Infrastructures/Governing/Queerness: How Health IT Infrastructures "Program Queer Health"
(University of Michigan)
Paper short abstract:
In a historical and ethnographic case study, I show how health IT infrastructures and their data “program health” for different classes of queer men in Atlanta and the US. Documents and interviews with experts reveal these systems as key vectors of governmentality and subjectification for queer men.
Paper long abstract:
I present a case study of layered health IT infrastructures that target gay, bisexual, and other men who have sex with men (MSM) - collectively "queer men." I focus on nationwide infrastructures overseen by the U.S. federal government and their local implementation in Atlanta. Data come from document-based research and interviews with administrators. The study discusses Electronic Health Record (EHR) technologies and their implementation, surveillance systems operated by CDC, and the Ryan White HIV/AIDS Program. My approach is grounded in infrastructure studies, the sociology of health, and LGBTQ studies. Health IT infrastructures generate knowledge about queer men on terms that are variously identitarian (eg. gay) and/or behavioral (eg. MSM). This produces a range of epidemiological, clinical, and healthcare priorities that different classes of queer men and their doctors are expected to internalize. These networks and the data they generate therefore collectively "program health" for different classes of queer men, generating "programmes" for them to implement and sustain their wellbeing. However, to do this, the infrastructures must be literally "programmed" and managed by a range of IT personnel, medical experts, and administrators. Ultimately, health IT infrastructures are revealed as key vectors of governmentality and subjectification for queer men. They stage contested relations between (1) biomedical and technical experts, (2) large public, private, and semi-public institutions, (3) varied collectivities of queer men, and (4) individuals charged with making "personal health choices" based on their epidemiological profile and their perceived duties as a citizen or member of a particular community.
Infrastructures, subjects, politics