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Bodily Interventions and Intimate LabourUnderstanding Bioprecarity$

Gabriele Griffin and Doris Leibetseder

Print publication date: 2020

Print ISBN-13: 9781526138569

Published to Manchester Scholarship Online: September 2020

DOI: 10.7765/9781526138576

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Intimate Labour and Bioprecarity

Intimate Labour and Bioprecarity

(p.21) 1 Intimate Labour and Bioprecarity
Bodily Interventions and Intimate Labour

Gabriele Griffin

Manchester University Press

Abstract and Keywords

This chapter elaborates the notion of bioprecarity as it is utilized in this volume by drawing on three theoretical concepts which have not been ‘thought together’ before. They are intimate labour as discussed in Boris and Salazar Parreñas’ work (2010); bios, as understood in Michel Foucault’s writings (2008); and precarity as originally developed in France in the 1970s, then taken up by Judith Butler (2004) in the context of war, terrorism, survival and grievable lives, and popularized in the relation to new forms of labour by Guy Standing (2011). The chapter develops these three concepts in the context of bodily interventions prompted by opportunities for bodily labour, meaning labour on and with the body, in order to investigate bioprecarity, a new form of vulnerability which is associated with providing and seeking intimate bodily labour in cross-cultural contexts.

Keywords:   bioprecarity, intimate labour, bios, bodily labour, vulnerability

Introduction: Understanding Bioprecarity

This chapter elaborates the notion of bioprecarity as it is utilized in this volume by drawing on three theoretical concepts that have not been ‘thought together’ before. They are intimate labour as discussed in Boris and Parreñas’ work (2010); bios, as understood in Michel Foucault’s writings (2008); and precarity as originally developed in France in the 1970s, then taken up by Judith Butler (2004) in the context of war, terrorism, survival and grievable lives and popularized in relation to new forms of labour by Guy Standing (2011). The chapter develops these three concepts in the context of bodily interventions prompted by opportunities for bodily labour, meaning labour on and with the body, in order to investigate bioprecarity, a form of vulnerability that is associated with providing and seeking intimate bodily labour, not least in cross-cultural contexts. While separating out intimate labour, bios and precarity for analytical purposes, we recognize and argue that they are deeply imbricated.

Bioprecarity conjoins the notion of bios as derived from Michel Foucault’s (2004) work on biopower and biopolitics and precarity as this has been developed in the works of Judith Butler (2004) and Guy Standing (2011). Foucault’s writings on the topic, as elaborated in the section on ‘Thinking about bios’ later in the chapter, concern the governance or regulation of life (= bios) at individual and institutional levels. This regulation structures subject positions in differential and discriminatory fashion. Such subject positions are entangled with the bodies of those they seek to regulate since individuals as people with certain bodily traits are regulated according to those bodily specificities. Foucault (2004: 249) talks of two technologies (p.22) of power in this context: ‘Both technologies are obviously technologies of the body, but one is a technology in which the body is individualized as an organism endowed with capacities, while the other is a technology in which bodies are replaced by general biological processes’. Biological processes such as sexuality, fertility, health, etc. become the objects of regulation or control through regimes and institutions such as medicine. These categorize individuals – as healthy or ill, for example – and thus exercise regulatory force. This force produces norms that ‘can be applied to the body one wishes to discipline and a population one wishes to regularize’ (Foucault, 2004: 253). In this volume we are interested in the meaning of bios both as it relates to the Foucauldian idea of biopolitics and biopower, and in bios as it references ‘life’, ‘bare life’ or life itself (Rose, 2009).

But we conjoin this with precarity since we want to foreground the fact that the regulation of bodies and of life brings with it certain precarities. Precarity, as we discuss it below, has its roots in labour politics and refers to the casualization and generally rendering insecure of workers and their livelihoods in capitalist cultures. This is important for us because in this volume we relate bioprecarity specifically to one form of casualized and insecure labour: intimate labour. We are interested in particular forms of intimate labour, as detailed in the next section of this chapter, and in how those who engage in and benefit from intimate labour, are put into and find themselves in bioprecarious positions. We interpret bioprecarity as a form of vulnerability, vulnerability in one’s embodied self as this is used in intimate labour. The demand on sex workers to perform sex acts they are not willing to undertake and the threat that they may be bodily harmed or not paid if they do not comply constitutes such bioprecarity. The appeal to ‘being needed’ from nannies’, carers’ and domestic workers’ employers to their workers, which pressurizes such workers to put in unreasonably long hours, constitutes another example of such bioprecarity. That embodied self has both somatic and psychosocial components. As we show below, sex workers as much as carers, for example, are exposed to bioprecarity through the manner in which they have to put their bodies to work.

Intimate Labour

Intimate labour and bioprecarity, the latter a concept to be developed theoretically in this and the next chapter, are closely intertwined. In their path-breaking anthology Intimate Labors: Cultures, Technologies, and the Politics of Care Eileen Boris and Rhacel Salazar Parreñas (2010) discuss the notion of intimate labour in relation to three particular kinds of work that are normally treated discretely but have become increasingly co-discussed: sex (p.23) work, care work and domestic work. They define intimate labour as ‘tending to the intimate needs of individuals inside and outside their home’, where intimate needs include ‘sexual gratification but also our bodily upkeep, care for loved ones, creating and sustaining social and emotional ties, and health and hygiene maintenance’ (Boris and Parreñas, 2010: 5). This tending to the intimate needs of individuals is what binds together the three work arenas that Boris and Parreñas’ volume addresses. It involves, importantly, corporeal as well as psychosocial dimensions, both for those conducting intimate labour and for those on the receiving end. This is evident in the boundary work done by sex workers, for example, to secure a distinction, albeit a precarious one, between their private and their professional selves. Elizabeth Bernstein (2010: 153–4), for example, cites a Swedish street prostitute who said: ‘If you work like this, you need to have unseen borders you don’t let people trespass. If you do [let them trespass], then you start to drink or use drugs … There are things that you allow and … things that you won’t do for money. There has to be a private place inside you.’ Sex work involves intimate bodily labour for the worker as well as the client. From the sex worker’s perspective, who acts here in a professional capacity, that corporeal intimacy has to be off-set by ‘unseen borders’, possibly both bodily ones (such as not allowing mouth-on-mouth kissing) and psychological ones that maintain the worker in the worker and the client in the client position, relative to any other kind of relational situation. In the quote above the maintenance of borders between self and client is articulated as crucial to the maintenance of the self. That maintenance of the self is tied to the notion of ‘a private place’, a spatialized sense of inviolability. Violation, the occurrence of trespass, is also explicitly and directly connected by the sex worker to the production of self-harm in the form of drinking alcohol or taking drugs. Negotiating boundaries with clients is evidently a tricky process; a lack of boundaries is experienced as a violation of self that in turn promotes self-violation.

Intimate labour in the form of sex work, but not only in that form, renders the labourer vulnerable to the client and to self-exploitation. This is because of the primary dyadic scene that work entails, because of the intimate, often bodily proximity between worker and client and because of the limited regulation or unregulated nature of the work. Vulnerability is here corporeal but also psychosocial, created in the interpersonal exchange between worker and client where being vulnerable to the client also entails becoming vulnerable to the self. The worker’s vulnerability may be matched by that of the client who is also potentially vulnerable to exploitation and injury, for instance in the context of institutional elder care where client abuse has been widely documented (see Aitken and Griffin, 1996). It is the combination of bodily engagement and one-on-one labour that is largely unregulated in (p.24) intimate exchange, which promotes what we term bioprecarity through the attendant vulnerabilization of the worker.

In dictionary definitions of intimacy such as that of the Oxford English Dictionary the word is consistently linked to notions of the ‘innermost’, closeness, the personal, the private, the familiar, the informal but also in respect of sexual relations, sometimes described as ‘illicit’. These notions spatialize intimacy both geo-socially and metaphorically, as involving engagement with others and proximity. Such proximity is, however, not necessarily associated with direct body contact: communication technologies and social media allow intimacy through the sharing of virtual space as Kalini Vora (2010) discusses in relation to long-distance call centre workers. It is further a proximity that is not neutral – it is invested, as Lauren Berlant (2000), for example, makes clear, with fantasy, attachment, optimism and emotion. Intimacy is hence associated with a range of emotions and dispositions, and one question to be addressed below is what happens to these associations when intimacy becomes linked with labour.

Conventionally associated with the private sphere, a sphere characterized in modernity by being unregulated, beyond the state and individualized, intimacy has co-occupied the personal and domestic sphere, supposedly separate from the public, collective (state-)regulated domain. But, not least since Anthony Giddens’ (1992) The Transformation of Intimacy: Sexuality, Love and Eroticism in Modern Societies has that idea of intimacy been called into question. A series of processes ranging from women’s increasing participation in the workforce globally, the dramatic expansion of the service sector, globalization itself and the mobilities this has engendered, technologization in all its forms, the gradual neo-liberalization of Western and non-Western societies alike with its emphasis on individualism, choice, marketization, monetarization and the decline of welfare, have all contributed to shifts in the labour market that have resulted in conventional binaries such as private/intimate–public, regulated–unregulated, close–distant, being challenged and indeed collapsing into each other. Obvious manifestations of this are phenomena such as air bnb and uber, which utilize the worker’s private or privately owned space (home, car) in an almost wholly deregulated manner (i.e. without public safeguards for workers or clients) for the conduct of business. Boris and Parreñas (2010: 14) argue that the processes described above have led to new forms of intimate labour among which they include ‘call center work, gender labor in the making of transsexual identity, surrogate mothering, and egg and sperm donation’. What these new forms of labour have in common is that they involve monetary reward for the performance of work that involves one-on-one contact and mobilizes direct bodily and psychosocial involvement on the part of the worker for the benefit of the receiving party.

(p.25) Viviana Zelizer discusses the interrelation between ‘economic rationality’ and ‘intimate ties’ and suggests that there are three views of that relation: one that regards them in terms of ‘separate spheres’, indeed ‘hostile worlds’ (i.e. diametrically opposed to each other); a second view that regards the comingling of intimacy and economy as ‘nothing but … another version of normal market activity’; and a third view that takes a ‘connected-lives’ approach, suggesting that economic rationality and intimate ties are a matter of interpersonal negotiation (Zelizer, 2005: 11, 21, 33).

What is, however, particularly striking when one reads both Zelizer’s and Boris and Parreñas’ work is the asymmetry that governs intimate labour of any kind. In performing intimate labour, people’s – and this is actually mostly women’s – choices are seriously circumscribed. Parreñas’ (2010) account of hostess work in Tokyo, for example, while attempting to show the agency of the women involved (they can, she argues for example, always leave and work somewhere else) indicates very clearly how economic necessity, peer pressure and employer coercion coalesce into a powerful incentive to do the things you do not want to do. As one such hostess, forced together with other hostesses against her will to bare her breasts to clients, said: ‘We would dance for an hour. Then it became ugly. We all started crying. We had to show our breasts … I’m getting upset just remembering it’ (Parrenãs, 2010: 143). Parreñas makes clear that these women felt coerced and unable to refuse to show their breasts because they were on six-month contracts that they did not know how to get out of. Asymmetry of this kind, with unequal power relations between those conducting the intimate labour, those employing them and those who receive that labour, is a shared trait across all intimate labour situations. It arises from the issue of boundaries, how these are drawn and who draws them – boundaries between the labour conducted and the intimacy associated with such labour.

Due to its association with the private and domestic sphere, intimate labour encourages the propagation of certain ideas of intimacy. Domestic help, for example, is often constructed in terms of the relevant person being ‘part of the family’. As such it is expected that intimate labour in domestic settings is conducted in a quasi-familial manner in which, however, differences between those employed and those employing continue to be maintained. Seemin Qayum and Raka Ray (2010), for instance, give a striking example of Indian professionals in New York employing domestic help from ‘back home’, paying them, as is common, minimal wages and at the same time seeking to extract maximum labour. When the employee in one case begins to create boundaries around this exploitation the employer reads it as ‘a betrayal of friendship’ (Qayum and Ray, 2010: 110), a notion that is laughable from the point of view of the reader, as the blatant inequality in economic, social and all other terms between the employer and the (p.26) employee is only too obvious and makes the idea of ‘friendship’ between employee and employer, assumed by the employer, seem presumptuous and naïve at the same time.

The processes that produce intimate labour mould intimacy itself and intimate labour in particular and situationally differentiated ways. For one thing, in contrast to the ‘factory paradigm’ of the worker that relies on large numbers of individuals co-working, much intimate labour is, at the point of the actual labour, dyadic, involving the person who does the work and the one worked for or upon. Boris and Parreñas (2010) argue that such labour de facto often involves a triad, including a commissioning entity, for instance the child of elderly parents employing a carer or parents employing a nanny for their infant. Indeed, more than one commissioning entity may be involved, namely a gatekeeping or regulatory body. Such is the case in the context of surrogacy, for example, where a person or couples seeking to engage someone to act as a surrogate mother for them, may have to deal with both an agency providing surrogates and the regulatory framework(s) that determine the legality or illegality of the process as well as the official status of the resulting child relative to the commissioning individuals and the birth mother.

Several issues come together here that begin to illustrate the relation between intimate labour and what we term bioprecarity. The first is that, as Berlant (2000) indicates, intimacy is linked to desire – in this last example, the desire for a child. As such, and in this instance, intimate labour is associated with an affectscape driven, on the part of the commissioning individuals, by a desire for and an optimism about becoming parents. Affect1 both structures and complicates intimacy. Boris and Parreñas (2010: 5–6) distinguish intimate labour from emotional labour, which they regard as one potential dimension of but not a necessary precondition for intimate labour. They argue, for example, that ‘surrogate mothers do not engage in emotional labour’, then concede ‘though their jobs may involve emotional labour that would occur in private and not public spaces’ (Boris and Parreñas, 2010: 7). It is unclear what to make of these statements but we would argue, very strongly, that all intimate labour involves emotional labour, whether expressive or suppressive. The notion that surrogate mothers do not do emotional labour is itself somewhat exploitative of the notion that acting as a ‘mere incubator’ does not affect the woman in question. However, as anybody who watched the 2013 BBC4 documentary ‘House of Surrogates’ or who has read ‘Womb for Rent: A Tale of Two Mothers’ (Anon., 2011) can testify, this is absolutely not the case. In ‘Womb for Rent’ the surrogate, Sonal, is reported as saying: ‘When I had my first surrogate baby, I fed her for three days, it felt as if it were my baby. When they took her away I cried for three days. I missed her so much’ (Anon., 2011: n.p.). In her case much of the (p.27) emotional labour she conducted was about suppressing her feelings for the daughter she had given birth to in order to be able to give her up to the social mother. The text details the surrogate’s and the social mother’s significant differences of expectation, with Carolina, the social mother, seeking to distance herself from the surrogate as soon as she had received the child, while the surrogate mother wanted to maintain relations, for example.

The text also indicates some of the vulnerabilities the process of surrogacy gave rise to regarding the surrogate mother whose aim in undertaking the surrogacy was to get enough money to educate and house her own children. One such vulnerability was the social one, associated with the stigma in the surrogate’s community of doing this work at all. Not only had her husband not wanted her to do it but her wider in-law family was an issue: ‘Although Sonal was careful not to tell anyone where she had been, her in-laws found out about the surrogacy. She says that when she sees them, she will deny having been pregnant’ (Anon., 2011: n.p.). As the text suggests, ‘as she comes to accept the loss of the baby she carried, she is defiant. “I have no regrets, even if society casts me out or does not invite me in, I don’t care. I am not doing a bad thing, I am doing this for my children,” she says. “I don’t want anything else now, I just want my kids”’ (Anon., 2011: n.p.). Sonal becomes socially vulnerable through her act of surrogacy, risking social exclusion and isolation, an act justified by her concern for her own children. Social stigmatization is just one potential vulnerability that surrogate mothers are exposed to; others include health complications, failure for the surrogacy to take, non-payment, refusal of the clients to take the child, lack of control over who the prospective social parents are and a host of others.

Health complications make their appearance in another intimate labour context: nail salons. In ‘Manicuring Intimacies: Inequality and Resistance in Nail Salon Work’ Miliann Kang (2010) discusses work in nail salons in California, done predominantly by Vietnamese women. Kang’s concern is with the ways in which the specific triadic relations between employer, employee and customer in this context of intimate labour facilitate or disable labour organizing to improve the workers’ conditions of service. Almost inadvertently, halfway through the text, the issue of the workers’ health makes an appearance. One Vietnamese interviewee is reported as saying, ‘I worry most about my health here – because I don’t know how bad it is, sometimes I just feel dizzy – there’s nothing you can do’ (Kang, 2010: 220). And a worker from the Asian Health Services, discussing the limited regulation of cosmetics manufacturers, points out,

They regulate themselves – they have their own Cosmetic Industrial Review Panel … they argue that the carcinogenic material is minimal, but they are looking at just one product. There’s no study of accumulated exposure to (p.28) many products over time, and they certainly don’t look at it from the workers’ perspective of long-term chronic exposures, six to seven days a week, eight, nine, ten hours a day.

(Kang, 2010: 225)

And this in a context where cervical cancer among Vietnamese women living in California is higher than among the indigenous population (Kang, 2010: 220). Here we arrive at the question of bios or ‘human life’.

Thinking about Bios

The Greek root of bios refers to (human) life.2 Such life is the subject of all manner of formal and informal regulation (legal, medical, social, economic), and it is through the regulation of life (and by implication death) that biopower and biopolitics, as discussed by Michel Foucault, are exercised. In his 17 March 1976 lecture on biopower and biopolitics Michel Foucault (2004) talks about the rise of a new technology of power, comprised of two dimensions, which begins to take shape in the second half of the eighteenth century. This new technology relates to ‘problems of reproduction, the birth rate and … mortality rate’, as well as ‘accidents, infirmities, and various anomalies’ and ‘control over relations between the human race … and their environment’ (Foucault, 2004: 244, 245). Here it is population, rather than individual-as-body that is at stake, and life in terms of ‘taking control of life’ so as to ‘optimize a state of life’ (Foucault, 2004: 246) that is to be regularized. Foucault argues that in this process of taking control over and regularizing life two technologies or techniques3 of power effectively come together:

One technique is disciplinary; it centers on the body, produces individualizing effects, and manipulates the body as a source of forces that have to be rendered both useful and docile … [the] second technology … is centered not upon the body but upon life: a technology which brings together the mass effects characteristic of a population … protect[ing] the security of the whole from internal dangers.

(Foucault, 2004: 249)

Foucault (2004: 250) describes the former as ‘the body-organism-discipline-institutions series’, the latter as the ‘population-biological processes-regulatory mechanisms-State’. This produces what he describes as ‘the normalizing society’ in which ‘the norm of discipline and the norm of regulation intersect’ (Foucault, 2004: 253). In Foucault’s imaginary, the biopower established through disciplinization and regulation may get out of hand ‘when it becomes technologically and politically possible for man not only (p.29) to manage life but to make it proliferate, to create living matter, to build the monster, and, ultimately, to build viruses that cannot be controlled and that are universally destructive’ (Foucault, 2004: 254). Here biopower grows ‘beyond all human sovereignty’, threatening life as such, making it precarious because vulnerable to failures of disciplinization and regulation (Foucault, 2004: 254).

We might argue that this moment has arrived in contemporary culture in that humans now can create matter even if, as in the case of surrogacy, for example, they still need humans as providers of matter and, as the anthrax attacks that occurred repeatedly in 2001 in the United States showed, man can certainly build viruses that once unleashed are difficult to control and are potentially universally destructive. But this apocalyptic vision of humanly abused biopower, which is of course a common trope of science fiction, is a rather extreme version of how bios, life, might be threatened, rendered vulnerable and precarious. Foucault is in many ways right in arguing that problems with disciplinization and regulation may threaten bios. But such threats, we would argue, occur at a much more insidious and commonly overlooked manner in the dailiness of human interactions in the context of intimate labour.

When Foucault discusses biopower and biopolitics one’s sense is always of a unitary entity, not unlike the sovereignty he invokes, where institutions and states, for example, act in a particular, quasi-unitary manner that impacts on those associated with or affiliated to the institutions and states in question. There is little sense that, on the one hand, states and institutions may produce multiple, mutually contradictory forms of regulation and disciplinization and, on the other, that such disciplinization and regulation interacts with regulations and disciplinizations operating via other states and institutions that create entanglements of multiple possibilities for those who are in positions to make choices between these states and institutions or those who are driven to take particular positions in relation to these states and institutions as an effect of their circumstances. Such is the case, for example, when trans people seek gender-affirmative surgery (see Nord, 2018) and decide to have different kinds of surgery in different countries due to differential procedures in the diverse countries but also, for instance, for financial reasons. Thus one country may prescribe the need for successive surgeries with particular processes of psychosexual counselling to be undergone and mandatory sterilization versus another country offering all-in-one surgery and making no demands for sterilization. Here bios – the life of both the individual, of whole populations and of subgroups within populations – is affected in differential ways through the medico-legal regulation of how certain bodies are to be treated. However, the fact that countries differ in what exactly they prescribe and proscribe means that opportunities and (p.30) constraints arise for those able to move between such countries to make choices about their lives.

We might argue the same for people who migrate in order to take on care work in other countries either for elderly people or for children or for domestic or health environments (see Ehrenreich and Hochschild, 2003). Driven by economic opportunity and need, such people decide to move to another country to attempt to gain employment and through their earnings to improve the lives of those dependent on them and of themselves. The work they engage in requires them to work both bodily and psychosocially in the manner already described in Hochschild’s (1983) The Managed Heart through putting immaterial dimensions of themselves such as their ‘relational, emotional and cognitive faculties’ (Morini and Fumagalli, 2010: 235) to work. Cristina Morini and Andrea Fumagalli (2010: 236) describe this in terms of ‘putting life to work’, which in their thinking refers to the ‘experiential, relational, creative dimensions’ of ‘subjectivity itself’. They argue that the body is explicitly incorporated into productive mechanisms, thus resulting in ‘biolabour’ defined by ‘relational activities (relational labour); … imaginary and sense-making activities (symbolic labour); corporeal and sensuous activities (corporeal and sensorial labour); affective and caring activities (affective labour)’ (Morini and Fumagalli, 2010: 240). Morini and Fumagalli (2010: 240–1) also argue that in this biolabour, the separation between working-time and life-time, between working-place and life-place, between production and reproduction and of production, reproduction, circulation and consumption is largely overcome. Here we see the collapse of separate spheres already referred to above that characterizes intimate labour and that, we would argue, results in what we term bioprecarity.

Coming at the question of life from a Marxist analysis of labour and capitalism, Morini and Fumagalli’s concern is with rethinking the Marxist theory of value to take account of the current post-Fordist phase of labour in which, they suggest, ‘life itself [or bios] is put to work and the role of working relations is emphasized, directly incorporated within the productive activity’ (Morini and Fumagalli, 2010: 236). In this they are quite different from Foucault whose preoccupation is with governance. But they both, and Foucault previously, recognize that the management of the self and its integration into public processes that are increasingly indistinct from what was previously considered private or beyond the realm of regulation puts bios or life into a new position.

Nikolas Rose (2009) discusses this in terms of The Politics of Life Itself, and the phrase ‘life itself’ keeps recurring in these contexts to signal the preeminence of bios in the new socio-economic arrangements in which (p.31) we labour. Rose’s work brings Foucaultian preoccupations with biopower together not with biocapitalism so much as bioeconomics. His interest is in ‘contemporary biological citizenship’, the move from regarding biomedicine as the means for curing the ill body to seeing biomedicine as part of a ‘promissory culture’ that is interested in the ‘customization’ of (preventive) medical intervention in the interests of enhancing the capabilities of others (Rose, 2009: 223, 87, 20, 40). This has produced significant biomedical and pharma-industries that enable individual citizens to become so-called responsible biocitizens4 through checking, for example, via DNA tests, the likelihood of their carrying certain genetic diseases or through maintaining an optimal weight by taking diet pills or other slimming devices. Such measures signal what Rose terms ‘economies of hope’ in an ‘ethopolitics’ where biomedical self-techniques hailing the ‘self-government of the autonomous individual’ conjoin with ‘the imperatives of good government’, identified at least partly in terms of the optimization of life itself (Rose, 2009: 167, 27, 82).

However, Rose’s biocitizen, intent on maximizing his (choice of pronoun deliberate here) life chances and quality of life, operates in an attendant world in which biovalue and biocapital reside, for example, in others’ bodily tissues that can be biotechnologically separated from their bodies and transferred to others. Referencing blood and blood products, organs and ‘the elements of reproduction – eggs, sperm, and later embryos’, Rose acknowledges that there may be difficulties in ‘free[ing] [these tissues] from their marks of origin and re-utiliz[ing] them in other bodies’ (Rose, 2009: 14). He also acknowledges that organs are, or were, ‘potent and controversial objects of commodification’ (Rose, 2009: 14). But in his focus on the receivers of such mobile vital organs (vitality here referring to ‘life itself’ or ‘lively matter’) Rose obliterates those who provide them and their somatic individuality, experience and costs.5 For biovalue, as conceived here, does not come without biocosts, for instance. In his striking film Pretty Dirty Things (2003), for example, Stephen Frears explores these biocosts in his depiction of illegal organ farming from sans papier migrants who sell their kidneys and other organs for money, at risk to their own life and limbs. The enhancement of others and the optimization of their lives thus does not only constitute biovalue but also entails biocosts, and this potentially both for those who provide and those who seek to acquire biovaluable goods and services. For those seeking biovalue in the form of tissue transplants, survival and success rates may be simultaneously the most crucial biovalues and biocosts, as may be the need for life-long medication such as immuno-suppressants and their attendant risks. For those providing biovalue as goods and services other biocosts are involved and it is these, in the form of precarity, that I turn to now.

(p.32) Precarity and Bioprecarity

The term ‘precarity’ as Kathleen Millar (2017: 1) notes, though considered by some ‘a relatively recent new concept’, has de facto a long history and diverse trajectories to contemporary consciousness. She indicates that Pierre Bourdieu (1998), Guy Standing (2011) and Judith Butler (2004) are commonly cited in discussions of the term (Millar, 2017: 2) but also, that they come from very different directions. Bourdieu and Standing are concerned with labour conditions and class identity, with the ways in which the rise of temporary, part-time, casualized low-waged work within neo-liberal, globalized economies together with the erosion of social benefits and opportunities for collective bargaining have generated worker insecurity and led to the emergence of a new kind of class, the precariat who ‘liv[e] and work … in insecure jobs and conditions of life’ (Standing, 2012: 589). Although the issue of whether the precariat is a class in the classic Marxist or Weberian sense or reflects conditions of labour has been much contested (e.g. Frase, 2013), Standing’s depiction of contemporary working conditions that, some argue, are not class-specific (Kalleberg, 2009; Thorkelson, 2016), nonetheless strikes a chord across a whole range of work scenarios, particularly in north-western countries.

Butler, in contrast to Bourdieu and Standing, interprets precariousness or precarity as an ontological condition. Discussing precarious life within the contexts of US interventions in and responses to war and terrorism, Butler (2004: 146) is concerned with the ‘normative schemes of intelligibility [that] establish what will and will not be human, what will be a livable life, what will be a grievable death’. Reading precarity in terms of human vulnerability because of ‘our social existence as bodily beings who depend upon one another for shelter and sustenance and who, therefore, are at risk of statelessness, homelessness, and destitution under unjust and unequal political conditions’ (Butler cited in Puar, 2012: 170), Butler proposes an ethics that proceeds from that understanding of a shared humanity, interpreted as ‘a social condition of political life’ (cited in Puar, 2012: 170). Here the economic questions of labour and class are less prominent than an ontoethics, which seeks to revitalize contemporary frayed understandings of interdependence and politics.

The more universalized claim of precarity as ontology made by Butler is of course distinct from the notion of the precariat as a particular, albeit large, class or group of workers suffering seven kinds of insecurities (Standing, 2011: 17). The difference between these two terms is further complicated by the notion of precarization. Indeed, Isabell Lorey (201: 11–13)5 distinguishes between three dimensions of the precarious: (1) precariousness as ‘the socio-ontological dimension of lives and (p.33) bodies’; (2) precarity as ‘a category of order’ that ‘denotes the striation and distribution of precariousness in relations of inequality, the hierarchization of being-with that accompanies the process of othering’; and (3) ‘governmental precarization’ relating to ‘modes of governing’ through biopolitical subjectivation. ‘Governmental precarization thus means not only destabilization through employment, but also destabilization of the conduct of life and thus of bodies and modes of subjectivation’ (Lorey, 2015: 13). This attempt to ‘capture the relationship between precarious labour and precarious life’ (Millar, 2017: 5) is, according to Millar, particularly useful because it combines the insights of a Butlerian approach to precarity with that of political economists and labour theorists.

Such a combined approach is also useful for this volume because it is concerned with the ways in which certain forms of current intimate labour that are precarious in a variety of ways constitute, in Millar’s words, ‘affect, subjectivity, psychological interiority, and lived experience’ (2017: 5) and render those who are the providers and recipients of this labour bioprecarious. By this we mean that their lives are rendered vulnerable through the labour they provide or the labour they are the objects of, and this in often quite specific ways.

One example of this is detailed in Maria de la Luz Ibarra’s (2010) chapter ‘My Reward Is Not Money’ about female Mexican end-of-life care workers. Ibarra presents two case studies of workers who formed ‘deep alliances’ with their wards. She wants to suggest, contrary to the commonplace notion in domestic labour literature that ‘personalism on the job – close personal relations between employer and employee … allows employers to continually add tasks and exploit workers’, that personalism also highlights ‘the cultural and moral imperatives that define the job’ from the worker’s perspective (Ibarra, 2010: 18). Ibarra constructs personalized care at home in opposition to work in care homes, which her interviewees and those in other studies left because of the paucity of the care they were supposed to perform and the ways in which both they and their wards were mistreated. One might argue that this constitutes a form of ‘institutionalized bioprecarity’ where both residents and carers are placed in positions of vulnerability, physically (‘a sadistic nurse would “punish” wards by leaving them to lie naked on the floor or by putting sugar in their eyes’ (Ibarra, 2010: 121)), emotionally and professionally (Ibarra cites a protest suicide by a nurse). This is vulnerabilization at work, in every sense of that phrase, a vulnerabilization that affects every aspect of the lives of those involved and beyond. This is partly because of the collapse of certain boundaries that intimate labour frequently involves. One of Ibarra’s informants said of her care of an elderly woman: ‘I lived there in the house with her, and her son would visit about three times a year … I knew that I could ask for more money, but I never did. (p.34) The less you ask for, the more God will give you’ (Ibarra, 2010: 128). Ibarra’s informants in certain ways reject the salarization that intimate labour as labour entails in favour of God-given rewards. The mobilization of religion as a mediating instance is very evident here. Ibarra recognizes that this is ‘deeply costly to workers’ (Ibarra, 2010: 129). Ibarra describes one worker relating how her care scenario developed: ‘I took care of [my client] as if she were my mother. But her condition grew worse, and her son put me in charge of hiring other people’ (Ibarra, 2010: 128). The carer’s new role to act as employer-representative puts additional demands on her, which she meets by hiring members of her own family: ‘I didn’t want anybody to hit [my client] or yell at her, which is very common. I couldn’t just hire any person for my own peace of mind’ (Ibarra, 2010: 128). Here the carer gets drawn into questions of care way beyond her job description; identifying with her charge, her own peace of mind is at risk. A new type of substantial dependency emerges here on ‘individual persons in the work relationship’ (see Lorey, 2015: 74–5), which indexes the interdependencies that constitute the vulnerability of the human an sich in Butler’s terms and simultaneously rewrite labour relations as a personalized social process that generates insecurities and bioprecarities in both employee and employer. As another informant told Ibarra: ‘[My charge] was fearful because he always asked me, “When will you return?” I was the only person who saw him every day, and he was lonely, but he did not want to go into a nursing home. My conscience ate me up, but I could not be in two places at the same time’ (Ibarra, 2010: 126). This strain on the carer, her vulnerabilization, or what we would term the bioprecarity it exposed her to, led to her sleeping at the old man’s house, enacting her subjectivation to him. Indeed, she said: ‘From the moment I submitted to him, everything changed. I felt much more calm … I did not ask him to pay me for sleeping at his home; what I was paid was enough to send to my children’ (Ibarra, 2010: 126).

The carer’s narrative reveals the ‘intra-action’, as Karen Barad (2007) would call it, between the vulnerabilities of the cared for and those of the carer, their mutual imbrication and interdependency that manifests itself in their affectscape, which constitutes something of a closed system of interrelation at multiple levels. The effect of the carer’s submission to her charge in terms of reducing her own emotional turmoil highlights this entanglement but also goes some way towards explaining the carer’s exploitability. One issue that Ibarra only partly addresses in her text is the role that religion plays in the attitudes and behaviours of the carers she interviewed. But as the title of her piece makes clear, the carers’ line is that ‘my reward is not money’ even as they clearly need money to sustain themselves and their families. Ibarra analyses the carers’ service as arising from the ‘deep alliance’ they (p.35) form with their charges and this is clearly the case. However, that alliance is quite specific and does not necessarily extend to the wider family of the cared for; in one of her two case studies Ibarra (2010: 127) reports ‘a severe estrangement’ following the death of the man cared for, with the carer not taking part in the funeral service organized by the man’s children and not being able to share in the grieving and mourning. The carer finally got help from her church with coming to terms with his death. Here it is evident that the vulnerabilities of the carer are not confined to the immediate engagement with her charge but extend beyond that interaction to the management of her emotions after his death. Those vulnerabilities, however, are not taken into account by those who employ her to do the caring. She is left to manage them herself.

Here the problematic of the salarization of care becomes evident, with the man’s children who employed the carer treating the arrangement solely as a matter of employment, while the carer had to negotiate the immaterial dimensions of the work, her emotional investments, herself. One might argue that this is indicative of what Boris and Parreñas (2010: 11) call the ‘devaluation thesis’, where care work is devalued in its commodification and where, as in the instance just described, the demands on the carer to invest beyond the employment situation are not necessarily recognized by those employing her. The collapse of the public and the private, of paid labour and care requirements as experienced by the carer, lead to a terrain of ambiguity in which it is not clear who determines and circumscribes the meaning of the work engaged in. In this particular case, there was little relation by the carer to the carer’s employers who therefore treated the carer solely as an employee. The second carer Ibarra discusses found, in contrast to this one, that on the death of her charge, the charge’s family ‘insisted that Lupe sit in the front pew [at the funeral service] with the family’ (Ibarra, 2010: 129) and Lupe was also fully involved in other associated rites.

In many ways these two examples indicate something of the range of ways in which carers can experience their work but also the ways in which their vulnerabilities may, or may not be, accounted for. Interestingly, although Lupe was invited to participate in her charge’s funeral, Ibarra found that on asking if she would consider caring for another elderly person Lupe said: ‘I don’t know. The truth is that it hurts one a lot, when one loves’ (Ibarra, 2010: 129). The emotional costs to the carer were such as to make her question the continuation of earning her livelihood as a carer. This constitutes another form of bioprecarity since earning a livelihood is key to one’s life and the quality of one’s life.6 Bioprecarity, then, has many shapes and I shall now briefly explore these before coming to some conclusions.

(p.36) Bioprecarities

Bioprecarity as understood in this volume arises in the interaction between the disciplinary and regulatory dimensions of life as discussed by Foucault with the socio-ontological dimensions of lives and bodies as elaborated by Butler, as these manifest themselves in different kinds of precarious employment in the context of intimate labour. Here the experience of bioprecarity is distributed across the employer, employee and charge or recipient of the intimate labour, but in diverse ways and to different degrees that are situation specific. They all have to do with the relationality, sociality and interdependence that characterizes such labour arrangements and that manifest themselves as those arrangements are recognized, remunerated and taken care of in only partial ways, with those who provide the care or service often being left to carry significant burdens and bear excessive costs corporeally, psycho-emotionally and socially. This constitutes extensive forms of disempowerment and vulnerabilization within the intimate labour market. An Indian surrogate, for example, will not only have to compromise her family life (by having to leave it behind for months on end), her social standing (acting as a surrogate is often viewed as a stigma in her own community), her physical health, her emotional well-being (missing her family and mourning the giving up of the child she has carried), but she may also have no say in, or even knowledge of, the prospective parents of the child she carries, may be able to be a surrogate only once or twice (in other words, have a strictly time-limited and physically circumscribed period of making a livelihood) and may not be successful in being impregnated in which case she often earns no money at all despite having already born significant costs in relation to the possibility of surrogacy. A carer may be required to be on duty way beyond ‘normal’ working hours, for less than minimal pay, without any training for tasks that may include heavy lifting and body care and being the object of the cared-for person’s and her employer’s whims. A person seeking surgical intervention abroad, whether this be a trans patient or someone seeking cosmetic or other medical interventions, will be the object of national and transnational regulations that circumscribe her ability to decide what is appropriate for her, that make her vulnerable to cultural specificities and procedures that she may not understand and whose long-term effects she may be in no position to calculate. A relevant study carried out by Valorie Crooks et al. (2013: n.p.) found that a focus group of seven professionals ‘representing the domains of tissue banking, blood safety, health records, organ transplantation, dental care, clinical ethics and infection control’ identified ‘five dominant health and safety risks for outbound medical tourists … (1) complications; (2) specific concerns regarding organ transplantation; (3) transmission of antibiotic-resistant organisms; (4) (dis)continuity (p.37) of medical documentation; and (5) (un)informed decision-making’. These risks indicate some of the bioprecarities that arise in the context of medical tourism or cross-border medical help-seeking as we might term it for those seeking services to their bodies for medical reasons. While one might argue that the bioprecarities identified here mainly affect the help-seeker or service recipient herself, this is not the case in the context of sex tourism where, as the texts cited early on in this chapter show, those providing intimate sex labour suffer a variety of bioprecarities in the provision of their labour, ranging from humiliation and bullying to the unwanted invasion of their bodily space, violence from clients, risk of employment termination, etc. Bioprecarities then take many forms, affect both intimate labour providers and those who seek intimate labour. However, in discussions of intimate labour such bioprecarities are frequently under-addressed, producing vulnerabilities through that very fact.


The growth of intimate labour, not least transnationally through the migration of care, sex and domestic workers, but also through cross-border medical help-seeking, has produced new forms of vulnerabilities, and in particular bioprecarities, for both those engaged in such labour and those who employ it or seek to benefit from it. One reason for this is the collapse of certain boundaries (e.g. private–public) that had safe-guarding properties for those providing intimate labour. Another reason is the individualization of labour that characterizes intimate labour and that makes worker organizing for protection purposes difficult (see part III of Boris and Parreñas, 2010). A third reason that is largely undiscussed in the relevant literature is that disciplinization and regulation as well as expectations of self-management are quite differently constituted across diverse countries and cultures, and may, even within a given context, be contradictory and conflictual, thus leaving the worker in a vulnerabilized position that commonly takes bioprecaritized forms such as not being able to earn enough to guarantee a livelihood, being required to undertake tasks and work hours that go beyond reasonable expectation. Such bioprecarity is not coterminus with Butler’s notion of precarious life as stemming from a basic human condition of interdependence. This is because the bioprecarities we address here arise in contexts of manifest inequality and power imbalances where the economic power to pay (for care, for sex, for domestic labour, for example) empowers employers to make bioprecaritizing demands on their employees, and where the deep alliances that may develop between carers and charges may exercise their own pull to encourage self-exploitation by the workers.

(p.38) Those seeking intimate labour in pursuit of medical and/or reproductive goals for example may find themselves the objects of quite different bioprecaritizing scenarios, the result of a potential lack of cross-cultural understanding and know-how, for instance, or of the pressures exerted by differential regulations in diverse contexts. These scenarios raise political, economic, sociocultural, but also ethical issues, not least around what are reasonable expectations in intimate labour situations and to what extent do the labour contexts, indeed the employers, take into account the demands of intimacy made by those labour contexts. A call centre worker who spends significant amounts of time engaging with lonely clients (see Vora, 2010) when she is paid for the numbers of calls she makes and the numbers of deals she closes is as much bioprecarized (here through the threat to her livelihood and her economic survivability) as a sex worker who is asked to do things with/for clients she does not want to do. The costs to the workers as much as to service recipients are potentially high, their bioprecarity almost a given. But we have little understanding of this phenomenon as yet, not least because the issues of biovalue and biocost are often treated entirely discretely and only from one side of the equation. This volume is intended to make a first intervention in this field, to suggest the need for approaches to intimate labour that take seriously the bioprecarities involved.

(p.39) References

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(1) There is no space here to elaborate on affect and emotion but for an excellent discussion of this see Wetherell (2012).

(2) For an extended history of the term see Esposito (2008).

(3) Foucault seems to use the terms technology and technique interchangeably in this text.

(4) ‘So-called’ here denotes the fact that this responsibilization makes demands on citizens in terms of medical knowledge and self-management that may well exceed citizens’ capacity. We need only think of the very elderly here who may well be fully compos mentis and legally adult but find it difficult to make choices about medicines administered to them because of the difficulty of understanding the bio-implications of what they are asked to or encouraged to take.

(5) For an account of ‘legally’ acquired organs and their associated values and costs see the Milliman 2017 Research Report U.S. Organ And Tissue Transplant Cost Estimates And Discussion (Bentley and Phillips, 2017). See also Addley (2003).

(6) I make this point despite the fact that critics of the notion of the precariat argue that ‘pro-worker politics must move beyond the workplace … [in a] world of diminishing long-term employment’ (Frase, 2013: 13) and that notions such as a universal basic income without conditions should be considered to avoid pauperism.