Toxic Disruptions : Polycystic Ovary Syndrome in Urban India

This book provides a unique ethnographic account of women living with polycystic ovary syndrome (PCOS) in India. It examines how contaminated environments and political–economic changes render urban middle-class women in India vulnerable to PCOS, a condition which has the potential to disrupt conventional, normative feminine biographies of marriage and childbearing. The volume revolves around two main themes: how toxic landscapes, the endocrine disrupting chemicals suffusing them, and the political–economic environments related to them are linked to endocrine disorders such as PCOS; and how the biosocial disruptions caused by PCOS are both affecting women and reflective of changes in contemporary urban India. The author draws on anthropological fieldwork to investigate these connections through a fresh approach, combining a political ecological framework with perspectives from the anthropology of toxic exposures and health–environment systems. The first of its kind, this volume will be indispensable to students and researchers of anthropology, particularly medical anthropology, medical sociology, human geography, science and technology studies, medical humanities, health–environment systems, endocrine disorders, public health, and South Asian studies. This book provides a unique ethnographic account of women living with polycystic ovary syndrome (PCOS) in India. Cover 1 Half Title 2 Title Page 4 Copyright Page 5 Table of Contents 6 Acknowledgments 7 Chapter 1: Introduction: Contaminated Landscapes, Endocrine Disruption, and PCOS 10 Polycystic Ovary Syndrome 13 The Rise of Metabolic Syndrome Disorders 15 Economic Liberalization 16 Post-Liberalization Sociocultural Transformations 16 Contaminated Landscapes 20 The Field Site and Methods 22 Living amid Toxicity 25 Notes 27 Chapter 2: “A New Normal”: Health Since Economic Liberalization 29 PCOS in the Media 31 A Lay Epidemiology of PCOS 33 Defective Modernization and Stress 33 Disruption of the Natural Order 36 Balancing the Traditional and the Modern 38 The Nutrition Transition 40 “A New Normal” 42 Health Since Economic Liberalization 44 Notes 46 Chapter 3: “Hormones Play Havoc with Your Body”: Toxic Locations and PCOS 47 An Ecosocial Approach 49 Early Adolescence and a Hypercompetitive Educational Environment 50 Adolescence and Delayed Intervention 53 Early Adulthood and “Modern” Identities 54 Marriage, Motherhood, and Balancing the “Modern” with the “Indian” 56 Structural Burdens and Local Biologies 58 Toxic Locations 60 Notes 61 Chapter 4: “Health Is No More a Priority”: PCOS and Clinical Encounters 62 Diagnostic Itineraries 63 Dermatologists 64 Gynecologists 66 Therapeutic Itineraries 67 Dermatologists 68 Gynecologists 68 Endocrinologists 69 Nutritionists and Dietitians 70 Homeopaths 71 Vaidya 72 Practitioners’ Perspectives on PCOS 73 Dietary Shifts 74 Lack of Routine 76 Stress 77 Pollution, Contamination, and Adulteration 78 Medical Objectivity and Medical Subjectivity 79 Medical Individualism 81 The Clinical Encounter and Barriers to Management 84 Clinical Encounters with PCOS 88 Notes 89 Chapter 5: “When You Are 17 or 18, It Doesn’t Bother You”: Living with PCOS 91 PCOS and Future Health Risks 92 PCOS and Presentability 94 PCOS and Subfertility 98 The Materiality of the Body 100 The Plastic Body 101 Medical Technology and Medicalized Possibilities 107 Embodied Subjectivities and Lived Experiences of PCOS 109 Notes 111 Chapter 6: “Kids Will Be a Bonus”: PCOS and Intimate Modernities 112 “It Doesn't Really Bother You” 113 Negotiating Subfertility 115 The Turn to Companionate Marriage 118 Pragmatism, Reproduction, and Companionate Marriage 122 “Supportive” Partners 125 Fertility, Gender Norms, and Middle-Class Distinction Projects 127 PCOS, Class, and Intimate Modernities 129 Notes 131 Chapter 7: Conclusion: Toxic Disruptions 132 Toxicity, Gender Nonconformity, and PCOS 133 The Intoxication of Toxic Locations 135 Harm Reduction 136 Toxicity and Uncertainty 137 PCOS and Toxic Worlding 138 Note 141 Bibliography 142 Index 163 central,obesity;,childbearing;,chronic,health,problems;,contaminated,environments;,contemporary,urban,india;,coronary,heart,disease;,economic,liberalization;,endocrine-disrupting,chemicals;,intimate,modernities;,metabolic,syndrome;,miscarriage;,political-economic,changes;,polycystic,ovary,syndrome;,toxic,disruptions;,type,II,diabetes;,urban,middle-class,women central obesity,childbearing,chronic health problems,contaminated environments,contemporary urban india,coronary heart disease,economic liberalization,endocrine-disrupting chemicals,intimate modernities,metabolic syndrome,miscarriage,political-economic changes,polycystic ovary syndrome,toxic disruptions,type II diabetes,urban middle-class women