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Remaking Biomedical Sexualities: Health Technologies and the Governance of HIV in the United States

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Remaking Biomedical Sexualities: Health Technologies and the Governance of HIV in the United States Remaking Biomedical Sexualities: Health Technologies and the Governance of HIV in the United States by Stephen Molldrem A dissertation submitted in partial fulfillment of the requirements for the degree of Doctor of Philosophy (American Culture) in the University of Michigan 2019 Doctoral Committee: Professor Alexandra Minna Stern, Chair Associate Professor John Cheney-Lippold Professor David M. Halperin Associate Professor Gayle S. Rubin Stephen Molldrem [email protected] ORCID iD: 0000-0002-1907-8081 © Stephen Molldrem 2019 Dedication To my mother, Beth Lipham, “my best person ever,” whose belief in and support for me has made my life possible; to Alex and David, who have nurtured me in my intellectual development unwaveringly, despite my many shortcomings; and to the memories of Scott O’Hara (d. 1998) and my grandfather, Professor James M. Lipham (d. 1986), both of whom I wish I’d had the chance to know. – – – – – Clams open on the table, lambs are eaten by worms on the plain. The motion of change is beautiful, as well as form called in and out of being. -Allen Ginsberg, excerpt from “The Terms in Which I Think of Reality,” Spring 1950 The weight of the earth is about things in captivity: animals and people and all that surrounds us. -David Wojnarowicz, tape-recorded journal entry, November 1988 ii Acknowledgements I am extremely fortunate to have had a huge amount of support from family, friends, faculty, mentors, comrades, colleagues, and institutions during my seven years as a PhD student at the University of Michigan in the Department of American Culture, fully four of which were spent on this dissertation project and over two of which were spent in the field. I must first and foremost thank my mother, Beth Lipham, who has been my primary source of support for my entire life. Through many moves, periods of ups and downs, health events, job opportunities, and changes in life circumstances, she has been there for me, providing an emotional and material foundation so that I could succeed. In so many ways, I owe my life to her. It is a privilege to be her son. I also extend my gratitude to my father, David Molldrem, who has been especially supportive during the final years of my doctoral process. My mother’s partner, Dale Baich, and his family in Cleveland have been like family to me and mom over the last several years. I look forward to many more Christmases in Cleveland, and thank Colleen Cunningham particularly. Peter Hall and Trish Martinez will remain chosen family for life – I cherish my relationships with them, and thank my mom for welcoming me into her friendships with them. My advisor and chair, Alexandra Minna Stern, has been a model mentor and guide. I will be forever grateful for her patience, critiques, and support. Her example is one I aspire to emulate. This is particularly true regarding her work as a public, engaged scholar with a broad portfolio of research interests, collaborative projects, and robust networks spanning academia and the worlds of advocacy and policymaking. Alex’s ability to leverage her knowledge and iii skills to support students, causes, and organizations with shared values and commitments – along with her intentional work to translate her research into policy outcomes and other forms of empowerment for the communities she partners with – is unparalleled. Alex has taught me, through deed and word, that one can act with unyielding conviction while also recognizing that the form of a statement is often as important as its conceptual content, that being inviting with one’s speech is usually a more effective strategy for advancing one’s positon than drawing bright metaphorical lines in the sand or planting discursive stakes in the ground, and that the ability to be thoughtful, considered, and even-handed (rather than reactive) is one of the greatest attributes of a leader and likely the greatest privilege of being an academic. It has been an honor to pursue advanced study under the tutelage of David M. Halperin, who I also thank for his patience, support, and most of all for his immense, voluminous, and incisive feedback on my work during the last seven years. I was lent a copy of David’s book Saint Foucault: Toward a Gay Hagiography by an undergraduate professor during winter break of my senior year during the 2010-2011 academic year. I devoured the text. Saint Foucault, along with a several other essays and books that I read during that period from the canon of queer and feminist theory, played a significant role in reshaping the course of my life. When I was applying to graduate school, David was kind enough to both take a phone call from me and to meet with me in person when I visited Ann Arbor. His “Late Foucault” seminar during my first semester at Michigan was the beginning of a series of ongoing conversations that have been among the most enriching of my life. David’s relentless, meticulous, and appreciative comments on my writing – and on my writing style – have improved my scholarship immensely. David’s admonitions to write without recourse to jargon, to “be good at your job,” to “earn your attitude” (which he imparted to me by way of ACT UP Boston), and to be one’s own harshest critic have iv all given me a greater appreciation for the possibilities of knowledge-production and of the stakes of “getting it right.” It is difficult for me to imagine living in a world without the intellectual, political, and cultural contributions of Gayle Rubin. It has been a tremendous gift to learn from Gayle, especially in her “Sexological Theory” and “Readings in Sadomasochism, Fetishism, and Leather” graduate seminars and during conversations over the phone and in office hours. Just as her scholarship has done for so many other people (including for me as an undergraduate and aspiring queer theorist and sex radical), studying under Gayle has given me an abiding appreciation for the politics of sexuality and the ongoing need to conceptualize sexual politics in their specific and irreducible dimensions. Gayle has also helped me develop an acute awareness of the politics of sexual knowledge and of the material consequences of particular regimes of sexual knowledge being given institutional legitimacy in universities, medical schools, learned societies, the law, social movements, and other institutions to the exclusion of others. These are lessons that I will continue to wrestle with and re-learn as the terrain of sexual politics transforms as I age, and as I continue to engage in struggles over sexuality, LGBTQ identity, and HIV/AIDS as an academic, an activist, and a Leatherman. The challenge of grappling with the theory of benign sexual variation and recognizing the value of constantly attending to the particularity of sexual politics are ones that I carry with me in my daily life. They are sources of abiding strength, resilience, and curiosity – and for that I largely have Gayle to thank. I also owe my commitment to empirical inquiry to Gayle. There are so many reasons for all of us to be thankful for Gayle Rubin. John Cheney-Lippold was my assigned advisor in my first year of graduate school and was supportive throughout my time at Michigan. I went through my qualifying exams and v prospectus-writing process as he worked his way through the tenure process. The chance to teach as a Graduate Student Instructor in his “Digital Studies” course helped me develop my own pedagogical disposition and approach to teaching about digital topics. I have come to deeply appreciate his commitment to individual autonomy and to taking things in stride while also demanding rigorous argumentation, empirically grounded claims, and no-frills theorizing that is accompanied by a deep appreciation for the power of creativity and playfulness. I admire the understated strength of his evident convictions and his Deleuzian bent. I owe a special thanks to Kristin Hass, who was Director of Graduate Studies in the Department of American Culture for my first several years in the program, and to Anthony Mora, who was Associate Chair for much of my time as a graduate student. I also thank Stephen Berrey and Julie Ellison, who were Directors of Graduate Studies during my final years in the program. I also owe a huge debt of gratitude to the administrative staff of the Department of American Culture, particularly to Marlene Moore, who was the Graduate Coordinator for my entire time in the program, and to Judy Gray, the Chief Administrator of the department. This dissertation is the culmination of seven years of work as a PhD student. However, it is also the result of a life, career, and undergraduate education which led me to choose to pursue graduate studies. From 2005-2012, I worked in a variety of roles focused on communications, research, and strategy in public affairs. It has taken me nearly the entire duration of my time as a doctoral student to recognize that my prior career in public affairs also deeply informs my approach to research, how I conceptualize data as an object of analysis, and my views on power relations and “the political.” For these experiences, I especially thank Joe Yuhas, Gary Kaasa, Pamala Milton Doan, Ruben Gallego, Alejandro Chavez, Selena Shilad, and Matt Hager. vi I have many people to thank from my undergraduate years. In a non-trivial way, the groundwork for this dissertation started to be laid when I composed my undergraduate special honors thesis in Political Communication at the George Washington University School of Media and Public Affairs during the 2010-2011 academic year. Through that research, I became intimately familiar with the myriad LGBTQ advocacy organizations that exist in Washington and their relationship to each other, the Democratic Party, and the legislative and administrative branches of the federal government.
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