Degendering Vulnerability: Power and Emotion in Assisted Injection Interactions

• In Event: 3221 - DIY Medicine: Hacking Health, Opting Out, Self-Medicating, and Consumer Resistance

Abstract

This paper analyses power dynamics in high-risk interactions with regard to broader sociological questions about gender, emotion, and power. Using the case of assisted injection practices among those who inject drugs, it examines how a participant’s role in interactions influences their emotional states. It is based on a series of ethnographic observations and interviews in San Francisco from 2015 to 2018 with 59 people who inject drugs. In San Francisco, about 2.3% of the population inject illicit drugs. About half of these persons give or receive injection assistance. People receiving injection assistance are over twice more likely than other persons who inject drugs to be infected with HepC and HIV, and are at increased risk of venous damage, overdose, theft, and robbery. However, it is not fully understood why they are at increased risk. Much of the public health literature on assisted injection presents the practice as a gendered power dynamic of male domination and female submission. Instead, this study breaks with the association of certain traits with gender, and instead finds that emotional states such as vulnerability and controlled detachment arise from power imbalances in the interaction. I propose a model of high-risk practices in which emotional ties between recipient and provider break down in the interaction. Then, microdynamics of power lead to the recipient displaying passive vulnerability and the provider controlled detachment. Dynamics in high-risk interactions are shaped less by gender than by resources and control. Thus, differential access to power may shape cultural norms of femininity and masculinity. Understanding assisted injection power dynamics as arising in the interaction captures the risks for all recipients. This approach can be extended to analyze interactions in unregulated fields in which there is an imbalance of power or skill.

Author

• Sarah Brothers, Yale University