Cultivated co-production: Sexual health,human rights,and the revision of the ICD

Abstract

STS scholars frequently have shown how science and sociopolitical arrangements are ‘co-produced’, typically tracing how scientific actors themselves keep ‘science’ and ‘politics’ far apart. Revealing co-production is therefore deemed the work of the STS analyst, who unearths linkages that the actors might be unaware of, or might ignore or deny. By contrast, the creation of a new chapter on ‘sexual health’ in the recent revision of the International Classification of Diseases (ICD) offers a case of what might be termed ‘cultivated co-production’. Neither oblivious to the linkages between science and politics nor invested in obscuring them, the designers of the sexual health chapter sought support for their work by demonstrating, transparently, how science, ethics, and human rights might properly be aligned. The intentional and visible character of co-production in this case indicates awareness of the need to manage the contested nature of gender and sexuality at a transnational level. It also reflects two changes in the organization of medical politics and medical classification: a widespread recognition of the necessity of reaching out to lay stakeholders and advocates, and the rise of an emphasis on ‘conventions’ as the backbone of transnational biomedical consensus processes.