Molecular Biopolitics, Somatic Ethics and the Spirit of Biocapital

La edad molecular: reimaginando la vejez desde laboratorios de experimentación en telómeros

El proceso conocido como “envejecimiento celular” se manifiesta en el acortamiento de los telómeros, que son los extremos de los cromosomas. En las últimas décadas, la posibilidad de la manipulación genética para preservar la longitud de los telómeros ha suscitado formas de pensar el envejecimiento como un proceso maleable y aplazable. Mediante una etnografía de los laboratorios de telómeros y su entorno de divulgación científica, aquí trazamos la emergencia de una “biopolítica molecular” (Rose, 2007) que desestabiliza la idea de una edad lineal y “cronológica”. En su lugar, se plantea una edad “biológica” que, siendo relativa a la longitud y velocidad de acortamiento de los telómeros, puede ser medida y manipulada a nivel micrométrico. Aquí describimos cómo la manipulación molecular de la edad se despliega junto a una intrínseca patologización de la vejez. Como consecuencia, la episteme y práctica biomédica transitan del objetivo de “curar” enfermedades hacia el de la optimización de la fisiología celular para frenar el envejecimiento. La huella del tiempo en el cuerpo deja de ser entendida como un proceso “natural”, y pasa re-imaginarse como un “fallo técnico”, accidental y corregible.

Chemical species: the art and politics of living with(out) drugs after addiction

We live within and are made up of ever-changing chemical flows. Witnessing a "chemical turn" in the social sciences, this article asks what a chemical reading of drugs and bodies can offer an understanding of drug dependency and recovery. Where chemicals render bodies "molecular" (Deleuze and Guattari, 1987), they open them up to more intimate forms of connection that extend our understanding of drug-body relationships beyond limiting categories such as addiction. Rather than a chemical drug entering a biological body, there are chemical interactions that expand the boundaries of where one ends and the other begins. While chemicals have long been a preoccupation in neurological models of addiction, they are seldom taken up in sociological studies of these concerns. Drawing on a series of body-mapping workshops with people in drug recovery/treatment in London, UK, to track these chemical bodies, this article explores the art of living a chemically transformed life. This is an art that thinks with Isabelle Stengers' (in Stengers and Savransky, 2018) notion of the word to include "not paying attention" as a mode of "paying attention to what may lurk" in living with the ongoing effects of drugs in unequally entangled worlds.

Death and the treatment imperative: Decision-making in late-stage cancer

Care at the end-of-life in the United States has expanded in the past decade in large part due to structural changes such as increased access to hospice care, the integration of palliative care, policy mandates, and financial incentives. Despite these shifts, research shows that appropriate end-of-life care continues to be underutilized. This paper uses conversation analytic (CA) and ethnographic methods to examine doctor-patient interactions among a sample of 14 Stage IV cancer patients and the way decisions unfold about next steps in treatment during a moment that larger policy changes began to take place following passage of the Affordable Care Act. This work reveals that, despite structures designed to better facilitate end-of-life care transitions for patients in late life, doctors continue to demonstrate interactional hesitancy in discussing the possibility of a patient's end-of-life in treatment discussions and an orientation to the treatment imperative. Examining doctor-patient interaction as one key trouble source in end-of-life care implementation shows in situ evidence that the treatment imperative supersedes the structural shifts supporting less medical intervention in late life.

Infrastructural capital in the Israeli vaccination campaign against COVID-19

This article examines the Israeli vaccination campaign against COVID-19, focusing on the state's acquisition of the vaccines from the pharmaceutical company Pfizer. In December 2020, Israel signed an agreement with Pfizer to purchase enough doses to vaccinate its entire population. In the months that followed, the country became a world leader in vaccination rates. But how was Israel able to purchase large quantities of then-scarce vaccines in the first place? To answer this question, I examine reports and publications by government and civil society bodies as well as news coverage about the campaign. Drawing on insights from the sociology of the state and from science and technology studies, I argue that Israel was able to secure vaccines by using its state-power as a form of currency. Theoretically, I suggest the term “infrastructural capital” – which I define as the resources a state can provide to an external capitalist actor by virtue of its power – to explain how Israel traded with Pfizer. In the conclusion, I discuss the potential implications of this case for other cases.

Politics of Plasticity: Implications of the New Science of the "Teen Brain" for Education

In recent years, claims that developmental brain science should inform pedagogical approaches have begun to influence educational policies. This article investigates the promise, pitfalls, processes, and implications of these claims. We explore how research on neuroplasticity has led to enormous interest in harnessing mechanistic models of development for applications in the classroom. Synthesizing analysis from the scientific literature on "neuroeducation" and interviews with key actors in the field, we analyze how neural and cognitive processes are mapped onto pedagogical constructs, and how psychological and social-structural factors are (or are not) integrated into explanations. First, we describe the historical trajectory of educational neuroscience and identify how tensions between antagonist groups struggling for authority over brain-based educational claims shaped the field. Second, we focus on the pervasive use of the concept of "neuroplasticity" in the literature. We argue that it is used as a rhetorical device to create hope and empower children, teachers, and parents through educational exercises that promote neurobiological reflexivity. Third, we turn to the notion of "self-regulation" in the neuroeducational programs. We argue that the rationale of these programs emphasizes the young person's responsibility in navigating their social worlds through the imperative to enhance their executive functions while failing to adequately account for the role of the social environment in the development of self-regulation.

Strategies of stratification: Regulating market access in the era of personalized medicine

Personalized medicine raises the stakes of pharmaceutical market regulation. Drawing on pragmatist valuation studies and science and technology studies literature on personalized medicine and pharmaceutical markets, this article demonstrates how complex negotiations about the value of a pharmaceutical can constitute a market in various ways, while also shaping the concerned patient populations. Tracing the path of a pharmacogenetic treatment, Spinraza, from its approval by the European Medicines Agency to its adoption in the publicly funded Danish healthcare system, we show how the market was formatted through particular stratifications of the patient population. We conceptualize these seemingly technical moves as strategies of stratification, that is, the application of techniques to assemble and divide data - and what data are meant to represent - into groups delineated by certain characteristics. We argue that stakeholders' use of strategies of stratification has important implications not only for market access, but also for the delineation of diseases and patient populations. Hence, it is crucial to make intelligible the mutual constitution of pharmaceutical markets and patient populations and the political efforts of delineating and connecting the two.

Introduction

The everyday lives of contemporary youth are awash with chemicals to boost pleasure, energy, sexual performance, appearance, and health. What do pills, drinks, sprays, powders, and lotions do for youth? What effects are youth seeking? The ChemicalYouth ethnographies presented here, based on more than five years of fieldwork conducted in Amsterdam, Brooklyn, Cayagan de Oro, Paris, Makassar, Puerto Princesa, and Yogyakarta, show that young people try out chemicals together, compare experiences, and engage in collaborative experiments. ChemicalYouth: Navigating Uncertainty: In Search of the Good Life makes a case for examining a broader range of chemicals that young people use in their everyday lives. It focuses not just on psychoactive substances—the use of which is viewed with concern by parents, educators, and policymakers—but all the other chemicals that young people use to boost pleasure, moods, vitality, appearance, and health, purposes for using chemicals that have received far less scholarly attention. It takes the use of chemicals as situated practices that are embedded in social relations and that generate shared understandings of efficacy. More specifically, it seeks to answer the question: how do young people balance the benefits and harms of chemicals in their quest for a good life?

Urban Emotion Sensing Beyond 'Affective Capture': Advancing Critical Interdisciplinary Methods

The use of mobile sensor methodologies in urban analytics to study 'urban emotions' is currently outpacing the science required to rigorously interpret the data generated. Interdisciplinary research on 'urban stress' could help inform urban wellbeing policies relating to healthier commuting and alleviation of work stress. The purpose of this paper is to address-through methodological experimentation-ethical, political and conceptual issues identified by critical social scientists with regards to emotion tracking, wearables and data analytics. We aim to encourage more dialogue between the critical approach and applied environmental health research. The definition of stress is not unambiguous or neutral and is mediated by the very technologies we use for research. We outline an integrative methodology in which we combine pilot field research using biosensing technologies, a novel method for identifying 'moments of stress' in a laboratory setting, psychometric surveys and narrative interviews on workplace and commuter stress in urban environments.

Souled out of rights? – predicaments in protecting the human spirit in the age of neuromarketing

Modern neurotechnologies are rapidly infringing on conventional notions of human dignity and they are challenging what it means to be human. This article is a survey analysis of the future of the digital age, reflecting primarily on the effects of neurotechnology that violate universal human rights to dignity, self-determination, and privacy. In particular, this article focuses on neuromarketing to critically assess potentially negative social ramifications of under-regulated neurotechnological application. Possible solutions are critically evaluated, including the human rights claim to the ‘right to mental privacy’ and the suggestion of a new human right based on spiritual jurisdiction, where the human psyche is a legal space in a substantive legal setting.

A critical analysis of debates on grief and depressive disorder in the age of the Diagnostic and Statistical Manual of Mental Disorders

Since the incorporation of the major depressive disorder in the Diagnostic and Statistical Manual of Mental Disorders (DSM-III) in 1980, and until its update in the DSM-IV-TR, the DSM classification system considered it necessary to include the criterion of "bereavement exclusion", with the aim of differentiating normal sadness linked to a loss, from a mental disorder, such as the major depressive disorder. In its latest version (DSM-5), this exception was removed, giving rise to a controversy that continues to this day. The debate has set those who are in favor of maintaining this exclusion and extending it to other stressors against those who have intended to eradicate it. Our hypothesis is that these positions account for two qualitatively diverse clinical and epistemological matrices, linked to major transformations in health sciences and in psychiatry. We show that this debate involved a profound renewal of the meaning of psychiatric practice, a change in the function of diagnosis and in the way of conceiving the etiology of mental disorders, as well as a reformulation of the patient's suffering status for the medical act.

Pleasure and HIV biomedical discourse: The structuring of sexual and drug-related risks for gay and bisexual men who Party-n-Play

Party-n-Play (PNP) is a social practice that refers to sex that occurs under the influence of drugs. This study critically examined the risk and pleasure discourses of gay and bisexual men who PNP to explore how epistemic shifts associated with advancements in HIV biomedical sciences influence gay and bisexual men's perceptions of HIV risks and their sexual and drug-related practices. This study also aims to provide a more nuanced understanding of how sexual and drug-related risk practices of gay and bisexual men are entangled with their search for pleasure. The study was framed within poststructural Critical Discourse Analysis (CDA) methodology. In-depth one-hour interviews were conducted with 44 self-identified gay, bisexual, queer, or Two-Spirit men, who lived in Toronto, and who reported using drugs before or during sex with another man. The findings from this study demonstrated the capacity of biomedical discourses to affect respondents' HIV risk perceptions and practices. The transition from condom-centered prevention to today's context where new highly effective biomedical tools for HIV prevention are available created possibilities for greater intimacy, increased pleasure, and less anxiety about HIV tranmission, while challenging many years of preventive socialization among gay and bisexual men. However, this new context also rekindled deep-seated fears about HIV risk and viral load verifiability, reinforced unequal forms of biomedical self-governance and citizenship, and reproduced practices of biopolitics. While discourses on risk and pleasure were interwoven within complex PNP assemblages, the notion of pleasure was mobilized as a discursive tactic of self-control, and the division between normative and non-normative pleasures highlighted the consequence of biopolitical forces governing the production of discourses on sex and drugs. Future HIV social science research needs to attend to the fluid nature of the discursive environments of HIV prevention science, and consider how both the material context of PNP and its social/discursive elements operate together.

On the body of the consumer: performance-seeking with wearables and health and fitness apps

Contributing to critical digital health research and the sociology of health consumption, this study investigates the phenomenon of self-tracking and interpretation of consumer data via wearable technology and mobile fitness software applications (apps). It critically analyses qualitative data collected from members of running communities in the UK who are heavy users of apps and wearables. The study seeks to understand the meaning and practise of long-term use of apps and wearables targeted at consumers interested in tracking fitness, and the collection of personal health information over time. The paper offers an interpretative perspective on runners as performance-seeking fitness consumers engaged in long-term self-management of health. These consumers are driven by a profound motivation to visualise and embody a long-term state of fitness. Participants were also hyper-aware of advertising and promotional methods used to engage consumers. The findings raise concerns about the validity of personal fitness data, and how its collection promises improved personal health while visually promoting sought-after fit bodies. Further research is required to understand the transformative impact of fitness-tracking and how individuals negotiate personal classifications of health.

Altruism, solidarity and affect in live kidney donation and breastmilk sharing

Social scientists have recently diverged from mainstream bioethical discussion on the topic of the medical use of human biological materials for therapeutic, reproductive and research purposes. Rather than justifying the donation and provision of biological materials solely in terms of alleviating physical, psychological and social suffering, saving or enhancing life, and advancing biomedical knowledge, this work looks beyond humanist bioethics to take a social justice approach to questions of the life sciences. In this article, I draw insight from these accounts to propose an approach to the sociology of live kidney and breastmilk donation that is situated at the interface of the new sociology of morality and affect studies. To do so, I examine the moral economy of tissue provision with respect to its organisation around the discourse of altruism and the gift. I then turn to recent work on tissue economies, which are in the business of creating and producing biovalue, to discuss the manipulation of affect and the entanglement of new forms of bio-intimacy in the production and reproduction of somatic life. The aim of the article was to contribute to the study of the sociology of donation as a substantive field of specialisation within sociology.

Between empowerment and self-discipline: Governing patients' conduct through technological self-care

Recent health policy renders patients increasingly responsible for managing their health via digital technology such as health apps and online patient platforms. This paper discusses underlying tensions between empowerment and self-discipline embodied in discourses of technological self-care. It presents findings from documentary analysis and interviews with key players in the English digital health context including policy makers, health designers and patient organisations. We show how discourses ascribe to patients an enterprising identity, which is inculcated with economic interests and engenders self-discipline. However, this reading does not capture all implications of technological self-care. A governmentality lens also shows that technological self-care opens up the potential for a de-centring of medical knowledge and its subsequent communalization. The paper contributes to Foucauldian healthcare scholarship by showing how technology could engender agential actions that operate at the margins of an enterprising discourse.

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Digital health policy in UK assumes an enterprising & empowered patient identity.

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Tensions between empowerment & discipline occur as patients self-care digitally.

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Digital health creates space for agential actions that improve communal health.

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A health-making agency operates in the margins of governmental self-care discourse.

Giving up sugar and the inequalities of abstinence

Sugar is increasingly supplanting fat as public enemy number one in public health campaigns, and calls for significant reductions in consumption have provided fertile ground for the proliferation of popular texts and services advocating sugar abstention. This article explores three modes of popular sugar abstention (evangelical, experimental and charitable). These vary in chronology, philosophy and the intensity of abstention, but all serve as sites of identity production and self-entrepreneurship for those able to advocate for, and engage with, them. The article argues that these abstention narratives are not only premised on the exercise of social privilege, but that they also necessarily reproduce and sediment those social hierarchies. This is achieved through a combination of nutritionism and healthism, dislocating sugar and its consumption from the vast social, economic and environmental inequalities within which both the consumption of sugar, and the act of giving it up, is made meaningful. (A virtual abstract of this paper can be found at: https://www.youtube.com/channel/UC_979cmCmR9rLrKuD7z0ycA).

Toxic politics: Acting in a permanently polluted world

Toxicity has become a ubiquitous, if uneven, condition. Toxicity can allow us to focus on how forms of life and their constituent relations, from the scale of cells to that of ways of life, are enabled, constrained and extinguished within broader power systems. Toxicity both disrupts existing orders and ways of life at some scales, while simultaneously enabling and maintaining ways of life at other scales. The articles in this special issue on toxic politics examine power relations and actions that have the potential for an otherwise. Yet, rather than focus on a politics that depends on the capture of social power via publics, charismatic images, shared epistemologies and controversy, we look to forms of slow, intimate activism based in ethics rather than achievement. One of the goals of this introduction and its special issue is to move concepts of toxicity away from fetishized and evidentiary regimes premised on wayward molecules behaving badly, so that toxicity can be understood in terms of reproductions of power and justice. The second goal is to move politics in a diversity of directions that can texture and expand concepts of agency and action in a permanently polluted world.

Rethinking Value in the Bio-economy: Finance, Assetization, and the Management of Value

Current debates in science and technology studies emphasize that the bio-economy-or, the articulation of capitalism and biotechnology-is built on notions of commodity production, commodification, and materiality, emphasizing that it is possible to derive value from body parts, molecular and cellular tissues, biological processes, and so on. What is missing from these perspectives, however, is consideration of the political-economic actors, knowledges, and practices involved in the creation and management of value. As part of a rethinking of value in the bio-economy, this article analyzes three key political-economic processes: financialization, capitalization, and assetization. In doing so, it argues that value is managed as part of a series of valuation practices, it is not inherent in biological materialities.

Reconciling conceptualisations of the body and person-centred care of the older person with cognitive impairment in the acute care setting

In this article, we sought reconciliation between the "body-as-representation" and the "body-as-experience," that is, how the body is represented in discourse and how the body of older people with cognitive impairment is experienced. We identified four contemporary "technologies" and gave examples of these to show how they influence how older people with cognitive impairment are often represented in acute care settings. We argued that these technologies may be mediated further by discourses of ageism and ableism which can potentiate either the repressive or productive tendencies of these technologies resulting in either positive or negative care experiences for the older person and/or their carer, including nurses. We then provided examples from research of embodied experiences of older people with dementia and of how nurses and other professionals utilized their inter-bodily experiences to inform acts of caring. The specificity and individuality of these experiences were more conducive to positive care experiences. We conclude the article by proposing that the act of caring is one way nurses seek to reconcile the "body-as-representation" with the "body-as-experience" to mitigate the repressive effects of negative ageism and ableism. The act of caring, we argue, is the essence of caring enacted through the provision of person-centred care which evokes nurses to respond appropriately to the older person's "otherness," their "variation of being" while enabling them to enact a continuation of themselves and their own version of normality.

Enacting the molecular imperative: How gene-environment interaction research links bodies and environments in the post-genomic age

Despite a proclaimed shift from 'nature versus nurture' to 'genes and environment' paradigms within biomedical and genomic science, capturing the environment and identifying gene-environment interactions (GEIs) has remained a challenge. What does 'the environment' mean in the post-genomic age? In this paper, we present qualitative data from a study of 33 principal investigators funded by the U.S. National Institutes of Health to conduct etiological research on three complex diseases (cancer, cardiovascular disease and diabetes). We examine their research practices and perspectives on the environment through the concept of molecularization: the social processes and transformations through which phenomena (diseases, identities, pollution, food, racial/ethnic classifications) are re-defined in terms of their molecular components and described in the language of molecular biology. We show how GEI researchers' expansive conceptualizations of the environment ultimately yield to the imperative to molecularize and personalize the environment. They seek to 'go into the body' and re-work the boundaries between bodies and environments. In the process, they create epistemic hinges to facilitate a turn from efforts to understand social and environmental exposures outside the body, to quantifying their effects inside the body. GEI researchers respond to these emergent imperatives with a mixture of excitement, ambivalence and frustration. We reflect on how GEI researchers struggle to make meaning of molecules in their work, and how they grapple with molecularization as a methodological and rhetorical imperative as well as a process transforming biomedical research practices.

On the emergence and consolidation of bioethics as a discipline, as seen from a sociological perspective

This article examines the emergence and consolidation of bioethics as a discipline from a sociological perspective. This reconstruction helps us to understand on the one hand what is meant by bioethics and what its practices and areas of inquiry are, and on the other to identify various concepts and expert opinions about what the field of study for bioethics should be, opinions which lead in practice to different applications of the discipline in health sciences. This becomes relevant for epistemological discussions about the discipline and for consolidating a sociology of bioethics in the context of Ibero-America.

Embodying positive aging and neoliberal rationality: Talking about the aging body within narratives of retirement

Within contemporary Western contexts, positive aging discourses are a key aspect of structured mandates for how to think about and act toward aging bodies. This study adds to previous work on embodiment that has situated how aging bodies are managed by focusing on the body as an aspect of retirement preparation, and critically considering how the imperative to govern the aging body in ways consistent with being a 'good' neoliberal citizen circulated through positive aging discourses is negotiated by aging individuals. Utilizing narrative data from a study addressing the discursive re-shaping and narrative negotiation of retirement within the Canadian context conducted with 30 informants aged 45 to 83, this paper draws upon a governmentality perspective to critically analyze ways informants talked about their aging bodies as part of preparing for and moving into retirement. Overall, the findings illustrate how informants embodied positive aging discourses and, in turn, embodied neoliberal rationality particularly in taking up the call to attend to the body as part of the broadening of retirement planning within a neoliberal context in which health, social, financial and other responsibilities are increasingly shifted toward individuals. Although informants described realizing some of the promises offered up with positive aging discourses, such as a sense of youthfulness and bodily control, their narratives also point to detrimental individual and social implications that can arise out of the limits of bodily practices, the need for perpetual risk management, an aversion to oldness, and attributions of failure. As such, this study raises concerns about the implications of the intersections of positive aging discourses and the neoliberal agenda of activation, responsibilization and individualization.

Postpartum Women's Perspectives on the Donation of Placentas for Scientific Research in Campinas, Brazil

Little is known about public perspectives of scientific and therapeutic uses of placentas. Gaps in knowledge potentiate ethical and clinical problems regarding collection and applications. As such, this study sought to assess the perspectives of placenta donation of a sample of women. Postpartum women's perspectives on placental donation were assessed at the State University of Campinas in the Centro de Atençäo Integral a Saúde da Mulher (CAISM) maternity hospital using a cross-sectional survey (n = 384) and semi-structured interviews (n = 12). Surveys were analyzed quantitatively and interviews were analyzed qualitatively using grounded coding; results were compared. The average age of respondents was 27. Fifty-six percent had more than one child, 45% were Caucasian, 38% were mixed-race, 74% identified with a Christian faith, 52% had high school education or higher, 13% regarded the placenta as spiritually important, 72% felt that knowing what happens to the placenta after birth was somewhat or very important, 78% supported the use of the placenta in research and medicine, 59% reported that consent to collect the placenta was very or somewhat important, 78% preferred their doctor to invite donation, and only 7% preferred the researcher to invite donation. Interviews suggested women appreciate being part of research and that receiving information about studies was important to them. Informed by these results, we argue that women support scientific and therapeutic uses of placentas, want to be included in decision making, and desire information about the placenta. Placentas should not be viewed as "throwaway" organs that are poised for collection without the involvement and permission of women. Women want to be meaningfully included in research processes.

The pharmaceuticalization of sexual risk: vaccine development and the new politics of cancer prevention

Vaccine development is a core component of pharmaceutical industry activity and a key site for studying pharmaceuticalization processes. In recent decades, two so-called cancer vaccines have entered the U.S. medical marketplace: a vaccine targeting hepatitis B virus (HBV) to prevent liver cancers and a vaccine targeting human papillomavirus (HPV) to prevent cervical and other cancers. These viruses are two of six sexually transmissible infectious agents (STIs) that are causally linked to the development of cancers; collectively they reference an expanding approach to apprehending cancer that focuses attention simultaneously "inward" toward biomolecular processes and "outward" toward risk behaviors, sexual practices, and lifestyles. This paper juxtaposes the cases of HBV and HPV and their vaccine trajectories to analyze how vaccines, like pharmaceuticals more generally, are emblematic of contemporary pharmaceuticalization processes. We argue that individualized risk, in this case sexual risk, is produced and treated by scientific claims of links between STIs and cancers and through pharmaceutical company and biomedical practices. Simultaneous processes of sexualization and pharmaceuticalization mark these cases. Our comparison demonstrates that these processes are not uniform, and that the production of risks, subjects, and bodies depends not only on the specificities of vaccine development but also on the broader political and cultural frames within which sexuality is understood.

Biographical value: towards a conceptualisation of the commodification of illness narratives in contemporary healthcare

Illness narratives play a central role in social studies of health and illness, serving as both a key theoretical focus and a popular research method. Despite this, relatively little work has gone into conceptualising how and why illness narratives - be they in books, websites, television or other media - are commodified in contemporary healthcare and its social environment; namely, how distinctive forms of value are generated in the production, circulation, use and exchange of illness narratives. In this article we propose the notion of biographical value as a first step towards conceptualising the values attributed to illness narratives in this context. Based on a secondary analysis of 37 interviews with people affected by 15 different health conditions in the UK (all of whom have shared their illness experiences across various media) and drawing on understandings of value in research on the bioeconomy and the concept of biovalue in particular, we sketch out how epistemic, ethical and economic forms of value converge and co-constitute each other in the notion of biographical value and in broader economies of illness experiences.

Problematizing the neurochemical subject of anti-depressant treatment: The limits of biomedical responses to women’s emotional distress

In this article we situate empirical research into women’s problematic experiences of anti-depressant medication within broader debates about pharmaceuticalization and the rise of the neurochemical self. We explore how women interpreted and problematized anti-depressant medication as it impeded their recovery in a number of ways. Drawing upon Foucauldian and feminist work we conceptualize anti-depressants as biotechnologies of the self that shaped how women thought about and acted upon their embodied (and hence gendered) subjectivities. Through the interplay of biochemical, emotional and socio-cultural effects medication worked to shape women’s self-in-recovery in ways that both reinscribed and undermined a neurochemical construction of depression. Our analysis outlines two key discursive constructions that focused on women’s problematization of the neurochemical self in response to the side-effects of anti-depressant use. We identified how the failure of medication to alleviate depression contributed to women’s reinterpretation of recovery as a process of ‘working’ on the emotional self. We argue that women’s stories act as a form of subjugated knowledge about the material and discursive forces shaping depression and recovery. These findings offer a gendered critique of scientific and market orientated rationalities underpinning neurochemical recovery that obscure the embodied relations of affect and the social conditions that enable the self to change.

Genomic designation: how genetics can delineate new, phenotypically diffuse medical categories

This paper reports and discusses 'genomic designation' as a way of classifying people. In genomic designation the object of biomedical analysis--and the concomitant medical category that is subject to scientific, clinical, and social action--is delineated on a genomic basis, while the phenotype is decentralized and tabulated post factum. Unlike prominent sociological concepts such as biosociality or geneticization, where genetic proclivities for or explanations of phenotypic categories affect social processes, genomic designation treats characteristics of the genome as the essential referent of new categories of illness. I outline the relevant sociological literature and the shift to what Nikolas Rose has called the 'molecular gaze' before explicating the concept ofgenomic designation and its half-century history. I use 22q13 Deletion/Phelan-McDermid syndrome as an example of genomic designation: investigations into the deletion of genetic material at site q13 on the 22nd chromosome preceded and made practicable the delineation of a syndrome more than a decade later, even though the associated phenotype is not distinct enough for diagnosis. Finally, I discuss the implications of this turn to 'rigidly designate' kinds of people according to observations made at the level of the genome and outline directions for future research.

Trans-biopolitics: Complexity in interspecies relations

This article introduces the concept of trans-biopolitics to account for complexity in the intermingling of animal and human bodies, with particular attention to diseases capable of crossing the species divide from animals to humans. While zoonotic diseases never disappeared, they had re-emerged as pressing concerns by the 21st century. The concept of trans-biopolitics takes into account the power relations inherent in human and nonhuman lives in contemporary global, industrial, and technological formations. More specifically, trans-biopolitics revolves around practices determining whose lives are possible or legitimate to prolong, whose bodies are sacrificed in order to preserve the vitality of other bodies, and whose bodies are sustained yet ultimately rendered insignificant. To illustrate, we examine connections between bovine spongiform encephalopathy and feline spongiform encephalopathy, to show how certain bodies (humans, livestock) are taken into consideration in terms of health and food regulations, whereas other bodies (pets) remain at the periphery. Acknowledging human—animal relations in contemporary technological and global contexts challenges us to rethink ways in which the politics of health continues to evolve.

Managing biomedical uncertainty: the technoscientific illness identity

This paper analyses how the biomedical uncertainty of breast cancer contributes to the development of a new type of illness identity that is grounded in biomedical knowledge, advanced technology, and biomedical health and risk surveillance. The technoscientific identity (TSI) develops through the application of sciences and technologies to one's sense of self. Analysing narrative data from 60 in-depth interviews with women diagnosed with breast cancer, this research demonstrates how women diagnosed with breast cancer develop and maintain TSIs through four processes: (1) immersion in professional biomedical knowledge, (2) locating themselves within a technoscientific framework, (3) receiving support for the emerging TSI from the medical system and support networks, and (4) eventually prioritising their biomedical classifications over their suffering. Developing a TSI enables people to make sense of biomedical information, make decisions, and manage medical processes and relationships in the face of biomedical and personal uncertainty even as it extends the reach of technoscience and biomedicalisation.

Negotiating the neurochemical self: anti-depressant consumption in women's recovery from depression

Anti-depressant treatment can be viewed as an exercise of biopower that is articulated through policies and practices aimed at the reduction of depression, population healthcare costs and effects on labour force productivity. Drawing upon a feminist governmentality perspective, this article examines the discourses that shaped women's experiences of anti-depressant medication in an Australian qualitative study on recovery from depression. The majority of women had been prescribed anti-depressants to treat a chemical imbalance in the brain, manage symptoms and restore normal functioning. One-third of participants identified anti-depressants as helpful in their recovery, while two-thirds were either highly ambivalent about, or critical of, medication as a solution to depression. Thirty-one women who identified the ;positive' benefits of anti-depressants actively constituted themselves as biomedical consumers seeking to redress a chemical imbalance. The problem of depression, the emergence of molecular science and the push for pharmacological solutions are contributing to the discursive formation of new subject positions - such as the neurochemically deficient self. Three themes were identified in relation to medication use, namely restoring normality, signifying recovery success and control/uncertainty. Anti-depressant medication offered women a normalized pathway to successful recovery that stood in stark contrast to the biologically deficient and morally failing self. These women's stories importantly reveal the gender relations and paradoxes arising from biopolitical technologies that shape selfhood for women in advanced liberal societies.