Studying Up from the Margins in a white‐supremacist‐cis‐hetero‐patriarchal‐capitalist culture1

You are a graduate student.

You’re in your late 20s, not white, a first-generation PhD student, and you’re asking yourself, “Why did I do this?”

You’re in your third year of a doctoral anthropology program (still wondering why you did this) and you’re desperately trying to settle down and commit to a dissertation project. It needs to be interesting to you but also feasible because you need to collect some data and write it up before your funding ends and you get kicked out of your program.

All the uncertainty and financial precarity associated with being a graduate student generates chronic anxiety.

And then there is the horrible job market. So you’re thinking, “What kind of fieldwork will also give me skills for a job outside of academia?”

You’re reminded daily that you made the selfish decision to go to graduate school for like seven years, not making any money. You’re only able to send your family a few pennies here and there when they need help. The clock is ticking. You need to get a job!

Fortunately, you get a grant, which gives you the chance to take a big risk: you decide to take some time away from your graduate program in anthropology to study public health, thinking optimistically that maybe this could lead to something.

Within the master of public health (MPH) program, you’re introduced to interdisciplinary scientists who design and implement clinical trials, and you start to meet with them in their office hours. They become interested in you because you ask weird questions, and maybe they even want to help you. They see some potential in you.

You’re excited, you don’t want to disappoint, and as snowball sampling goes on, you’re connected to more people who work on clinical trials that target pregnant populations. These trials don’t test pharmaceutical drugs but instead test behavioral interventions in diet and exercise that are deemed safe for pregnant participants. After a year and a half and countless emails, you finally get to meet with the principal investigator (PI) of a clinical trial you plan to ethnographically study. She’s very nice and asks you if you speak Spanish and if you’ve had any research experience in nutrition studies. You say yes and yes because you do and you have.

This particular trial is not located in a large urban area, so there are staff shortages, and they need well-qualified bilingual people. You happen to fit the profile. After thinking it over, the PI agrees to sign you on to be a staff member on the trial; you won’t be paid, but you’ll have access to interviewing, observing, and learning firsthand about the trial design and implementation.

After anxiously waiting for months and months, you finally get the letter of invitation, which you immediately send to your Institutional Review Board (IRB) to get approval for your research. Then you realize you’ll need IRB approval from the trial’s institution. The PI helps you with this, and in the process, she writes down what you do and do not have access to write about.

During your initial research with the US clinical trial, you realize there is another trial that they recommend you study, one that is designed similarly but is being conducted in another country. You’re intrigued, excited, ambitious, and slightly masochistic, and your grad seminars really pushed the literature on multisited ethnography, so you think, “Why not? This is a good idea!” So, as another year goes by, you’re simultaneously working on the first trial and trying to gain access to the next one.

You’re finally granted access to the second trial. You find a way to move to another country, patch together some more funding, find some cheap housing, and start your next phase of fieldwork. Being ambiguously single and childless are key to the feasibility of this phase.

Two years into fieldwork, you’re still a (relatively) young, nonwhite, nonintimidating graduate student, and your key interlocutors are still the white senior scientists who are leading and designing these big important clinical trials. No one talks openly about racism or queerness, but they’re always hidden in plain sight, appearing across the vast differences in access, equality, and treatment among poor, Brown and Black, immigrant pregnant people and in the hierarchies of leadership and funding at national and international levels.

As a feminist ethnographer, you approach your relationships with sincerity and transparency, always reminding everyone that you’re both a staff member and an ethnographer on the trial. And you also know that your access to these sites is so precarious that one false move could mean being cut off.

You’ve always been good at walking on eggshells. As a kid, you had to be vigilant, collecting all kinds of behavioral data in hopes of predicting or preventing disagreements with or episodes from the adults in charge of caring for you. Twenty-plus years of school taught you how to manage racial biases from peers and teachers and how to “behave” and perform your emotional rage in a rational, palatable, puritanical manner. Moving through a PhD is the ultimate test of all your survival skills.

In the end, you get lucky. You get lucky enough to work with scientists and staff who are welcoming, reasonable, confident, and not threatened by your different methods and approaches. They’re even curious about your critical view—to a point. And it helps that you have credentials, previous experience in health interventions, funding, anthropological training in multisited ethnographies, and the emotional intelligence to navigate your precarious position in an uneven landscape of power.

No one should have to be this “lucky” to study up.

Making Intellectual Genealogies (In)visible via Citations

Intellectual genealogies become known through pedagogy and citational practices. When Judith Stacey wrote the article “Can There Be a Feminist Ethnography?” in 1988, the assumption was that ethnography, interviews, and participant observation could never be done on a level playing field (Stacey, 1988; see note for citational context).² Stacey went one step further to state that “ethnographic methods … subject research subjects to greater risk of exploitation, betrayal, and abandonment by the researcher than does much positivist research” (1988, 21). In some ways, Stacey’s framing of ethnographic research as harmful to research subjects is warranted considering the racist, colonial, and imperial history of anthropology as a field. And while the feminist claim that ethnographic research reproduces uneven power dynamics is well established and durable, the provocation that ethnographic researchers expose “research subjects to greater risk … than does much positivist research” is less stable, especially in the context of studying elite scientific spaces (Stacey, 1988, 21, my emphasis). By tracing this citation further, we can situate Stacey’s critical claim within the disciplinary transformations that were taking place in the late 1980s and early 1990s with the rise of debates around Writing Culture (Clifford and Marcus, 1986) and “Writing against Culture” (Abu-Lughod, 1991) alongside projects that began to “study up” (Nader, 1972).

In Laura Nader’s canonical piece “Up the Anthropologist: Perspectives Gained from Studying Up” (1972), she called for anthropologists to examine not only vulnerable populations but also wealthy, elite, and powerful people and networks. This propelled a research trajectory that shifted the ethnographic gaze onto elite, hard-to-reach spaces in the US and Europe, such as, Wall Street (Ho, 2009), private equity firms (Souleles, 2021), elite preparatory schools (Khan, 2012), elite European secret societies (Mahmud 2014), and Hollywood film sets (Ortner, 2010, 2013). This tradition, along with the growth of science and technology studies and the anthropology of biomedicine, brought with it a focus on elite spaces of scientific knowledge production (Gusterson, 2004; Traweek, 1988). While these examples of studying up, or even ideas about “studying sideways” (Ortner, 2010),³ shape my own understanding of ethnographic methods, I do not see my experience of doing fieldwork in hard-to-access scientific spaces mirrored in these texts because these texts do not explicitly address the power relations inherent to racism and white supremacy experienced by ethnographers who study scientific knowledge production from multiple positions of marginality.

A quick glance at the intellectual genealogies that shape anthropological methods of studying up reveals how this analytical framework for examining power relations was shaped by particular readings of Marxism. As Hugh Gusterson wrote in 1997, “now anthropology—revitalized by the return of Marxism, the eruption of feminism, and the infusion of Foucault’s theories of power, to name just three developments—has new theoretical tools to apply to studying up” (1997, 114). Yes, Marxism, feminism, and biopolitics made a significant impact; however, only certain interpretations of Marxism and particular feminist theories cast an empirical gaze on class, gender, and labor. Predominantly white and Eurocentric interpreters of Karl Marx and Michel Foucault are consistently referenced and taught as the main figures in the US anthropological canon.

Other Marxist and biopolitical interpretations, namely the Black Marxist tradition (Robinson, 2000) and the scholarship across postcolonial and Black feminisms (Hartman, 2008; hooks, 2000; McKittrick, 2006; Mohanty, 2003; Spillers, 1987; Wynter, 2003) pushed beyond class, gender, and labor alone to examine white supremacist, colonial, and imperialist conceptions of race as a key framework for analyzing power relations. For instance, in the Black Marxist tradition, contemporary forms of exploitation and oppression are tied to 400 years of transatlantic slavery. Yet this history and the scholarly works that analyze it are missing from contemporary examinations of, for instance, capitalism in science and technology.⁴ Furthermore, Sylvia Wynter (2003), Alexander Weheliye (2014), and Katherine McKittrick (2015) center Black feminist philosophy in their analyses of biopolitics and biopower. They point to how European definitions of humanity are tied to classical liberal and Lockean notions of rights-bearing bodies that systematically exclude certain kinds of flesh. Their scholarship illustrates how modern medical, governmental, and educational institutions are cut from the same ideological cloth foundational to the justification and reproduction of slavery.

Scholars have recently documented how anthropology has historically struggled to cite Black feminist scholarship (Smith et al., 2021). For instance, during the Writing Culture movement mentioned earlier, there were others writing about how and why ethnographic methods needed to keep changing, exemplified in Faye Harrison’s edited collection Decolonizing Anthropology: Moving Further toward an Anthropology of Liberation (1997). While the work by Black feminist anthropologists in the late 1980s and 1990s did not receive the mainstream attention it deserved then, it is now being recognized as central to anthropology, as evidenced by Faye Harrison’s keynote (“Reckoning with Dread: Dilemmas of Democracy When All Lives Don’t Matter”) at the 2021 American Anthropological Association conference, which was organized under the leadership of Bianca Williams. The recognition and centering of Black feminism in ethnographic methods (see, for instance, Davis and Craven, 2016) are long overdue. Similarly, in the fields of feminist science and technology studies and medical anthropology, BIPOC scholars have been studying different dimensions of scientific knowledge production from a variety of positions (Agard-Jones, 2013; Asher, 2009; Bailey and Peoples, 2017; Benjamin, 2019; Carter, 2021; Charles, 2022; Chen, 2012; Deomampo, 2019; Edu, 2018; Fullwiley, 2011; Massie, 2021; McKittrick, 2021; Nelson, 2016; Noble, 2018; Prescod-Weinstein, 2020; Subramaniam, 2014; TallBear, 2013; Vora, 2015).⁵ This scholarship exists, yet these references are not frequently circulated or cited, which reproduces the (mis)perception that medical anthropology and science and technology studies are predominately white public spaces.

When I set out to develop and implement an ethnographic project on clinical trials I did not have the ethnographic tool kit or citational references that would have helped guide me through the complex landscape of power that ended up contouring my climb to study up from the margins. My book, Weighing the Future: Race, Science, and Pregnancy Trials in the Postgenomic Era (2022), is the first ethnographic examination of ongoing pregnancy trials in the United States and the United Kingdom. Drawing on epigenetics and the developmental origins of health and disease, the trials I focused on were testing behavioral interventions in diet and exercise on diverse pregnant populations deemed obese as a way to prevent the risk of obesity and diabetes in future generations. I argue in the book that these pregnancy trials are an understudied site for examining emergent forms of capitalism, racism, surveillance, and environmental reproduction.

Studying any ongoing clinical trial is challenging; however, ethnographically studying clinical trials in wealthy Global North countries as both ethnographer and clinical staff member requires navigating multiple dimensions of ethics and politics. Another layer of context to consider is the geopolitical history of slavery, imperialism, and settler colonial relations of power that shape how marginalized or underrepresented graduate students study elite spaces of scientific knowledge production. My own positionality as a Brown, queer, financially precarious, first-generation doctoral student created a particular set of power relations that shaped how I experienced studying up, which was distinct from how I was taught to study up.

My purpose in writing this article is to offer a lens on the dialectical role that citational politics play in teaching ethnographic methods of studying up and the improvised practices that emerge when one is studying up from the margins. I incorporate my own experience of studying up with the aim of expanding the citational landscape in the anthropologies of medicine, science, and technology. In so doing, I illuminate the complex tensions of doing ethnographic work in spaces that are challenging to access while simultaneously being embedded in what bell hooks describes as a culture of “white supremacy, capitalism, and patriarchy” (2000:118). Attention to the layers of contexts—not just the ones ethnographers study but the ones that we are indoctrinated by and work within—is important for spotlighting the tenuous politics and ethics that influence past and present ethnographic and citational practices. In what follows, I share openly about my methodological process, including how I gained access, the ethics and politics of studying up, and how my positionality shaped not only my methodological approach but also my motivation to study up.

What Do I Study? And how Did I Gain Access?

As a medical anthropologist and feminist science and technology scholar, science and its methods, practices, experts, and networks are the contexts that I study. In my research, I ethnographically focus on the people and places that hold the resources and power to design randomized controlled trials (RCTs)—the gold standard of evidence-based medicine. Since most international clinical trials are designed and funded in wealthy countries, my work was based in the United States and the UK. In my research, clinical trials, specifically trials that target pregnant populations for behavioral interventions, are my object of study. Thus, studying up in my case centers around people, systems, and logics that influence scientific knowledge production. At times, this means engaging with academics who are part of elite and wealthy spaces. In my experience, the key people designing and leading these trials have been predominately white, well educated, and situated within a middle to upper socioeconomic class, while much of the staff that implement trials and the targeted participants come from much more diverse backgrounds and socioeconomic classes.

There is no disciplinary expectation that ethnographers disclose how they gained access and no standard way to do so. Researchers doing ethnographic projects in elite, hard-to-reach places gain access through a variety of avenues that are not openly discussed. It is up to the individual to decide whether, for example, they want to share transparently in their publications that a family connection helped them meet with the chief executive officer of a biotech corporation. Yet it is known that well-established networks, elite pedigree, and proximity to wealthy, educated spaces facilitate access (Hoang, 2022; Ortner, 2010). A tenured professor at an elite school can employ different strategies for gaining access than a marginalized graduate student embarking on their first ethnographic project. Thus, it is not a coincidence that many ethnographic examinations of elite spaces are second or third book projects.

For instance, in the book Spiderweb Capitalism: How Global Elites Exploit Frontier Markets (2022), Kimberly Kay Hoang includes an extensive methodological appendix that transparently explains how she gained access to wealthy elite spaces. She identifies two key factors: (1) she was working at an elite university with global reach and name recognition, and (2) it was her second book. After publishing her award-winning first book, she started a position at the University of Chicago, and her work was promoted through the university’s networks. These institutional networks created opportunities for invited international lectures to alumni affiliated with the economics and business departments. And it was at these events that she met people who made introductions on her behalf to wealthy international elite figures in finance (Hoang, 2022).

While ethnographic transparency in accessing powerful sites is not even a requirement by ethical review boards, a topic I explore further below, it is vital for the development and advancement of anthropological methods. Examining power and elite spaces from different positions and locations within hierarchical landscapes and sociopolitical climates shows us that it is not only about direction (up, sideways, down) but also involves a whole slew of imperfect metaphorical factors including incline, altitude, climate, and timing. Drawing on feminist epistemology, a detailed description of ethnographic positionality is vital to studying power (Davis and Craven, 2016; Haraway, 1988; Hurston, 1935, 1942; Visweswaran, 1994). Aligned with this approach, in what follows I provide three levels of context for how I gained access to powerful and obscure spaces of scientific knowledge production.

One

For my dissertation research, I was not a well-established scholar, and I had no access to scientific networks. I had gone straight from undergraduate studies at the University of Florida to the PhD program in anthropology at the University of California, Irvine (UCI). My main point of entry for developing contacts with people who were doing work on pregnancy trials came out of time in the school of public health at the University of California, Berkeley (UCB). In my second year of graduate school, I had applied and been accepted into the MPH program at UCB, and that same year I was awarded a National Science Foundation Graduate Research Fellowship Program (NSF-GRFP) grant. I was not allowed to receive the grant and start a different program at the same time, so I took the grant money and participated in the University of California exchange program, which allowed me to spend a year in UCB’s public health program. While taking courses in epidemiology, biostatistics, and maternal health, I was seen and framed as a young graduate student. And the professors and scientists (mostly white women) that I interacted with initially took on a mentoring role (a dynamic that structures a very particular power relation). Through these relationships, I was introduced to more networks of scientists doing research in maternal health, which led to people who were designing pregnancy trials.

After my year at UCB, I came back to UCI to complete my qualifying exams and advance to candidacy. I tried to make the case that epidemiology and public health were my foreign languages, since most anthropology programs still have a language requirement to advance to candidacy. This requirement is connected to a long legacy of anthropological colonialism and imperialism. Today, it is a requirement that is misaligned with most projects that study up in colonial and settler colonial contexts like the United States and the UK. My plea was denied, but thankfully I speak Spanish and met the language requirement that way. After passing, I waited another six months to officially start fieldwork, which was about a year and a half after initially contacting the PI of the trial I had proposed to study.

The first trial site I gained access to was situated within a large national consortium of trials across the United States and was located in a small town that was not affiliated with a large teaching hospital. This context shaped the need for bilingual researchers who could recruit what the trial classified as “Hispanic and Caucasian” participants out of a local area that, although small, was surrounded by Mexican and Latinx immigrant farming communities. I fit the profile as someone who not only spoke Spanish but also had experience doing research.

The location of this specific trial site helped justify its funding by the National Institutes of Health (NIH). As a result of the 1993 NIH mandate to include more “women and minorities” in clinical trials, consortia or groups of clinical trials include a variety of trial sites across the nation to meet these “diverse” recruitment goals. For instance, this consortium included trial sites in Puerto Rico, the West Coast, the East Coast, and southern and southwest regions of the United States, although two of the trial sites could not recruit enough “diverse” participants, so their funding was eventually cut.

As a “diverse” graduate student, I was in the right place at the right time to meet the need for diversity and inclusion initiatives in medicine, science, and technology. I use scare quotes for diverse because the term itself is vague and has been politically wielded by neoliberal institutions to pay lip service to issues of injustice but it does not directly address enduring structural forms of inequality that are, for instance, intimately tied to racism and not just ethnic classifications of race. What I explain in my book is that most of the “diversity, equity, and inclusion” (DEI) approaches in clinical research focus on individual-level definitions and classifications of race and ignore systemic or institutional forms of racism as a key source of health inequity. Consequently, the effort to include more “women and minorities” in clinical trials fails to address the root causes of health disparities (Valdez, 2022).

For the purposes of this article, the point I want to highlight is the layering of context associated with studying up within white-supremacist-cis-hetero-patriarchal-capitalist culture. DEI initiatives impacted my own experience as a graduate student moving through my field site, and they played a role in the sites and subjects I was investigating. For instance, as I was studying the focus on recruiting more “diverse” participants in clinical trials, my own “diversity” became operationalized in ways I could not have controlled or predicted, all of which shaped my experience of studying up.

I did not know at the time that gaining access to this smaller US trial site was a step toward accessing a larger, more well-resourced hospital-based trial in the UK. Once the PI in the UK found out that I was working on a very similar US trial, they were curious and allowed me to come and do an initial research visit. Once I met the UK PI, was vetted and vouched for by the US PIs and collaborators, and submitted another IRB request for approval through the UK institution, I was then allowed to observe the UK trial. I could not tell you what my strategy or approach was as it was happening. Only after a lot of time, distance, and prompting from graduate students who ask me how I gained access to “study a study” did I become more aware of the tacit and intuitive knowledge I was trying to put into place to navigate my research from multiple positions of marginality and privilege. Reflecting on this also reveals how critical it is to understand how networks of prestige reproduce themselves.

Two

On the surface, methods such as snowball sampling may be helpful for research design; however, the nitty-gritty of accessing powerful elite spaces of knowledge production requires more than just traditional qualitative skills. Pedagogically, and beyond family connections or socioeconomic status, networking and reaching out to spheres beyond your own community require practice. It is by design, for instance, that master of business administration (MBA) programs focus heavily on incentivizing networking opportunities through multiple social events and large travel budgets. Such programs also require a certain number of meet and greets with relevant consulting contacts for degree completion. The networking focus motivates applicants to aim for elite MBA programs. In anthropology, as in business, the school you attend and the pedigree you hold matter (Kawa et al., 2018). Especially in an international context, introducing yourself as a graduate student from Harvard, Princeton, or another comparable institution will get you a foot in the door at places that might be harder to access if you’re affiliated with a lesser-known school, with no recommendations or connections, and your primary option is to use the cold-calling/cold-emailing method.

Unlike business programs, anthropology programs do not typically train graduate students in how to network for the purposes of studying up. I was taught to critique the business approach but not to name it as a strategy that might already be used by my peers. Nor was I given the tools to see how my own experience navigating elite, hard-to-reach academic spaces was a methodological resource for studying up. What I argue here is that holding methodological curiosity for how graduate students study up in a white-supremacist-cis-hetero-patriarchal-capitalist culture may reveal some insights that are taken for granted. For some students, like myself, moving through a PhD in anthropology—no matter one’s pedigree—is itself a lesson in studying up.

Three

When students ask me how I gained access, what I think about is the years of experience I have had navigating higher education. I began navigating elite spaces that I never felt I belonged to or was entitled to be a part of at an early age. When I was nine years old, my mother decided to move us away from our large extended Mexican family and out of a small working-class suburb outside Chicago to a wealthy, elite retirement suburb in south Florida. I remember her saying, “If we stay in this town, you’ll end up quitting school and getting pregnant too early.” Her critical judgment and concern came from her own family’s experience and the entrenched social stigma and stereotype of teen pregnancy that still plagues Latinx communities across the United States. Throughout elementary and high school, my sisters and I experienced various forms of racism. We had to navigate racial biases from our teachers and peers, limit who we invited into our comparatively small home, sometimes even lie about where we lived, and never speak Spanish at school or tell anyone at school that we spoke Spanish at home since that would be grounds for segregating us into the English as a second language program.

From my experience, which is consistent with the literature on racism and xenophobia in education, students of color, including immigrant children who speak different languages, are often misidentified as having learning disabilities or behavioral issues and are segregated into harmful educational settings (Grindal et al., 2019). At age 12, I made a conscious effort to stop speaking Spanish during the school year, which came with a lot of teasing and ridicule during the summer, when I would spend time in Mexico with my family and had lost all my words. Just when I was getting the hang of speaking Spanish again, it was time to go back to school. I still struggle with my Spanish and carry some shame around my elementary language competency. Little did I know growing up that my “gringa” Spanish, as my cousins used to call it, would be more than enough to get through my doctoral language test and fieldwork.

As kids, my sisters and I also quickly picked up the social cues of what was appropriate to wear, how to straighten our curly hair, and how to be quiet, polite, and not take up too much space. These behaviors became necessary for proving to people that I deserved to be in the “gifted” classes despite my brown skin and background.⁶ For a long time, I was convinced that if I just kept overperforming and behaving like the smart Brown girl, I would be tolerated, and this was socially affirmed. To survive and navigate spaces that I did not feel I had a right to be in, I developed conscious and unconscious behaviors or layers of protection to confront the hostility around me. As if I could prevent racism from getting under my skin. In an ideal world, no one should have to learn how to pass in any place in such a harmful way. Yet these childhood experiences and sociopolitical contexts shaped how I approached graduate school and studying up in a white-supremacist-cis-hetero-patriarchal-capitalist culture.

Bringing these experiences and contexts into methodological inquiry is a provocation for reexamining anthropological training, citational practices, and writing. By sharing this, I am not implying that students should do what I did—quite the opposite. The point here is that how we teach and practice ethnographic methods to study up in medicine, science, and technology requires more explicit discussion and awareness of the social, experiential, and embodied contexts that shape the development and implementation of qualitative projects. This approach shifts attention toward understanding how students might create their own terms of engagement for negotiating uneven power landscapes from multiple dimensions of marginality. Doing so recognizes that studying power from the margins is dynamic and not a standard process. Different positionalities and sites of research create different routes toward studying up with varied degrees of steepness.

Ethics and Protocols for Ethnographically Studying up

Once I gained initial access, I had to negotiate what kind of data I would be allowed to collect and use in my publications. In the US trial, I worked as an interventionist staff member while also collecting ethnographic data for my dissertation project. As an interventionist, I met with pregnant participants randomized into the study every two weeks for about five to six months of their pregnancies. We also had weekly meetings with the PI to troubleshoot any issues with participant compliance. These sessions gave me insight into the experiences and challenges of other interventionists and their assigned participants. Beyond the actual intervention sessions that I had with participants, my work involved a lot of data entry. The interventionists wrote memos and reports after each session, we reviewed participants’ food journals, and we recorded various kinds of behavioral data into online systems. Working on the trial was a full-time job, and I was also collecting my own ethnographic data at the same time.

Throughout my time on the US trial, I was very transparent about my dual roles as a staff member and anthropologist. Guided by traditional IRB protocol, I repeatedly explained my position: “I am an anthropologist who is also working on this trial, interviewing staff and doing participant observation. If you are uncomfortable with me taking notes, please let me know and I will stop or leave the room.” It was very clear that the rules, regulations, ethics, and protocols were intended to protect everyone else around me from my research. This framing is an artifact of IRB protocols that came out of the unethical implementation of studies on human populations after World War II. This was not an ethical framing that considered my position as a young graduate student who was (willingly) providing free labor in exchange for ethnographic access.⁷ These situations are common in the STEM fields, which have an enduring legacy of apprenticeship/internship models based in hierarchical structures of scientific knowledge production.

Moreover, these IRB models and existing approaches to studying up proved useless to me when I needed to negotiate what data I could collect and how to write about the data I was collecting as both an ethnographer and staff member on the trial. Initially, the PI explained that I could interview all the staff, I could listen to recordings of all the participants’ visits, and I could write about my own experiences as a staff member, but I could not interview participants who were enrolled in the trial or write about any individual participants from my observations. I had no leverage, so it was not really a negotiation. I agreed to all her terms. Similarly, the trial in the UK allowed me to interview all the staff and observe all trial visits with participants but not to interview the participants. Although I felt very anxious throughout fieldwork, wondering how I would eventually write about the data I had access to, I compartmentalized this as a problem for future Natali.

While my various IRB and ethics protocols allowed me to reference the PIs at the US and UK trials by name because they were public scientists, I decided to do my best to keep all names and trial sites confidential—a common practice among scholars who study public and private clinical trials (Fisher, 2020; Petryna, 2009). It is impossible to protect people’s anonymity entirely, but I did take some extra steps by not citing the PIs’ scholarship by name in my book. This was challenging at first because editors would question why I was only including dates and not names when referencing certain publications (another curious aspect of citational politics). However, the world of pregnancy trials is small, and anyone who is determined to find names and locations will most likely find something.

I had also heard a story about how an anthropologist at an elite school had been sued by a scientist she interviewed for her research because he did not like how he was represented. Although he consented to being named and recorded in his interview, he still pursued legal action against the anthropologist—who was a woman of color. I was not naive to the fact that while being a “diverse” researcher in elite spaces was embraced and welcomed in name, it also came with unpredictable and uneven risks and consequences. This anecdotal story terrified me, so maintaining confidentiality was an effort to protect everyone involved, including myself. Although my hypervigilance was probably not necessary, practices of confidentiality in addition to and regardless of IRB consent and permission should be evaluated on a case-by-case basis because the historical context of the IRB reminds us that it was not designed to protect graduate student researchers who study up from the margins.

Why Did I Study Up?

Why did I decide to study up? The short answer is that I wanted to study power. I wanted to understand why RCTs are so influential in evidence-based medicine, who designs them, where they are implemented, and who funds them. And while these research questions fundamentally shaped the development of my larger project, they do not tell the whole story. A more nuanced response to the question of what shaped my decision to study pregnancy trials deals with my own personal experiences doing ethnographic fieldwork. In my feminist ethnography class, I explain to my students that I originally started out working on the topic of obesity and diabetes in the United States and Mexico with Latinx populations and shifted toward studying primarily white scientists designing and implementing RCTs in the United States and the UK.

During the first few summers in graduate school, I did some preliminary research in Mexico and stayed with my extended family in Oaxaca, Oaxaca. They were very supportive but also did not take my work seriously because they had no idea what I was doing there, hanging out at markets and observing how people cooked and ate. Also, in Mexico I was constantly asked, “Where are you from?” Every taxi driver noticed my American accent when I spoke Spanish, and they would grill me on my family tree. When I finally shared that one of my grandparents on my mom’s side was from Puerto Rico, they would say, “Oh, of course. I could tell you had something else in you.” Not only was I the gringa prima when I was there, I was also the secretly queer gringa prima. So, when I was in Mexico and my family half-jokingly/half-seriously tried to find me a man to marry, my internal shame and discomfort were activated. It did not help that I already felt like an imposter from being in graduate school. In addition, the colorism, racism, anti-Blackness, and violence against women and Indigenous communities in Mexico psychically impacted me. Although these issues exist in the United States and the UK as well, I did not experience them in the same way I did while in proximity to a familiar “home.”⁸

While I felt like a failure for a long time because I could not manage researching and writing about these very important aspects of everyday life near my family in Mexico, I eventually stopped forcing it and allowed myself to shift my research elsewhere; however, others have provided valuable insight, tools, and examples of how to move through the challenges of doing fieldwork near and with family (see Daina Sanchez’s [2018] critical work on “native anthropology” and Chelsey Carter’s [2019] methodological intervention of “homework”). Even after the completion of fieldwork, the internalization of complex racial and gendered politics across my personal and professional life limited me when it came to writing and thinking analytically and creatively about race and racism in my dissertation. Only after completing the PhD, many years of therapy, landing a stable job, and finding a supportive queer and BIPOC community was I finally able to write about and develop concepts like the improvisation of race (Valdez, 2019) or to begin exploring how racist environments viscerally, materially, and discursively impact health outcomes across poor communities of color (Valdez, 2022). This is all to say that, for me, I had to focus on healing my wounds before I could develop a writing voice to communicate any message, especially messages on the dynamics of race, gender, and power. Making this experience visible and part of the intellectual record and citational landscape is important for reevaluating ethnographic methods of studying up.

Conclusion

This article examines the citational politics of teaching, learning, and doing ethnographic projects that study up across medical anthropology and science and technology studies. By examining the references that are often cited, the ones that exist but are not widely circulated, and my own experience of studying from the margins, I show how complex the landscapes of power can be for ethnographically examining elite scientific spaces. Prompted by students’ questions as to how I gained access to ethnographically study and work on clinical trials in the United States and the UK, this article centers the position of the graduate student ethnographer and emphasizes the layered contexts that come together in learning and improvising methods from lived experiences.

The shift from the second-person perspective in the vignette at the beginning of the article to the first-person voice in its middle and end illustrates the analytical significance of positionality in learning, doing, and writing about studying up. Exploring the question of access in studying elite and powerful communities from multiple perspectives also reveals the politics of citation that shape how intellectual genealogies and methodologies are taught and framed in anthropology. Teaching citations and contextualizing them in methods courses is a part of this process (see the endnotes for examples). In addition, transparently considering the dynamic position of an ethnographer stimulates different kinds of questions with multiple dimensions beyond up, down, and sideways. For instance, how steep is the climb toward accessing elite spaces? What kinds of hostile conditions or climates shape the ethnographic process? What does harm reduction look like in these spaces for ethnographers? How do approaches and methods change as ethnographers transition to different stages in their career and across different institutions?

Through a reflexive lens, I have mapped out the dynamic topography of power that shaped my experience of learning how to study up in graduate school, why I decided to study up, and how I experienced it. Retrospectively, the academic narrative of how I gained access to studying ongoing clinical trials seems straightforward, but upon further evaluation my journey reveals the fractured politics and ethics of ethnographic methods that are intimately entangled with systemic racism, gender, sexuality, and class.⁹ Only in looking back do I realize how persistent exposure to racist environments in higher education generated strategies and coping mechanisms aimed at navigating hard-to-reach spaces or places that I did not feel I belonged in. For some students from underrepresented or marginalized groups that have been historically and institutionally excluded from participating in elite spaces of scientific knowledge production, doing ethnographic projects that study power can activate past trauma or survival responses that they may or may not be conscious of in the moment. Exploring our positions and experiences in a critical and transparent way can offer valuable insights on how we might transform ethnographic approaches to studying power in medicine, science, and technology. In sharing my methodological reflections on studying up from the margins, my hope is that current and future students feel empowered to draw on their existing experiences as a methodological resource to pave their own alternative paths—ones that steal, disrupt, and stitch together ethnographic approaches in unruly and transdisciplinary ways.

Acknowledgements

This research was funded by the NSF-GRFP, the Wenner-Gren Foundation, and the AAUW. I am grateful to all the people who agreed to participate in this project. This article would not have been possible without the editorial guidance of Emily Yates-Doerr and Alex Nading, as well as the generous feedback from the peer reviewers. I am eternally grateful to all my friends and family who have supported me in this process, especially my older sister Michele Valdez, who paved the way for us through all the classrooms.

Notes

¹ This title is derived from and indebted to bell hooks’ extensive work on understanding interlocking forms of oppression across imperialism, white supremacy, capitalism, and patriarchy (2000). In a tweet from 2015, Laverne Cox added the terms cisnormative and heteronormative to bell hooks’ original concept.

² Citational context: Around the same time as Stacey’s (1988) article was published, Lila Abu-Lughod published her article with the same title (Abu-Lughod, 1990). Stacey and Abu-Lughod were both writing in response to James Clifford and George Marcus’s edited volume Writing Culture: The Poetics and Politics of Ethnography (1986), which excluded feminist theory in general and feminist anthropology in particular. They were both also responding to Marilyn Strathern’s article titled “An Awkward Relationship: The Case of Feminism and Anthropology” (1987). Abu-Lughod expands her critique of Writing Culture in her chapter titled “Writing against Culture” (1991) by showing how anthropological framings of “culture” are based in Western hegemonic contexts that take for granted the position of anthropologists who also partially relate to or identify with the communities they study. This note is in part performing a form of citational politics by providing the context in which these references are placed in conversation with one another, a practice that would be nearly impossible to carry out for every reference.

³ Sherry Ortner, along with other contemporaries, makes the case that studying up is really studying sideways because “these folks are not ‘up’ relative to us, they are—with certain modifications … us.” (2010, 223). The modifications discussed later in the article are narrowly focused on class, and Ortner does not consider intersectional aspects of race or gender. In addition, the “us” that Ortner is referring to does not necessarily include BIPOC graduate students who are not tenured professors. When Ortner wrote about studying up and sideways in Hollywood she was a well-established scholar. Yet, even with professional status, there are some among the very few BIPOC tenured faculty that do not ever feel like they belong to elite spaces.

⁴ One example of this is Shoshana Zuboff’s 600-page examination of surveillance capitalism, which selectively ignores the fundamental role of transatlantic slavery in shaping Western capitalism (Zuboff 2019).

⁵ This is not an exhaustive list. See also the Black Feminist Health Science Studies Collective and the Collaboratory for Black Feminist Health and Healing group.

⁶ In the schools I went to, students were segregated into “gifted” and “regular” classes. The former required an IQ test, which was primarily accessible to families who could afford to pay a private psychologist to administer it. Everyone else had to move through a lot of administrative bureaucracy to have the public school test their children. I requested my own test in sixth grade.

⁷ See Souleles (2021) for a critique of the ethics implicit in studying up.

⁸ For instance, in the UK people were not as direct in asking me where I was from. Yet I did experience discrimination, mostly in certain neighborhoods of London, Glasgow, and Edinburgh from people who assumed I was from Pakistan, Turkey, or Bangladesh. In those places, being read as ethnically ambiguous revealed how improvisational and mercurial racism can be depending on the historical context.

⁹ I have not referenced a wide variety of dimensions that impact studying up, including disability. This is a vital topic, and the lack of attention to it here reveals the limits of my expertise and areas for future growth. For more informed examinations, see Casper and Talley (2016), Thomas (2002), and Garland-Thomson (1997).

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