Medical Research Participation as Citizenship: Modeling Modern Masculinity and Marriage in a Mexican Sexual Health Study

Abstract

In this article, I discuss people's use of medical research participation to perform and model modernity amid societal insecurity. I analyze data from interviews with heterosexual Mexican couples undertaken throughout men's multiyear participation in a human papillomavirus (HPV) study. I argue that through activities like willingly undergoing genital examination and involving wives in husbands' clinical visits, spouses used the study as a forum for performing ideals of modern gender and health, specifically companionate marriage and non-macho masculinities emphasizing male self-care. They also hoped to serve as role models for their children and for society at large. I discuss how specific elements of the Mexican context made fomenting social change through individual research participation seem possible: cultural narratives of the Mexican populace as a bioculturally homogenous whole;longstanding state efforts to modernize the population away from "traditional" gender and health practices; and ongoing failures of the "slippery State" to reliably provide the resources those practices required. In this context, participants framed themselves as a middle-class vanguard and experienced sexual health research as an act of citizenship through which they hoped to spur national progress despite state failures and the persistence of antimodern gender and health attitudes. [medical research, modernity, Mexico, gender, health] RESUMEN En este artículo, discuto el uso de la participación en investigación médica por individuos para representar y modelar la modernidad en medio de la inseguridad social. Analizo la información de las entrevistas con parejas heterosexuales mexicanas llevadas a cabo a lo largo de la participación de hombres en un estudio del virus del papiloma humano (VPH) durante varios años. Argumento que a través de actividades como tomar voluntariamente un examen genital e involucrar las esposas en las vistas clínicas de sus esposos, los esposos usaron el estudio como un foro para representar los ideales modernos de género y salud, especialmente el matrimonio de compañerismo y masculinidades no machistas enfatizando el autocuidado masculino. Ellos también esperaban servir como modelos para sus hijos y para la sociedad en general. Discuto cómo elementos específicos del contexto mexicano hicieron el fomentar el cambio social a través de la participación individual en investigación parecer posible: las narrativas culturales del pueblo mexicano como un todo homogéneo bioculturalmente; los esfuerzos estatales de larga data para modernizar la población alejándose de las prácticas de género y salud "tradicionales"; y fallas continuas del "estado inestable", para confiablemente proveer los recursos que esas prácticas requirieron. En este contexto, los participantes se enmarcaron a sí mismos como vanguardia de clase media y vivieron la investigación de salud sexual como un acto de ciudadanía a través de la cual esperaron estimular el progreso nacional a pesar de las fallas del

Psicoeducaciónin the land of magical thoughts: Culture and mental‐health practice in a changing Oaxaca

“…I suggest that this conflation of structural violence and cultural difference is intrinsic to the very process of modernization and the system of logic that simultaneously enables the state to fail its citizens while absolving it of responsibility, displacing it instead onto the “cultural” citizens who feel the state's failures most keenly. In the process, those citizens learn to embody behavior and forms of personhood that “facilitate governability and national advancement” (Wentzell , 653).…”

“…The “political‐ethnic ideal” of a bioculturally homogenous population has undergirded the country's “long history of national projects that cast health and hygiene”—and race—“as engines of population modernization” (Wentzell , 653). Numerous public campaigns have sought to instill “modern” notions of sexuality, gender, reproduction, domesticity, and health comportment (Carrillo ; Franco ; Laveaga Soto ; Lester ; Schell ) .…”

“…Mexican modernization projects have frequently linked the population's culture, race, and biology to notions of progress, and a variety of campaigns have directly attempted to inculcate “modern” forms of personhood, gender, health, and reproduction (Bartra ; Bliss ; Braff ; Carrillo ; Franco ; Lester ; Rivera‐Garza ; Sanders ; Smith‐Oka ; Stepan ). In the interests of fostering a cohesive national identity, many of these campaigns have promoted the ideal of a bioculturally homogenous population and have “cast unmodern behavior as the product of indigenous or lower‐class cultures while obscuring state failures to reduce the poverty and inequality that determined health opportunities” (Wentzell , 653; cf. Laveaga Soto ).…”

Medical Research Participation as “Ethical Intercorporeality”: Caring for Bio–Social Bodies in a Mexican Human Papillomavirus (HPV) Study

“…Thus, projects like Mexico's national public health services have reflected and reinforced ideas of the Mexican population as a racially homogeneous entity, which can be either improved by citizens’ modern gender and health practice or marred by individuals’ adherence to behaviors seen as problematically traditional (Bliss ; Carillo ). Elsewhere, I argue that many HIM participants framed study involvement as a citizenship practice, through which they performed and modeled self‐consciously modern gender and health behaviors in the hopes of advancing Mexican society despite weakening public institutions (Wentzell ).…”

“…They drew on middle‐class Mexican tropes of seeing one's own health practices as a way to set oneself apart from indigenous or low‐income others (Braff ). This included Cuernavacan state health workers’ tendency to blame poor and less‐educated people's failure to perform preventative health care on a “culture of ignorance” that more educated citizens could combat (Schneider ) and to frame enrollment as a way to both perform modern health and gender behavior and to model it for others (Wentzell ). Here, I investigate how they drew on the cultural notion that individuals form parts of larger bio–social wholes, stemming from cultural beliefs about the nature of the Mexican social body, in their interlinked efforts to act morally in affairs of health and gender and to care for others by caring for themselves.…”