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ABSTRACT
In this article, we demonstrate how living kidney donation is a particularly gendered experience. We draw on anthropologists’ contributions to understanding the globalization of reproductive technologies to argue that kidney donation similarly endangers and preserves fertility, thereby unsettling and reifying gendered familial labor. Based on fieldwork in two ethnographic sites—Egypt and Mexico—we examine how kidney donation is figured as a form of social reproduction. In both settings, kidney recipients rely almost exclusively on organs from living donors. We focus on how particular gender ideologies—as evident, for example, in the trope of the “self-sacrificing mother”—can serve as a cultural technology to generate donations in an otherwise organ-scarce medical setting. Alternatively, transplantation can disrupt gender norms and reproductive viability. In demonstrating the pervasiveness of gendered tropes in the realm of transplantation, we unsettle assumptions about the “family” as the locus of pure, altruistic donation.
Notes
1. This dependence on living donors remains true despite considerable public attention to the issue of organ donation in both countries. In Mexico, concerted recent public promotion campaigns have aimed to increase deceased donation, particularly under the aegis of Mexican billionaire Carlos Slim (Horvat Citation2009; Harrison Citation2010). Yet from 1999–2013 the proportion of living to deceased donor kidneys transplanted in the region where the Mexican research was conducted remained highly skewed and fairly stable (Consejo Estatal de Organos y Tejidos Citation2014). In Egypt, a law was formally passed in April 2010 to legalize procurement from deceased donors for the purpose of organ transplantation, but this has yet to be systematically applied, as there is still no centralized national organ donation system in Egypt. Furthermore, the infrastructural impediments to developing such a system have been exacerbated by political unrest in the country since 2011 (Hamdy Citation2012).
2. See Smith and Mbakwem (Citation2007) on the notion of “life projects” in the context of antiretroviral therapy.
3. Indeed, in Mexico the image of la Virgen is shadowed always in complex, contested ways by darker doubles such as La Malinche and La Llorona that explore the potentials for betrayal and destruction inherent in the roles of lover, wife, mother (Romero and Harris Citation2005)
4. This on-the-ground observation is corroborated by data across many settings that consistently report gender imbalances in living donation as most acute among spouses, with wives as much as six times more likely to donate than husbands in one study (Zimmerman et al. Citation2000).
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Megan Crowley-Matoka
Megan Crowley-Matoka is assistant professor in the Medical Humanities and Bioethics Program and the Department of Anthropology at Northwestern University. Her research focuses on biotechnology, clinical uncertainty, medicalization, and shifting forms of subjectivity, focusing on organ transplantation in Mexico, and on the political and moral economies surrounding pain in American biomedicine.
Sherine F. Hamdy
Sherine F. Hamdy is associate professor of Anthropology at Brown University. Her book Our Bodies Belong to God: Organ Transplants, Islam, and the Struggle for Human Dignity in Egypt (University of California Press, 2012) analyzes crises in medical, religious, and state authority in Egypt. Her current project, with Soha Bayoumi, is on the role of physicians in ongoing political upheavals in the Arab world.