Plastic bodies is a required read for researchers interested in anthropological approaches to issues such as the body, health, gender, technoscience, biomedicine and pharmaceuticals. Emilia Sanabria’s ethnography of different substance flows such as sex hormones and menstrual blood in Bahia, Brazil, explores the idea of “body plasticity”, a concept inspired by Catherine Malabou.
It is not by chance that the book opens and ends with Elsimar Coutinho, the Bahian MD who is locally and internationally known for his involvement in the development of a series of contraceptive technologies to suppress both menstruation and ovulation. As one of the main proponents of menstrual suppression through the continuous use of synthetic sex hormones, Coutinho argues that contemporary menstruation is a “social” phenomenon due to its efficacy in the control of women’s fertility in “modern” societies. According to him, in “nature” females don’t menstruate – which situates menstrual suppression through the use of sex hormones as a sort of “paleofantasy” technique that aims to restore, through technology, female bodies to their alleged “natural” state.
As Sanabria discusses in the book’s introduction, the development of the pharmaceutical industry and hormonal contraceptive methods in the second half of XXth century made it possible to “manage” sex hormones and menstrual blood. The image chosen for the book’s cover, for example, draws attention to the birth control pill’s pause or placebo pills that mimic monthly bleedings. Although the technical possibility of menstrual suppression was only explored by the global pharmaceutical industry near the 2000s, many Brazilian women have experienced long-term hormone-induced menstrual suppression since the 1970s, possibly due to Coutinho’s local importance and influence.
Sexuality and biological reproduction, as we learned from Foucault, are very political matters. When crossed intersectionally, that is, considering not only gender, but also race and class, the discussions become even more politically charged. Subdermal implants, for example, faced tenacious opposition from feminist and black-feminist movements in Brazil, both, as they were being developed, and in their early stages of use (in clinical trials, family planning programs and/or commercialization in private clinics). How feminist movements dealt (and deal) with contraceptive technologies and the medicalization of reproduction continues to be of central importance today. How should we think about biomedical interventions such as sex hormones? Should our bodies be less plastic, and more closed?
Indeed, bodies and substances are not put in relation to one another arbitrarily. Instead, they are mingled according to very different biopolitical criteria. In order to consider what Sanabria argues to be the malleability and plasticity of Brazilian bodies that renders their “openness to intervention” (p. 6), certain connections must be considered. For example, between substances (sex hormones in different forms and shapes), projects of population control and nation-building (the “modernity” project in Brazil) and biopolitics (which lives are valuable and welcomed, and which are dispensable).
In a very thought-provoking text, Sanabria follows both “hormônios” and menstruation. Her work sharply addresses racial, class and gender issues without falling into the trap of taking them as a given, or fixed condition situated in the body (in the case of race and gender, especially). These differences and inequalities appear throughout her work as she narrates the circumstances witnessed during her research, and tries to situate her interlocutors’ narratives.
Sanabria’s work is innovative and inventive, responding to the impacts of neomaterialism, feminist studies of science and the “ontological turn” in anthropology. Instead of taking the bodies’ frontiers for granted, Sanabria prefers to focus on the very process of their making. This is a great contribution to contemporary studies of the body, for it represents a well-succeeded effort to think about bodies in flux with the world and their materiality, plasticity and malleability. They are living bodies, in action and in context. Her book goes beyond the vision of bodies as given entities, considering their agencies and as parts of the assemblages that compose vital and post-human processes. This includes different engagements with technoscientific artifacts, such as the sex hormones.
In Chapter 3, we learn how travestis from Bahia make use of some of these artifacts (estrogens, mainly) to overcome expectations of sexual dimorphism and gender identity based on stable corporeal forms. As Sanabria beautifully shows, the material potency of hormones exceeds their “gender-microfascist” prescription – as Preciado might put it. Once the bodies are considered open to different flows, bodily modification can be performed on a molecular level by a (subversive) use of these substances. In this case, to feminize a male body.
I find the idea of an “excess” of potencies of a technological object – that is, in this case, the off-label properties of sex hormones – as very stimulating to explore and to engage with politically. We might attribute, as the travestis show, a political positivity to sex hormones’ agency in terms of gender and sexuality, by questioning heteronormativity and the two-sex model. On the other hand, it is this very same “excess” of potency that compounds the basis for classifying “collateral” or “side” effects of a medication or substance.
Her book made me think if it is not this same potency or agency of sex hormones that haunts us when white-well-settled-powerful men such as Coutinho express their confidence in the strength and appeal of this technical object among women. With a trajectory marked by gender, class and race privileges, that I address in my doctoral dissertation, Coutinho defines contraceptive hormones that suppress menstruation as libertarian artifacts at women’s disposal because he knows that most Brazilian women are trapped in a beauty and body-centered heterosexual subjectivity. Based on numerous patient stories, he knows the perversities reproductive life may cause to (often black) poor women’s lives, the difficulties menstruation and maternity in general represent to working women in a context of competition, reduction of labor rights and scarce resources. He also knows how much (often white) upper-middle class women are willing to pay to “enhance” their sexual desire, body attractiveness and to have their fertility and sexuality controlled in molecular terms, with the help of convenient subdermal capsules changed every other semester. He knows the power and ability of contemporary and local biomedicine to solve such problems, although he prefers to dodge discussions about the problems (side/collateral effects?) they may cause.
What is stimulating about this “excess” of agency has to do with the discomfort Sanabria expresses at the end of the book with positions like Coutinho’s and the usual academic and social movement responses to this expansion of biomedicalization and the pharmaceutical market: pure and absolute technophobia doesn’t solve the problem. As Donna Haraway made clear when she brought the figure of cyborgs to feminist-marxist theoretical/political stage, there is no point of “pre-artifice” to which we can return and no way to refuse being part of this global-contemporary process. We have to “stay with the trouble”. And yet, from within, be able to forge detours and escape routes. We need to give better answers to the question of how to deal with the politics that rely on, and take advantage of, certain bodies’ plasticity.
The stabilization of technical objects such as sex hormones in Brazil (or any other context within reach of pharmaceutical markets) has to be thought about critically, and ethnographically addressed, to reveal its technopolitics and the complexities involved. In this sense, Plastic Bodies is disturbingly accurate to disclose how Brazilian bodies engage multiple agencies within public and private health policies and institutions; biomedicine and its biopolitics; pharmaceutical markets; gender, sexuality and reproductive expectations; and race and class tensions. Sanabria proves menstrual blood, its suppression, and sex hormones are viscerally important to any analysis of life dynamics in a contemporary world – a welcome contribution for such violently conservative, xenophobic and misogynistic times.
Daniela Tonelli Manica has a PhD in Social Anthropology from the University of Campinas, São Paulo, Brazil. She hopes Brazilian public universities will survive Brazil’s recent state coup, so she can continue to be an Adjunct Professor in the Cultural Anthropology Department of the Institute of Philosophy and Social Sciences at the Federal University of Rio de Janeiro (IFCS/UFRJ). She is also a professor in the Sociology and Anthropology Post-Graduation Program at IFCS/UFRJ, where she co-coordinates the LEIC, Laboratory of Ethnographies and Knowledge Interfaces. With Suely Kofes, she organized the collection of essays “Vida & Grafias: narrativas etnográficas, entre biografia e etnografia”. She is currently (2017), a post-doctoral researcher at the Department of Scientific and Technological Politics in the Institute of Geosciences at Unicamp, where she is revising her PhD thesis for publication as a book, and conducting ethnographic research with Brazilian scientific laboratories that are trying to develop “stem cells” out of menstrual blood.