Re-envisioning fertility science: From J. Marion Sims’s invasive gynecology to Sophia Kleegman’s “conservative surgery” hermeneutic

Abstract

ABSTRACT This essay explores the discursive means by which ingrained trajectories of medical knowledge and practice have been re-envisioned and recalibrated in U.S. history. It takes for its case study the development of the field of fertility science and medicine, which is an outgrowth of Dr. J. Marion Sims’s notorious, nineteenth-century gynecological tradition of invasive and injurious surgeries targeting the female body. More specifically, this essay offers a critical-comparative analysis of Sims’s mid-to-late-nineteenth-century medical publications and Dr. Sophia Kleegman’s mid-twentieth-century medical publications to highlight the differing pedagogies of sight at work therein. The analysis reveals that—in contrast to the objectivist, myopic, and exclusively female-focused visual pedagogy that Sims articulated—Kleegman’s pedagogy provided disciplinary readers with a distinct, “conservative surgery” hermeneutic for scientific study and treatment that illuminated new diagnostic heuristics related to the proximity of pain, the scale of efficiency, and the boundaries of corporality and expertise. In this way, Kleegman’s articles instantiated an alternative disciplinary optics that balanced past ways of seeing with emergent, ethically calibrated modes of clinical judgement. Ultimately, this technical intervention into medical vision facilitated the realization of increasingly humane and effective practices across reproductive medicine and fertility science beginning in the mid-to-late-twentieth century.