Title: Making Healthy Families: The Biomedicalization of Kin Marriage in Contemporary Turkey
Funder: Economic and Social Research Council

Abstract: The objectives and aims of the fellowship to be achieved by the end of it are as follows: (1) Development of a publication track record: I intend to increase the visibility of my research through the development of a publication track record. I aim to successfully submit one article to a generalist sociological journal (first goal: Sociology) and one article to a specialized medical sociology journal (first goal: Sociology of Health and Illness), both based on PhD thesis chapters, and to work on turning my PhD thesis into a book by developing and submitting a book proposal to an academic publishing house (first goal: Manchester University Press "Inscriptions: Writing the Social Studies of Science" series). (2) Communication of research findings and impact generating activities I seek to increase the impact of the research by communicating research findings to a variety of different audiences, among them crucial stakeholders who drive and shape the management of genetic risk and reproductive health in Turkey. For this purpose, I intend to arrange a 10-day trip back to my fieldsite (Istanbul). Pre-Covid-19 I had proposed a robust impact activities plan consisting of 2 presentations and 1 workshop. In light of continuing Covid-related insecurities, I foresee the need to scale down and suggest the following. Plan A: If travel and social distancing regulations permit me to do so, I will (a) organize a medical sociological workshop about reproduction and genetic medicine with students at a university in Istanbul with a strong focus on the social sciences which I see as a valuable opportunity to keep critical discussion about societal developments in Turkey going at a time when the government increasingly diminishes the space for such engagement and to give back to the academic circles/institutions in Turkey who supported me in carrying out my research; and (b) give an internal talk to the medical staff at the clinic where I conducted ethnographic fieldwork in Istanbul to share research outcomes with former medical professional participants and key actors who are centrally involved with reproductive genetic health care in Turkey and the treatment of families experiencing genetic risk. If these activities are rendered impossible/difficult due to Covid-19, I propose the following Plan B: I will (a) offer to give an online presentation of research findings as part of the "Human, Medicine, Society" research cluster lecture series at the Orient-Institute Istanbul which had hosted me as a PhD Fellow during fieldwork and which regularly organises events/hosts presentations that are open to a mixed academic and lay, Turkish and international audience, and (b) I will offer to give a second online presentation of my research to be hosted by a university in Istanbul with a strong focus on the social sciences and medical sociology. I also intend to drive the building of professional academic relationships and seek academic exchange on work in progress by presenting at two different conferences with relevant streams matching my research interests, preferably the 2021 Annual Eastern Mediterranean Family Health Conference in Adana, Turkey, and the 2021 Annual ASA Conference in the US. Whereas the Adana conference would allow me to re-connect with the medical circles in Turkey who facilitated my research and who might benefit from learning about my research findings, presenting at a larger overseas conference would provide me with a chance to develop my international academic networks within the social sciences and gain valuable feedback for work in progress. (3) Teaching In light of the contained teaching experience gained during my PhD, I seek to make use of my time as a postdoctoral fellow by engaging in additional teaching activities at the LSE. I would preferably be a guest lecturer for one week on a course matching my research expertise at the LSE Sociology Department.

Lay abstract: This fellowship aims at following up on my PhD research by making it available to wider audiences through different pathways of engagement. This research focuses on the impact of reproductive genetic health services on the making of "healthy" families in Turkey by exploring how kin marriage is being conceptualized, managed, and negotiated as a genetic risk factor and reproductive health concern within intersecting biomedical and genetic spaces in contemporary Turkey. It asks how notions of "healthy" reproduction and "healthy" familyhood inform the health policies, discourses and practices surrounding the biomedical management of kin marriage, and how couples practicing kin marriage respond to and negotiate concepts of "risky reproduction" and "genetic risk" in their experiences with genetic services. Although kin marriages as close as first cousin marriage are legally accepted and comparatively frequent in Turkey, these marriage patterns have long occupied a contested position within Turkey's society. Modernist nationalist discourse depicted kin marriages as a remnant of the Ottoman past signifying the lingering presence of internal "non-modernity", "traditionalism" and "Oriental" otherness. These existing legacies of otherization and stigmatization of kin marriage have gained a new biomedical quality with the emerging re-conceptualization of kin marriage as a reproductive health problem following the spread and routinization of reproductive genetic health services in Turkey from the 1980s onwards. This "biomedicalization" (Adele Clarke) of kin marriage has shifted the question of how future citizens should be brought up in a socially and politically desirable familial environment to the question of how these future citizens should be conceived and born in the first place. Based on a critical reading of relevant government issued texts on reproductive health, family making and kin marriage, 37 qualitative interviews with medico-genetic professionals as well as couples practicing kin marriage, and observations during a two-and-a-half months stay at a public genetics clinic in Istanbul, this research explores the (bio)political implications of this "biomedicalization" process. It reveals how the redefinition of a formerly socially stigmatized practice (such as kin marriage) as a medical concern does not necessarily end but may intensify stigmatization. It also sheds light on how the expansion of reproductive genetic health services opens up new sites for the (self)surveillance and (self)management of family making and reproduction at the molecular/genomic level while perpetuating existing legacies of state intervention into the intimacies of family life and reproduction. This research thus emphasizes the need to investigate not only the transformative potential of technoscientific innovation in healthcare but also its capacity for extending enduring, unsettling affinities between medicine, nationalisms and state governance into the 21st century while rendering these more sublime through an emphasis on individualized genomic medicine and voluntary choice. Finally, this research cautions against notions of genetic health services as a panacea for improving reproductive health by foregrounding these services' potential for unequal targeting as well as the stratified and stratifying context within which they become employed.

Research activity codes: 4.3 INFLUENCES AND IMPACT
Health categories: REPRODUCTIVE HEALTH AND CHILDBIRTH