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This is an extract from Canadian Broadcasting's 5-hour program, The Corruption of Christianity, which featured Ivan Illich in conversation with David Cayley. It was broadcast in 2000 and is now available in recorded form from CBC.

Ivan Illich Talks Tools, Cybernetics,...

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Illich, I. (1975). The medicalization of life. Journal Of Medical Ethics, 1(2), 73.

The Medicalization Of Life

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Updated 4 years ago

AUTHOR: IVAN ILLICH
TITLE: The Sad Loss of Gender
SOURCE: New Perspectives Quarterly 15 no3 special issue 4-8 '98

The magazine publisher is the copyright holder of this article and it is reproduced with permission. Further reproduction of this article in violation of the copyright is prohibited.
In the following comments, excerpted from a long conversation which took place at the McCormick Seminary in Chicago, we review with Illich some of the themes of Gender.
We have lost, irretrievably, a way of being human. And although there still remains, in our flesh almost, the vague presence of something which has been, I do not see how such an ephemera can be passed on to our children. Standing beyond the edge of an extraordinarily rich and varied epoch, we must now face the sad loss of gender. The epilogue of the industrial age and its chimeras may be read in this loss.
At the end of the 20th century, the modern myth of sexual equality has finally triumphed completely over the complementarity of gender in which the plurality of cultures -- distinct ways of living, dying and suffering -- was rooted. The reign of vernacular gender marked a profoundly different mode of existence than what prevails under what I call the regime of economic sex. They are male/female dualities of a very different kind: economic sex is the duality of one plus one creating a coupling of exactly the same kind; gender is the duality of two parts that make a whole unique, novel, nonduplicable.
By economic sex I mean the duality that stretches toward the illusory goal of economic, political, legal and social equality. Male and female are neutered economic agents, stripped of any quality other than the functions of consumer and worker.
By complementary gender I mean the eminently local and time-bound duality that sets off men and women under circumstances that prevent them from saying, doing, desiring or perceiving "the same thing." Together they create a whole which cannot be reduced to the sum of equal, merely interchangeable parts; a whole made of two hands, each of a different nature.
Gender implies a complementarity within the world that is fundamental and closes the world in on "us," however ambiguous or fragile this closure might be. The domains of activity inside that closure -- be it child-rearing, cooking, sewing, plowing, the use of a hammer or a pot -- have a dignity and meaning, often ritually expressed or mythologically represented, and valued solely by their contribution to the subsistence of a community.
Before industrial times, no culture lacked a gender dividing line in the use of tools, although no two cultures drew that line in exactly the same way. In many pockets of rural Europe today, tools still smell of gender. In Styria, for example, men's sickles are clean-edged for cutting; women's sickles are indented and curved, made for the gathering of stalks. Animals are also tied to gender. In one area of the upper Danube, women feed cows but never the draught animals. Farther east, women milk cows that belong to the homestead, while the herd in the pastures is milked by men.
In short, each activity is embedded in a circumscribed whole. How that embeddedness is articulated defines the novel way of life of a community, what I call the "art of living" or "art of suffering" and what is commonly referred to as culture. No one is the same, or does the same thing. Men and women complement each other; nothing which is necessary for their life in society can be done by their hand alone. Discrimination has no meaning in this context.
THE ORIGINS OF DISCRIMINATION
Once gender is disembedded from the commons, and ways of doing things are transformed into scarcity-based exchanges or tasks of production meted out as the exchange of labor for pay, discrimination arises. Of everything economics measures, women get less.
Clearly, the rise of market relations, the penetration of capitalism, monetarization and commodity dependence accelerated the abolition of gender.
I believe, however, that the demise of gender preceded the rise of capitalism, dating to the middle of the 12th century in Europe. It was in the first marriage contract that we find the origins of the notion of male/female equality in the idea of bonding equal parts in a contractual couple. Before men and women took the marriage oath before God, swearing had been completely prohibited by the Church. Henceforth, God became the cement, the witness, of a bond between two individuals broken out of the community as abstract legal entities.
This mechanization of the "thou" of the other gender ended the self-imposed limits of community and opened up the possibility of unlimited inter-marriage. Hence, the limited size of community, once imposed by gender, dissolved and the concreteness of the "we" disappeared.
That transition, in my view, was the key anthropological root of the birth of a new kind of conceptualization of human activity: society and culture as a "system" with interchangeable and substitutable parts. Also arising out of this transition was an abstract notion of the global "we," disembedded from any concrete reality and seeking the fulfillment of "needs" made scarce by a limitless domain of possibility.
By the end of the 20th century, "systems" thinking has gone so far that the main demand of the global "we" is the equal provision of the universally standard requirements for average survival -- which in its most advanced stage means biocracy: the management of human life from sperm to worm, from conception to organ harvest. All that was disembedded from a way of being in the limited community must now be managed with the result that everyone is assigned the same way of living.
FETUS AS THE CORRUPTION OF HOPE
We can see how far we've gone down the systems path by reviewing the history of the conception of the unborn.
Historically, the fetus didn't exist. It was unseen, unborn, a "not yet." Pregnancy had the same meaning in all languages: something which is there, but at the same time is not. The "not-yetness" was fundamental. When the unseen embryo developed and was born, it may have been a child, a cripple, a "molecalf" or a clump of blood.
Now, with new medical technologies, the embryo becomes a "fetus"; the "not yet" loses its mystery as we see it in the sonogram. It becomes another patient, another disconnected part of a way of being to be managed.
To me, the fetus is a symbol of the corruption of hope, just as the medicalization of dying is the corruption of agony. Hope is transformed into expectation -- the awaited results of technological intervention.
We now have a new emblem of what the future will be. Every moment of existence, since it is all encompassed by the "system," is a profaned domain open to intervention.
The final step of "systems thinking" is the elimination of time itself. With real-time computers that are never shut down, all potentiality will be subject to management, choice, selection and intervention. The future will hold no surprises because it will be part of the present. [NPQ WINTER 1990]
ADDED MATERIAL
IVAN ILLICH, the social philosopher, is author of numerous books, including The DeSchooling of Society, Medical Nemesis and Gender.
THE BIRTH PANGS OF ECONOMIC SEX
One story suffices to enliven my description of the birth pangs of economic sex: A Lutheran village in Württemberg bears witness to the reactions of men and women faced with the first imposition of genderless work.
Between 1800 and 1850, the unusual number of four dozen divorce proceedings were recorded in Württemberg. The historian David Sabean has tried to interpret the grounds given for the dissolutions, grounds unlike any adduced in earlier times. To understand what had occurred, he had to consider the economic transformation of the region during this period. A railroad was being built, tenancy was being altered, and most of the families were being forced from homesteading toward producing cash crops from fruit trees. Plum and apple orchards, together with the large-scale production of sugar beets, replaced diversified farms and kitchen gardens. Putting in and harvesting the cash crops proved to be more labor-intensive than homesteading had been. And the change occurred in one generation.
Women were suddenly forced to join men in men's work in order to earn enough family income to buy what had formerly been grown in the garden plot. They were also forced to work more and faster in the kitchen. The divorce proceedings reflect how deeply disturbing these innovations were for both men and women, how helpless each felt, how unable to understand the implications of their seemingly rational decisions. Women complained that men suddenly ordered them around at work, a totally new experience for them. No matter how much the gender-defined work of women might seem subordinated to that of men, the notion that men could direct women in the work itself had so far been unimaginable. Women resented the loss of domain. Women also complained that, while men had time after working at the rhythm of the plow to relax at the inn, they had to hurry back and forth between the hoe and the kitchen. Envy of a new kind, envy for the other gender's schedule and rhythm, thus appeared, an envy destined to remain as a central characteristic of modern life, an envy fully "justified" under the assumptions of unisex work but unthinkable under the shield of gender. The men, on the other hand, regularly complained that their women were inferior to their mothers: Formerly their diet had been rich and varied; now they had to eat spaezli day after day. The curtain closed on the epoch of broken gender and conjugal coproduction. In this microcosm, we see vividly how the new script for the industrial age was to be written. For the drama to live and move, the stage had to be peopled with heterosexual actors who were also economically neutered workers.
In most versions of the modern drama, a short intermission separates gender from sex -- the reign of gender (where the household obtains its subsistence from the apportioned tasks accomplished by the sets of non-interchangeable hands) from the regime of industrial economics (where genderless hands produce commodities in exchange for pay). During this proto-industrial intermezzo, unisex work, to be performed in the home, is forced on the household. Thus, the household is transformed into a mill where gender is ground down until only sex is left. The sufferings this crushing of gender caused both men and women have gone largely unreported. Two reasons can be offered to explain this blind spot. On the one hand, the new experience of economic misery became the glue of proletarian unity. Wage labor brought a new kind of pain that annihilated women and men. All wage laborers suffered from the very same epidemic of disorientation, loneliness and dependence. These feelings brought forth political interpreters and an elite of a new class. The diagnosis of the universal woe became the career field for new professions -- educators, physicians and other social engineers -- which thrived on the production of policies, guidance and therapies. The self-interest of both the revolutionary leader and the socialization merchant precluded any attempt to understand the gender-specific pain of loss. On the other hand, the pain of impoverishment, due to the obliteration of gender, constituted something quite different in each region; few possessed a language suitable for translating the subtle vernacular varieties of this pain of loss.
IVAN ILLICH [NPQ, Winter 1990]

The Sad Loss Of Gender

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