Book Review: Unseen Flesh

Unseen Flesh: Gynecology and Black Queer Worth-Making in Brazil, by Nessette Falu (2023). Durham, NC: Duke University Press.

Nessette Falu’s Unseen Flesh: Gynecology and Black Queer Worth-Making in Brazil is an indispensable account of how Black lesbians experience and contest gynecologic racism. Falu’s ethnography is largely centered in a working-class neighborhood of Salvador – the capital city of the State of Bahia – where she traces the labor of Black women’s survival through the lives of Black lesbian activists and the everyday care work of families, friends, and intimate partners. Within the first pages, we meet Juliana, a Black lesbian activist who responds strongly to Falu’s focus on gynecological trauma, saying “there is a lot to think about regarding that medical experience that we don’t talk about” (2). This vignette establishes the book’s central issue, disclosing how Black lesbians suffer from widespread gynecological trauma that too often remains unspoken.

This unspoken or socially invisible trauma is the primary problematic of Unseen Flesh, one which the book interrogates by asking, implicitly, invisible to whom? The book’s replacement of “invisible” with “unseen” quietly shifts the question towards one of institutional action – who or what is being willfully concealed? “Unseen” thus conceptually hinges together two reciprocal processes: first, the homophobic misogynoir of medical systems that marginalize Black lesbians by refusing to truly “see” them; and second, the internalization of that marginalization as shame which contributes to the culture of silence Juliana underscores in the book’s first pages and prevents these women’s worth from being fully “seen.”

Further leveraging Hortense Spillers’s conception of “the flesh” (6-7), Falu makes another subtle but important shift. Rather than situating the “captive subject-position” (7) Black lesbians encounter within gynecological medicine as a product of a foundational racial ontology, the book ethnographically engages gynecologists themselves to emphasize how medical labor practices produce racial-sexual subjection. This account considers how the history of gynecology in Brazil has seeded heteronormative and eugenic assumptions into medical practice over the centuries, and how those ideas emerge in everyday tools like contemporary screening questions (88-105). Consequently, the book opens essential space for attending to the question of survival, highlighting how Black lesbian communities contest their subjection within recursive processes of “gyno-trauma” that emerge “at the social intersections of intimate violence” (7).

These conceptual shifts provide critical grounding for the book’s central idea of “worth-making,” or “the human energy expended or consumed to create pathways that sustain and claim agential living” (2). Ethnographically, worth-making persuasively balances the theoretical demands of afropessimism and afrofuturism by attending to the embodied encounter between the white-supremacist social machinery of medicine and “Black lesbians’ journeys to make and remake the embodied substance of well-being, where Black flesh and body conjoin, to define worth and worthiness despite devaluation by the world” (7). Unseen Flesh’s central feminist method of “shadowboxing fieldwork” (13) allows us to follow these journeys well beyond the gynecological clinic to scenes of Black lesbian worth-making enacted within Candomblé terreiros (the temples of an Afro-Brazilian religion, 162), activist feijoadas (feasts of “beans and assorted meats with side dishes,”119), queer film festivals (24), Black lesbian encontros (closed, often invitation-only gatherings, 131-33), anti-femicide vigílias (public vigils, 2), and even a mischievous family meal in which Falu is tricked into eating shredded stingray (43). The diversity of these ethnographic vignettes – across which Falu weaves her own experiences as a Black queer woman who has dealt with gynecological complications and worked as a physician assistant – offer an intimate portrait of Black lesbian life in Brazil, grounding worth-making as something far beyond a too-simple binary of domination and resistance. Worth-making offers new ways to imagine care work as more than acts of social maintenance, providing a sense in which it becomes a creative tool for communal survival by disrupting cycles of social trauma via their recognition and naming.

In this sense, Unseen Flesh raises critical questions about recognition. For instance, the book offers the story of Marcia who self-describes as a “sexually active lesbian virgin” (23). By refusing penetrative examinations (36) and contesting gynecology’s patriarchal privileging of reproductive sex (38), Marcia seeks care for uterine fibroids on terms consistent with her desire to be fully recognized as a homosexual woman with “erotic autonomy” (39-40) over her body. Similarly, Taina’s story (69-74) of contesting diferenciada – or the assumed racial-aesthetic ideals of feminine beauty – by wearing her hair in locks and publicly displaying Candomblé beads reflects a contested politics of recognition as she “[scans] institutional spaces” (71) for prejudicial reactions (preconceito), a strategy that many Black lesbians deploy to manage potentially hostile medical encounters. An interview with Dra. Sandra (89-94), a white woman gynecologist who has a lesbian daughter, further contextualizes these demands for recognition by discussing how gynecologists typically treat “issues of sexuality” (89) as separate from issues of anatomy and physiology, even as gynecology continues to enshrine heteronormative reproduction as the ideal health outcome (91). In this way, gynecologists contest the recognition of homosexuality by asserting it to be a “private” issue (104) irrelevant to their work.

These instances seem different than forms of recognition that have been previously considered ethnographically, including those by Audra Simpson in “The State is a Man” (2016), where “flesh” operates as a foundational ontology of exclusion; by Elizabeth Povinelli in The Cunning of Recognition (2002), where liberal inclusion is the prime mechanism of subjection; and by Erica L. Williams in Sex Tourism in Bahia (2013), where Blackness becomes recognized only to be traded as a commodity within a liberal capitalist paradigm. Unseen Flesh’s attention to the intimate politics and labor of care thus challenges us to rethink the dynamics of recognition – which, in the existing literature, have primarily been examined within large-scale political processes. As Falu asks, how might we understand recognition differently if we were to contextualize it within the everyday politics of worth-making as a necessary practice of survival against hegemonic systems, including those that underpin gynecological care?

Ultimately, the greatest strength of the book lies in its decision to refrain from depicting scenes of traumatic violence. Quietly furthering criticisms of the social suffering paradigm in anthropology, Unseen Flesh refuses to reproduce consumable pornotropic violence and instead leans into its interlocutors’ affective recollections of the embodied distress gynecological care induces: “sometimes my participants’ facial expressions were enough to convey the crass, aggressive feelings of the speculum exams they experienced” (65). This decision emerges from the queer Black feminist methods at the heart of this ethnography as well as Falu’s conception of Bem-estar Negra, or Black femme wellbeing – which “grounds the necessary nurturing and sustenance of the self” (144) within an erotic politics of healing. Here, the ethnographic act remains one of witnessing, but not as through a transparent window.

The ethnographic norms within the literature of social suffering attempted to remind people that the subjects depicted are human by showing readers their traumatic experiences. Unseen Flesh, by contrast, asks why we cannot think of our interlocutors as human from the beginning and refuse to write for, or educate an audience that will not recognize this basic truth? This is a foundational practice in Black studies – one that W. E. B. Du Bois himself articulated in Black Reconstruction (originally published in 1935) in which he writes, of a reader coming to the text with deep-seated racism, “this latter person, I am not trying to convince”; rather, “I am going to tell this story as though Negroes were ordinary human beings, realizing that this attitude will from the first seriously curtail my audience” (1998: xix).

In the context of Black lesbians’ labor to heal from the cyclical wounds of gyno-trauma propagated by the embedded racial-sexual norms of gynecology, Falu reorients medical ethnography’s long-standing relationship to the depiction of suffering through her grounding in Black studies. In centering a queer Black feminist practice of opacity and refusal, Falu offers needed revisions to our writerly methodologies by treating the intimate encounter of ethnographer and interlocutor as a sacred foundation for knowledge, one which must be cared for “to define worth and worthiness despite devaluation by the world” (7). Unseen Flesh, in this regard, is a critical text for teaching Black feminist ethnographic methods to undergraduate and graduate students alike and is a key reference for medical ethnographers studying race in gynecology and reproductive health. In light of the book’s wide-ranging applicability, Falu has undoubtedly become an important interlocutor for those scholars tracking the promising development of contemporary Black queer anthropology. 

References

W. E. B. Du Bois, Black Reconstruction in America: An Essay Toward a History of the Part Which Black Folk Played in the Attempt to Reconstruct Democracy in America, 1860-1880 (New York: The Free Press, [1935] 1998).

Elizabeth Povinelli, The Cunning of Recognition: Indigenous Alterities and the Making of Australian Multiculturalism (Durham, NC: Duke University Press, 2002).

Audra Simpson, “The State is a Man: Theresa Spence, Loretta Saunders and the Gender of Settler Sovereignty,” Theory & Event 18, no. 4 (2016).

Erica L. Williams, Sex Tourism in Bahia: Ambiguous Entanglements (Champaign, IL: University of Illinois Press, 2013).

Author Biography

Benjamin M. Slightom is Visiting Assistant Professor of Feminist and Gender Studies at the Colorado College and Postdoctoral Fellow with the Center for Religious Diversity & Public Life at the University of Colorado, Colorado Springs. His research engages Black women’s organizing movements against the nonprofit aid industry in Detroit, Michigan, USA.