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Sex and gender

Revealing cracks in the logic

When Sarah Riley pitched to the Routledge Critical Health Series, she knew she wanted to write with Adrienne Evans and Martine Robson. Here, they explain how they addressed psychological questions on women’s health, from a transdisciplinary perspective underpinned by philosophy, in a book which won the British Psychology Society academic monograph book award in 2021.

28 February 2022

Recognition for Postfeminism and Health from the BPS and scholars whose work we admire has truly moved us. But perhaps what delights us most is that, without losing academic rigour, our book speaks to a diverse group of people outside of the academy. A relative asked for another copy because her 20-something art-school daughter had taken her copy into her bedroom and 'it's not coming out'. In New Zealand, a senior member of the Ministry of Health perused a shelf carrying the books in this Series and walked away with ours in hand. In Poland, a clinical psychologist reviewing the book for Feminism and Psychology described reading it as a form of 'self-help'. Her description resonated with our own experiences – through writing this book we have come to different understandings about our bodies, health, and psychology, including the relationships between our health, identities, behaviours and the wider commercial and mediated world.

What's the secret to this impact? We discussed this in a recent Zoom meeting connecting us across time zones – Coventry and Aberystwyth in the UK, and Wellington in New Zealand.

Being a good person

We reflected on how we have long recognised the importance of connecting media, culture and psychology – a sense of dis-identification with the disciplinary boundaries given in undergraduate psychology lectures, an 'un-disciplined' approach which connects with feminist theory and research more generally. Actively using philosophy to think through these issues is important. The complexity of the relationships between psychology, our wider social, mediated and digital cultures and health require a logical and ethical framework for exploring psychological thinking and experience.

In particular, we reflected on how Michel Foucault helps us think about the dynamics between power, psychology and subjectivity through the concept of discourses. Discourses – ways of thinking about the world that circulate in our social milieu, including ideas about what it means to be a good person – come to structure our understanding and our innermost thoughts. Once these ideas are part of our innermost thoughts they feel like they originate from us, which makes them particularly hard to challenge, especially as we are exposed to the idea that good people make independent, autonomous choices. This makes it hard to recognise when ideas that feel like they come from us started outside of us – i.e. that we are influenced. Or it makes us feel bad if we recognise we are.

Coupled with the idea that good people also make healthy choices, it becomes very difficult to challenge the commercial interests that are invested in us having particular desires, desires that might be harmful to our health. And this is especially so when media supported by these commercial interests recognise the damage. For example, in our chapter entitled 'intimate responsibilities', we analysed how a baby milk formula advertisement recognised the divisions and difficulties mothers are exposed to when making decisions around baby-feeding, appearing to offer an affirmative and supportive address to mothers in an otherwise judgemental world. However, at the same time it is commercially motivated to direct parents towards bottle feeding at a time when public health experts highlight the importance of breastfeeding.

A philosophical toolbox

How do people make sense of themselves? What can people say, think or do when they understand themselves this way? And what social, political, economic or material conditions enable such understandings? These questions allow us to understand the person in context, value their sense making, and explore capacities for action with a view to identifying more affirmative directions when needed.

To answer these questions we drew on Foucauldian ideas of genealogy, power, norms, confession and technologies of self (the work we do on ourselves in order to produce ourselves into particular culturally valued self or body); Deleuzian thinking on desire and flow; and when called for, psychoanalytic or sociological concepts such as melancholia, mis/recognition, symbolic violence and cultural habitus and capital. Laurent Berlant's (2011) concept of cruel optimism, when desires are directed towards things that ultimately are toxic for us or unachievable, was also important. In doing so, our work aligns with Guattari's (2007) affirmation of the practical uses of philosophy in his statement that he is an ideas thief and a shuffler of second-hand concepts, and with Foucault's statement: 'I would like my books to be a kind of tool-box which others can rummage through to find a tool which they can use however they wish in their own area' (1974, p.523-524).

We brought this philosophical toolbox into dialogue with Rosalind Gill's concept of postfeminist sensibility, and the more sociological work on postfeminism of Angela McRobbie. The term postfeminist sensibility describes a set of ideas about ideal femininity in which regulatory work on the self and body to meet cultural ideals is framed as a form of empowered, individual choice underpinned by biology. Thus, at a time of unprecedented economic and public participation women's desires are directed back to traditional feminine pursuits of appearance concerns, heterosexual attractiveness, consumption, and domestic responsibilities, but framed within a language of empowerment, pleasure and choice. A postfeminist sensibility captures the multiplicity and complexity of often contradictory ideas that coexist or actively enable each other, but which make it almost impossible for women to be good people, citizens or health citizens – to be one, you're not the other.

We discussed this, for example in the expectation of 'normal perfection', an apparently affirmative idea that perfection is attainable that creates a range of anxieties. A 'postfeminist perfection' presents health as both a normal, anticipated outcome of engaging in particular practices, behaviours and thoughts, which anyone with a bit of effort could achieve, but also as a perfect, idealised way of being. Women are encouraged to measure themselves against this, find themselves failing, and work on their selves and their bodies. Thus, postfeminist perfection actually creates the contexts for anxiety and fear (Evans, Riley & Robson, 2020), where feeling good about oneself can also create forms of sickness.

Healthism

So we thought a postfeminist sensibility was an important lens to explore women's health through, but so far these two areas have not been connected. To do this, we brought postfeminist sensibility into dialogue with the sociological concept of healthism. Healthism refers to an understanding of health as a personal responsibility, risk to be managed through lifestyle choices, and site of identity, in relation to being a 'good' health citizen and consumer (Cheek, 2008; Crawford, 1980, 2006; Robson et al., 2022).

Using these analytical tools, we started with a chapter on self-help, with its promise that we can be agents of change for a happier life. We considered how very old ideas about gender and health are repackaged as new: for example, historical notions of women as psychologically flawed continue to circulate in a variety of ways but, in a postfeminist twist, contemporary self-help locates not just the problem but the solution in women working on themselves. We continued to explore the gendered nature of self-help as part of a special issue for Feminism and Psychology – one of their most cited articles of the last three years, a metric that points to the importance of taking a postfeminist lens to psychological issues of our time.

We couldn't write about contemporary issues of health without having a chapter on weight. Body mass index is a population level measure now being used to regulate individuals, a ubiquitous proxy measure for health, despite its poor efficacy and rhetoric of blame and judgement. Many of us will have put our own weight and height into the NHS 'your choices your health' website, and perhaps felt a rush of relief if the result comes out in the green. We can make sense of that feeling through Foucauldian ideas of norms and confession – we learn what is normal and expected and review ourselves against these norms, confessing if we fail to meet them, and then working on ourselves to rectify our failures.

These norms are powerful – we use norms to think, we make ourselves through norms, they are part of us. This is why they have such an affective pull on us, why they are so hard to resist. Our chapter ended suggesting that the question 'what is a normal weight?' cannot and should not be answered in our contemporary context: as Wann argues, 'Just as Kurt Cobain of Nirvana sang, "everyone is gay", in a fat-hating society everyone is fat' (2009, p.xv).

Technologies and the life course

It was from that point that we started to discuss technologies people can use to work on their bodies, including weight loss surgery and female genital cosmetic surgery. For example, one woman who underwent surgery said her 'before' fat body looked how you would imagine without clothes. In contrast, her slim post-surgery body appeared normal in clothes, but naked was as wrinkled as one might expect on a woman 50 years older. For her, the offer of normalcy through surgery was an illusion.

The next chapters implicitly follow a normative life course approach – around sex, pregnancy and childcare responsibilities. Weaving through these were ideas about how normative notions of these elements of a life course were performative. Every era has its own discourse about sex, shaped by the major ideas of that particular moment. More recently, framed through a postfeminist sensibility, this has included the notion of the sexually agentic, active and choice-ful heterosexual woman. However, there are risks with this concept, where heterosexual women still have to navigate sexuality in relation to, among other things, class and race. The resulting performance of sexuality appears to many feminist researchers to reproduce a look very similar to what is valued by heterosexual men. Sex as highly stylised, penetrative and orgasm-oriented limits what the body can do and how it can experience pleasure.

In looking at pregnancy, its performative elements were in representing perfection, a wholesome and enjoyable bodily transformation that needed constant care and attention (and consumption). We located this as a tightening of power around the pregnant body, since in it represents a challenge to neoliberal, individualistic and stable embodiments. We showed how this challenge is managed, from imagining the foetus as separate from the mother in photography and medical imaging to ideas of post-partum bodies 'snapping back' into shape.

The final topic was pro-ana communities, flipping our analysis by looking at what is considered unhealthy to better understand and develop a critical understanding of what is healthy. We also highlighted tensions in feminist theory, where eating disorders can be lethal and yet also celebrated as resistance to patriarchal body ideals, tracking the contradictions and tensions that a flow between these different digital spaces of value and devalued bodies.

Lines of flight

Throughout our book we took an affirmative poststructuralist approach – not just 'doing critique' but finding directions, or 'lines of flight', that increase capacities for action. Within Deleuze's philosophy, the fullest capacity for connecting and acting in the world is the definition of health. We can change the fundamental questions about what something is, to how it works and for whom? What does it allow? Then we can explore the complexity of lived experience, and how we can meet needs and offer a challenge when discourses reduce these capabilities.

Being committed to an affirmative poststructuralist approach wasn't always easy, it required us to do extra work, but it was always worthwhile. We saw where the pleasures were in what might otherwise be considered disciplinary practices. We noticed cracks in the logic that limited women's ability to experience health, we highlighted the role of psychology as a medium through which ideas about health are circulated. Ultimately, we hope we've got readers thinking differently.

References 

Berlant, L. (2011). Cruel optimism. Durham, NC: Duke University Press. 

Cheek, J. (2008). Healthism: A New Conservatism? Qualitative Health Research, 18(7): 974-982. https://doi.org/10.1177/1049732308320444 

Crawford, R. (1980). Healthism and the medicalization of everyday life. International Journal of Health Services, 10(3), 365-388. https://doi.org/10.2190/3H2H-3XJN-3KAY-G9NY 

Crawford, R. (2006). Health as a meaningful social practice. Health: An Interdisciplinary Journal for the Social Study of Health, Illness and Medicine, 10(4), 401-420. https://doi.org/10.1177/1363459306067310 

Deleuze, G. and Guattari, F. (1987). A thousand plateaus: Capitalism and schizophrenia. (B. Massumi, Trans.) London: Continuum. 

Evans, A., Riley, S. and Robson, M. (2020). Postfeminist healthism: Pregnant with anxiety in the time of contradiction. Jura Gentium: Journal of Philosophy of International Law and Global Politics, XVII, 1: 95-118.

Foucault, M. (1974). 'Prisons et asiles dans le mécanisme du pouvoir' in Dits et Ecrits, t.II, (pp. 523-524). Paris: Gallimard.

Gill, R. (2007). Postfeminist media culture: Elements of a sensibility. European Journal of Cultural Studies, 10(2), 147-166. https://doi.org/10.1177/1367549407075898  

Gill, R. (2009). Mediated intimacy and postfeminism: A discourse analytic examination of sex and relationships advice in a women's magazine. Discourse & Communication, 3(4): 345-369. https://doi.org/10.1177/1750481309343870  

Gill, R. (2017). The affective, cultural and psychic life of postfeminism: A postfeminist sensibility 10 years on. European Journal of Cultural Studies, 20(6), 606–626. https://doi.org/10.1177/1367549417733003 

Guattari, F. (2007). Soft Subversions. Los Angeles, CA.: Semiotext(e)

McRobbie, A. (2004a). Postfeminism and popular culture. Feminist Media Studies, 4(3), 255-264. https://doi.org/10.1080/1468077042000309937 

McRobbie, A. (2009). The aftermath of feminism: Gender, culture and social change. London: Sage. 

Riley, S., & Evans, A. (2017). Gender. In B. Gough (Ed.) Handbook of critical social psychology. London: Palgrave. https://doi.org/10.1057/978-1-137-51018-1 

Riley, S., Evans, A., Anderson, E. & Robson, M. (2018a). The gendered nature of self-help. Feminism & Psychology, 29 (1), 3-18. https://doi.org/10.1177/0959353519826162

Riley, S., Evans, A., & Robson, M. (2018b). Postfeminism and health: Critical psychology and media perspectives. Routledge.

Robson, M., Riley, S., Gagen, E., & McKeogh, D. (2022). Love and lifestyle: How 'relational healthism' structures couples' talk of engagement with lifestyle advice associated with new diagnosis of coronary heart disease. Psychology and Health

Wann, M. (2009). Fat studies: An invitation to revolution. In E. D. Rothblum, & S. Solovay (Eds.), The fat studies reader (ix-xxv). New York University Press.