Cosmopolitan Conceptions: IVF Sojourns in Global Dubai. Marcia C. Inhorn, Durham: Duke University Press, 2015, 408 pp.
Late in the summer, I arrive early to a dinner with a friend and pull out Marcia Inhorn’s Cosmopolitan Conceptions as I wait. As usual, I am riveted by her ambitious ethnography. Always in awe, I am struck by her dogged determination to gather hundreds of “reprotravel” stories. Inhorn never shies away from difficult subjects, subjects that are intimate and private. Inhorn collects narratives at a world-renowned clinic in Dubai, a global city of medical cosmopolitanism. Personal narratives rife with suffering bookend chapters that engage theoretically with cross-border reproductive care, painted as a global assemblage.
Marcia Inhorn’s 14th book must be considered a guide for any future scholar of infertility, IVF, or reproductive travel. In fact, Göknar’s Achieving Procreation is a testament to Inhorn’s amassed work, which is cited throughout Göknar’s engagement with Turkish couples experiencing childlessness. These two authors stand at very different stages of their scholarly careers, with Inhorn acting as a role model for young, emerging scholars like Göknar. Both authors weave together theories regarding globalization, gender, social relationships, kinship, and religion as they share complexities inherently involved in the lives of those childless.
Reading the introduction to Achieving Procreation, I thought that the subtitle “Childlessness and IVF in Turkey” a bit misleading. In the early pages of Göknar’s work, she clarifies her primary concern to be about the experiences of childlessness for women among their kin and social networks, rather than about their experiences with reproductive technologies. Even further, Göknar frankly speaks of her naiveté in her initial questions with women she encountered in two different fertility clinics in Istanbul: “Why do you want children?” She assesses the blank stares she receives from many of the women to indicate the way that bearing children is naturalized. She also speaks of how she had to rebuild trust that had been lost with this first question since it betrayed to her informants her impertinence or ignorance as a researcher. Göknar situates her own Turkish, academic identity within the cultural and political milieu of her work and maintains a stance that is both intimate yet substantially different from many of her informants. Refreshingly, she frankly admits to the shortcomings of conducting her interviews with patients in IVF clinics at particular points along their “cycle” as well as in certain areas of the clinic.
As with Inhorn’s work, I was struck by Göknar’s ability to interview over a hundred women. However, I then wondered whether two-minute conversations should truly be counted as an interview among the longer, more in-depth conversations she had. The second half of Göknar’s fieldwork among villages gives the readers a better sense of the author as she relies on close friends for entry into intimate worlds of women. Her relationships with her informants are personal and meaningful and bring better insight to the struggles for women suffering childlessness among extended family and friends. I did wonder, however, about her quick claim that Bosniak ethnic identity did not have a large influence on village life.
Throughout her book, Göknar deftly situates her own work neatly within various strands of theoretical debates in anthropology and confidently makes her arguments and convincingly complicates her discussions of discourse, ideology, and kinship. Achieving Procreation swiftly situates the reader in the Turkish context of popular media representations of IVF and the political, legal climate surrounding assisted reproductive technologies in this global space. While infertility is medicalized, IVF has been socialized in this Islamic–European state. In her first chapter, Göknar writes of the metaphor of the fruitless tree to unveil various meanings of isolation, incompleteness, and ambiguity of childless marriages for many of her informants. Her next chapter delves into religious discourse and the ways that it can, for many women, aggravate the feelings explored in the first chapter. However, she convincingly shows the agency women have by employing religious discourse to empower themselves in the context of others’ scorn. Throughout, Göknar contributes to the growing field of feminist ethnography while she also boldly strays from conventions found in Euro–American ethnographies of infertility and assisted reproduction by insisting on the importance of affinal interactions for women experiencing infertility.
The heart of Göknar’s ethnography shines in Chapter Three, in which she reveals the ways in which power often fluctuates and is itinerant within the world of extended familial relationships. Intragender relationships heavily play on a woman and man’s experiences of infertility, in which both must negotiate stigma management and relations that are sometimes conflicting. Although the majority of her informants are women, she delves into manhood ideologies in the next chapter. As she does in each chapter, Göknar complicates notions of masculinity, showing that men may exhibit various types throughout their lives. Nevertheless, infertility claims a total loss for manhood ideologies, which lends itself to women assuming the responsibility for infertility, and thus for pursuing treatment.
In the final chapters of her ethnography, Göknar returns to the topic of IVF and the ways that women may be empowered by achieving conception through IVF. She defies “biopolitical presumptions” that paint women as desperate pursuers of IVF and hammers home the fact that women who seek IVF are seeking to achieve procreation. Her title is no misnomer. Rather, it succinctly and beautifully captures the main threads of her timely work.
While Goknar’s ethnography shows the particularities of childlessness in a hybrid Turkish context, Inhorn’s astute ethnography centers the reader within a much wider scope, in the burgeoning global city of Dubai. Inhorn deftly situates Dubai within a global context of IVF and its shadows and absences for many infertile couples who are still unable to seek treatment. She portrays varied IVF sojourns of “boundaryless global citizens” traveling to a cosmopolitan clinic that relies heavily on its infamous head doctor and his care workers. Throughout, Inhorn casts a critical eye on the intersection of reproductive travel and processes of globalization. Inhorn borrows from Appadurai’s well-known theory of globalization that uses “scapes” to characterize the global flows of technologies, people, ideas, and finance (1996).
Inhorn’s knowledge of the varied regulations, restrictions, absences, and global inequalities when it comes to assisted reproduction is astounding. The fact that she has teamed with international lawyers, bioethicists, scholars, and doctors is clear as she guides the reader through the complicated global context of IVF technologies and laws. She has argued against any usage of the term “tourism” when it comes to talking about reproductive travel. I respectfully disagree with the idea of completely throwing out the term given the propensity of IVF clinics and brokers using it. Nevertheless, her passionate plea and characterization of reproductive outlaws is convincing. Her informants’ narratives reflect people evading low-quality patient care as well as restrictive reproductive laws.
Cosmopolitan Conceptions is a beckoning call for future scholars of cross-border reproductive travel to continue to show the reality of the 21st-century movements of infertile couples to IVF clinics. What strikes me most, as an anthropologist also engaged in the uphill struggle of tracing varied global reproductive travel routes, is Inhorn’s uncanny ability to truly engage with her informants. She embodies the cultural cosmopolitanism of which she writes. Her empathic nature and ability to speak with couples from all over the world reveals her skills of engaging with people—the heart of the anthropological endeavor.
Appadurai, A. 1996. Modernity at Large: Cultural Dimensions of Globalization. Minneapolis: University of Minnesota Press.