Distraction Free Reading

“Un-fixing” hormones: searching for the multiple in hormonal selves

What are hormones? While biomedical notions of hormones focus on their biological functions in bodies, hormones are also cultural artifacts, shaping understandings of health, normalcy, and what it means to live “hormonally balanced lives.” These molecules activate processes across emotions and physiology, social and material worlds, mental and physical health, organic and synthetic biology, the gendered and the non-gendered, and the normal and the pathological. Thus, hormones carry multiple, sometimes conflicting meanings, and sit at the meeting point between many different biomedical and social spheres of life, making them subject to multiple kinds of knowledges (Roberts, 2007).

Drawing on interviews with Swedish women regarding their contraceptive choices and experiences, in this post I explore a few of the multiple perspectives and spheres in which hormones are deployed and operate. My particular interest revolves around how hormonal contraceptives participate in the production of affect and emotions as well as modes of embodiment and lived experience. These hormonal practices raise questions regarding which bodies are biomedically and socially constructed as in need of hormonal regulation, and the implications for gendered relations, and the cultural conceptions of health, “femininity,” and the “responsible female subject” that are implicit in the promotion and use of hormonal contraceptives. I argue that by adopting an interdisciplinary perspective when researching hormones, we might allow for an “un-fixing” of binary understandings of gender, the normal, and the deviant.

Medical reguulation of the female body

Graphic illustrating the endocrine system and biomedical methods for hormonal regulation of bodies. Source: @GettyImages/VectorMine.

Hormonal bodies and hormones on the mind

Hormonal contraceptives are commonly understood to have strengthened the role of women in society and they are widely promoted as a tool for enabling gender equality and women’s sexual emancipation (Preciado, 2018). The possibility of regulating fertility and deciding when or if one wants to become a parent has made it possible to “take control” of one’s reproductive life. Reproduction and parenthood are therefore no longer destiny, but very much an area of life where planning and management are expected.

In my conversations with women using hormonal contraceptives, they emphasize their experience of managing their fertility as an “on-going project,” continuously assessing whether they still feel “like themselves.” One of them puts it this way;

You know, it feels like… There is something in me that finds all this a bit strange. Because I know that it affects me. And how much do I want that? What is it that affects me and how much? And I don’t think that it’s very dangerous nowadays, but I also have this idea that [hormonal] contraceptives and the female body is neglected in medical research.

Remaining like oneself reoccurs in the interviews as important—if a contraceptive method affects a woman in a way that changes her conception of the self it is unlikely that she will continue to comply with the prescribed hormonal regimen. However, if it changes things in a positive manner the reverse is true, making visible cultural divisions between good and bad that are intimately related to ideals of femininity and gender roles.

For example, one of the women stated that she didn’t like feeling like her contraceptive method might have resulted in an increase in appetite; it made her worry that she could potentially put on weight. As a result of this uncertainty, food and meals had become a continuous hassle for her and she felt the need to keep track of what she ate in order to manage this potential side effect. At the same time, she also noticed that her skin had become clearer, an effect that pleased her. She explains;

I guess I just want it to work smoothly. I don’t want to experience an increase in appetite which then makes me think more about what I eat. I just want to be able to carry on as usual without my contraception affecting my life. (…) It is a bit of a trifle, but still becomes a pretty big part of the daily life if your appetite and hunger is affected by your pills. But then again, I don’t know if it is because of the pills (…) But yes, I’m happy on the Pill. But I wonder… There are definitely things that are affected.

The women I talked to are very much aware of their nuanced and complex relations to their chosen contraceptive method. It is important for them to notice it as little as possible, but at the same time to feel convinced and reassured of its efficacy. They expressed discomfort with the thought of medically intervening in their bodies and bodily functions during long periods of time, stating that this realization caused them to worry about the long-term effects. They expressed happiness and relief at being able to regulate their fertility and manage their menstruation but also felt frustrated that the contraceptive methods available were specifically developed to regulate the female body. One of the interviewees describes it this way:

It feels a bit weird, I don’t know, so many people start using some type of hormonal contraceptive method when you’re like 15. And then you keep going until menopause. (…) I think it’s kind of odd. Like, for instance, why are women the ones who are expected to do that? Keeping on doing all the things connected to that, like going to the clinic, talking about it, paying for it, putting things in [your body] and taking things out, or remembering pills and all that. I think that it’s a sort of work having to manage these things. But I also wonder about what if you’d have like a 25% increase in sex drive if you weren’t on those hormones. And you just don’t know cause you’ve been on them since you were 15.

Faced with this contraceptive burden that falls exclusively on women, they question the achievement of gender equality through hormonal contraceptives. Instead of feeling liberated or “equal”, they express feeling obligated to manage their own sexual and reproductive health, as well as that of their partner(s).

Regulating the “normal”

To this day, hormonal contraceptives are exclusively aimed at bodies with uteruses and ovaries. They are marketed and promoted as desirable for all women, offering the means to control the “unruly” female body and fertility, treat PMS, and to regulate menstruation. The idea that it is “normal” or desirable for the female body to be hormonally regulated becomes visible in sexual health campaigns where the question is not whether to use hormonal contraceptives or not, but to find the birth control method that is “right for you.” In this context, it is interesting to consider which bodies and subjects are considered “hormonal” in the first place. Think about it; the expression “you’re so hormonal!” implies being “moody” or “unreasonable,” an expression that is highly gendered—aimed at women who express discontentment or frustration. This points to a gendered molecularization of affect, where female sex hormones are understood to be the source or reason for less pleasant moods in women. Interestingly enough, this molecularization of affect is also provided with a pharmaceutical solution where women are offered the possibility to manage their hormones with hormones—medicalizing women’s moods, bodies, and subjectivities in ways that yet have no male equivalent (Reed & Saukko, 2010).

The biomedical and cultural targeting of particular bodies (re)produces ideas of those bodies as potentially problematic and in need of regulation to be considered “stable.” This could be conceived of as a process with the intention to “hormonally normalize” the targeted population. Meanwhile, as the male body remains invisible in contraceptive discourse and practice, it also becomes visible as not constructed as in need of hormonal regulation. The male body is—in this context—implied to be hormonally balanced, or even not “hormonal” at all, in the popular understanding of the term.

Also implied in the widespread promotion of hormonal regulation of the female body and fertility is a routinized medicalization of female bodily processes (Clarke 2010, and Reed & Saukko 2010). This medicalization expressed through hormonal regulatory practices is deeply embodied by users and non-users of hormonal contraceptives, it produces lived experience that on the one hand can result in feeling safe or in control of one’s body and fertility, and on the other hand, feelings of frustration in being “medically targeted” as a potential risk or in need of regulation to be considered responsible, healthy and safe. Hormonal contraceptives have opened the door for hormones as a widespread normative management practice, effectively shifting understandings of what it means to be “hormonally balanced” as well as shifting biomedical conceptions of gendered practices of hormonal bodily regulation as desirable, or even necessary.

Can hormone research contribute to “un-fixing” presumed binaries?

Hormones and hormonal contraceptives extend far beyond the reproductive sphere. Hormones are mobilized in biomedical and cultural discourses and conversations to “make sense of” gendered norms, gender roles, understandings of health, risk, and bodies as normal (or in need of “normalization”). Hormones are fluid in the sense that they carry multiple and shifting meanings. They circulate in and between bodies and in our environment. They are pharmaceutical commodities of gender production and they are symbols of affect, social relations, and behaviors.

The fluidity of hormones and the ability to tinker with bodies and subjectivities present possibilities for transgressing normative categorizations, and to re-think the role of hormonal regimens in maintaining health, or even enhancing bodies by regulating bodily functions. This opens up new possibilities for hormone research to consider, starting with some necessary questions: What do hormones and the way they are researched, conceptualized, produced, and promoted tell us about our social and cultural selves in this particular time and space? What is at stake in the molecularization of social relations and processes? And whose “hormonal state” is understood as problematic and in need of biomedical interventions?

The objective of hormone research should be to unpack this issue, and to explore which hormonal futures we can make possible by working and engaging with biomedical researchers and health practitioners. The aim is to allow for the complexity of hormones to unfold, to explore their multiple meanings, and the potential for constructing a space for research that is norm-critical, inclusive, and solidary. Here lies the potential of understanding our hormonal selves.


References

Clarke, Adele (red.) (2010). Biomedicalization: technoscience, health, and illness in the U.S.. Durham, NC: Duke University Press

Preciado, Paul B. (2018). Testo junkie: sex, drugs and biopolitics in the pharmacopornographic era.

Reed, Lori Stephens. & Saukko, Paula. (red.) (2010). Governing the female body: gender, health, and networks of power. Albany: State University of New York Press

Roberts, Celia (2007). Messengers of sex: hormones, biomedicine and feminism. 1. publ. Cambridge: Cambridge Univ. Press

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