Mapping Redesign: Gynecological Neoliberalism and the Spatiality of Project Yona’s Speculum

Abstract

This essay offers a spatial reading of a prototype for a redesigned speculum and pelvic exam by the technology design team Yona. I contend that the speculum is a racialized and gendered technology that must be understood as situated in a history of the body as space. Using the theoretical tools of feminist geographers and rhetoricians of health and medicine, I interpret the redesign of the speculum through the reassembly of social relations and map how the speculum’s redesign alters the relationality of bodily space. Yona’s exigencies for redesign move the speculum from a troubled history of inefficiency and violence toward neoliberal, feminist notions of health and health care. I clarify how Yona’s reimagined device and exam remap patient bodies in the image of empowerment to produce a patient who is responsible for their own health care, effectively reproducing new formations of oppressive power geometries in the space of the body.

Keywords:

• Feminist geography
• health and medicine
• neoliberalism
• space
• speculum

Acknowledgments

For their labor, generosity, and guidance through this project’s various stages, the author thanks E Cram, Ace Eckstein, Kristiana Báez, Joan Faber McAlister and Jennifer Bay’s Midwest Winter Workshop pod, Claire Sisco King, and the anonymous reviewers.

Notes

1 Snorton (2017) notes that the Latin origin of “speculum” translates to “a tool for looking” and refers to a surgical instrument meant to dilate orifices (p. 31).

2 For some foundational texts see Bell and Binnie (2000), Binnie and Valentine (2005), Halberstam (2005), McKittrick (2006), and Valentine (1989).

3 I place these words in scare quotes to signal the arbitrary nature and exclusionary potential of these categories. Practitioners of gynecology serve people who may not identify as woman or female. Further, as Joan Scott (1986) reminds, critiquing these categories helps us consider how not only sex and gender, but race and class, are “incorporated into institutional assumptions and organizations” (p. 1075).

4 C. Reilly Snorton (2017) notes that chattel persons were at especially high risk for vesicovaginal fistulae and that the condition, marked by tears in the vaginal wall, functioned as a signifier of slavery. Further, Harriet A. Washington (2006) clarifies that while the use of anesthesia was commonplace at this time, enslaved, Black women were thought not to need it as they were believed to be more tolerant of pain than white women.

5 Terri Kapsalis explains that this is because vaginal exams were associated with sex work. Sex workers were often hired as model patients on whom doctors publicly practiced.

6 Linda Gordon elaborates that midwives of color had previously dominated this realm of health care.

7 This work was born from a material theoretical intervention that asserts bodies have communicative agency. It emphasizes physical matter and the nature of bodies knowable when enmeshed in certain contexts. See Condit (1999) and DeLuca (1999).

8 Condit (2013) cautions rhetoricians to be critical of analyses that produce “science bad” and “science too powerful” conclusions (p. 2). While acknowledging that scientific and technological power contributes to the oppression people who occupy varying subject positions, she asserts that rhetoricians who take a zero-sum approach place constructive academic work at risk.

9 As discrete objects, technologies have a life span that moves from potentiality in the prototype phase to a settled form that is black-boxed (i.e., we see the effects but may not know how they are produced). As a way of life, “technology reconfigures society by creating new connections between disparate parts of our social world” (p. 4).

10 Kelly Happe’s (2013) work, for example, emphasizes an understanding of a history in order to explore how racist ideology is reified in discourses of breast cancer genomics.