Book Reviews

Abstract

Annandale, E. Women’s Health and Social Change . Abingdon : Routledge , 2008 £15.99 ISBN 0-415-19087-8 (pbk) . Ellen Annandale’s book on women’s health and social change is a landmark text, and was recently shortlisted for the BSA Sociology of Health and Illness Book Prize. Annandale explores how social scientists and feminists have understood the relationship between women’s lives and their health from the eighteenth century through to the present day. As Annandale argues, ‘Health is an important vehicle for feminists to explore the ways in which women’s lives are entangled in a social economy that seemingly offers endless (liberatory) possibilities, but positions them in complex and contradictory ways that do not necessarily benefit their health’ (p.146). The key argument advanced throughout is that the old binary distinction between biological sex and social gender that used to characterise men’s and women’s lives is now combined with diversity in late modern neoliberal economies. The book begins by uncovering a rich and hitherto largely unexplored body of women’s writing on health and the body from the seventeenth to the early twentieth century. Annandale introduces the reader to relatively unknown women writers and shows how these early feminists brought an embodied health politics into being. This then leads on to an exploration of how these concerns were picked up and developed (by feminists and others) from the mid-twentieth century through to the late 1970s and early 1980s, and the fundamental crafting of a distinction between biological sex and social gender in order to counteract patriarchal conflation of women with their (inferior) biology. This distinction is a central theme throughout the book, and Annandale questions whether it is really the ‘treasure trove’ it first appeared, or whether we should regard it more as a ‘Pandora’s box’. The central body of the book provides an extensive and sophisticated overview of research on women’s health, throughout which Annandale maintains her division between two distinct traditions: ‘equality feminism’ which stressed women’s parity with men, played down biological difference in favour of social similarity and saw the route to liberation as being through equal access to positively valued social positions; and ‘difference feminism’ which emphasised women’s difference, and saw the reproductive body as both the major site of oppression and the route to liberation. In addition to providing this overview, Annandale invites us to consider the key questions of whether this divergence matters, and what its consequences have been. In the concluding chapters, Annandale returns to the key issue of whether the sex/gender distinction has been a help or a hindrance, a ‘treasure trove’ or a ‘Pandora’s box’. Her insightful analysis highlights the limitations and problems of this distinction which have increasingly come to light as research in the area has progressed. Her own persuasive argument is that we now occupy a social world in which sex and gender depend on each other for understanding just as much as they ever did, but where meaning and lived experience of biological sex and social gender, as well as the connections between, are far more fluid. In a nice piece of imagery, Annandale argues that ‘This new relationship has been conceptualised as a ‘new single system’ of patriarchal capitalism, a world where...the old shackles have been replaced by slippery silken ties that nonetheless bind’ (p.146). This is a beautifully written book, with flowing prose and some nice pieces of visual imagery that help bring the arguments expressed to life. Each of the seven chapters is well crafted as both a standalone piece of writing and as a building block for the book as a whole. The key points made and the arguments advanced in each chapter are well drawn out and summarised in concluding paragraphs, whilst the overarching threads that run throughout the book are regularly picked up and advanced, without ever becoming repetitive. This book will be equally rewarding for both those new to the area of gender and health, and those who have worked in it for some time. It represents both an excellent overview of work in this area and insightful analysis that contributes to long-running debates and suggests potentially fruitful directions for new work. In her Acknowledgements section, Annandale states that she ‘began this book more years ago than I care to remember’. In my view, the time and effort that have gone into writing this book are clear, and it has very much been worth waiting for.