Toxic disruptions: Polycystic ovary syndrome in urban India By Gauri Pathak, New York, NY: Routledge. .  pp (original) (raw)

In Toxic Disruptions: Polycystic Ovary Syndrome in Urban India, medical anthropologist Gauri Pathak offers an empirically grounded and theoretically informed account of the rise in polycystic ovary syndrome (PCOS) in India. Through detailed interviews primarily with middle class women and doctors in Mumbai, the book traces how the condition is tied to the prevalence of endocrine disruptive chemicals (EDCs) in the environment, a phenomenon which she traces back to the social, economic, and dietary changes which have been ushered in by India's 30-year-long experiment with economic liberalization. The book offers a structured and compelling account of the ways in which PCOS in India is tied to changing gender norms and the evolving aspirations of the Indian middle class, while attending to the ways in which the condition poses risk to women who are negotiating it through a series of novel strategies in India's ever changing healthcare landscape. PCOS is primarily a gynecological and endocrinal condition. It can impact the regularity of the menstrual cycle and can cause reduced fertility. Its symptoms also include obesity, cystic acne, hirsutism, hair loss, and increased risk of type II diabetes and cardiovascular conditions. Studies of PCOS have shown that its rates among women in India can be twice the global average. Urban Indians face high and prolonged exposure to EDCs in the environment which has been linked to PCOS. Such EDCs are commonly found on everyday objects like credit cards, plastic packaging, fertilizers, mattresses that humans are regularly in contact with. Though the actual rates of prevalence of EDCs is hard to determine, the book looks at the increased rates of PCOS diagnosis as an outcome of toxic environments created by India's liberalization experiment which has encouraged rapid growth in harmful chemical producing sectors. The book draws on the literature on science studies and medical anthropology, to understand the possibility of inhabiting a world structured by toxicity. Pathak begins the book by interrogating how her interlocutors understand the causes behind their diagnosis. Her interlocuters agree that lifestyle changes ushered in by India's economic liberalization are the primary cause for the rise in PCOS. Pathak uses the term "disruptive modernization" to describe India's relentless push to modernize and the unsettlement of the "natural" cycle of life that it causes. A growing Indian economy has expanded the opportunities for middle class women to play a greater role in India's work force. But gender norms have remained intransigent, and women are expected to fulfill the traditional role of the wife, mother, and daughter. Pathak's interlocutors argue that this leads to greater pressure on them manifesting in the form stress. Furthermore, the extractive capitalist system has disrupted sleep and dietary cycles of women in the work force. Pathak's research shows an awareness