Reflections on an Inclusive Boundary Worker

I remember vividly where and how I met Adele Clarke for the first time. It happened during the 4S/EASST conference in Amsterdam in 1988, the first 4S/EASST meeting I ever attended. To be honest, it was a bit scary to be there. After I presented my paper challenging dualisms in research on sex hormones, Adele embraced me enthusiastically. She told me that my research was important because there were only a few scholars working at the intersection of feminism, STS, and the medical sciences. During the conference she also introduced me to other scholars and told them about my research. Ever since, the 4S annual meetings have been an inspiring and warm intellectual home for me. I mention my experience as a young STS scholar here because we cannot underestimate the importance of scholars taking the effort to make STS into a welcoming, warm community, particularly but not exclusively for young female scholars for whom English is not their mother language. Such efforts were important in the early days of the STS community and remain important because of the increased individualism in the academic world, and the enormous growth of the 4S and EASST conferences. Adele showed us how we can do this.

In terms of research, Adele Clarke made many invaluable contributions to STS, often in close collaboration with other feminist scholars. She had a deep commitment to studying sciences that are understudied by humanities and social science scholars, despite their importance in shaping human lives. In this respect, she made an excellent choice by selecting the emergence of the reproductive sciences as a case study for her first major study. In Disciplining Reproduction, she described the reproductive sciences as a field that has been “ignored, overshadowed, and otherwise made invisible by other sciences during the twentieth century” (Clarke 1998, 21). The book provides a fascinating account of what happened to scientists who tried to turn research on reproduction into a discipline. Because the study of reproduction had been controversial for centuries, scientists who tried to build the discipline faced an uphill battle. The controversies and deep cultural tensions that accompanied reproductive issues had major implications not only for the careers of reproductive scientists but also for social scientists. When I began my research on the failure of innovation in contraceptives for men, Adele warned me that this choice of topic may not be helpful to building an academic career. She had received similar warnings when she began studying reproductive sciences. Luckily, we both persevered because we were convinced these sciences were too important to remain largely invisible.

Adele's call to study marginalized fields of science contributed not only to creating a more balanced and inclusive history of the sciences, but also shaped knowledge production in STS. For a long time, STS research prioritized study of the natural sciences, such a physics, thus reiterating the longstanding hierarchy in the sciences. The study of the medical sciences was not considered core STS business. Although much has changed, this early preference is still reflected in the name of two of our major journals (Social Studies of Science and Science, Technology, & Human Values). I remember the fierce discussions we had in the ST&HV Editorial Board in the early 2010s about whether to include the medical sciences in the journal's name, but it did not happen and still has not happened. Disciplining Reproduction thus contributed to a game change within STS in which other feminist scholars played an important role as well (e.g., Borell 1976; Epstein 1996; Fausto-Sterling 1992; Franklin 1993; Haraway 1991; Jordanova 1989; Long 1997; Martin 1987; Oudshoorn 1994). In this respect, the late 1990s were an exciting time to be part of the growing community of STS because feminist scholars, including myself, were actively involved in building bridges between Women's Studies and STS, ultimately changing knowledge production in STS itself.

In situating Adele Clarke, I therefore want to stress her situatedness in the women's movement, particularly feminist concerns about the impacts of technoscience on women's health and on constructing and legitimizing sex and gender differences. Throughout her academic life, Adele's deep commitment to feminism and women's health issues was a major source of inspiration. In Disciplining Reproduction, she did not restrict her research to understanding the social and cultural dynamics of the reproductive sciences, but also how they contributed to the construction of sex/gender differences. To quote her: “it is difficult to conceive of a more sex- and gender-constructing and maintaining discipline and set of practices than those of the reproductive sciences” (Clarke 1998, 22). In her later books, she focused more explicitly on how reproductive knowledge and practices across the twentieth century shaped women's health. Together with Virginia Olesen, she edited Revisioning Women, Health and Healing (Clarke and Olesen 1999), a pioneering work on how technoscience shapes women's health (see also Ruzek, Olesen and Clarke 1997). Her commitment to women's health was also reflected in her teaching. As a faculty member of the Department of Social and Behavioral Sciences in the School of Nursing at the University of California in San Francisco, she developed the first curriculum in the United States on the social, cultural, and historical dimensions of women's health. ¹

Adele Clarke loved to collaborate with other feminist scholars, including some of her graduate students: Melanie Jeske, Laura Mamo, Jennifer Fishman, Jennifer Fosket, and Janet Shim. These collaborations exemplify the importance of going beyond the image that knowledge production is solely the work of a genius individual (although Adele was one, of course). Together with this collective of feminist scholars, Adele published a series of books and articles on biomedicalization, a concept they introduced as a critique of the concept of medicalization that dominated classic medical sociology at that time (Clarke et al. 2003, 2010, 2023). The major incentive for introducing this concept was that medical sociology did not sufficiently address the importance of technoscience (Clarke et al. 2023, 91). In their groundbreaking 2003 article, they described the vast social transformation of biomedicine in the US since about 1985, emphasizing that these changes can only be understood by acknowledging the role of technoscientific innovation and the crucial differences between medialization and biomedicalization. Medicalization has been a useful concept to understand social transformations in US medicine after the Second World War, whereby medicine became increasingly important in controlling biomedical phenomena by constructing many aspects of life as medical problems. By contrast, biomedicalization refers to a second important change in US medicine in which new technologies helped transform biomedical phenomena, ultimately making and remaking life itself (Clarke et al. 2003, 161). This call for research to understand how medicine controls human life but also how it transforms humans and nonhumans paved the way for understanding crucial developments in biomedicine, including a “new focus on health, risk, and surveillance, the techno-scientization of biomedicine, transformations of knowledge production, distribution and consumption, and the transformation of bodies and identities” (Clarke et al. 2003, 183). The introduction of the concept of biomedicalization, again, shows that Adele did not hesitate to cross boundaries between different fields—in this case medical sociology and STS. Her capacity to speak to the interests of different fields and to connect theory-building across disciplinary boundaries has been one of her major strengths.

Finally, situating Adele Clarke is also about tracing where she came from. She began her academic life as a student of the late Anselm L. Strauss, who provided her “with the intellectual home I had long been seeking” (Clarke 1998, xv). As a student of Strauss, she first met Susan Leigh Star, who was a member of her dissertation group, and became her life-long close friend and colleague until Leigh Star's untimely death in 2010. One of the traces of their strong intimate bounds can be found in Leigh Star and Geoffrey Bowker's book Sorting Things Out which is dedicated to Adele and her partner Allan Regenstreif: “chosen family, hors de catégorie” (Star and Bowker 2002). The remodeling of Strauss's grounded theory, a qualitative method he developed together with Barney Glaser (Glaser and Strauss 1967), has been one of Adele's key contribution to STS and medical sociology. In one of her most important books, Situational Analysis (Clarke 2005), she extended grounded theory and developed situational analysis as an innovative method to account for the multiplicity and complexity of science, technology and society relations. ²

The reworking of Strauss et al.’s (1985) notions of invisibility and invisible work constitutes an equally important contribution. ³ Together with Leigh Star, Adele extended Strauss's work to intervene critically in actor-network approaches which often restricted research to experts and producers, and focus instead on design and innovation in understanding sociotechnical change. Referring to this implicit method as the “executive approach,” Leigh Star convincingly argued that this scholarship erased the work of crucial actors like laboratory technicians and secretaries, and paid less attention to “non-standard positions, including women's voices” (Clarke and Montini 1993, 45; Star 1991, 29). By introducing the concept of implicated actors, referring to “those silent or not present but affected by the action,” Adele extended this critique to the role of end-users in socio-technical change (Clarke 1998, 267); they may be “physically present they are generally silenced, ignored, or made invisible by those in power” (Clarke, unpublished). The notion of implicated actors can thus be considered as a crucial call for a more inclusive approach to understanding the power relations in the development of technoscience. It thus constitutes an important addition to the toolbox within the subfield of user studies (Hyysalo, Jenssen and Oudshoorn 2016; Oudshoorn and Pinch 2003).

I feel privileged to have known Adele Clarke for more than 35 years. She has been the most supportive, compassionate, and inspiring colleague and friend that I could ask for.