Ellen K. Feder
Foucault explicitly introduces the composite term, “power/knowledge” (pouvoir/savoir) in the middle, “genealogical” period of his work. At the same time, however, the concept of power/knowledge in many ways encompasses the entire corpus, characterizing the implicit project of his “archaeological” works, the explicit focus of the “genealogical”, and the working out of the implications for living a good life in the later “ethical” work.
To understand what Foucault means by power/knowledge we first have to engage in a little translation. Notice that when the term is used in philosophy written in English, the original French in which Foucault spoke and wrote often follows it. In French, there are different ways of expressing distinctive categories of knowledge which English speakers mark by qualifications such as “folk knowledge” or “book knowledge”. In many of his earlier, archaeological works, Foucault is interested in investigating how a particular kind of implicit knowledge – the savoir – permeating a historical period, that is, the understanding that counts as the “common sense” of that time/place/people, shapes the explicit knowledge – the connaissance – that is institutionalized in the disciplines that make up the human sciences, including natural (e.g. biology) or social (e.g. psychology) science (Foucault 1972: 182–3).
As a noun, pouvoir is most typically translated as “power”, but it is also the infinitive form of the verb meaning “to be able to”, and is the most common way of saying “can” in Romance languages. In Foucault’s work, pouvoir must be understood in this dual sense, as both “power” as English speakers generally take it (which could also be rendered as puissance or force in French), but also as a kind of potentiality, capability or capacity. Power, Foucault tells us, must be understood to be more complex than a term like puissance conveys; it has multiple forms and can issue from “anywhere”. Foucault urges us not to think of power only in terms of its “old” monarchical form, as something an individual possesses or wields over another or others. For him power works through culture and customs, institutions and individuals. Likewise, its effects are also multiple, not simply negative or positive, but, as he puts it, “productive”: they are both positive and negative, unstable valuations that can be reversed through history.
The composite “power/knowledge” is also not quite translatable. Literary theorist and translator Gayatri Spivak helpfully calls our attention to what she describes as the “homely verbiness of savoir in savoir-faire [a ready and polished kind of ‘know-how’, in English], savoir-vivre [an understanding of social life and customs] into pouvoir”, and suggests that regarded in this way:
you might come up with something like this: if the lines of making sense of something are laid down in a certain way, then you are able to do only those things with that something that are possible within and by the arrangement of those lines. Pouvoir-savoir – being able to do something – only as you are able to make sense of it.
(1993: 34)
The kind of knowledge to which Foucault directs us with this term, then, is one that has no clear source, but that a genealogical analysis – an examination of the historical conditions of possibility – illuminates, describing the accidents of history that result in particular consolidations of what counts as truth or knowledge. It is not the knowledge that is decreed by some authoritative body “from on high”, but is more precisely described in the passive voice: it is the kind of knowledge that is “recognized as true”, “known to be the case”. For Foucault, this knowledge can only exist with the support of arrangements of power, arrangements that likewise have no clear origin, no person or body who can be said to “have” it.
An example illustrates many of the dimensions of power/knowledge as they are taken up in Foucault’s work. It will also help to clarify how the concept of power/knowledge is salient throughout the different periods into which scholars generally divide Foucault’s corpus: the early (archaeological) texts where, Foucault later says, power/knowledge was present even if unnamed;1 the middle (genealogical) texts where the concept power/knowledge is explicitly introduced; and finally the late (ethical) reflections, where power understood as capacity becomes more central. In what follows, I examine the concept of sexual difference and its enforcement. Despite his famous interest in questions concerning “sexuality”, Foucault does not take up the matter of sexual difference directly; nevertheless, Foucault’s work has been highly influential among scholars and activists over the past several decades who have done so, and have compellingly demonstrated how the tools offered by Foucault’s analysis can help us to clarify and deepen our understanding of a critical, yet surprisingly under-studied, concept.
We take for granted sexual difference. It seems obvious that men and women, boys and girls, make up the world’s populace. We may recognize that sexual difference can be understood somewhat differently across the globe; some cultures have standards for masculine and feminine behaviour that differ from others. But there remains under the blanket of social distinctions what we take to be a brute biological or genetic “fact” of sexual difference. Common sense – a kind of unquestioned knowledge – tells us that this sexual division into male and female is true, how things are. But if this difference is so obvious we might ask why the distinction between the sexes requires enforcement.
Take the example of four-year-old Nathan who is teased by his classmates because he enjoys playing “like a girl”, dressing up in high heels and dresses instead of like a cowboy, enjoying play with baby dolls instead of trucks. Perhaps we could say that the boy suffers the teasing of his preschool classmates because his play violates the other children’s common sense. “You can’t be a little girl” (Rekers & Varni 1977: 428), the other children tell Nathan.
What happens to Nathan is not unusual among preschoolers. But Nathan’s story is distinctive because his is a published case, among the first of a number of cases, of a condition that was first discussed in US psychiatry in the early 1970s. “Gender Identity Disorder”, or GID, continues to be actively treated today. In the paper in which Nathan’s story is featured, the authors recount how Nathan’s diagnosis led to a long period of therapy designed to help him accept that as a boy he was expected to play with “boys’ toys”. His parents were instructed to observe him and offer positive reinforcement for playing with gender-appropriate toys, and to ignore him when he played with inappropriate toys. Eventually, the case study reports, Nathan was given a wrist counter and told to press the counter when he played with boys’ toys but not when playing with girls’ toys. When he accumulated enough points he received a prize.
Reading the story of Nathan through the theoretical lens of Foucault, it is striking how closely Nathan’s treatment regimen corresponds to the levels and character of surveillance Foucault describes in Discipline and Punish, and to the levels of surveillance the Panoptic structure organizes. Most accounts of the Panopticon focus on the prisoners (or madmen, paupers, schoolchildren) in the machine, those who are isolated and are the clear objects of the anonymous gaze signified by the invisible inhabitant(s) of the central tower. The objective of panopticism is the “internalization” of the authoritative gaze, where one:
subjected to a field of visibility … assumes responsibility for the constraints of power; he makes them play spontaneously upon himself; he inscribes in himself the power relation in which he simultaneously plays both roles; he becomes the principle of his own subjection.
(Foucault 1979: 202–3)
But among the many lessons of panopticism is that the power that seems focused on one individual is in fact “distributed” throughout the structure, so that every individual is at the same time both “object” and “subject” of this power: the prisoner is “watched”, but is being trained to watch himself, to be his own inspector. The inspector is by definition the “watcher”, and yet he, too, is the object of a gaze: his performance as watcher is ever under scrutiny. The Panopticon is Foucault’s best lesson in unsettling the way we typically conceive power and its operation.
Foucault’s analysis points us to ways that power can be exercised from unexpected places. As the study reports the succession of events, it is not Nathan’s distress – over his desire to play with girls’ toys, or the teasing he faces – or worry by his parents or teacher about his behaviour that brings him to the team of psychologists and researchers who subject him to treatment; it is, rather, the other children’s teasing that distresses the teacher, who alerts the parents, who finally bring Nathan to treatment. It may seem obvious that children’s interaction with one another is an important dimension of their psychosocial development, but the authority the children’s voices command is arresting. We could speculate that the parents, teacher and treatment team see something important, even “natural”, about the other children’s intolerance of Nathan’s behaviour. Viewing children as natural arbiters of gender norms might capture something of the intuitive sense of the adults involved in the case of Nathan, but this perspective calls for analysis of how such authority is vested in Nathan’s four-year-old peers.
In Discipline and Punish, Foucault contrasts disciplinary power with the ordinary understanding of power as something that can be “possessed as a thing” and brandished against another (1979: 177; see also 1990a: 94). Disciplinary power, according to Foucault, is instead an expression of power that is associated with what he calls, in The Archaeology of Knowledge, the “assignment” of subjective positions (1972: 95), whereby individuals are allotted roles in the social world, positions that provide different possibilities for the exercise of power. The power that one can exercise as parent, simply by virtue of being a parent – power that is supported by society and by law – is one good example, but so is the power that is exercised by a bureaucrat in the Department of Motor Vehicles (DMV). It is not that the individual in one or the other of these positions “is” powerful in Foucaultian terms, but that different positions individuals take up or are assigned afford specific arenas for the exercise of power. Once an individual no longer occupies a given position – the parent goes to school to finish his college degree and at least for some part of the day occupies the position of student, or the clerk at the DMV goes home after a day of work – the power associated with that position can no longer be exercised. In the first volume of The History of Sexuality, Foucault clarifies that “power is not an institution, and not a structure; neither is it a certain strength we are endowed with; it is the name that one attributes to a complex strategical situation in a particular society” (1990a: 93). The story of a little boy who is teased in the playground and becomes a psychological case-study illustrates how power relations are distributed widely among young children, teachers and mental health professionals, forming what Foucault described as a “dense web that passes through apparatuses and institutions, without being localized in them” (ibid.: 96). Power is for Foucault inaccurately described as issuing “from above” or “outside”; instead, it is more instructive to understand first the way it “comes from below” (ibid.: 94).
In Bentham’s design of the Panopticon, the occupants of the central tower take up positions of surveillance vis-à-vis each of the inmates (and indeed, of one another). Nathan’s classmates are similarly enjoined, enlisted in a panoptic apparatus that operates to ensure properly gendered subjects. If the exercise of the classmates’ gaze is evidenced by their teasing, it should be counted among the “essential techniques” of disciplinary power. Foucault describes such techniques as:
always meticulous, often minute techniques, but they defined a certain mode of detailed political investment of the body, a “new micro-physics of power“ [that] had constantly reached out to ever broader domains, as if … intended to cover the entire social body.
(1979: 139)
Loosed from its discursive field, the children’s forthright announcement to Nathan that “You can’t be a little girl” resists characterization as a subtle expression of power. Conceived within the terms of its field, however, their blunt repudiation is precisely the sort of “capillary intervention” (1990a: 84) that epitomizes a microphysics of power. It is consequential not for its sheer force but for the disciplinary effects it can provoke, that is, for its ability to “reach out to ever broader domains”. The children’s intervention in the case of Nathan activates a complex machinery of interlocking institutional interests – embodied by his teacher, his parents and an entire team of psychologists, assistants and technicians – functioning to subject Nathan to a “field of visibility” whereby he will learn, as his peers have already learned, to assume “responsibility for the constraints of power … [to] become the principle of his own subjection” (1979: 202–3). Located at the extremities of this “productive network of power which runs through the whole social body” (1980d: 119), the children’s exposure of Nathan’s violation is instrumental in two linked ways: it rouses the apparatus that will therapeutically draft Nathan into his prescribed role and correct the parental missteps that resulted in Nathan’s deviation; it also provides an opportunity to produce new knowledge, that is, new “understandings”, new “truths”, not only about Nathan, but about the increasing numbers of children – and their parents2 – who would be identified under this new disorder.3
Bentham himself understood that “panopticism” functions not only to circulate power, as it clearly does in the example of the prison, but also to produce knowledge. Foucault’s formulation of the term “power/knowledge” is developed from Bentham’s own expectation that the Panopticon would serve as a “laboratory … [that] could be used as a machine to carry out experiments, to alter behavior, to train and correct individuals” (Foucault 1979: 203). It is a “privileged place for experiments on men, and for analyzing with complete certainty the transformations that may be obtained from them” (ibid.: 204). “Thanks to its mechanisms of observation,” Foucault reflects, the Panopticon “gains in efficiency and in the ability to penetrate into men’s behavior; knowledge follows advances of power, discovering new objects of knowledge over all the surfaces on which power is exercised” (ibid.: 204). But while many would understand in narrow terms the new “object” that is created to be the “gender disordered” child of the late twentieth century, Foucault’s advancement of the analysis of power/knowledge clarifies that the objects must be taken to be more widely dispersed, that no one, in fact, escapes the objectification that comes, in the nineteenth century, to be centred around the notion of sexual identity.
Foucault most famously elaborated on this expression of power/knowledge in the first volume of The History of Sexuality (tellingly titled in French as La Volenté de Savoir, “The Will to Knowledge”), the book that immediately follows Discipline and Punish. In The History of Sexuality Foucault makes the remarkable claim that “the ‘question’ of sex” becomes in the late nineteenth century the most important question “in both senses: as interrogation and problema-tization, and as the need for confession and integration into a field of rationality” (1990a: 69). A whole host of technologies are born to regulate what becomes understood as a person’s (sexual) “essence”, the truth of an individual, who he or she “really” is. The most salient of these technologies is confession, first religious (as mandated by early Christianity), then psychological (in the nineteenth-century science of psychoanalysis) and finally political, as the mandate to produce information becomes the ground for what became known as population control.4 What unites these different technologies is the concern with identifying (and so, Foucault explains, what in fact turns out itself to create, as a category, or object of understanding) a whole variety of “perversions” born during this time, different ways to violate the multiplying rules governing the important distinction between licit and illicit, normal and abnormal.
Of all the technologies, medicine comes to play the most important role in the development of “the norm”, dictating, for example, what constitutes normal marital relations. Children’s sexual activity also became an object of keen interest and concern, not only because of a perceived need to “detect” violations of new norms, but, as we saw in the example of the case of Nathan, to be on the alert for problems with parents’ rearing of their children:
Wherever there was the chance that [masturbation] might appear, devices of surveillance were installed; traps were laid for compelling admissions … parents and teachers were alerted, and left with the suspicion that all children were guilty, and with the fear of being themselves at fault if their suspicions were not sufficiently strong … [parents’] conduct was prescribed and their pedagogy recodified; an entire medical-sexual regime took hold of the family milieu.
(Foucault 1990a: 42)
Further, a whole class of deviant individuals comes to be identified at this time. Among the zoophiles (those who engage in sex with non-human animals), auto-monosexualists (those who are only able to experience erotic pleasure by themselves), gynecomasts (men with atypically large breasts), presbyophiles (those who engage in sex with the elderly) and dysparauenistic women (those for whom sexual intercourse is painful), perhaps the most lasting category of individual is “the homosexual”, a new species of individual “born” in 1870 (ibid.: 43).5
In the late-twentieth-century diagnosis of the gender dysphoric child there is embedded a whole history of power/knowledge that involves a complex of elements that come to be designated in Foucault’s work by the term “normalization”. Normalization, the institutionalization of the norm, of what counts as normal, indicates the pervasive standards that structure and define social meaning. Norms are at once everywhere and nowhere. They are obvious when we are talking about the sorts of standards against which one can be tested with respect to intelligence or body mass, for example. But they are less conspicuous when they are unspoken, what we may even take to be natural or understand as our own (what Foucault would see as their “internalization”), as is often the case with norms concerning gender.
We may think that medicine has always played the role it has in shaping our understanding of the norm, but Foucault’s earlier history of medicine, The Birth of the Clinic, suggests otherwise. In the ancient period, conceptions of health were understood not in terms of a single standard against which one should be measured, but rather in terms of the harmonious functioning of the individual. The role of medicine was to provide “techniques for curing ills” (Foucault 1975: 34). This view of medicine persisted into the eighteenth century, at which time, according to Foucault, medicine begins to fashion a concept of “the healthy man, that is, a study of the non-sick man, and a definition of the model man” (ibid.). At this point, medicine assumes a “normative posture, which authorizes it not only to distribute advice as to healthy life, but also to dictate the standards for physical and moral relations of the individual and the society in which he lives” (ibid.). This is a crucial change in the understanding of medicine, by the profession and by the public at large, paving the way for the shift that will take place from a focus on health understood as qualities specific to an individual, to normality, a standard imposed from without.
In the example of Nathan, and of his parents, there is an obvious effort to correct the behaviour that is regarded as abnormal. The techniques described by the case study – enforcing “good” behaviour with reward and punishing bad behaviour with being ignored, asking him to regulate himself with a wrist counter – exemplify the sorts of practices Foucault characterized in Discipline and Punish with respect to the operation of the Panopticon. For Foucault it is not accurate to describe the aim of these practices in terms of “repression”. Instead, the aim of the panoptic expression of power/knowledge is to enforce a standard that it is at the same time trying to establish by comparing individuals against one another, measuring their differences and then asserting the truth of the standard it “discovers” as the rule (1979: 182–3). Practices such as these exemplify why Foucault makes use of this composite term, power/knowledge: the expression of each term, power and knowledge, are at every point implicated with one another.
In looking at the operation of power/knowledge, it can be difficult to remember that for Foucault power should not be understood solely in the negative terms of repression or constraint. In Discipline and Punish, Foucault insists that:
we must cease once and for all to describe the effects of power in negative terms: it “excludes,” it “represses,” it “censors,” it “abstracts,” it “masks,” it “conceals.” In fact, power produces; it produces reality; it produces domains of objects and rituals of truth. The individual and the knowledge that may be gained of him belong to this production.
(1979: 194)
While many seek to resist the effects of normalizing power that have wrought so much harm (arguably to us all, albeit in different ways, and to different effect), for Foucault the very effort of resistance must be understood itself as an expression of power. In the first volume of The History of Sexuality, Foucault returns to the exemplary case of homosexuality to make this point:
There is no question that the appearance in nineteenth century psychiatry, jurisprudence, and literature of a whole series of discourses on the species and subspecies of homosexuality, inversion, pederasty, and “psychic hermaphroditism” made possible a strong advance of social control … but it also made possible the formation of a “reverse” discourse: homosexuality began to speak in its own behalf, to demand that its legitimacy or “naturality” be acknowledged, often in the same vocabulary, using the same categories by which it was medically disqualified.
(1990a: 101)
What does Foucault mean by “reverse” discourse? If the “normalization” of the homosexual by nineteenth-century medicine marked the production of a new conception of abnormality, and with it the abnormal individual, twentieth-century resistance to this process must likewise be understood in these terms, but in reverse; as an effort, in other words, to recast normalcy, to understand as normal this new person the homosexual. The recasting of normalcy would mean making use of the medical category, not in the sense of the one constricting norm against which all of us should be judged, but to understand homosexual orientation in the “older” sense of the individual standard of health that continues to be active in, and provide validation of, current conceptions of normality. (Even as there are clear standards of health of all kinds, it still makes sense for us to talk about what is healthy “for me”.) This normalizing power that “made up” the “homosexual person” as an object of psychiatric medicine also produced “improbably”, “spontaneously”, as Foucault puts it (ibid.: 96), the previously unthinkable concept of “gay pride”, which led to the depathologization of homosexuality in the United States in 1973.
The story of the depathologization of homosexuality, of its removal as a diagnosis from the handbook of psychiatric disorders called The Diagnostic and Statistical Manual of Mental Disorders (DSM), is remarkable in many ways (among them: it was the first, and to date the only, time that a diagnosis was removed from the DSM as a result of a vote by the membership of the American Psychiatric Association) (Bayer 1981). But it is also notable because the first edition of the DSM that did not include homosexuality as a diagnosis (DSM III, published in 1980) introduced Gender Identity Disorder (GID) of children as a diagnosis. The “risk” of what are characterized as untreated “problems” of gender identity, according to the most influential researcher responsible for the diagnosis, is the eventual assumption of a homosexual identity (Rekers et al. 1977: 4–5).6
There are at least two lessons to be learned from the replacement of homosexuality with GID. One lesson concerns the role of children in the “society of normalization”, something that Foucault addresses in some detail in the first volume of The History of Sexuality. For the purposes of understanding the operation of power/knowledge, it is a lesson in how resistance, expressed as a “reverse discourse”, can itself be resisted: psychiatry found, in the diagnosis of GID, a new way to pathologize (or maintain the pathologization of) homosexuality, a new way, in other words, to make it known as an object of psychological intervention, to dictate its truth and to manage the treatment of those so labelled, both medically as well as socially.
As a new revision of the DSM is currently in preparation (scheduled for publication in 2012) there has been a great deal of controversy about the diagnosis of GID, with many activists and mental health practitioners, as well as some academics, arguing in favour of removing the diagnosis, just as homosexuality was removed more than two decades ago. And yet, removal of the diagnosis could inhibit those mental health practitioners who have made use of the diagnosis to treat the distress that gender nonconforming, or “gender variant”, children may experience as a result of familial or societal intolerance, a form of counter-attack that validates gender variant behaviour. This approach to treatment is itself a form of resistance to the “usual” understanding of the diagnosis of mental disorder, which locates the problem in the individual so diagnosed. And while many, perhaps even most, practitioners continue to see GID in the terms dictated by the DSM, which perceives mental disorders “in” the individual, there are those who understand the problem to lie instead in the hostile conditions that gender variant children may face. The implicit rationale of those who approach treatment of gender variation in this way is similar to that made about a variety of forms of disability (is the problem in the bodies of those with disabilities, or in the material conditions that make mobility or communication difficult?).7 What some mental health practitioners have done in their practice is turn psychiatric treatment on its head, seeing a child whose gender behaviour does not correspond neatly with her assigned sex as suffering not from a gender identity disorder, but rather as a victim of an intolerance of gender variation that should instead be the focus of intervention.
Seeing the diagnosis in this way would mean, practically speaking, that it should be cast differently (for example, using terms like “Gender Variance” rather than “Gender Identity Disorder”, which is an unnecessary and furthermore misleading term, because it suggests that psychological identity is the problem that needs to be corrected). Rather than remove the diagnosis, another possibility could be to rename and reformulate the diagnosis to better reflect the life goals and distress experienced by individuals, and furthermore direct treatment toward the most appropriate means of alleviating distress and promoting flourishing.
Beyond the change of name, an interesting and promising recommendation may be to make use of complementary diagnostic codes known as “V-codes”. V-codes are defined in the International Classification of Disorder (ICD, a global handbook with which the DSM is meant to correspond) as “other conditions that may be a focus of clinical attention” (World Health Organization 2004). Some V-codes are diagnoses that have not yet been formally established as diagnoses through appropriate research (and in this sense it would seem that GID as it stands would qualify). Other V-codes are “conditions” that are located outside the individual, but that nevertheless affect the individual’s functioning or well-being. An “Acculturation Problem” (V62.4), for example, can include a variety of problems adjusting to a new culture, a problem that is cast not as “the individual’s” problem; an “Occupational Problem” (V62.2), which the DSM conservatively describes as “job dissatisfaction”, could include distress as a result of working in a hostile environment where again, the problem cannot be understood properly to belong to an individual. With respect to GID in children, probably the most typical problem would be described as a “Parent–Child Relational Problem” (V61.20), but it could also include a “Phase of Life Problem” (V62.89). Including V-codes in the very structure of the diagnosis would provide a more accurate picture of the problems that gender variant children face, and furthermore indicate to practitioners that the object of treatment needs to be differently understood.8 The use of V-codes in the case of GID could (indeed, would) entail disciplinary effects, but rather than seeking to activate these effects in the life of an individual subjected to treatment, these effects could promote – among therapists and society at large – a different story to tell about sexual difference.
The possibility of making use of V-codes in the diagnosis of GID is one that is consistent with Foucault’s analysis of power/knowledge as a pervasive apparatus from which there is no escape, but that can at the same time be resisted or “reversed”. Possibilities such as these become the focus of Foucault’s attention in his later, “ethical” works.
After the first volume of The History of Sexuality, Foucault does not explicitly make use of the term “power/knowledge”. Yet the focus on “technologies of the self” in Foucault’s ethics provides what could well be understood as an elaboration of the concept of power/knowledge in the “positive” terms that are only suggested in the middle work. He is still interested in the notion of subjectivity (assujettissement), both in the sense of “making a subject” and “making subject to”. He is also concerned with disciplinary practices. Rather than focusing, as he does in Discipline and Punish, on how disciplinary practices promote normalization, he is far more concerned with how these practices can be put to work to resist normalization. At this point in Foucault’s analysis he turns to the subject’s relationship to her self, that is, her own subjectivity.
One of the most important ways that knowledge is constituted is through the asking of questions. Investigation of the kinds of questions that can be asked within a given historical period was arguably the focus of Foucault’s earlier, archaeological works, and the use to which particular questions could be put and to what effect, the focus of the genealogical works. In the later, ethical works, Foucault turns to the kind of knowledge resulting from reflection, “an exercise of oneself in the activity of thought”, or askesis (1990a: 9). Practices of thought that could be promoted in gender variant children, their parents and the mental health workers charged with their care could include a reframing of the questions posed. Interrogating “the problem” of gender variance, for example, could provide an opportunity, as Foucault recounts, to “learn to what extent the effort to think one’s own history can free thought from what it silently thinks, and so enable it to think differently” (ibid.). Seeing the diagnosis of Gender Identity Disorder not as a disorder located in the individual, but as a larger problem of intolerance and the suffering it causes would indeed exemplify how this exercise of thought could, as Foucault remarked in an interview, “show people that they are much freer than they feel, that people accept as truth, as evidence, some themes which have been built up at a certain moment during history, and that this so-called evidence can be criticized and destroyed” (1988: 10).
Our understanding of madness, standards of “health”, “normal” sexuality: all of these, Foucault finally argues, are consequences of a complex operation of power/knowledge of which his own works are also a part. His aim, in narrating the histories that make up his work, is not to uncover “the timeless and essential secret … behind things” but rather to expose the greater secret: the “secret that they have no essence or that their essence was fabricated in piecemeal fashion” (1977: 142). With his own projects, he is interested, as he put it in an interview, in exploring “the possibility of a discourse that would be both true and strategically effective, the possibility of an historical truth which could have political effect” (1980f: 64).
1. One way power/knowledge manifests itself in Foucault’s early work is in the closely related concept of the episteme, elaborated in The Order of Things (1973). An episteme, the prevailing order of knowledge particular to a historical period, accounts for the understanding of how things are connected in the overall “field” of understanding or knowledge; it describes the conditions under which what is taken to be knowledge is possible.
2. Parents of children with GID have themselves been diagnosed with different psychopathologies, and become themselves “cases” for further investigation (see e.g. Coates 1990).
3. The incidence of the disorder has ranged over the years. At the outset it was understood as very rare, affecting perhaps 1 in 100,000 children (Rekers et al. 1977: 4–5); by 1990 clinicians had concluded that it “may occur in two percent to five percent of the general population” (Bradley & Zucker 1990: 478), a finding revised by these same authors nine years later, who liken its frequency to a disorder such as autism, itself a diagnosis with an estimated incidence rate that has steadily increased over the past decades (Zucker & Bradley 1999: 24). For Foucault these differences would indicate changing historical needs to justify diagnosis and treatment.
4. Interventions by the state in matters such as population control are an example of what Foucault called “biopower”. For discussion of this distinctive form of power, which must also be seen as an expression of power/knowledge, see Chapter 3 on biopower in this volume.
5. For a detailed treatment of the history of the “invention” of homosexuality, see Katz (1995).
6. Later in the development of the diagnosis, perhaps even greater risk of untreated GID is the assumption of a transsexual identity (Bradley & Zucker 1990: 482).
7. See, for example, Fine & Asch (1988).
8. This could also be seen in light of the idea of “exteriorizing” a problem faced by an individual or a family, a process that allows the emergence of a different meaning, “the development of an alternative story”, as the psychologist Michael White, himself a close reader of Foucault, has put it (see e.g. White & Epston 1990: 39).