Abortion Pills, Test Tube Babies, and Sex Toys: Emerging Sexual and Reproductive Technologies in the Middle East and North Africa. L. L. Wynn and Angel M. Foster, eds., Nashville: Vanderbilt Press, 2016, 251 pp.
Sexual and reproductive health technologies are accepted, adapted, and resisted in a multitude of ways across different societies and within a single society. L. L. Wynn and Angel M. Foster have put together a collection of engaging essays that explore such technologies in different contexts across the Middle East and North Africa. Abortion Pills, Test Tube Babies, and Sex Toys is a must read for scholars and students interested in gender, medical anthropology, science and technology studies, Middle East studies, ethics and morality, and religion. In the introduction, Wynn and Foster remind readers that while the word “technology” frequently suggests “innovations at the cutting edge of science” (p. 2), this is not always the case. They deliberately used the term “emerging” in the title to bring our “attention to technologies that may or may not be globally new, but that are emerging to have new significance in local societies” (p. 3). This notion has shaped the volume’s organization into three sections that together cover a wide array of technologies, from methods of contraception and abortion to assisted reproduction to technologies concerning sex and sexuality. The book “focuses equally on technologies that advance normative sexual and reproductive roles and those that advance non-normative roles” (p. 6).
One of the major strengths of the volume is that it highlights the many intricacies of sexual and reproductive health technologies. A theme that runs through the different chapters is that these technologies “are far from neutral” (p. 12). The accounts illustrate that how a “society approaches a new technology [reveals] a great deal about the complex relationship between politics, medicine, bodies, and the body politic” (p. 12). The authors work through these complexities by drawing on rich qualitative data from different contexts. Each of the chapters details the lived experiences of individuals who engage with sexual and reproductive health technologies in addition to the broader political, legal, religious, and social debates within a particular country and more globally. There is a tacking between the local and the global throughout the volume, which helps to situate the authors’ different field sites, topics, and approaches within the “global transfer of reproductive health technologies” (p. 12).
In the introduction, Wynn and Foster write of why the volume is significant: “Emerging reproductive health technologies are particularly important to study because they are life and death, both literally and figuratively” (p. 1). The authors work to uncover the multiple ways that these technologies are shrouded in meaning, power, and politics, thus demonstrating they are much more than just medical and scientific inventions.
Part One focuses on “Preventing and Terminating Pregnancy.” Ahmed Ragaa A. Ragab (Chapter 1) explores the religious debates surrounding the intra-uterine device in Egypt. Elena Chopyak (Chapter 2) examines the struggles involved in introducing emergency contraception in Morocco and the eventual rollout of pills currently available. Foster (Chapter 3) focuses on medication abortion in Tunisia, both historically and ethnographically, with a discussion of the impacts of the Tunisian Revolution. And Francoise Daoud and Foster (Chapter 4) detail how “the story of misoprostol [brand name Cytotec©] in the West Bank is much more than a story about public health” and access to abortion, but “it is a testament to women’s resilience” (p. 67).
The volume then moves to Part Two, “Achieving Pregnancy and Parenthood.” Daphna Birenbaum-Carmeli, Efrat Dagan, and Suzi Modiano Gattegno (Chapter 5) explore fertility preservation among young breast cancer patients in Israel. Due to the therapies needed to treat cancer, cryopreservation may be these women’s only option for having children in the future. The following two chapters center on assisted reproductive technologies. Shirin Karsan (Chapter 6) investigates in-vitro fertilization (IVF) in the United Arab Emirates (UAE) and Marcia C. Inhorn (Chapter 7) investigates the nexus of IVF, high-order multiple pregnancies, and multifetal pregnancy reduction based on fieldwork in Egypt, Lebanon, and the UAE. Inhorn notes there is “a strong regional IVF industry” in the region, which has in part led “the dramatic increase in the rate of multifetal pregnancies” (p. 100). Although this may be exciting to couples that have had difficulty conceiving, it also comes with a new set of health risks and social concerns. The section ends with Elly Teman’s chapter (Chapter 8) on gestational surrogates in Israel and Katrina MacFarlane’s chapter (Chapter 9) on the politics surrounding cesarean sections in Turkey.
The final section of the volume, “Engaging Sex and Sexuality” includes essays that interrogate “how technologies inflect and are influenced by cultural constructions of both femininity and masculinity” as well as how they help create “nondichotomous, nondualistic ways of inhabiting social worlds” (p. 6). Faysal El-Kak (Chapter 10) offers a history of the human papillomavirus vaccine in Lebanon and analyzes the struggles involved in increasing its uptake, which include “misinformation, stigma surrounding premarital sex, and the high cost” (p. 138). Azal Ahmadi (Chapter 11) draws on ethnographic research in Tehran to “detail the intricate web of contested medical, sociocultural, and religious–juridical contemporary discourses” surrounding hymenoplasty, or “medical ‘re-virginization,’ which renders them [women] ‘marriageable’” (p. 145). Wynn (Chapter 12), in her comparison of Viagra with female reproductive health drugs and a government family planning campaign, illustrates that Viagra in Egypt takes on a much different meaning than in other global contexts, as it is “associated more with exuberant sexuality than it is with shame and sexual lack” (p. 160). Wynn shows how Viagra, female reproductive health technologies, and the family planning campaign are tied together through the “discourse of aspirational consumerism” (p. 171). Jessica Marie Newman (Chapter 14) examines how discussions of sex toys in Morocco produce particular female sexualities and the ways that sex toys illustrate “pervasive anxieties about the role of sex and its proper place in Moroccan society” (p. 173). The final chapter of the volume, by M. A. Sanders (Chapter 14), focuses on the experiences of transgender Kurdish women in Turkey as they “navigate the difficult everyday social, legal, political, and urban spaces in which they are vulnerable to violence” (p. 186). The volume closes with a conclusion by Donna Lee Bowen.
The authors all use interesting and innovative ethnographic starting points to get at questions of religion, morality, legality, health, sex and sexuality, culture, and globalization. This volume would be suitable to both undergraduate and graduate courses in anthropology, public health, Middle East studies, and religious studies. The book could be assigned as a whole, or, given that each chapter includes history and context, chapters could be assigned individually. The volume could benefit from more chapters focused on male sexuality and masculinity, but this is not the editors’ failure. It rather points to the fact that these topics need further exploration within the context of the Middle East and North Africa. The volume highlights that the region is not homogeneous; this is no more evident than in that fact that emerging technologies take on specific meanings and debates within the different contexts researched by the authors.