This is a segment of my most recent research paper, “Discursive Limits: How Medical Discourse Produces Genital Herpes Stigma” at UC Berkeley.
In Archaeology of Knowledge, theorist Michel Foucault argues that, “in every society the production of discourse is at once controlled, selected, organized and redistributed” (216). Discourse, or authoritative knowledge that is produced through speech acts and writing, is never neutral. For Foucault, discourse is quite the opposite; knowledge production is inherently intertwined with power and desire, having profound affect on subjectivity, perceptions of behavior, and the construction of institutions (216). So what then are the implications of authoritative writing about and around disease? Science, and medicine in particular, speaks with finality; medicinal knowledge is perceived as unquestioned truth and concrete knowledge. However, as Foucault explains, the discipline of “medicine does not consist of all that may be truly said about disease” (223). For all that is written about disease, there is equally that which is not uttered. These omissions, or ‘prohibitions’ as Foucault calls them, illuminate the fundamental fact that, “we are not free to say just anything, that we cannot simply speak of anything when we like or where we like, not just anyone, finally, may speak of just anything” (216). Thus the experience of genital herpes is only ever authoritatively materialized through the discursive processes of science and medicine, producing a particularly stringent and clinical image of who and how the virus infects, while largely ignoring other obverse complexities of equal validity.
We can see this most clearly when we examine the CDC’s recommendations for avoiding contraction/transmission of genital herpes. They offer only this: “The surest way to avoid transmission of …genital herpes is to abstain from sexual contact, or to be in a long-term mutually monogamous relationship with a partner who has been tested and is known to be uninfected” (CDC). As an authoritative epistemological site, literally shaping the ‘reality’ of what it means to live with this condition, in a single sentence the CDC reduces a life with herpes to a sexless journey or one confined to a single body willing to ‘take the risk’. Although their recommendations are certainly viable and can work for a variety of individuals, just like suggesting one could not walk in order to avoid scraping their knee, their suggestions are difficult to live up to for the sexually active who will typically have multiple sexual partners prior to entering into a long-term relationship. By framing the ‘best’ way to avoid contraction/transmission as abstinence, rather than providing a multitude of options that acknowledge variations of sexuality, kinship formations, and sexual orientations, the CDC exemplifies Foucault’s notion of ‘prohibitions’. As he argues, “in appearance, speech may be of little account, but the prohibitions surrounding it soon reveal its links with desire and power” (216). Potential alternative lifestyle options that the CDC chooses to discursively withhold from the readership of their genital herpes webpage lead the analytical eye to observe two things: 1) according to the CDC, the herpes population should not be sexually active, or only in restrictive ways and 2) that transmission should be avoided at all costs. In gesturing towards these two finalities, the CDC condones people with genital herpes who are having sex with multiple partners, who aren’t practicing monogamy, and, with an emphasis on preventing transmission, villainize the oftentimes-unavoidable act of transmitting.
These two observations are haunted by the 19th century shift in discursive focus on sex and sexuality. In The History of Sexuality: Volume I, Foucault explains that:
Claiming to speak the truth, [science] stirred up people’s fears: to the least oscillations of sexuality, it ascribed an imaginary dynasty of evils destined to be passed on for generations; it declared the furtive customs of the timid, and the most solitary of petty manias, dangerous for the whole society; strange pleasures, it warned, would eventually result in nothing short of death (54).
In ending their information page with the foreclosure of ones ability to be sexually spontaneous, while the preceding sections simultaneously focus on “complications,” “the link between genital herpes and HIV,” and how herpes can “affect a pregnant woman and her baby,” the CDC produces an image of the condition as something certainly to be afraid of and one that will cause a kind of ‘social’ death (Gruter & Masters 150).
Like a rhetorical map, the CDC’s genital herpes webpage linguistically connotes to readers precisely why and how they can socially ostracize those living with the condition, which becomes the same source for the HSV positive community to ostracize themselves. Literary theorist, Roland Barthes, argues that connotations are “naturalized as hegemonic, that is, accepted as ‘normal’ and ‘natural’” and thus produce what he considers myths (Barker & Galasinski 5). Through this theoretical lens, we can critique, not necessarily the epidemiological information the CDC provides about genital herpes, but the way in which they utilize language to frame and produce an ostracizing myth, naturalizing herpes as a condition that is always contagious, always linked to HIV, and always complicates pregnancies, which predominantly functions in proliferating stigma.
In thinking of stigma and the notion of social death, we can call upon sociological theorist Irving Goffman when he says, “by definition of course, we believe the person with a stigma is not quite human” (Stigma 5). Within the first paragraph of the CDC’s genital herpes information page, in a short section titled, “How Common is Genital Herpes,” the CDC uses the term ‘infected’ synonymously with ‘person/persons’. In a section only consisting of 117 words, they use ‘infection/infected’ 7 times, all as the subject of the sentence or as adjectives to describe the subject, which has the linguistic affect of shifting people with genital herpes from what could be considered a ‘healthy’ person to certainly someone who isn’t ‘quite human,’ but is most decidedly and perhaps most importantly ‘infected’ (CDC). Goffman posits in his seminal book, Stigma: Notes on the Management of the Spoiled Identity that:
[Society] constructs a stigma-theory, an ideology to explain [another’s] inferiority and account for the danger he represents, sometimes rationalizing an animosity based on other differences, such as those of social class. We use specific terms such as cripple, bastard, moron in our daily discourse as a source of metaphor and imagery, typically without giving thought to the original meaning (5).
In focusing on ‘infection’ and referring to the bodies that carry the virus as ‘infected’, the CDC establishes a discourse that connotes people with genital herpes as inferior, dangerous through ‘contagiousness’, and provides a multitude of terms for society to use in their efforts to stigmatize genital herpes while naturalizing the conditions perils through their authoritative lens.