Rene Almeling

Selling Genes, Selling Gender: Egg Agencies, Sperm Banks, and the Medical Market in Genetic Material

Eggs and sperm are parallel bodily goods in that each contributes half of the reproductive material needed to create life. Yet these cells are produced by differently sexed bodies, allowing for a comparative analysis of how the social process of bodily commodification varies based on sex and gender. Drawing on interview and observational data from two egg agencies and two sperm banks in the United States, this article compares how staff recruit, screen, market, and compensate women and men donors. Results show how gendered norms inspire more altruistic rhetoric in egg donation than in sperm donation, producing different regimes of bodily commodification for women and men. I conclude by discussing the implications of these findings for debates in sociology of gender about biological differences among women and men and the cultural norms attributed to these differences; debates in economic sociology about how social factors shape the expansion of the market; and debates in medical sociology about the intersection of the market and medical practice.

Objectification, standardization, and commodification in health care: a conceptual readjustment.

Historically, medical sociologists have used the interrelated concepts of objectification, commodification, and standardization to point to the pathologies of modern medicine, such as the depersonalization of care and the effects of bureaucratic control. More recent work in science studies, economic sociology, and sociology of health and illness, however, has begun to explore how the social processes of objectification, commodification, and standardization produce a wide variety of biomedical achievements. We provide a theoretical synthesis of this emerging body of scholarship centered upon the intended and unintended consequences of objectification, commodification, and standardization to improve health. We then outline a research agenda that would result from a more comprehensive assessment of how these processes manifest themselves in clinical care.

Abortion training in U.S. obstetrics and gynecology residency programs, 1998.

CONTEXT Since the late 1970s, the number of obstetrics and gynecology residency programs providing abortion training in the United States has steadily decreased. Given the documented shortage of abortion providers, assessing and ensuring the availability of abortion training in graduate medical education is critical. METHODS In 1998, the National Abortion Federation surveyed the 261 accredited U.S. residency programs in obstetrics and gynecology, and analyzed the availability of first- and second-trimester abortion training. RESULTS Of the 179 programs that responded to the survey, 81% reported that they offer first-trimester abortion training--46% routinely and 34% as an elective. Seventy-four percent of programs offer second-trimester training--44% routinely and 29% as an elective. Some programs that do not offer training give residents the option of obtaining it elsewhere. While 26% of programs indicated that all residents in their programs receive abortion training, 40% said that fewer than half are trained, including 14% that train no residents. The operating room is the most common training site: Fifty-nine percent of programs reported that abortion training takes place in the operating room. CONCLUSIONS After a decades-long decline in the availability of abortion training, opportunities for abortion training have increased. However, there is reason to be cautious in interpreting these results, including possible response bias and pressure to report the availability of abortion training because of new guidelines from the Accreditation Council for Graduate Medical Education.

More and Less than Equal: How Men Factor in the Reproductive Equation

In both social science and medicine, research on reproduction generally focuses on women. In this article, we examine how men’s reproductive contributions are understood. We develop an analytic framework that brings together Cynthia Daniels’ conceptualization of reproductive masculinity (2006) with a staged view of reproduction, where the stages include the period before conception, conception, gestation, and birth. Drawing on data from two medical sites that are oriented to the period before pregnancy (preconception health care and sperm banks), we examine how gendered knowledge about reproduction produces different reproductive equations in different stages of the reproductive process. We conclude with a new research agenda that emerges from rethinking the role of men and masculinity in reproduction.

Public opinion on policy issues in genetics and genomics

Purpose:The aim of this study was to examine public opinion on major policy issues in genetics and genomics, including federal spending on genetic research, the perceived significance of the Genetic Information Nondiscrimination Act of 2008, and whether clinicians should be involved in direct-to-consumer genetic testing.Methods:This was a survey with a nationally representative sample of 2,100 American adults administered by the nonpartisan research firm YouGov in January 2011.Results:The majority of the respondents (57%) believe that the federal government should spend more on genetic research, 82% rank the 2008 antidiscrimination law as “important,” and 65% say that clinicians should be involved in explaining genetic test results (contra the practice of some direct-to-consumer companies). On all three policy issues, gender and political party affiliation were statistically significantly associated with respondents’ views, whereas race/ethnicity and education were less consistently associated with policy opinions.Conclusion:Americans demonstrate widespread support for scientific research on genetics, laws protecting citizens against genetic discrimination, and the need to involve medical professionals in the process of genetic testing. These results are useful for scientists designing research projects, clinicians interacting with patients, professional organizations lobbying for resources, federal agencies setting budget priorities, and legislators designing regulation.Genet Med 16 6, 491–494.

Reacting to Genetic Risk An Experimental Survey of Life between Health and Disease

Medical sociologists contend that we are living in an era of surveillance medicine, in which the emphasis on risk blurs the lines between health and disease. Yet, data to examine these claims are generally drawn from patients, raising questions about whether this modern experience of medical risk extends beyond the clinic to healthy people in the larger population. We use the specific case of genetic risk to construct a survey experiment designed to induce the conditions theorized by surveillance medicine. Each respondent in a nationally representative sample (N = 2,100) was assigned a genetic risk (20%, 30% … 80%) for a disease (colon cancer, heart disease, Alzheimers disease) and asked about many potential reactions. We find that people in the general population-regardless of health status or family history-respond to hypothetical genetic risk information by wanting to take action, and their reactions are stronger in domains related to self and family than to community and polity.

Does genetic risk for common adult diseases influence reproductive plans? Evidence from a national survey experiment in the United States

Prospective parents have long been able to learn details about their offsprings DNA, and social scientists have demonstrated that this form of genetic information influences reproductive decision-making. Now, new tests offer adults information about their own genetic risk for common diseases that begin later in life, raising new questions about whether this kind of personal risk will also affect fertility plans. Drawing on a survey experiment (N = 223) that assigned individuals a genetic risk (20%, 30% … 80%) for an adult-onset disease (heart disease, colon cancer, Alzheimers Disease), this study examines whether such risks lead people to reconsider their plans to have children. Bringing together qualitative research on genetic risk and reproductive decision-making with demographic analyses of uncertainty and fertility, we find that when assigned a hypothetical genetic risk for a common adult-onset disease, childless individuals who plan to have children in the future are unlikely to reconsider those plans.

Being Paid to Produce Eggs and Sperm: Gender, Commodification, and the Bodily Experiences of Gamete Donors

Donated eggs and sperm are key components of many modern-day fertility treatments. In the USA, egg and sperm donors are typically paid to produce gametes for anonymous recipients. In this chapter, I draw on 39 interviews with donors to examine women’s and men’s experiences of bodily commodification. Egg donors and sperm donors have different physical experiences of gamete donation; women must manage their bodies through shots and surgery, while men must engage in routine masturbation and abstinence. However, both egg and sperm donors offer insight into the embodied experience of donating sex cells for money and provide evidence that the social context in which physical experiences occur can produce variation in how the body feels.

The Business of Egg and Sperm Donation

rene almeling on the framing of sex cell donations.

Cold Intimacies: The Making of Emotional CapitalismCold Intimacies: The Making of Emotional Capitalism, by IllouzEva. Cambridge, UK: Polity Press, 2007. 144 pp.

Marshaling such disparate evidence as Jane Fonda’s autobiography, the writings of Slavoj Žižek, and interviews with people looking for love on match.com, Eva Illouz contends that over the course of the twentieth century, emotions have suffused economic life while economic calculations have suffused emotional life. In three essays, which were originally delivered as the Adorno Lectures in Frankfurt, Illouz shades in the contours of this culture that she calls “emotional capitalism.” The first essay traces the rise of psychoanalysis and psychological ways of understanding the self, both in workplaces and in homes. Illouz begins with the lectures Freud gave at Clark University in 1909 to introduce what she calls the “therapeutic emotional style” that came to dominate American popular culture. She credits Elton Mayo’s Hawthorne experiments, which investigated the relationship between emotions and productivity, with importing therapeutic categories into the corporation. These findings became codified in the search for managers who emphasized communication or, later, who evinced “emotional intelligence,” and workers were subjected to personality tests as part of job applications. Outside of work, Illouz argues that over the next several decades, the ongoing institutionalization of psychology coalesced with the emerging feminist movement to redefine “healthy” intimate relationships as based on equality, open communication, and sexual pleasure. Because these egalitarian norms required individuals to identify and then work to enact their preferences, the result was a “rationalization” of intimacy. In the second essay, Illouz excavates the narrative of self-realization, which defines those who are not self-fulfilled or “self-actualized,” in the words of Abraham Maslow, as in need of psychological attention. But what it meant to be self-actualized was never clearly defined, leaving open a wide range of behaviors that could be labeled neurotic or dysfunctional, resulting in an ever-expanding role for psychologists. In support groups, on talk shows, during therapy sessions, or online, individuals are encouraged to locate the source of their current troubles in the past, a process of articulation designed to encourage behavioral changes so as to create new futures. In this way, “therapeutic culture paradoxically privileges suffering and trauma” (p. 52). Invoking Bourdieu, Illouz suggests that the narrative of self-realization and the concomitant claims of suffering were institutionalized by the state, psychologists and other professionals, social movements, and the pharmaceutical industry, forming an “emotional field” in which emotional health became a commodity and emotional competence another form of capital. The third essay explores the world of internet dating sites, which Illouz believes epitomizes the rationalization of emotions. People post profiles exhaustively cataloguing their own selves and ideal others, and they are able to search through thousands of listings, efficiently evaluating potential partners based on written and visual self-presentations. This market in love upends the standard romantic narrative, in which attraction precedes in-depth knowledge. Illouz draws on Goffman and Merleau-Ponty to suggest that it is just the sort of attraction that can happen (or not) when two people meet in person, based on a sort of bodily intuition, that is obviated by meeting on the internet. This results in disappointing date after disappointing date, despite the seeming abundance of romantic possibilities. In a challenge to critical theory, Illouz exquisitely demonstrates the multiple and contradictory effects of commodifying and rationalizing emo-