Cosmopolitan Conceptions: IVF Sojourns in Global Dubai
Marcia C. Inhorn
Durham and London: Duke University Press, 2015, 379 pp.
Reviewed by Stacy Lee Lockerbie
I have been following the work of Marcia C. Inhorn for several years and jumped at the opportunity to read and review her recent ethnography, Cosmopolitan Conceptions: IVF Sojourns in Global Dubai. This is important work on embodied technology that is that is rooted in the literature in medical anthropology, specifically “medical tourism” or “repro travel” (interestingly, some participants voiced that they felt more like “migrants” or “travelers” than “tourists”) and more broadly on globalization showcasing Dubai as an important node of medical cosmopolitanism or “global gynecology.” This is a rich ethnography of one IVF clinic, in particular, Conceive located in Dubai, “the global city” of the Middle East.
This ethnography is the result of a decade of research in this clinic and a much longer standing connection to the UAE and all the historical changes over the course of its presence on the reproductive global stage. Diverse groups of research participants with a remarkably diverse set of circumstances are drawn to pursue IVF treatments at the same clinic in Dubai. For example, some couples come from resource poor countries where the technology or expertise related to assisted reproduction is sparse or does not exist. Others come from countries with socialist medical systems where waitlists are incongruently long in the race against time/age. Some couples seeking treatment come from restrictive countries, where there are too many rules and restrictions or a fear of stigmatization that prevents couples from seeking treatment locally. Finally, some couples are too cosmopolitan or “betwixt and between” and are no longer living or paying taxes in their country of origin and therefore do not have access to this technology in their birth countries.
The strength of this ethnography is not, surprisingly, in the participant’s narratives. In fact, the monograph opens and closes with the harrowing story of Rahnia, a woman who risked her own life in the pursuit of conception. I was also struck by how much of an important role Inhorn played in the intimate lives of these women and couples as a confidante, a friend, a support person, and a researcher. Participant observation at its finest with an emphasis on participation. For example, one participant “reiterated many times how much [Inhorn] being there had helped her to ‘sleep well at last’ and how much [Inhorn] had unburdened her by listening to her story” (xxvii). The narratives are incredibly rich and personal. Other scholarly contributions this ethnography makes are: she highlights the complexity of the technology (love the glossary of medical terms) and its users without neglecting to showcase how the technology mirrors long-standing social inequalities in its accessibility on a global scale. This piece also lends a voice to the trials and tribulations of infertility, considered an “invisible disability” where people suffer in silence and sometimes shame. It also highlights this cosmopolitan clinic as a global space of possibility. Inhorn coins the term “reproscapes” to describe the reproflows from all directions coming to Dubai and the reproductive imagination of couples struggling with fertility to include medical tourism. This term builds on the work of Appadurai’s “ethnoscapes,” which describes the real and imagined global movement of people as mobile and delocalized and cultural identity is not located in place. A global ethnoscape, Appadurai argues, is a social context where the imagination plays an important role, as “more persons in more parts of the world consider a wider set of ‘possible’ lives than they ever did before” (1991:196). Inhorn highlights the financial burden of this technology and the travel associated with it in a section she calls “ethnographic arithmetic” and the cultural pressures and preferences in what procedures are considered acceptable. Finally, Inhorn encourages us as readers, and she herself joins an activist movement LCIVF (Low Cost IVF), to make the technology more accessible to people in vulnerable economic circumstances, including many of those who were part of her study. She frames infertility and assisted reproduction technologies as a medical problem rather than a social one. I recommend this piece to readers interested in cosmopolitanism, the UAE, technology, and the body. It is very rich, comprehensive and enjoyable to read.
Appadurai, Arjun 1991 Global Ethnoscapes: Notes and Queries for a Transnational Anthropology In Interventions: Anthropologies of the Present. Ed: R.G. Fox. Santa Fe: School of American Research, 191-210.
Dr. Stacy Lee Lockerbie is a Research Associate in the Department of Family Medicine, at the University of Calgary in Calgary, Alberta. Lockerbie holds a PhD in anthropology from McMaster University in Hamilton, Ontario. Her research interests include: kinship, reproductive issues, motherhood, globalization, medical anthropology and applied health sciences