the marketization of identity politics

Sociology47(5) 1011 –1025

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The Marketization of Identity Politics

Catherine BlissUniversity of California, San Francisco, USA

AbstractSociology has begun to question how new genetic sciences affect older ways of constructing and contesting social identity, including forms of identity politics that have brought women and minorities significant gains. This article presents US debates on genetics, identity politics, and race in order to theorize emergent transformations in light of the genomic revolution. Examining recent developments in the realms of pharmaceuticals and ancestry estimation, I argue that traditional forms of identity politics are still actively at work, though they are being marketized in novel ways. This article combines theories of racialization and medicalization to detail how genomics ushers in a subtle new version of identity politics: a pharmaceuticalized citizenship wherein health rights and political participation are co-envisioned in individualistic molecular terms.

Keywordsidentity politics, genetics, pharmaceuticals, race

In March 2011, a student blogger at the Harvard Political Review warned fellow mem-bers of the genome generation that the availability of new DNA ancestry tests was pro-moting a biological form of racial identity politics:

The good news: it won’t have anything to do with race-baiting demagogues like Al Sharpton and David Duke. The bad news: it’ll be the objective, hard result of new findings in human population genetics that speak revisionist truth to the foundational myths of nations and individuals alike. (Lipson, 2011)

The blogger went on to argue that claims to the political racial identities of yore were long gone, since the genomic field that spawned the burgeoning industry of DNA tests was not engaged with social aspects of race. As he hastened to warn that the hard evidence of human variation genomics could provide xenophobes with a powerful molecular justification for

Corresponding author:Catherine Bliss, University of California, UCSF, 333 California Street, San Francisco, CA 94118, USA.Email: [email protected]

495604 SOC47510.1177/0038038513495604SociologyBliss2013

Article

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their prejudices, the blogger simultaneously celebrated contemporary bioscience for leaving behind an identity politics based on subjective belief, memory, and overt politicization. Signaling ongoing debates about the potential for science to create new racisms, but also broader desires for a world beyond identity politics, he predicted a complete overhaul of race and identity as we know it.

Studies of the relationship between new genetic sciences and society have indeed shown that identity and its politics are changing rapidly (Bliss, 2012; Clarke et al., 2010; Epstein, 2007). Identity politics is a US-based concept, arising from the black and femi-nist movements’ struggles for equal rights and opportunities, and the resulting affirma-tive action policies. The question of how identities are founded and who can claim membership in which groups has been a central theme in this discussion. This article discusses two concurrent developments, the marketization of genetic tests for racial identity and ancestry and the medicalization of race through drugs approved by the Federal Drug Administration (FDA) for use only in members of a specific race. The conclusion is that the biologization of race, which occurred through these developments in the past decade, undermines and disintegrates the inclusive and choice-based founda-tions of identity politics that had developed in the second half of the 20th century.

In 1996 Paul Rabinow argued that the management of personal health in terms of everyday risks would lead individuals to form new social groups based on one’s biologi-cal profile instead of political ties. Yet, others have found more recently that traditional identity politics has deeply shaped the genomic turn toward race (Bliss, 2012; Epstein, 2007; Hauskeller, 2006). Around the world, patient advocacy groups have fought for collective awareness, health rights, and resources for diseases shown to affect specific identity-based groups, such as blacks and Jews (Novas and Rose, 2004; Rose, 2007). In the United States, lay activists and policymakers have waged a politics of identity in Congress to engender minority inclusion across the emerging biosciences, inspiring a resurgence of research on race (El Haj, 2007; Epstein, 2007). These events imply that genetic sciences appropriate and study social facts such as race at the behest of laypeople and their identity politics, which they then reaffirm in genetic research and development (Bostanci, 2011; Duster, 2004; Reardon, 2005).

This article addresses the conflicted entanglements of genetic testing technologies and pharmaceuticals in the USA with identity politics, as they have brought minority communities gains whilst undermining previous ways of group formation. Opening with a discussion of previous research on identity and identity politics, and the persistence of identity politics in the American political mainstream, I next present recent develop-ments in racial identity politics in the pharmaceutical and biotechnology industries. Analysis of the influence of the drug BiDil (a cardiovascular disease drug licensed for prescription to black patients only) on long-standing American debates about racial iden-tity will demonstrate how DNA innovations provide new avenues for traditional civil rights activism. At the same time, it will show that identity politics understood as social justice struggles, including Affirmative Action petitions and tribal claims-making, are both individualized and essentialized in this process. The analysis illuminates the ways that companies, who are interested in maintaining a genetic version of solidarity, recreate the terms for group construction. As their clients adopt new therapies and technologies to fight for rights and resources, people who formerly defined their identities in terms of

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collective political experiences and oppression give up authority to these technologies, experts, and new market entities. Marketization of racialized drugs and genetic testing for the relevant racial identity thus distort identity politics in ways that redirect it from an inclusive political group empowerment to a personal negotiation base for social status.

Identity Politics Then and Now

Identity politics is a form of political activity based on the collective experiences and memories of injustices affecting identity-based social groups (Bernstein, 2005; Brown, 1995). Politicization along the lines of identity has afforded women and minorities social recognition and opportunities to change negative stereotypes (Polleta and Jasper, 2001; Snow and McAdam, 2000). Activists have thus conducted grassroots and electoral cam-paigns that ‘frame’ identities in ways that expand their constituencies and distinguish insiders from outsiders (Benford and Snow, 2000). Identity-based groups have also artic-ulated common causes, and pointed to the intersectionality between race, gender, and sexuality, in efforts to draw attention to shared mechanisms and consequences of oppres-sion (Crenshaw, 1995).

A defining factor of identity politics is the production of a shared sense of groupness (Brubaker and Cooper, 2000). Groupness consolidates around obligatory membership, imposed by ascription and de facto policies such as the one-drop rule – the idea that one iota of African ancestry classifies an individual as black and only black. Groupness also forms around the embodiment and enactment of commonsense classifications. As schol-arship on race has shown, embodiment makes the most highly politicized identity-based constructs of human experience ‘“common sense” – a way of comprehending, explain-ing, and acting in the world’ (Omi and Winant, 1994: 60). Individuals perceive and expe-rience the world as racially real, because racial ideas condition the memories they have of prior experiences (Daynes and Lee, 2008). The racialized social spaces individuals inhabit impose specific frameworks for constructing the self and perceiving the world (Wacquant, 2004; Wade, 2004), or ways for ‘living as’ specific categorizations according to shared norms of group membership (Appiah, 2005; Jenkins, 1997). Despite the sem-blance of essential groupness, scholars recognize that US racial minorities often strategi-cally promote groupness without a biological assumption of racial kinds (Omi and Winant, 1994). They thus distinguish between activism that draws on an uncritical bio-logical essentialism and a ‘strategic’ essentialism that tactically draws on political convictions.

At the turn of the 21st century, identity politics in the USA experienced new contesta-tions over what qualities could serve as a core basis for groupness (Winant, 2006). Unlike other national contexts, where territory, colonialism, and empire have prevailed over identity struggles (Hinterberger, 2012; Nash, 2008; Sommer, 2012; Wade, 2007), contes-tations over the line between whites and blacks, and the meaning of whiteness in a broader sense, have framed debates. Critics deemed identity politics ‘reverse racism’, and waged war on the merits of Affirmative Action, while supporters worked to reveal the diversity and inequality within identity-based groups (Lloyd, 2005). Research on race, gender, and sexuality-based identity politics revealed that political constructions had often been based on essentialist scientific and sociopolitical definitions (Bernasconi


and Lott, 2000; Fausto-Sterling, 2004; Gilroy, 2000). Research also demonstrated that government officials had conceived the very administrative taxonomies (e.g. US Directive No. 15 or Brazilian Census) that were being reclaimed and repurposed by racial advocates for political organizing (Yanow, 2003), with essentialist biological dis-courses in mind (Nobles, 2000). Scholars thus theorized alternative postmodern and post-structural modes of politics, arguing for group-based forms of struggle that would represent multifaceted, in-process identities amenable to broad-based coalition politics (Mandel, 2010).

Still, identity as a political framework for mobilization has remained important to mainstream American politics, as can be seen in recent developments in voting debates. In the 2012 elections, racial identity politics was an especially hot topic for political analysts. Reporters questioned whether it was the Democrats or Republicans who were losing ground due to identity politics (Douthat, 2012; Hayes, 2012). Conservative pun-dits charged liberals with supporting minority candidates simply because of their racial affiliations (Taranto, 2012), while liberal pundits countered that it was conservatives who were obsessed with racial offenses committed against whites (Kilgore, 2012; Hayes, 2012). Following Barack Obama’s re-election, all agreed that identity politics was a game-changer in the elections, and that articulations of collective victimhood, authentic-ity, and conflicting interests revealed that America was anything but ‘postracial’ (Goodwin, 2012; Younge, 2010). Although – in the wake of a successful multiracial movement, a growing presence of Latinos, and scientific statements against race – racial categories have blurred (Hochschild et al., 2012; Roth, 2012), political campaigns still heavily rely on racial framing (Bailey, 2009; Harvey-Wingfield and Feagin, 2012).

Identity politics perseveres, in part, because it has dovetailed with the burgeoning health social movements that have fought health inequality and biomedical injustice into the 21st century (Frickel, 2004; Nelson, 2011; Reardon, 2009). Epstein (1996, 2007) has shown that, as policymakers waged their own identity politics in their shaping of a policy framework that would extend health rights and resources to women, children, and racial minorities, these politics became a driving force of medicalization, or the amplification of biomedicine’s scope. Public representatives, who identified with dominant political frames such as minority inclusion and racial self-determination, created political incen-tives for specific lines of scientific research into race (also see Bliss, 2014; Reardon, 2005). Studies of pharmaceuticalization – ‘the process by which social, behavioural or bodily conditions are treated or deemed to be in need of treatment, with medical drugs by doctors or patients’ (Abraham, 2010: 100) – have also shown that identity politics is reconstituted through the dominant therapies and diagnostic technologies marketed in a given social and historical context (Biehl, 2007). Private companies, many of whom partner with public health agencies, have equally attuned their research and development toward identity-based medicine (Roberts, 2011). The final result has been a public sphere wherein race, gender, and sexuality are redefined as DNA-based entities, and individu-als’ everyday identities are cast with a genomic imprimatur (Montoya, 2011; Nelson, 2008).

As companies capitalize on race-based identity formations, and seize authority from traditional identity-politics champions through technical means to assign membership (Almeling, 2007; Franklin, 2007; Fullwiley, 2008; Mamo, 2010), a market-based set of

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actors unconcerned with politics remakes identity in a process previously enacted under the logic of politics (Fortier, 2012; Lindee, 2008; Panofsky, 2009). In the process, this new form of authority reinforces the most heretofore visible classifications of human difference: racial categories (Bostanci, 2011; Duster, 2004). The medicalization of race, through the genetic pharmaceuticalization of racial identity, is thus an individualizing marketization of identity politics.

Methods

The reported research is part of a larger ethnography of changing meanings of race and identity in the genomic age (see Bliss, 2012). The study consisted of interviews and observation of leading population genomicists, other experts, and policymakers, and sys-tematic analysis of scientific debates over the meaning of race, human variation, and ancestry. To this end, I examined a discursive archive of over 1000 articles on genomics and race, published from the years 1986 to 2013, that I collected using individual Boolean searches on rac* and gene* or geno* in the over 3000 unique scientific journals in Stanford University’s SULAIR/Lane Medical Library, New York University, and Brown University electronic databases. The documents analyzed in the following section repre-sent a select subset of pharmaceutical and biotechnological events taking place in the years following the publication of the draft map of the human genome.

Justice by Racialized Medicine – the Drug Bidil

Pharmacogenomics, the pharmaceuticals branch that investigates the genomics of drug response, emerged at a time when biomedicine was bringing race into the construction of study protocols and ethical debates. Throughout the early 1990s, the US Department of Health and Human Services and the UK Department of Health had been ramping up efforts to create policies mandating the participation of racial minorities in clinical trials. As the Human Genome Project and its private sector correlates devised the first methods for sequencing variation in drug response mid-decade, the US FDA released its most stringent policy yet: the Demographic Rule. The Demographic Rule required the meas-urement of drug dosage and efficacy by race:

(1) Different subgroups of the population may respond differently to a specific drug product and (2) although the effort should be made to look for differences in effectiveness and adverse reactions among such subgroups that effort is not being made consistently. (FDA 1998)

This policy translated health justice and national civil rights into distinct genetic terms.While, in clinical trial reports, race was already a common feature, in genomic publi-

cations, talk of racial health disparities and their pharmacogenomic roots erupted (see Phillips et al., 2001; Xie et al., 2001). The first industry-based companies rallied to the cause. As Genaissance Pharmaceuticals CEO Gualberto Ruaño reasoned, drugmakers could target the racial groups known to benefit from a drug. He argued: ‘Efficacy could be proven in small cohorts of a few hundred patients compared to 3,000 or 5,000 as we do now’ (Weiss, 2000). Race-specific clinical trials were conceived as a simultaneous


solution to research inefficiency and the institutionalized discrimination that prevented racial minorities full access to research and therapies.

Illustrative of the market-based transformations in identity politics that ensued is the emergence of the first race-based drug: BiDil (cf. Kahn, 2012). On 23 July 2005, the US FDA approved the fixed-dose combination of a generic antihypertensive and vasodilator solely for use in people of African descent, after a blacks-only randomized clinical trial demonstrated a 43 percent relative one-year mortality decrease in their research subjects (Taylor et al., 2004). Although the separate generic drugs that make up BiDil were known to work for all populations, the fixed-dose compound only showed results in black study participants. Drugmakers attemtped to salvage the com-pound by reapplying for a race-specific patent and FDA approval to conduct a final placebo-controlled trial in persons of self-reported African ancestry. Although this study was not based on genetic analyses of ancestry or drug response markers, trial scientists attributed the drug’s success to a unique black pathophysiology. In the events leading up to its release, we can see the way drugmakers framed their products as a tool in the traditional identity-based struggle for minority groups’ rights to equal health care and inclusion in biomedical research, shifting the terms of that struggle toward a never before seen pharmaceuticalized way of defining citizenship in terms of individ-ual access to race-specific medicine.

As early as 2001, BiDil’s makers were seen using post-hoc racial analyses to pave the way for race-specific pharmacogenomic clinical trials (Exner et al., 2001; Yancy et al., 2001). The scientific community followed suit in interpreting its findings of dif-ferential racial outcomes as a sign of some underlying genetic variation by race. For example, 2001 study results, which appeared in the New England Journal of Medicine, were joined by two editorials that debated the merits of racial pharmacogenomics (Schwartz, 2001; Wood, 2001). Although these editors did not agree with one another, they joined the study’s scientists in calling for more pharmacogenomics research into minority health and a proactive inclusion of minorities in health sciences and biomedi-cine. The inaugural issue of the Pharmacogenomics Journal (2001) also hosted a debate over race-based medicine wherein scientists agreed that a concerted inclusion-ary program would best protect the interests of racial minorities in gaining access to genomic therapies.

At this early stage in BiDil’s development, its makers garnered the support of the leading African American advocacy groups, such as the NAACP, National Medical Association, and the Association of Black Cardiologists, to conduct a ‘blacks only’ clini-cal trial. Jay Cohn, BiDil’s principal scientist and patent-holder, framed the drug as an identity-based issue:

Here we have the black community accepting the concept that African Americans need to be studied as a group, and then we have the science community claiming that race is dead … It seems to me absolutely ludicrous to suggest that this prominent characteristic that we all recognize when we look at people should not be looked at. (Stolberg, 2001)

Cohn framed BiDil as a solution to the race-blindness that black advocates had been arguing all along was the root of contemporary racism.

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Though many in the wider genetics community openly criticized the idea that race was a valid proxy for genetic variation (Collins and Mansoura, 2001), leading genome mappers were then working toward the launch of a global genome project stratified by race, the International HapMap Project, and another project focused entirely on African American genomes (Goldstein and Weiss, 2003). Like Cohn, the International HapMap Project’s Methods Group Chair Eric Lander argued:

We must make sure the information is not used to stigmatize populations. But we have an affirmative responsibility to ensure that what is learned will be useful for all populations. If we shy away and don’t record the data for certain populations, we can’t be sure to serve those populations medically. (Wade, 2002)

Race-aware research and clinical trial protocols were lauded as the only way to ensure equal opportunity for racial minorities.

Chief of the African American Diversity Project, Charles Rotimi, similarly framed the main purpose of his prospective biobank as extending cutting edge, personalized medicine to African Americans: ‘If you want your clothes to fit, you’d better go to the tailor to be measured’ (Goldstein and Weiss, 2003: A6). The project’s leaders claimed that the race-specific biobank would be the first project that would study and seek therapeutic solutions to the genomic health effects of racism. America’s leading African American medical associations endorsed this approach, arguing that genomics was a social good to which racial minorities deserved access. Although this latter pro-ject did not ultimately garner the funding it needed, its pharmaceuticalized encourage-ment of an identity-based health movement became a norm in pharmacogenomics. Likewise, a commodified version of racial justice took hold across the biosciences in which researchers and healthcare professionals re-envisioned their job as one of offer-ing biologized notions of race, and their medical correlates, as political weapons for identity-based groups.

Pharmaceutical Citizenship

Following BiDil’s approval, in 2005, there has been an upsurge of support from US fund-ing and regulatory agencies, health justice groups, and community representatives for race-based medicine. For example, the American College of Medical Genetics and the US FDA have called for the testing of drug response by race in blockbusters, or drugs that generate over $1 billion in revenue per year. A representative of the National Minority Health Month Foundation has argued:

Underrepresentation of African Americans in clinical studies might partially explain the development of a standard treatment for heart failure that has proved to be less effective for them … Race may be the coarsest of discriminators, but it now has proven life-saving potential for heart-failure patients. The evidence that convinced the FDA predicts a dramatic increase in black patients’ survival rate. (Puckrein, 2006: 371–2)

These organizations recommend racial analysis ‘to perform a sort of economic triage to focus on those for whom the test is most likely to produce a useful result’ (Kahn, 2009:


82; also see Aspinall, this issue). Framing race-based medicine as a necessary shortcut to leveling the playing field, they encourage the fight for rights and resources through a pharmacogenomics prism.

Identity-based organizations have continued to sponsor the production and dissemi-nation of other race-based therapeutics, becoming the political cheerleaders for drugs such as Bystolic, a beta-blocker designed for hypertension therapy in people of African descent. Since bringing Bystolic to market, Forest Pharmaceuticals has been approved for race-specific trials in Mexican Americans and has subsequently filed for race-spe-cific patents (cf. Kahn, 2009). Other companies, such as AutoGenomics and Pharmigene, offer minority-targeted genetic tests for drug response variants that con-fer receptivity to blockbusters such as Bristol-Myers Squibb’s blood thinners Warfarin and Plavix. Of Bystolic, president of the Association of Black Cardiologists, Paul Underwood, has told the press: ‘We’re excited to add another therapeutic tool to the armamentarium in the treatment of high blood pressure in African-Americans’ (British Cardiovascular Society, 2012). His association and other minority advocacy groups have petitioned insurance companies to place race-based medicine on their formularies and targeted minority physicians to prescribe them. Bioethics advocates focused on health in the Global South, pointing to the growing ‘genomic divide’, have also called for pharmaceutical companies to create race-based medicine for the developing world and to examine whether their unsuccessful chemical combinations can be ‘resusci-tated’ for underserved populations (Daar and Singer, 2005; also cf. Benjamin, 2009; Whitmarsh, 2008).

Advocates have also attempted to raise public support for using pharmaceuticals as the newest incarnation of identity politics. For example, in a series of recent public broadcasts, African American studies scholar and co-editor of the interdisciplinary identity-politics volume Identities, Henry Louis Gates, Jr. has made black-targeted research and drug development synonymous with equality for blacks. In 2006, Gates launched a two-part mini-series that mapped the genealogies of famous African American celebrities. African American Lives presented the history of the black expe-rience through individual ancestral lineages, with a distinct focus on genetic heritage. One year later, he launched the recreational genomics company AfricanDNA, and began work on a prime time celebrity genomics television show, Faces of America. In 2010, he became a board member of AesRx, a pharmacogenomics company dedicated to finding a race-based therapy for sickle cell anemia. Gates has consistently argued for blacks to be at the forefront of personalized medicine, and has modeled his com-mitment to African American genomics by offering himself as the first African American to have his whole genome sequenced.

These efforts show that pharmaceutical advances are being accepted as solutions to the social ills that American identity-based groups face. Companies provide new angles for identity-based health justice struggles just as race-based advocacy groups and medi-cal organizations appropriate pharmaceuticals for their ‘armamentarium’. The state and its public health agencies are still a filter and site for identity-based struggles, yet advo-cates approach them as gatekeepers of pharmaceutical resources. Concerns with broader environmental and social factors of racial inequality are replaced with drug-seeking peti-tions for individual members of a race affected by a disease.

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A New Groupness

As the recombinant DNA revolution that spawned genome projects and a burgeoning biotech market has given way to whole-genome sequencing, personalized medicine, and a slew of personal genetic services (Garvey, 2010), the success of BiDil and other race-based therapies and technologies has also advanced a genetic model for construct-ing groupness and identity in the general public (cf. Hauskeller, 2004). As part of the development of race-based therapies and diagnostics, companies have produced an array of ancestry estimation techniques that permit the classification of patients and clients. For example, the pharmacogenomics firm DNAPrint Genomics developed a system of reporting genomic data to customers based on their affiliation with a singular continental ancestral lineage whilst launching a forensic suite of services and a pharma-ceutical subsidiary, DNAPrint Pharmaceuticals. In 2004, they encouraged clients to use their personal ancestry reports to inform medical decision-making and to petition for Affirmative Action and Native American tribal enrollment (Harmon, 2006; for a cri-tique see Bolnick et al., 2007). Firms such as Oxford Ancestry and African Ancestry have likewise encouraged consumers to use test results to inform official classifications, offering educational resources on genetic lineages for reconstructing identities (Sykes, 2002, 2007a, 2007b).

Companies have also created databases and social networking platforms to encourage racial organizing, socializing, and health advocacy. In 2011, the Google-sponsored per-sonal genomics company 23andMe – a firm that also reports personal genetic suscepti-bilities data by race – launched a race-specific research campaign ‘Roots into the Future’, which calls on African Americans to ‘Be part of a 10,000 person movement to power genetic research for African Americans’ (23andMe, 2013). The project aims to create a black database within their research branch, 23andWe, to spur race-focused innovations. Similarly, FamilyTree DNA hosts AfricanDNA, a suite of genealogy services that draw on the expertise of Henry Louis Gates, Jr., among other public intellectuals who are lead-ing efforts to bring blacks into the fold of genomic research (AfricanDNA, 2012). AfricanDNA offers DNA evidence to ‘roots seekers’ (Nelson, 2008) who want to estab-lish a genetic basis for their racial identity, and who can then introduce the data into personal health management.

This model of genetic groupness portends negative consequences for former concep-tions of relatedness, such as familial and communal notions of connectedness (cf. Tallbear, 2008; Tallbear and Bolnick, 2004). Within the model, individual genetic mem-bership can trump cultural membership, or membership born of common experience. In place of family lore and social interaction, DNA ancestry testing then comprises the identification process. Test results become a tool for future bargaining, such as the peti-tion for affirmative action or access to certain medical therapies, but they do not support collective empowerment.

The result is the geneticization (Lippman, 1991, 1992) of political rights and dis-course. While identity-based movements have traditionally tried to use strategic essen-tialism to expose the inadequacy of social labels and their inability to stand in for biological difference, this new political climate makes genetic essentialism a basic prin-ciple of identity claims. Therapies and technologies form a prism for how the public can


conceptualize race, but also for how a sense of belonging and memories of solidarity take shape. Genetic conceptions preside over the interpretation and negotiation of administra-tive categories. As race is adopted as the predominant geneticized classifier, identity politics alters its nature from a rights and equality demanding movement of stigmatized groups to that of a descriptive distinction.

Finally, political action is geneticized, and thereby individualized at the level of demands pertaining to DNA profiles. Genetic test-taking replaces group organizing in state petitions and identity-based claims-making. Personal history and activism through the purchase of identity-based goods take precedent over collective disputation. Thus identity politics is fueled, yet transformed, as it is woven into the fabric of new markets.

Conclusion

Have the new markets in pharmaceuticals and biotechnology replaced US identity poli-tics with a preoccupation with genetic heredity and disease-based classification? Have subjective belief, memory, and overt politicization receded from mainstream American politics as a result? Or have sciences and companies been responsive to identity politics and found ways to subsume identity politics into the commodification of health and medicine? This analysis has shown that new pharmaceutical therapies and genetic tech-nologies do not erode all prior identity-based ways of creating and contesting identities. Yet because there is a market incentive to medicalize older notions of race in the new genetic framework, marketization spawns a geneticization of identity and an individuali-zation of politics.

This intersection of a commodified brand of medicalization and identity politics has important ramifications for racialization, or the sociohistorical formation of racial groups (Omi and Winant, 1994). First, racial identity forms through a marketized logic that allows virtual participation and membership rather than collective experience. This indi-vidualizes identity processes, while hiding the basis for group construction behind a curtain of scientific expertise. Second, the transfer of authority from lay representatives to companies means that market logics, such as the economic success or failure of a particular therapy or technology, drive what groups are consolidated and how. For exam-ple, the marketability of African ancestry pushes companies to offer therapies that legiti-mize membership in the diaspora. Likewise, the availability of race-based patents determines how groups bargain for personalized medicine.

Most importantly, in a world in which identity politics can exist without racism or other ‘isms’ (Skinner, 2006), anti-racist forms of strategic essentialism are a compelling factor for both drugmakers and consumers. Medicine and recreational services are tools for scientists and policymakers interested in leveling the so-called playing field and a public interested in gaining access to rights and resources. Thus, pre-genomic categories of identity-based difference, and ways of managing such distinctions, remain salient to emerging markets and technologies even as marketization produces new avenues for identity and politics.

Though genome mappers see it as their duty to challenge lay misconceptions of race with genetic classifications (Bliss, 2012; Hauskeller, 2006), the broader biomedical

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establishment dedicates itself to creating justice by serving identity-based groups race-targeted healthcare. With differential medical care as the solution to racial injustice, the state is relieved of addressing broader sociological inequities, such as subpar living con-ditions and institutionalized racism.

The public acceptance of a genetic model of groupness, in which racial groups are essentialized as genetically distinct and individuals can obtain rights and resources with prescriptions and test results, suggests that identity-based groups will increasingly find less reason to petition for structural solutions, and less need to collectively organize for social equality. When groups cede authority to technologies that no longer represent their common experiences of injustice, those experiences recede from the political main-stream. As identity politics moves to the private sector, a recreationalized sense of poli-tics and a pharmaceuticalized citizenship may take hold wherein health rights and political participation become primarily envisioned in personal biological terms.

The profit-seeking entities that are driving the marketization of identity politics have little interest in steering an alternative course for racialization. Pharmaceutical and bio-technology companies save considerable money by narrowing their research sampling, analysis, and reporting in terms of singular racial groups. Furthermore, drugmakers and bioengineers that stand to lose FDA approval or patent licenses can, as with BiDil, extend their viability by reapplying as a race-targeting application. Therefore, it is imperative that sociologists attend to the re-inscription of pre-genetic notions of race into public health institutions and personal healthcare on the one hand, and new trends in identity politics on the other, now that groups and individuals are able to buy their right to affirm-ative action or health equality. Individual consumers could become the political unit of the 21st century in ways that permanently hinder the possibility of group advancement.

Acknowledgements

I would like to thank Aaron Panofsky and five anonymous readers for their insightful comments. Thanks are also due to the editors of this special issue, especially Christine Hauskeller.

Funding

This research received funding from the National Science Foundation: SBS-0727360 and was generously supported by the Andrew Mellon Foundation and Howard Hughes Medical Institute.

References

23andMe (2013) Roots into the future. Available at: https://www.23andme.com/rootsAbraham J (2010) Pharmaceuticalization of society in context: Theoretical, empirical and health

dimensions. Sociology 44(4): 603–22.AfricanDNA (2012) Available at: http://www.africandna.com/history.aspxAlmeling R (2007) Selling genes, selling gender: Egg agencies, sperm banks, and the medical

market in genetic material. American Sociological Review 72: 319–40.Appiah A (2005) The Ethics of Identity. Princeton, NJ: Princeton University Press.Bailey SR (2009) Public opinion on nonwhite underrepresentation and racial identity politics in

Brazil. Latin American Politics and Society 51: 69–99.Benford RD and Snow DA (2000) Framing processes and social movements: An overview and

assessment. Annual Review of Sociology 26: 611–39.


Benjamin R (2009) A lab of their own: Genomic sovereignty as postcolonial policy. Policy and Society 28(4): 341–55.

Bernasconi R and Lott T (2000) The Idea of Race. Indianapolis, IN: Hackett.Bernstein M (2005) Identity politics. Annual Review of Sociology 31: 47.Biehl JG (2007) Pharmaceuticalization: AIDS treatment and global health politics. Anthropologi-

cal Quarterly 80: 1083–26.Bliss C (2012) Race Decoded: The Genomic Fight for Social Justice. Stanford, CA: Stanford

University Press.Bliss C (2014, forthcoming) Defining health justice in the postgenomic era. In: Richardson S and

Stevens H (eds) Postgenomics. Durham, NC: Duke University Press.Bolnick DA, Fullwiley D, Duster T, Cooper RS et al. (2007) The science and business of genetic

ancestry testing. Science 318: 2.Bostanci A (2011) Genetic ancestry testing as ethnic profiling. Science as Culture 20: 107–14.British Cardiovascular Society (2012) Beta-blocker for blacks is effective. Available at: http://

www.bcs.com/pages/news_full.asp?NewsID=2228Brown W (1995) States of Injury. Princeton, NJ: Princeton University Press.Brubaker R and Cooper F (2000) Beyond ‘identity’. Theory and Society 29: 1–47.Clarke A, Fishman J, Fosket JR, Mamo L and Shim JK (2010) Biomedicalization: Technoscience,

Health, and Illness in the US. Durham, NC: Duke University Press.Collins FS and Mansoura MK (2001) The Human Genome Project. Revealing the shared inheri-

tance of all humankind. Cancer 91(1 Suppl): 221–5.Crenshaw K (1995) Critical Race Theory. New York: New Press.Daar AS and Singer PA (2005) Pharmacogenetics and geographical ancestry: Implications for

drug development and global health. Nature Reviews: Genetics 6(3): 241–6.Daynes S and Lee O (2008) Desire for Race. Cambridge: Cambridge University Press.Douthat R (2012) The democrats’ identity politics problem. Available at: http://douthat.blogs.

nytimes.com/2012/09/04/the-democrats-identity-politics-problem/ (accessed 6 February 2013)

Duster T (2004) Selective arrests, an ever-expanding DNA forensic database, and the specter of an early-twenty-first-century equivalent of phrenology. In: Lazer D (ed.) DNA and the Criminal Justice System. Cambridge, MA: MIT Press, 315–34.

El-Haj NA (2007) The genetic reinscription of race. Annual Review of Anthropology 36(1): 283–300.Epstein S (1996) Impure Science. Berkeley: University of California Press.Epstein S (2007) Inclusion. Chicago: University of Chicago Press.Exner DV, Dries DL, Domanski MJ and Cohn JN (2001) Lesser response to angiotensin-converting

–enzyme inhibitor therapy in black as compared with white patients with left ventricular dys-function. NEJM 344: 1351–7.

Fausto-Sterling A (2004) Refashioning race: DNA and the politics of health care. Differences 15: 1–37.

Food and Drug Administration (FDA) (1998) Investigational New Drug Applications and New Drug Applications. Available at: http://www.fda.gov/oashi/patrep/demo.html

Fortier A-M (2012) Genetic indigenisation in ‘The People of the British Isles’. Science as Culture 21(2): 153–75.

Franklin S (2007) Dolly’s body: Gender, genetics and the new genetic capital. In: Kalof L and Fitzgerald A (eds) The Animals Reader. New York: Berg, 349–61.

Frickel S (2004) Chemical Consequences. Piscataway, NJ: Rutgers University Press.Fullwiley D (2008) The biologistical construction of race. Social Studies of Science 38: 695–735.Garvey C (2010) Ten years of genome biology. Genome Biology 11: 101.Gilroy P (2000) Against Race. Cambridge, MA: Belknap Press.

http://douthat.blogs.nytimes.com/2012/09/04/the-democrats-identity-politics-problem/

Bliss 1023

Goldstein A and Weiss R (2003) Howard U plans genetics database. New York Times, 28 May.Goodwin M (2012) Hillary Clinton leaves office triumphant despite few accomplishments. New

York Post, 27 January.Harmon A (2006) Seeking ancestry in DNA ties uncovered by tests. New York Times, 12 April.Harvey-Wingfield A and Feagin J (2012) Yes We Can? White Racial Framing and the Obama

Presidency, 2nd edn. London: Routledge.Hauskeller C (2004) Genes, genomes and identity. Projections on matter. New Genetics and Society

23(3): 285–99.Hauskeller C (2006) Human genomics as identity politics. Genomics Network. Available at: http://

www.academia.edu/3310846/Human_genomics_as_Identity_PoliticsHayes C (2012) White identity politics doomed 2012 Republican effort. Up w/Chris Hayes.

Available at: http://tv.msnbc.com/2012/11/10/white-identity-politics-doomed-2012-republi-can-effort/

Hinterberger A (2012) Investing in life, investing in difference: Nations, populations and genomes. Theory, Culture and Society 29(3): 72–93.

Hochschild JL, Weaver VM and Burch TR (2012) Creating a New Racial Order: How Immigra-tion, Multiracialism, Genomics, and the Young Can Remake Race in America. Princeton, NJ: Princeton University Press.

Jenkins R (1997) Rethinking Ethnicity. Thousand Oaks, CA: Sage.Kahn J (2009) Beyond BiDil. Saint Louis University Journal of Health, Law, and Public Policy

3: 61–92.Kahn J (2012) Race in a Bottle: The Story of BiDil and Racialized Medicine in a Post-Genomic

Age. New York: Columbia University Press.Kilgore E (2012) White identity politics. Political Animal. Available at: http://www.

washingtonmonthly.com/political-animal-a/2012_11/white_identity_politics041415.php?page=all&print=true#

Lindee MS (2008) Moments of Truth in Genetic Medicine, 1st edn. Baltimore, MD: Johns Hopkins University Press.

Lippman A (1991) Prenatal genetic testing and screening: Constructing needs and reinforcing inequities. American Journal of Law and Medicine 17: 15–50.

Lippman A (1992) Led (astray) by genetic maps: The cartography of the human genome and health care. Social Science and Medicine 35: 1469–76.

Lipson J (2011) DNA and the new identity politics. HPR. Available at: http://hpronline.org/online-only/hprgument-blog/dna-and-the-new-identity-politics/

Lloyd M (2005) Beyond Identity Politics. Thousand Oaks, CA: Sage.Mandel J (2010) Identity politics, feminism, and social change. Available at: http://userpages.

umbc.edu/~korenman/wmst/identity_pol.htmlMamo L (2010) Fertility, Inc. In: Clarke A, Mamo L and Shim JK (eds) Biomedicalization: Tech-

noscience, Health, and Illness in the US. Durham, NC: Duke University Press, 173–96.Montoya M (2011) Making the Mexican Diabetic. Berkeley: University of California Press.Nash C (2008) Of Irish Descent: Origin Stories, Genealogy, and the Politics of Belonging. New

York: Syracuse University Press.Nelson A (2008) The factness of diaspora. In: Koenig B, Lee SS-J and Richardson SS (eds) Revis-

iting Race in a Genomic Age. Piscataway, NJ: Rutgers University Press, 253–69.Nelson A (2011) Body and Soul. Minneapolis: University of Minnesota Press.Nobles M (2000) Shades of Citizenship. Stanford, CA: Stanford University Press.Novas C and Rose N (2004) Biological citizenship. In: Ong A and Collier SJ (eds) Global Assem-

blages: Technology, Politics, and Ethics as Anthropological Problems. London: Blackwell, 439–63.

http://www.washingtonmonthly.com/political-animal-a/2012_11/white_identity_politics041415.php?page=all&print=true#

http://userpages.umbc.edu/~korenman/wmst/identity_pol.html


Omi M and Winant H (1994) Racial Formation in the United States: From the 1960s to the 1990s. New York: Routledge.

Panofsky AL (2009) Behavior genetics and the prospect of ‘personalized social policy’. Policy and Society 28: 327–40.

Phillips KA, Veenstra DL, Oren E, Lee JK and Sadee W (2001) Potential role of pharmacogenom-ics in reducing adverse drug reactions: A systematic review. JAMA 286: 2270–9.

Polletta F and Jasper JM (2001) Collective identity and social movements. Annual Review of Sociology 27: 283–305.

Puckrein G (2006) BiDil: from another vantage point. Health Affairs 25: w368–w374.Rabinow P (1996) Essays on the Anthropology of Reason. Princeton, NJ: Princeton University

Press.Reardon J (2005) Race to the Finish. Princeton, NJ: Princeton University Press.Reardon J (2009) Finding Oprah’s roots, losing the world. Available at: http://globetrotter.berke-

ley.edu/bwep/colloquium/papers/FindingOprahLosingWorld%20Oct%203%202009%20PDF.pdf

Roberts D (2011) Fatal Invention: How Science, Politics, and Big Business Re-create Race in the Twenty-first Century. New York: New Press.

Rose NS (2007) Politics of Life Itself. Princeton, NJ: Princeton University Press.Roth W (2012) Race Migrations: Latinos and the Cultural Transformation of Race. Stanford, CA:

Stanford University Press.Schwartz RS (2001) Racial profiling in medical research. NEJM 344: 1392–3.Skinner D (2006) Racialized futures: Biologism and the changing politics of identity. Social Stud-

ies of Science 36: 459.Snow D and McAdam D (2000) Identity work processes in the context of social movements. In:

Stryker S, Owens TJ and White RW (eds) Self, Identity, and Social Movements. Minneapolis: University of Minnesota Press, 41–67.

Sommer M (2012) ‘Do you have Celtic, Irish, or Germanic roots?’ Applied Swiss history before and after DNA. In: Schramm K, Skinner D and Rottenburg R (eds) Identity Politics and the New Genetics: Re-creating Categories of Difference and Belonging. London: Berghahn Books, 116–40.

Stolberg SG (2001) Shouldn’t a pill be colorblind? New York Times, 13 May.Sykes B (2002) The Seven Daughters of Eve. New York: WW Norton.Sykes B (2007a) Blood of the Isles. London: Corgi Books.Sykes B (2007b) Saxons, Vikings, and Celts. New York: WW Norton.Tallbear K (2008) Native-American-DNA.coms. In: Koenig BA and Richardson SS (eds) Revisit-

ing Race in a Genomic Age. Piscataway, NJ: Rutgers University Press, 235–52.Tallbear K and Bolnick DA (2004) ‘Native American DNA’ tests: What are the risks to tribes?

Native Voice 3–17.Taranto J (2012) Most-racial America. Wall Street Journal, 26 November. Available at: http://

online.wsj.com/article/SB10001424127887324469304578143204261655348.htmlTaylor AL, Ziesche S, Yancy C, Carson P et al. (2004) Combination of isosorbide dinitrate and

hydralazine in blacks with heart failure. NEJM 351: 2049–57.Wacquant L (2004) Body and Soul: Notebooks of an Apprentice Boxer. Oxford: Oxford University

Press.Wade N (2002) Race is seen as real guide to track roots of disease. New York Times, 30 July.Wade P (2004) Human nature and race. Anthropological Theory 4: 157–72.Wade P (2007) Race, ethnicity and nation: Perspectives from kinship and genetics. In: Wade P

(ed.) Race, Ethnicity and Nation: Perspectives from Kinship and Genetics. London: Berghahn Books, 1–32.

http://globetrotter.berkeley.edu/bwep/colloquium/papers/FindingOprahLosingWorld%20Oct%203%202009%20PDF.pdf

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Weiss R (2000) The promise of precision prescriptions. Washington Post, 24 June.Whitmarsh I (2008) Biomedical Ambiguity: Race, Asthma, and the Contested Meaning of Genetic

Research in the Caribbean. Ithaca, NY: Cornell University Press.Winant H (2006) Race and racism: Towards a global future. Ethnic and Racial Studies 29:

986–1003.Wood AJ (2001) Racial differences in the response to drugs. NEJM 344: 1394–6.Xie HG, Kim RB, Wood AJ and Stein CM (2001) Molecular basis of ethnic differences in drug

disposition and response. Annual Review Pharmacology and Toxicology 41: 815–50.Yancy CW, Fowler MB, Colucci WS, Gilbert EM et al. (2001) Race and the response to adren-

ergic blockade with carvedilol in patients with chronic heart failure. NEJM 344: 1358–65.Yanow D (2003) Constructing ‘Race’ and ‘Ethnicity’ in America. New York: ME Sharpe.Younge G (2010) Who Are We – And Should It Matter in the 21st Century? New York: Viking.

Catherine Bliss is Assistant Professor of Sociology at the University of California, San Francisco. Her research explores the sociology of race, gender and sexuality in medicine, though she is espe-cially interested in scientific controversies in genetics. Bliss’s book Race Decoded: The Genomic Fight for Social Justice (Stanford University Press, 2012) examines how genomics became today’s newest science of race. Her latest research examines convergences in social and genetic science in the postgenomic age.

Date submitted July 2012Date accepted May 2013

the marketization of identity politics

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