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Special Anniversary Forum | Looking Back: Taking Stock at Year Twenty: The Unfinished Journey of Critical/Cultural Scholarship
Guest Editor: Robert L. Ivie

The medicalization of the culture wars

Pages 36-42 | Received 02 Jan 2024, Accepted 05 Jan 2024, Published online: 21 Mar 2024

ABSTRACT

Communication and Critical/Cultural Studies was a product of the 9/11 era. In this article, I consider the ways the COVID-19 pandemic displaced 9/11 as the defining event of our time and, in the process, fundamentally altered the intellectual landscape for producing scholarship. The so-called culture wars provide a compelling case study for assessing this contextual transformation. Building on the writings of Paul Preciado, I engage the new-found emphasis on pharmaceutics and their role in the culture wars. I focus on three topoi cultivated from works published in CC/CS to explore these changes: those related to biopower, bureaucracy, and coalitional politics.

In early April 2020, just weeks into the COVID-19 pandemic, former Obama speech writer Ben Rhodes published a piece in The Atlantic that proclaimed: “The 9/11 Era is Over.”Footnote1 Rhodes lamented the Trump administration’s uncoordinated, if not amateurish, response to the unfolding crisis and argued that the chaotic reaction was a mirror image of the 45th president’s tenure. As the headline enthymematically relayed, the COVID-19 pandemic was now the defining event of the modern era. Rhodes wrote that the outbreak “revealed that government is essential; that public service is valuable; that facts and science should guide decisions; and that competence matters more than Washington’s endless gamesmanship.” The pandemic, he observed, had revealed fatal flaws in our spending priorities, our national security, and our relationship with government. Although it was too early to know how COVID might reconfigure the intricacies of everyday life, there was good reason to believe it would affect the design of our buildings, the ways we educate children, the locations from which we work, and so much more.

Communication and Critical/Cultural Studies (CC/CS) is a product of the 9/11 era. It premiered in March 2004 and half of the essays that appeared in its inaugural issue explicitly mentioned either 9/11 or George Bush in their titles. The lead article focused on “the increased tension between friendship and enmity in international and transnational relationships” as a symptom of globalization.Footnote2 Over the last two decades, CC/CS has published papers exploring the rituals that hegemonically sustain and reinforce nationalism, Bush’s framing of the Iraqi people in his war rhetoric, the influence of 9/11 families on policy creation, the US security apparatus, and the role of patriotism in the classroom, among others. The long shadow of 9/11 provided a backdrop to the scholarship featured in CC/CS, even when such work was never explicitly about that fateful day or its aftershocks. CC/CS furnished readers with a lexicon for performing conjunctural analyses and modeling productive cultural critique in an age of rapidly expanding surveillance, ill-conceived conflicts, and intense civic agitation.

I am skeptical of Rhodes’s claim that COVID subsumed 9/11’s influence in the global imaginary. To take just one instance: the US’s response to the pandemic, with its debates over emergency executive powers and militaristic medical metaphors, was clearly informed by the rhetorical legacy of 9/11. Still, for the purposes of this forum, I am intrigued by the idea that the pandemic constitutes a new paradigmatic era for critical analysis. What might it mean for contributors and readers of this journal to assume a fundamentally altered intellectual landscape? How does COVID’s status as a medical phenomenon influence our interpretation of world events and inspire generative criticism? What political, economic, and social realignments will most affect the ways we approach issues that exist at the intersection of communication and culture until the next epoch arrives?

I propose that the so-called culture wars, which have been both revitalized and reimagined in the third decade of the new millennium, provide a compelling case study for assessing this contextual transformation. 9/11 reworked the fabric of the culture wars by giving emphasis to a neoconservatism that prized Manichean dualisms of good vs. evil. But today, issues traditionally narrated as part of the culture wars, particularly those related to abortion, safe sex, and LGBT rights, are being litigated under the banner of medical interventions. Building off the writings of Paul Preciado, this article contemplates the new-found emphasis on pharmaceuticals and their role in this round of the culture wars. Ultimately, I argue that rhetorical critics are well positioned to investigate the shifting norms and relationships that exist between medicaments and quotidian life. The power struggles between those on the Left and the Right are reshaping the language we use to appraise public affairs and the heuristics we employ to dissect them. The work published in CC/CS over the last 20 years offers an entry point for approaching such issues and reconsidering them anew. In what follows, I focus on three topoi related to the medicalization of the culture wars: shifting understandings of biopower, the relationship between bureaucracy and capitalism, and the ongoing necessity for coalitional politics.

Pharmacological identities and the ascendancy of the medical apparatus

The political dynamics of the culture wars have long been defined by rhetorics of health and medicine. Conservative attacks on LGBT people, for example, reached a fever pitch during the AIDS crisis. Abortion is a medical procedure facilitated using either pills or surgery. Recently, however, social altercations about these issues have entered a new phase of intense contestation over the pharmaceutical interventions that enable and sustain personal sovereignty and transformation. In deep-red states, for example, conservative lawmakers have made access to hormone therapies for trans folks increasingly inaccessible. Likewise, right-wing judges have ruled that employers are under no obligation to provide insurance coverage for birth control or HIV-prevention medications such as PrEP. In the aftermath of the Dobbs decision, Republicans continue their crusade to outlaw safe abortifacients, such as mifepristone, on a national level. These topics, along with those that focus on vaccine controversies, the regulation of insulin prices, and the ramifications of weight-loss medications such as Ozempic, all contribute to novel conversations about structure and agency. Critics scrutinizing the medically inflected constitution of personhood are confronted with a complicated matrix of controversies that require a deep focus on topics such as bureaucratic rhetorics, pharmaceutical lobbying, and class privilege.

Scholars who wish to intervene in these evolving disputes would be wise to turn their attention to the evolving nature of key cultural concepts such as personhood and agency. The monumental shifts in culture and communication since 9/11 justify both innovative theoretical and methodological perspectives, as well as a renewed commitment to the rhetorical resources that have animated criticism. The European trans philosopher Paul Preciado, who champions a novel understanding of subjectivity that extends beyond typical academic scripts of social construction or performativity, provides an excellent model. For Preciado, subjectivities are no longer ortho-architectural, or “applied to the body by apparatuses beyond it.”Footnote3 Rather, identities are now energized “through new pharmacological technologies that are physically incorporated into the body at the molecular level and regulate everything from birth control and erectile dysfunction to our mood, attention, and sleep.”Footnote4 Medical technologies, he writes, have enlivened “the concepts of the psyche, libido, consciousness, femininity and masculinity, heterosexuality and homosexuality, intersexuality and transsexuality into tangible realities.”Footnote5 So ingrained is this new dialectic between pharmaceuticals and personhood that it is difficult to know where one ends and another begins. Preciado notes, “technologies enter the body to form part of it: they dissolve in the body; they become the body.”Footnote6

Importantly, Preciado is attuned to the centrality of language in the social imaginary, particularly as it relates to the constitution of identity. His conceptualization of a “pharmaco-pornographic” regime refers to “the processes of a bio-molecular (pharmaco) and semiotic-technical (pornographic) government of sexual subjectivity.”Footnote7 In the case of gender affirming care for trans folks, for example, his heuristic could account for both the hormones that might help modify subjectivities, but also the fact that debates over pronouns are fundamentally about who gets to narrate the terms of someone’s livelihood. As part of this reconceptualization, Preciado is especially critical of Foucauldian approaches to discourse and subjectivity because, he believes, the late philosopher failed to account for the technological boom in the years following World War II that radically altered the ways we imagine personhood. As such, when Preciado argues that the “truth about sex is not a disclosure; it is sexdesign,” he is reworking ideas such as the confessional, which have steered generations of thinking about power and identity.Footnote8

I raise the medicalization of the culture war and Preciado’s call to rethink understandings of subjectivity in the context of this forum because CC/CS has played an integral role in reimagining Communication Studies’ conceptual toolbox for conducting critique. In the remainder of this essay, I borrow from some of the many thinkers who have published in this journal to map the movement from the 9/11 era to the present day.

Biopower, bureaucracy, and resistance

CC/CS contributors have frequently investigated the shifting dynamics of biopower, biopolitics, and biosociality in the modern world. Like Preciado, these scholars have taken up the ways biopolitical techniques of control, surveillance, and management have been utilized by state and corporate entities to contain risks and discipline those who inhabit non-normative identities. Those invested in the medicalization of the culture wars will no doubt be concerned with notions of risk, especially as they are invoked to expand or curtail the use of pharmaceuticals such as mifepristone or PrEP. People using such banal medications are often marked as morally tainted, and these accusations are generally underwritten by scripts of racism, sexism, and homo- and transphobia. In the pages of this journal, Natalie Fixmer-Oraiz took up the work of Nikolas Rose to engage the ways Nadya Suleman, popularly known as Octomom, was disciplined through rhetorics of pathology that were articulated to Western conceptions of motherhood. Suleman was positioned as an “unruly reproductive body, a perpetrator of risk, and a threat to be contained through assertions of medical authority.”Footnote9 Fixmer-Oraiz argues that the logics of race, gender, and sexuality that underlined this case study were elided by an ethos of medical expertise that naturalized Suleman’s supposedly threatening persona. Indeed, biopolitical invocations of race must be scrutinized when engaging any mention of the culture wars, as racist figurations have been the centerpiece of reactionary policy creation and the development of antagonistic whiteness for at least a half century. As Eric King Watts contends in his study of the affective economies of post-racial fantasies, “biopolitical modes of surveillance and scrutiny were invented and deployed as ‘security mechanisms’ against the threat of epidemics not only from foreign spaces but from within the segments of the population.”Footnote10 Like Preciado, Watts nuances Foucault’s claims by noting that the “sovereign power to kill did not evaporate with the emergence of the State, it was superimposed upon the disciplinary-regulatory regimes organized and unleashed through the technologies of modern racism.”Footnote11 To this point, one of the consequences of the regulation of trans bodies is the disproportionate impact these policies have on cis women of color. Conservative invocations about the naturalness of femininity regularly implicate, and frequently harm, people who are not white, particularly women of color. These gestures toward biopower and personal autonomy were taken up by Megan Foley in her CC/CS article focusing on Terri Schiavo, whose “voiceless body interrupted biopolitical strategies of American governance that hinged on citizens’ right to self-determination.”Footnote12 Turning to the works of Giorgio Agamben, Foley suggests that biopower and sovereignty are not separate political rationalities. Instead, she argues, “democracy harbors a zone of undecidability, where the sovereign right to kill and the biopolitical mandate to let die become indistinguishable.”Footnote13 We can see here the remnants of a 9/11 contextual framework that highlights the stakes of biopolitical analysis, but also lessons that can be applied to the contemporary moment. The intense focus on medicalization requires a persistent reassessment of biopolitical management strategies, and the studies featured above are exemplars of such critiques.

Whereas the cultural wars once rested primarily in the spheres of media and politics, today they are also deeply implicated in the mundane bureaucratic rhetorics that facilitate them. Medical matters are situated in administrative systems that both complement and deviate from public rhetorics privileging politics. Insulin-dependent diabetics know well that government inaction keeps the price of this most essential medication high, but also that corporations and healthcare providers construct labyrinthine mazes that contribute to these seemingly intractable costs. Ahmad Muhammad Auwal, Tamar Haruna Dambo, and Metin Ersoy put it simply in their study of Nigeria’s deportation of neglected children during the COVID-19 pandemic: “bureaucratic corruption is a form of structural violence.”Footnote14 Bureaucracies are a source of inequality and systemic oppression just as much as they are a conduit for support and sustenance. Too frequently, those deserving of aid are dehumanized in their quest to stay well or seek vital resources. As E. Johanna Hartelius contends, “In the bureaucratic paradigm, alienation … is the process by which the familiar is made unintelligible and awkward, eliciting vague discomfort or embarrassment.”Footnote15 Indeed, the reliance on the impersonal in bureaucratic systems ensures that “no personal knowledge or lived experience is impervious to alienation.”Footnote16 Such bureaucratic alienation is commonplace and is sustained by the invocation of specious ideological frameworks, such as neoliberal individualism. As readers of this journal know, neoliberalism underscores how individual responsibility and free market enterprises are positioned as the remedy to all that ails the world. In her study of women’s empowerment campaigns, Lisa Daily warns that such tendencies can reinforce the logics of neocolonial capitalism while simultaneously masking disciplinary capitalist regimes.Footnote17

Finally, the medicalization of the culture wars requires a focus on the ways people are positioned in relation to these contentious issues. Those most affected by limits on gender-affirming care or abortion are at the heart of these debates. How those folks respond to such restrictions deserves critical attention. It could very well be that social interlocutors develop messages and identities in ways that mimic traditional understandings of publics, counter-publics, social movements, organizations, or campaigns. But it may also be the case that novel coalitions and collectives will emerge from the evolving cultural landscape. In this capacity, CC/CS has done a remarkable job of offering a wealth of scholarship for assessing change. Digital technologies, collective organizing, and social media have altered the character of the culture wars in significant ways, and detailing how communication influences such topics remains a vital enterprise. For example, Phaedra Pezzullo’s writing on impure politics hints at the unusual bedfellows that materialize when issues impacting large swaths of the population take center stage. According to Pezzullo, impure politics “not only implicates the contingent array of tactics from which an advocate can choose, but it also provides a way to underscore the complexity of the adversaries one might face” during a crisis.Footnote18 This can be seen in the 2022 electoral results that illustrate the complicated mix of voters who prize reproductive freedom but who might reside outside typical markers of party allegiance. Likewise, LGBT folks might be concerned about the restrictions placed on trans care, but so too might residents who are skeptical of government overreach. In this vein, Isaac West has offered a guide for contemplating coalitional possibilities. West outlined the partnership between queer and disabled activists at the University of California, Santa Cruz who sought to make public bathrooms both safer and more accessible for those implicated in both groups (to say nothing of those whose identities rest at the intersection of queer and disabled life). These factions, West observes, were an ironic coalition because queers have long had to counter the pathologizing of their identities and desires while disabled people have often been figured as asexual or deviants.Footnote19 Ultimately, however, this alliance found common cause in both the language and politics of accessibility. In a similar vein, Cristina Mislán and Sara Shaban examined a transnational collective created between Palestinian activists and Black protestors in Ferguson, Missouri, in the wake of Michael Brown’s murder to ascertain the ways digital platforms might produce a “community of feelings.” In doing so, they explored how “activists infused a hyper-local movement with discourses that linked racial oppression and militarization to broader transnational political patterns.”Footnote20 The medicalization of the culture wars will not simply focus on policy creation or the forces of domination, but also on the uptake of these issues by everyday people desperate to foment change.

CC/CS has engendered a rich, diverse, and compelling archive of scholarship over the last two decades. That work offers a model for performing productive cultural criticism for the next 20 years. In an early issue, founding editor Robert Ivie eschewed clinging to any one vision for CC/CS, opting instead to keep open the possibilities that await. As he keenly observed, “No one map of the territory dominates our collective imagination.”Footnote21 Ivie contended that, “Our perspective is at once local and global, national and international, on a wide field of play at the confluence of communication and culture. We critique cultural practices for their democratic potential or lack thereof.”Footnote22 Years later, Ivie’s vision for the journal provides an invitation to openness that accounts for the fungibility of context and the malleability of critical practices. The discursive remnants of the conflicts of the early 2000s linger, even as new challenges arise. CC/CS provides a horizon of possibilities that are at once intellectually rigorous, methodologically innovative, and theoretically astute.

Disclosure statement

No potential conflict of interest was reported by the author(s).

Notes

1 Ben Rhodes, “The 9/11 Era is Over,” The Atlantic, April 6, 2020, https://www.theatlantic.com/ideas/archive/2020/04/its-not-september-12-anymore/609502/.

2 John L. Lucaites and James P. McDaniel, “Telescopic Mourning/Warring in the Global Village: Decomposing (Japanese) Authority Figures,” Communication and Critical/Cultural Studies 1, no. 1 (2004): 1–28.

3 Paul Preciado, “Pharmaco-Pornographic Regime: Sex, Gender, and Subjectivity in the Age of Punk Capitalism,” in The Transgender Studies Reader Remix, eds. Susan Stryker and Dylan McCarthy Blackston (New York: Routledge, 2022), 404.

4 Preciado, 404.

5 Ibid., 407.

6 Ibid., 409.

7 Ibid., 407.

8 Ibid.

9 Natalie Fixmer-Oraiz, “(In)Conceivable: Risky Reproduction and the Rhetorical Labors of ‘Octomom,’” Communication and Critical/Cultural Studies 11, no. 3 (2014): 232.

10 Eric King Watts, “Postracial Fantasies, Blackness, and Zombies,” Communication and Critical/Cultural Studies 14, no. 4 (2017): 321.

11 Watts, 322.

12 Megan Foley, “Voicing Terri Schiavo: Prosopopeic Citizenship in the Democratic Aporia between Sovereignty and Biopower,” Communication and Critical/Cultural Studies 7, no. 4 (2010): 382.

13 Foley, 383.

14 Ahmad Muhammad Auwal, Tamar Haruna Dambo, and Metin Ersoy, “Chastising the Child of Necessity: Peace Journalism and Almajiri Repatriation During COVID-19,” Communication and Critical/Cultural Studies 19, no. 4 (2022): 365.

15 E. Johanna Hartelius, “Undocumented and Unafraid’? Challenging the Bureaucratic Paradigm,” Communication and Critical/Cultural Studies 13, no. 2 (2016): 138.

16 Hartelius, 138.

17 Lisa Daily, “‘We Bleed for Female Empowerment’: Mediated Ethics, Commodity Feminism, and the Contradictions of Feminist Politics,” Communication and Critical/Cultural Studies 16, no. 2 (2019): 140.

18 Phaedra Pezzullo, “Contextualizing Boycotts and Buycotts: The Impure Politics of Consumer-based Advocacy in an Age of Global Ecological Crises,” Communication and Critical/Cultural Studies 8, no. 2 (2011): 132.

19 Isaac West, “PISSAR’s Critically Queer and Disabled Politics,” Communication and Critical/Cultural Studies 7, no. 2 (2010): 156.

20 Cristina Mislán and Sara Shaban, “‘To Ferguson, Love Palestine’: Mediating Life Under Occupation,” Communication and Critical/Cultural Studies 16, no. 1 (2019): 44.

21 Robert L. Ivie, “What We Are About,” Communication and Critical/Cultural Studies 1, no. 2 (2004): 125.

22 Ivie, 125.