Parcours de santé, parcours de genre ed. by A. Meidani and A. Alessandrin (review)

This edited volume explores interactions between health and gender across nine chapters representing a variety of disciplines. What impact do health status, illness, or biomedical categories have on gender roles and relationships? How does gender condition preventive attitudes, perceptions of risk, the experience of pathologies, and relationships to care and treatment? In responding to these questions, the book pursues two ambitions, which are set out in the introduction by Anastasia Meidani and Arnaud Alessandrin. The first is to replace binary essentialist thinking, which is widespread in the biomedical approach, with dynamic intersectional analysis of the imbrications of gender trajectories and health pathways. The second is to offer a non-naturalizing vision of gender and health, drawing on insights from a diversity of thematic, theoretical, geographic, and disciplinary perspectives. The introduction takes a very instructive look at the contributions and pitfalls of the different conceptual frameworks that have predominated in the study of the relationships between health and gender across time and theoretical currents: categorical thinking, post-structuralist feminist theory, relational approaches, intersectional analysis.

The book is then organized into three thematic parts, each consisting of three chapters. The first deals with the experience of cancer. In the first text in this section, Pierre Aïach examines the phenomenon commonly known as the ‘gender paradox’ with regard to mortality, in particular from cancer: namely, that mortality is lower in women than men despite higher prevalence and less favourable socio-economic positioning. Aïach seeks to shed light on this apparent paradox by analysing social conditions, notably employment trajectories and sociocultural dispositions that precede the observed differences in cancer outcomes. Next, Brigitte Esteve-Bellebeau offers a philosophical reflection on gender identity in the face of treatment protocols and cancer-induced damage to the body, based on observations in a clinical context. She describes successive breaks in representations of self as a sexed body at different stages in the process: when the diagnosis is communicated, during medical treatment, and, finally, during remission. The first part ends with a sociological text by Anastasia Meidani which, based on observations and interviews in an oncology clinic, highlights the force of sexed perceptions both in patients’ experience and in the medical treatment of the disease. Meidani describes, for example, how stereotyped figures of women as ‘exhausted’ (by life) but ‘strong’ in the face of illness, and of men who are ‘robust’ (in life) but ‘weakened’ by illness, contribute to differentiated clinical responses to pain reported by women and men.

The second part of the book deals with reproductive health and sexuality, with three chapters each taking an original approach. The first is devoted to the management of reproductive toxicant risks in the workplace. Based on company monographs and sociological interviews, Emilie Legrand and Anastasia Meidani explain that outside the period of pregnancy, these risks are almost entirely concealed at all levels of prevention policy. Female employees themselves strongly underestimate these risks, which runs against the widespread idea of an almost ‘natural’ female prudence in the face of health risks. The study of the combined effects of gender, age, and cohort, but also socio-occupational status, career implications, and parental status, helps to explain women’s concealment, and even denial, of these risks. In the next chapter, Virginie Rozée presents an analysis of the conditions of surrogacy in India based on an in-depth ethnographic survey. Rozée shows that the practice of surrogacy is now an integral part of a globalized system for the management of the reproductive capacity of women, who seek to improve their living conditions through an exceptional financial opportunity. An intersectional approach sheds light on interacting axes of domination (linked to gender, socio-economic status, and the primacy given to the wishes of the intended parents and to biomedical power) to which pregnant women are subjected throughout a process in which they are assigned the place of ‘silent bodies’. The second part concludes with a text by Meidani and...