceutical Anthropology Twenty Years On. Annual Review of Anthropology, 46.

Martin, E. (2001). The Woman in the Body: A Cultural Analysis of Reproduction (2nd editio). Boston, Mass.: Beacon Press.

McCallum, C. (2005). Explaining caesarean section in Salvador da Bahia, Brazil. Sociology of Health & Illness, 27(2), 215–242. http://doi.org/10.1111/j.1467-9566.2005.00440.x

Mol, A. (2014). Language Trails: “Lekker” and Its Pleasures. Theory, Culture & Society, 31(2–3), 93–119. http://doi.org/10.1177/0263276413499190

Strathern, M. (1992). After Nature: English Kinship in the Late Twentieth Century. Cambridge: Cambridge University Press.

van de Port, M. (2011). Ecstatic Encounters: Bahian Candomblé and the Quest for the Really Real. Amsterdam: Amsterdam University Press.

Yates-Doerr, E. (2015). Intervals of confidence: Uncertain accounts of global hunger. BioSocieties, 10(2), 229–246. http://doi.org/10.1057/biosoc.2015.9

 

Notes

[1] As I reread this, I note the irony of using the term “seminal” to describe Martin’s work which certainly warrants that as part of our feminist toolkit we enable the term “ovarian” to describe work of great influence for a field!