Get It Out:
On the Politics of Hysterectomy
by Andréa Becker (NYU Press)
It is almost like you have to consider women as people; all those years of reading Aristotle never prepared me for that!
This is a book about elective hysterectomy, “elective” requiring sufficient air quotes as to have its own shoe line. Less glibly, the book is about “elective” as a concept, using the medical procedure of a hysterectomy to understand the act of electing to have a medical procedure done: who decides, why, and what influences those decisions.
The answer is the usual suspects of race, gender, and class. What elevates it is, like the recent the recent Sanger/Dennett book, it cuts through the culture war tropes and routines…or at least provides the evidence for anyone so inclined to look at the question as a matter of facts on the ground rather than a contest of ideas.
Peeking at the other reviews, I am shocked to see people refer to it as repetitive. It is repetitive in a structural sense (i.e. a sociological study). It is a series of interviews with people who have had, want, or considered a hysterectomy. The notable feature here is the variation in the stories, inclusive of people who want one and cannot get it as well as people who did not want one but had it. It is the message of the book.
The answer is not uniform. Hysterectomy is not something that we can say that there need to be either more or less of in a categorical sense. Rather, the failure point is having systems around the procedure that act scientifically and respectfully; scientifically, because of the poor states of the research around the uterus and uterine problems in general, and respectfully in terms of decision-making that includes the patient in the process.
What then gives this book an applicability far in excess of this arguably limited conclusion is that the specific events create a sort of negative space to see culture itself. In the ongoing culture war, we (the U.S. we) tend to talk about things like gender, class, race, and reproduction in abstract terms, as if something like misogyny was a debate over theory and ideas. Here is the sausage of bigotry getting made. You can come to different conclusions, but you must reconcile with the facts here.
The strength is a weakness. It is the customary problem with an impassioned cry for nuance. Since the point is that there is not a point, not An Answer, it is easy to miss the forest for the trees.
Similarly, there are two topics that get extended consideration – fitting this into the grander question of what (if these were oligarchs) we would call biohacking and trying to negotiate the distinction in good and bad patient advocacy, since the distinction is not in the means, only in the ends. These are interesting questions, and stick with me. But the book is focused elsewhere.
It is not for everyone, but the kind of book that I wish everyone would read. Receiving the information here would do a lot for getting the facts right to have substantive discussions about big problems, as opposed to…whatever politics is now.
My thanks to the author, Andréa Becker, for writing the book, and to the publisher, NYU Press, for making the ARC available to me.
CITATION HEEDED 