A review by aurora linnea

“Do compliant women sleep well at night?” Renate Klein asks in her career-spanning new essay collection, Radical Reckonings: Survival in Patriarchy, released in September by Spinifex Press. Reading through these essays, it becomes clear that if such women do sleep soundly, it is only because they have been anesthetized, their minds and bodies sedated unto tractability by the good doctors of patriarchal rule. Compliant women sleep the sleep of the dead, for their lives are not in their hands. Their lives are not in their hands because their bodies are not, because they have handed their bodies over to men, to medicate and to manage. In the late 1960s, the women’s health movement emerged as a core initiative of the struggle for women’s liberation, with the aim of recouping female bodies from the controlling “care” of male-dominated medicine. Feminists of the period recognized the medical establishment as both institution and industry, ravenous for profit, certainly, but equally concerned with the maintenance of male rule. They responded with challenges to male medical authority, opening grassroots autonomous women’s health clinics and gathering to re-educate themselves about their own female bodies, mystified and pathologized by the teachings of patriarchal “experts.” The movement’s slogan, adopted from the title of Boston Women’s Health Book Collective’s landmark guide, published in 1970, was “Our Bodies, Ourselves.” Klein tells us that this is her favorite feminist catchphrase from the era. It is mine as well. 

A biologist who fled the fraternal order of scientific elites in 1978 to plunge into the then-nascent (and presently defunct) field of Women’s Studies, Klein has spent the last four decades at the forefront of the international women’s health movement, putting her science background to excellent use by keeping a sharp-sighted feminist eye on medicine’s advancing incursions into women’s bodies and lives. Radical Reckonings is a testament to the tirelessness and the remarkable scope of her sustained attention to the physical, ethical, and political harms of the “medical marvels” peddled to women as treatment for femaleness. From in-vitro fertilization (IVF) to the experimental contraceptives tested on the poor and indigenous women of colonized regions under the auspices of “humanitarian” Population Control, from the gateway eugenics of prenatal screening to the scare-mongering marketing of hormone replacement therapy (HRT), Klein has exposed it all. Most recently, she has stationed herself as a leading figure in the global fight to stop surrogacy, which she decries as barefaced reproductive exploitation and violence against women. Klein’s past books, to name just a few, include The Exploitation of a Desire: Women’s Experiences with in Vitro Fertilisation (1989), The Ultimate Colonization: Reproductive and Genetic Engineering (1992), and Surrogacy: A Human Rights Violation (2017). 

As a women’s health activist, Klein co-founded the Feminist International Network of Resistance to Reproductive and Genetic Engineering (FINRRAGE), in collaboration with other luminaries like Janice Raymond, Farida Akhter, Maria Mies, and Gena Corea. (Sadly, I learned this month that Corea, author of the 1985 classic, The Mother Machine: Reproductive Technologies from Artificial Insemination to Artificial Wombs, died at the beginning of the year. She will be sorely missed.) FINRRAGE’s founding mission, Klein explains, was to put an end to, not to regulate, injurious and exploitative reproductive technologies, in the conviction that “they are part of women’s oppression and constitute violence against women and other non-human animals and plants.” At its zenith, the network spawned affiliate groups in 20 countries, with its thousands of members organizing conferences, heading research projects and public campaigns, writing books, and editing FINNRAGE’s own publication, Reproductive and Genetic Engineering: A Journal of International Feminist Analysis. 

Today, however, little remains of the energy and outrage that propelled the women’s health movement, which Klein pronounces “sadly, almost nonexistent.” By her estimation, the movement was “derailed by liberal ‘choice’ arguments, the seductive insistence that technology, drugs and vaccinations are [the] real saviours of women and girls, and above all the notion that to challenge men’s might is not strategic (meaning too radical and dangerous).” Add to that the abortion myopia induced by the ongoing attrition of access that has resulted from resurgent patriarchal conservatism; the state-funded conversion of formerly autonomous women’s health clinics into “feminism-free zones”; a desperate collapse-era clinging to the myth of progress’s promise of Better Living Through Science; and the post-Covid reverence for medical authority piously adopted by uncritical liberals as a stamp of social conscience, and we find ourselves in a cultural climate where to confront medicine’s role in the war on women is not merely unfashionable, but off-limits. 

Criticism of what Klein terms “the medicalization of women’s lives” has been largely purged from the public conversation. Contemporary writers who do apply a feminist analysis to issues of women’s health, like Maya Dusenbery in Doing Harm (2018) and Abby Norman in Ask Me About My Uterus (2018), adhere to a liberal framework, and generally call on women to ask for more from their doctors: more diagnoses, more tests, more pharmaceuticals. (An exception here is Jennifer Block’s Everything Below the Waist: Why Health Care Needs a Feminist Revolution (2019), which though basically liberal, does lodge a complaint against overdiagnosis and overtreatment.) Klein argues that women have succumbed to a “new ‘docility’” towards “the wisdom dispatched by medical authorities,” a receptive readiness to submit to doctor’s orders. To be a compliant patient is seen as a virtue; to be a proactively service-seeking health care consumer, evidence of empowerment. Meanwhile, medicalization continues to intensify, the industry scrambling to cash in on every crevice and cranny and quirk and quiver of our female anatomy. By this process women are converted into “walking diseases,” as Klein puts it, in need of continuous monitoring and regulation. All for our own good, of course. 

In her essay, “The Medicalization of Women’s Lives from Childhood to Old Age,” Klein charts a staggering timeline of the medical industry’s “powerful and lifelong influence over women.” Puberty marks the beginning of the onslaught, when a child’s femaleness is specifically targeted for medical intervention. Menarche is accompanied by diagnoses of Premenstrual Syndrome and Premenstrual Dysphoric Disorder, for which a doctor might prescribe hormonal birth control. If she’s not given “the pill” for PMS – or acne, heavy or irregular bleeding, endometriosis, or undesired un-feminine hairiness – she’ll be pressured onto the script as soon as she is sexually active. Naturally, the girl’s heterosexuality is taken for granted. Hormonal contraceptives are pushed with especial fervor on indigenous women and women living under neocolonial rule, whose bodies are the primary targets of racist, imperial Population Control crusades. For decades, these women have been the uninformed and nonconsenting guinea pigs for experimental contraceptives like the Depo-Provera injection and the Norplant implant, the harms of which Klein outlines in her essays, “Implanon: Just Slip It In?” and “Contraceptives and Vaccines: The ‘Silent’ Weapons of the Population Controllers’ Femicide.” 

Many adolescent girls will receive the Gardasil vaccine against human papillomavirus (HPV), promised to reduce the risk of developing cervical cancer, though the vaccine’s efficacy has been contested and its dangers documented by a steadily growing heap of injury reports. If a girl is conned into the delusion that she is not a girl but a boy, or non-binary, she may be prescribed the bone-thinning prostate cancer drug Lupron for off-label use as a “puberty blocker,” followed upon by a lifelong course of cosmetic endocrine disruption. She may be encouraged by kindly and affirming medical professionals to have her breasts amputated. And if she is one of the growing cohort of teenage girls diagnosed with depression, anxiety, and ADHD, she may also be prescribed psychoactive pharmaceuticals as a balm for her ailing “mental health.” 

Should a young woman become pregnant and wish to end her pregnancy, few options will be forthcoming. Thanks to a combination of abortion bans and medical industry maneuvering, her most likely recourse will be a “medical” or “pill” abortion in the form of the drugs mifepristone and misoprostol, the risks of which – hemorrhage, sepsis, death – Klein describes in “Abortion Drug Not the Safest Method” and “The Ethics of Disclosure: RU 486 and the Suppression of Facts.” Today, these drugs can be procured through the mail following a one-off telemedicine appointment, with minimal oversight or follow-up. But regardless of the potential harms, young women should be grateful to get any kind of abortion at all; they are hardly in a position to protest. As always, for women: beggars can’t be choosers. 

If a woman is pregnant and intends to have the child, then the screening begins, a rigorous regime of blood tests, ultrasounds, and amniocentesis to scry for disease, defects, abnormalities, and genetic disorders. If her child is declared fit to be born by professional standards, then the birth itself is likely to be heavily medicalized, despite the recent surge of popular interest in, and relative acceptance of, midwives and home birth. The vast majority of births still take place in a hospital setting, while the global C-section rate has climbed from 7% up to roughly 20% over the last thirty years. In the United States, where more women die in pregnancy and childbirth than in any other comparably affluent nation, that rate is over 30%.

Once the woman delivers her child, she’ll need to be surveilled for signs of post-partum depression and psychosis; there will be breastfeeding diets for her to follow and “vaginal rejuvenation” surgeries to consider, correctives for the havoc that childbirth has wreaked on her genitals, in order to restore them to an aesthetic standard better aligned with modern porn-fed sexual sensibilities. 

If a woman struggles to become pregnant, the reproductive technicians are ready at hand to recommend IVF, with its potent hormonal drug cocktails and success rates so dismal that Klein prefers to refer to failure rates, remaining stagnant at around 80%. And if the woman thinks she might like to become pregnant one day, but for today she’s otherwise occupied? In that case, she may be counselled to put her eggs on ice, as  “top female talent” in Silicon Valley and teenage girls eager to “trans” their womanhood away are encouraged to do. Alternatively, if she’s not sure yet of her intentions for her clutch of eggs but knows she needs some extra cash, she can “donate” (i.e., sell) them to couples and researchers in need. The medical industrial complex is only too pleased to provide her with such a bounty of options. 

Solicitously concerned for women’s well-being as they are, the good doctors recommend that adult women undergo genetic testing at some point to prophesy their cancer risk. If the results come back suspect, then “prophylactic” mastectomies and/or hysterectomies may follow. According to John Hopkins Medicine, “uterus removal is a common treatment for a variety of conditions that affect a woman’s reproductive organs,” including cancer, but also endometriosis, fibroids, prolapse, painful periods, and “gender” confusion. Approximately 500,000 hysterectomies are performed each year in the U.S., making it the second most common surgical procedure among women. The most common, unsurprisingly, is C-section. 

Forever looming is the problem of female aging, that hellish decline into brittle-boned, desiccated, unsexy redundancy. Fortunately, though, our trusty friends from the medical industry are prepared to leap to our rescue here as well. Menopause, framed as a degenerative disease of womanhood – a state of “living decay,” in the words of American gynecologist Robert Wilson, an early crusader against “estrogen deficiency” and author of  Feminine Forever (1966) – can be managed with hormone replacement therapy. In recent years, perfectly timed with the resurgence of HRT as a miracle drug for the malady of female maturation, we have witnessed the coming of a new scourge: perimenopause. One can only hope that soon we will have the good sense to begin staving off hormonal degradation during our grade school years, in the manner of the forward-thinking 10-year-old girls already undertaking anti-aging skincare regimes for the prevention of future crow’s feet. 

Finally, should a woman survive to old age despite the countless questionable “cures” she has been persuaded to consume over the course of her life, she is more likely than her male peers to spend her golden years institutionalized in a “care home,” where overmedication, neglect, and abuse are rampant. 

Klein is critical of the manifold medical and biotechnological interventions she spotlights in the pages of Radical Reckonings not just because they can be physically harmful – and the evidence of harm she compiles is sobering – but because of their political implications, the ways in which they exploit women and facilitate our subjugation. In the essay “From Test-Tube Women to Bodies without Women,” Klein quotes a 1985 FINRRAGE resolution: “We know that technology cannot solve any problems created by exploitative conditions.” More pointedly, technologies are too often used to cement those conditions, and to entrench exploitation, to intensify and institutionalize it, for the maximization of both power and profit. Radical Reckonings brims over with examples to this point. 

IVF exploits women’s culturally overdetermined and enforced desire for biological motherhood, still the sole route to self-actualization as “real women” endorsed under patriarchy. It also exploits the guilt experienced by women who cannot supply their partners with children, sensed as a failure to fulfill their womanly duty. Klein discusses this guilt in “‘The Only Ones it Works for Are the Doctors and Scientists – Not us’: Women’s Experiences with In Vitro Fertilisation.” 

“Medical” abortion by means of the drugs mifepristone and misoprostol exploits women’s need to terminate pregnancies in order to avoid dependency on men and to participate in public life within a male-supremacist system that excludes and penalizes mothers unhusbanded by a male handler. It exploits women’s poverty, and women’s estrangement from the workings of our own bodies, which, if we understood them better, would enable easier avoidance of unwanted pregnancies. It exploits women’s lack of sexual autonomy, our oppression by compulsory, coerced penetration. In the U.S., it also exploits the desperation of women barred from other options by the flurry of state bans and clinic closures set off by the overruling of Roe v. Wade in 2022. Although Klein cites a 2009 study which found that women rated medical abortion as “more unpleasant, more disagreeable, harder and more painful” than suction abortion, the pill method is nonetheless becoming the new norm, promoted as “safe” and “effective” and “easy” by providers and feminists alike, with scarce mention of the risks. As an added bonus for Big Pharma, the hyperfocus on abortion access as liberal feminism’s call to arms has meant the shouting down of any and all criticism as “anti-abortion,” hence anti-feminist and anti-woman, right-wing and reactionary. 

“Trans” medicalization exploits the hatred of female bodies instilled in women by a woman-hating culture, and their understandable desire to dodge the objectification, denigration, violence, and abuse they correctly perceive as women’s lot under male dominion. The self-loathing of sexually abused girl children in particular is exploited, no less than it is by the prostitution industry. So too is the social uneasiness and rigid thinking of young women with autism exploited. 

HRT exploits women’s terror of aging, of growing old and obsolete, no longer suitable for (hetero)sexual use therefore no longer deserving of life: of reaching their expiration date and being discarded, by men, by the world. 

Surrogacy is so unequivocally exploitative that many feminist critics call it “reproductive prostitution.” The “surrogate mother” grants use of her body to men, to be used according to men’s purposes for her as a generic woman, in exchange for a fee attractive to her primarily due to the manufactured poverty of her sex class. Ukraine, the poorest European country, now wracked by war, boasts a booming surrogacy industry. Notably, since the fall of the Soviet Union, the country has also been a top exporter of women into the international sex trade. More insidiously, surrogacy exploits women’s eagerness to showcase the selfless compassion held up as femininity’s essential virtue, to prove themselves good in a consummately feminine maternal sense by providing others with the precious “gift” of a child. In reality, as Klein observes, the women are “seen as expendable empty vessels, good enough only to grow a child,” itself just another commodity to be unceremoniously turned over to paying customers. 

In all cases, vulnerabilities sown by sex-class oppression are exploited by male-dominated medicine, accruing massive profits for the industries involved while women suffer the consequences and complications, our disposable lives callously endangered. So, why should we line up to subject ourselves to these technologies and procedures, or celebrate them, or demand expanded access to them as our “right”? Yet such has been the liberal feminist position: pleading for the poisonous crusts the men on top condescend to toss down for us, whatever the cost. 

The cumulative effect of lifelong medicalization, of subjection to intrusive biotechnological surveillance and professional “help,” compounded with being daily made a sex-commodity on male dominion’s marketplace, is alienation from the female bodies that we are. Mistrust filters into the gulf riven between body and self, along with blame, contempt, fear. We learn to fear our bodies as malfunctioning machines, as monsters liable to run rampage if not maintained under sedulous control. Bluntly put, the female body must be mastered, or else it is a danger: to society and to ourselves. By nature this body is bad. For routine maintenance and mastery, the bad body requires servicing by trained technicians, like a car entrusted to the mechanic’s garage. The trust we do not have in our bodies, our selves, we are obliged to place in the doctors. Lacking elementary knowledge of anatomy and physiology and the basic vocabulary required for self-understanding, women concede to the wisdom of learned men. It is no accident that we lack this knowledge, nor is it the consequence of congenital female stupidity. Once it was ours, a body-knowledge common to women as healers, but since the rise of male-dominated medicine it has been withheld from us, rarefied through jargon and obfuscation into esotericism, accessible only to a special elite. The technologization of medicine has widened the knowledge gap, making our bodies seem still more unknowable. 

To further confuse matters, we have postmodern “feminist” theory, a product of the 1980s with remarkable staying power in spite of its notorious incoherence, lately assumed as the framework for voguish “queer” theorizing about bodiliness. Here, the female body is dematerialized. The Body is a central fixation of the genre, but The Body of philosophical interest is no body at all but a text and a surface, a site of inscription, contradiction, and most subversively of all, “play.” It is not solid matter, but fluid. Not an organism in its wholeness, but an unruly “assemblage” of fractured fragments. Bodily integrity and holism are old hat, traded out for a dream of perpetually fluctuable hybridity so baffling that the edifice of male power shall crumble before it, terminally perplexed. Or such is the theory, in any case. Klein argues that this postmodern “feminist” glorification of transgressive fluidity and fragmentation “dismembers real live women … as much as reproductive medicine does.” The writers responsible are “cutters with words,” working in tandem with their scalpel-wielding confreres as high-class marketers for plastic surgery, cyborg prostheses, biohacking, and every other body mod promised to scramble the norms of humdrum human materiality. 

Cyborgism is Donna Haraway’s special contribution to postmodern “feminist” body-play, and the subject of Klein’s wonderfully titled essay, “The Politics of CyberFeminism: If I’m a Cyborg Rather Than a Goddess Will Patriarchy Go Away?” As Klein writes, cyborgism is in direct collaboration with the technophilic male master class by encouraging women to conceptualize ourselves as fundamentally machine-like. The cyborg self-actualization it promotes is a process of questing after “upgrades” and “optimizations,” keeping up with technology as it improves. All the while, the medical industrial complex and its league of good doctors are standing benevolently by, itching to assist. The postmodern fluid fluxy body and Haraway’s cyborgism are upscale rebrandings of a timeworn patriarchal fantasy: that the organic, mortal material body will be abandoned and supplanted by superior manmade technologies. At present, this yen for disembodiment reveals itself most overtly  in the millenarianism of billionaire transhumanists, and in the steady creep of our forced migration into virtual realms. As for the bodies we’ve been exhorted to leave behind, the patriarchal salvage project is already underway. Whole or in parts, our scrapped bodies are sure to be a boon to men of industry, even now lining up to take their cut. 

In defiance of the expropriation and exploitation of the female body, Klein sounds the call for feminist re-possession. Bodily integrity is absolutely fundamental. On this point, Klein is adamant: “Holding on to our Bodies, to ourselves, for dear life needs to become our most important focus of resistance.” Klein calls on women to cast aside the patriarchal creed of bodies as objects owned, vehicles driven, vessels inhabited. Instead, our bodies are the very substance of our personhood: we are our bodies, and bodies are what we are. If more women could recognize this, and feel it fully, how much more difficult would it be for men to claim us as their property? And how many fewer of us would be coaxed into placing ourselves in men’s hands, or pummeled into the alienated self-abandonment that leaves too many women and girls tragically, effortlessly exploitable? 

Klein also calls for a renewal of critical feminist attention to medicine and biotechnology as arms of male dominion. I have barely scraped the surface of the medical and technological violations that Klein catalogs in Radical Reckonings, each one an invitation into confrontation with the patriarchal imperatives of these industries. Flip to any page of the book and you will find a new provocation towards some avenue of investigation and inquiry in urgent need of radical feminist resuscitation. This work – the revival of the women’s health movement, not the propping up of a corporate-sponsored sham soured by forty years of neoliberalism, but the rekindling of an energetically rebellious and resourceful, woman-centered, woman-loving grassroots movement for female bodily self-determination, integrity, and well-being – falls now to a new generation of radical feminists. And somehow, despite the many outrages that Klein has warned of only to watch come to fruition, she has hope for us yet. Her wish, she writes, is for “a vigorous Take-Back-the-Body-Movement of young women (and men) who turn their backs on sterile laboratories, resist their ‘duty’ to be screened, poked and prodded, and instead embrace a passionate love for life in its diversity.” Klein has done so much for us, for so long, with such generosity of verve and vibrance, the least we can do is rise to the challenge of her optimism. 

Thank you to Spinifex for kindly providing a copy of Radical Reckonings: Survival in Patriarchy for this review. 

Aurora linnea is a radical (eco)feminist writer living at the ocean’s edge in the region of North American colonizers dubbed “Maine.” She strives to contribute to the global feminist struggle to end male dominion through poetic dissidence and uncompromising disloyalty to the necrophilic patriarchal empire presently destroying life on earth. She is the author of Man Against Being: Body Horror & the Death of Life published by Spinifex Press.