Monday, June 20, 2011

Sarah Franklin: Transbiology - A Feminist Cultural Account of Being After IVF

Transbiology: A Feminist Cultural Account of Being After IVF
by Sarah Franklin
Scholar and Feminist Online

This article is a rewritten version of a keynote lecture given at The Scholar & Feminist Conference 2009, "The Politics of Reproduction: New Technologies of Life," held on February 28 at Barnard College in New York City.[1]

The 2009 Scholar and Feminist Conference coincides with the 40th anniversary of the first experimental fertilisation of a human egg, in 1969, and thus offers a timely moment to examine the cultural legacy of IVF. A good place to begin is the enormous, and largely neglected, feminist literature on new reproductive technology—or NRT. Even without Google Scholar, the most cursory search of this literature will confirm that NRT is one of the major themes of post-war 20th century feminist scholarship, and a field that is as rich in equivocation as it is impressive in its erudition. It is no exaggeration to say that thousands of books and articles have been written by feminists on reproductive technologies—old and new.

Artificial insemination, surrogacy, surgery, and hormonal enhancement of fertility, as well as contraception, can all be counted as forms of technological assistance to reproduction, or what are known as 'new' or 'assisted' reproductive technologies. But it is the rapid expansion of IVF technology, and its evolution as a platform for genetic as well as reproductive intervention, that gives rise to the acronyms ART and NRT from the 1980s onwards. The feminist scholarly literature that developed during this period is highly diverse and unusually international.[2] One of the most prominent strands of debate associated with this vigorous early period is the denouncement of new reproductive technologies from prominent radical feminists during the 1980s, including Maria Mies, Janice Raymond, Gena Corea, Renate Klein, Jalna Hanmer, and Robyn Rowland, among others. This group is also associated with the formation and leadership of FINRRAGE, the Feminist International Network of Resistance to Reproductive and Genetic Engineering, founded in 1986.[3]

To the extent that there is a 'trademark' or 'generic' radical feminist position in this period, it can be characterised by its presumption of an identity between new reproductive technology and patriarchal culture. According to this view, new reproductive technologies encapsulate, enforce, and intensify the core values of patriarchal culture. IVF is the unadulterated offspring of patriarchal science, or, following Mary O'Brien, the manifestation, or even proof, of a masculine desire to colonise and control the female reproductive process.[4] Within this political framework, female consumers of NRT were perceived by some radical feminists, such as Renate Klein and Gena Corea, as not only victims of exploitation, but as collaborators with a male dominated medical establishment. This 'mirror theory' of new reproductive technology, and its accompanying rhetoric of female exploitation, victimisation, and collaboration, arguably did not always show feminist radicalism, scholarship, or politics at their very best.[5]

However, the emphasis on only one version of radical feminism in this period, and even the representation of it as dominant, are, like many retrospective accountings, both superficial and somewhat misleading. Like the feminist literature on NRTs more broadly, the 'FINRRAGE position' was somewhat more complicated.[6] Already, in the 1980s, the 'NRT = patriarchy' position, and its corresponding view of women who had amniocentesis or IVF as being, in Renate Klein's infamous phrase, 'dupes,' was resisted by many feminists—including other radical feminists, and large sections, if not a majority, of the FINRRAGE membership. Some feminists were motivated by alternative views of mothering, such as in the writings of Adrienne Rich, which differentiated between motherhood as a patriarchal institution and as a potential source of radical empowerment. Others, such as Naomi Pfeffer and Anne Woollett, sought to empower women to use new reproductive technologies to their advantage. Pfeffer and Woollett's sympathetic account of female infertility, published in 1983 by the London feminist publishing house Virago, was partly motivated by opposition to the 'feminists against women' who denounced women IVF patients as victims complicit with patriarchy. Similar studies exploring women's experience of IVF and infertility were generated from within FINRRAGE in the mid 1980s in response to the 'hard line' against NRTs, which increasingly, to some, resembled a caricature of radical feminist goals. Studies of women's reasons for choosing IVF were undertaken from the mid-1980s onward by FINRRAGE members Christine Crowe (Australia), Lene Koch (Denmark), Marte Kireczyk (The Netherlands), Linda Williams (Canada) and myself in the UK.[7] Conflict arising from these and other challenges to the FINRRAGE 'hard line' of complete opposition to all forms of reproductive technology led to the decline of the network from 1989 onwards.[8] These early FINRRAGE studies of women's experience of IVF in several countries, and the pioneering work of Margarete Sandelowski in the United States,[9] have since become part of a tradition of feminist studies of IVF that has been continued by Judith Lorber, Gay Becker, Charis Thompson, Marcia Inhorn, Karen Throsby and many others.[10] This comparative empirical tradition of feminist literature on IVF, largely focused on women's ambivalent experiences of it, is now a well established and rapidly expanding area of research, yet one that is rarely used to address questions of biotechnology more broadly.

Another important tradition of feminist work on NRTs that avoided the 'renounce and defame' politics of a minority of FINRRAGE members was modelled on the women's health movement. Three British feminists in London—Gail Vines, Sue Himmelweit, and Linda Birke—produced a guidebook for women seeking to use new techniques such as IVF in 1990 entitled 'Tomorrow's Child.'[11] This practical approach drew inspiration from Barbara Katz Rothman's pioneering work on amniocentesis in the mid-1980s, which she ended with an Appendix offering 'Guidelines for Personal Decisionmaking' to help women navigate the arduous choices offered by prenatal screening and to cope with the condition she identified as the 'tentative pregnancy.'[12] The defining feature of tentative pregnancy was its uncomfortable ambivalence: paradoxically, having more information and more reproductive choice could be oppressive and disempowering. This ambivalence was not used as a basis to reject the technology, but rather to enable women to negotiate its demands more effectively. Rothman's study drew direct inspiration from Rosalind Petchesky's highly influential 1980 article "Reproductive Freedom: Beyond a Woman's Right to Choose," in which she famously claimed that:

The 'right to choose' means very little when women are powerless ... women make their own reproductive choices, but they do not make them just as they please; they do not make them under conditions that they themselves create but under social conditions and constraints which they, as mere individuals, are powerless to change.[13]

Rather than the need to denounce IVF or amniocentesis, it is the difficulty of navigating 'the right to choose' that has proven to be the most consistent theme in feminist literature on NRT, as well as abortion. Somewhat paradoxically, this has proven to be as much of a challenge in the context of the 'new' reproductive choices—such as egg donation, IVF, or PGD—as for the 'older' choices of abortion, amniocentesis, or contraception. If there is any single take-home lesson from this entire body of feminist scholarship, it is that the relationship between technology and reproduction can never be separated from wider questions of women's status and empowerment. In the disappearing margin between limited choices and having-no-choice-but-to-choose-one-of-them lies the signature paradox of feminist debate over new reproductive technologies.

It has, of course, been argued that no one needs to choose IVF, amniocentesis, egg donation, or PGD (Preimplantation Genetic Diagnosis) at all (indeed this is exactly what the early feminist critics of NRT were advocating). It has also been argued that feminists concerned with reproductive choice might have more pressing issues to worry about than infertility, IVF, or ultrasound—such as reducing maternal mortality, and protecting access to contraception, as well as legal abortion. Indeed the difficult reproductive choices for women who can even afford IVF or PGD might seem most politically legible as a measure of widening health inequalities. This view of IVF and its ilk as an elite gambit for which, like cosmetic surgery, the rich who can pay should rightly serve as the guinea pigs for a change, may well be one of the reasons IVF remains a virtually unregulated industry in almost every country in the world. I suggest, however, that part of a re-evaluation of IVF, and feminist politics toward it, should include greater consideration of its biopolitical implications for the general population. Especially now that IVF makes up as much as 5% of the birth-rate in some countries, and has become the gateway to new genetic technologies, such as PGD, and new treatments, like regenerative medicine and tissue engineering based on human embryonic stem cell derivation and cloning, its implications have been greatly magnified. This rapid expansion of the IVF platform is particularly significant given that many basic aspects of IVF remain both problematic and controversial.

To Read the Rest of the Essay, to Listen to it as a Podcast and/or Watch it as a Video

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