2. Mapping the lexicon: defining epistemic harms and resistance

Before turning to our case study, it is necessary to clarify some terms and situate ourselves in the broader evolving landscape of epistemic injustice. Epistemic injustice is a term coined by Miranda Fricker in her 2007 book by the same name. There, Fricker defined two main kinds of epistemic injustice—testimonial injustice and hermeneutical injustice. Testimonial injustice occurs “when prejudice causes a hearer to give a deflated level of credibility to a speaker’s word” (Reference Fricker2007, 1). We can think of something like the infamous Larry Nassar case, where it took the testimonies of more than 100 young women to counteract the authority of one male doctor as an exemplar of this type of injustice.Footnote ⁵ Hermeneutical injustice, on the other hand, occurs “when a gap in collective interpretive resources puts someone at an unfair disadvantage when it comes to making sense of their social experiences.” (Reference Fricker2007, 1). The exemplar in Fricker’s original work was the Carmita Wood case and the emergence of sexual harassment as a legible concept in the 1970s (Reference Fricker2007, 150).

The literature around hermeneutical injustice has evolved significantly over the past almost 20 years, particularly indebted to critiques and contributions by scholars including José Medina, Kristie Dotson, and Gaile Pohlhaus, Jr. Discussions of hermeneutical injustice have largely been concerned with conceptual lacunas, or what can be understood as harms of absence. However, there is another type of hermeneutical injustice, which can be understood as a harm of presence—concepts and narratives that operate to actively block understanding and meaning. Most recently Medina has referred to this insidious type of silencing as hermeneutical blocking (Reference Medina2023, 229–30). This is the type of hermeneutical injustice that I take up in this paper.Footnote ⁶

Further, most of the discussions around hermeneutical injustice have been concerned with what Fricker has referred to as the primary harm of hermeneutical injustice—that is making one’s experience intelligible to others (Fricker and Jenkins Reference Fricker, Jenkins, Garry, Khader and Stone.2017). However, Fricker notes another deeper type of harm, identity-related harm (Fricker Reference Fricker2007, 163–66), and specifically a kind of identity-related harm “in which in which a person’s very sense of their own identity comes to be shaped by the negative meanings structuring the social space” (Fricker and Jenkins Reference Fricker, Jenkins, Garry, Khader and Stone.2017). It is this identity harm that I am concerned with. However, in contrast to Fricker and Jenkins, one of my interests in examining breast cancer survivor narratives in particular is that I think we need to pay attention to those narratives that may have “positive meanings” structuring the social space. Specifically, I will argue that we need to pay attention to the identity power wielded by these narratives and how it operates to harm those who do not comply.

With the type of hermeneutical injustice and identity harm I want to address in view, in the next section, I introduce the dominant breast cancer survivor narrative, tracing how it shapes which survivor identities become legible and which are forced into silence and invisibility.

3. The need for rebellion: Lorde’s army

Audre Lorde warned that “imposed silence about any area of our lives is a tool for separation and powerlessness” (Reference Lorde2020, 1). Reflecting on her experience living with cancer in particular, she writes,

To resist this imposed invisibility and silence, Lorde called on breast cancer survivors to claim our post-mastectomy bodies and use our voices, envisioning an “army of one-breasted women” marching on Congress to demand systemic change (Reference Lorde2020, 9). Forty-five years after Lorde’s reflections and social critique in The cancer journals, a cacophony has replaced the silence surrounding the disease. Each October a gender-reveal party disguised as awareness paints coffee cups and merchandise baby pink, while stories of bravery and resilience flood social media. However, the ways in which pink ribbon rhetoric and its surrounding narratives have evolved only amplify Lorde’s concerns about the practices and stories that socialize survivors into silence and keep political justice out of the conversation.

To bring the dominant breast cancer survivor narrative into view, we can begin by examining the structure of the narrative itself. Cancer survivor narratives generally share a linear structure with clear delineations between the binary of illness and health. Regardless of the specifics, the outcome as it relates to one’s identity is the same—cancer survivors by our very definition must claim a place on the other side of a magical line that divides those that die of cancer from those that survive. Often cancer itself is portrayed as an “enemy” to be “battled”: those who die are said to have “lost their battle” while those of us who survive become the victors who “won.” The images conjured by this active, violent metaphorical use of language may lead one to believe that treatment is a sort of epic fight scene choreographed to a dramatic score punctuated by heroic clanks of metal. The lived experience of cancer treatment and survivorship, however, is not quite as exciting, or at the very least, a lot less active. It would perhaps be better represented by a long, awkward elevator ride under harsh fluorescent lighting, scored with an incessant onslaught of easy listening. (Think less Braveheart, more Beckett.) For one thing, there is a lot more waiting involved—for results, exams, infusions; for an insurance authorization to be approved; for the blaring buzz of an MRI machine to end; for the voice to instruct us to “hold your breath” or “breathe”; for our bruises to go away; our hair to fall out, our eyelashes to grow back; for “your call to be answered in the order it was received”; for “the doctor will see you now.” In fact, for the fighting metaphor to hold, a more accurate depiction of modern cancer treatment may be to say that the doctors are battling the cancer, while we try our best not to die.Footnote ⁷ If we have been to war, it’s our bodies that are the battlegrounds.

Breast cancer is different from other cancers precisely because the cancer forms in a person’s breast and its number one risk factor is simply “being a woman.”Footnote ⁸ When becoming a breast cancer survivor, an intersection appears that forces a person to negotiate their identity not only against the binaries of sickness and death or healthy and in remission but also against a rigid gender binary. As anthropologist S. Lochlann Jain puts it, “breast cancer in particular drags one by the hair into the territory of gender” (Reference Jain2013, 68). The “territory of gender” that defines breast cancer is by-and-large white, cis, heteronormative, and hyper-feminine (literally, “think pink”). This of course complicates the image of the “Cancer Survivor,” as breast cancer survivors are somehow seen as those same courageous warriors wielding clanking metal, only now she’s wearing a hot pink tutu, perhaps pausing for a demure sip from her baby pink Stanley cup before happily getting back to the battle. If this imagery sounds a bit absurd, you are starting to get the picture. Lorde noted her feelings of alienation during diagnosis: “I have cancer. I’m a Black lesbian feminist poet … Where are the models for what I’m supposed to be in this situation? But there were none” (Reference Lorde2020, 21).

As the cancer survivor narrative produces a survivor identity, the dominant breast cancer survivor narrative attempts to create a feminized version of this identity manufactured to ideal specifications of a “normal woman” (e.g., white, cis, heteronormative). In some ways this manufacturing takes the form of physical changes, such as encouraging a bilateral mastectomy—regardless of where cancer has been detected—or through invasive reconstruction techniques pitched by surgeons as a “tummy tuck”Footnote ⁹ covered by insurance. In other ways the production of this ideal is more insidious, created through reinforced narratives of the warrior or grateful breast cancer survivor—a woman who “beat cancer” through some unique combination of bravery and/or luck, and afterwards, returns “back to normal.” This socially imagined survivorFootnote ¹⁰ greets each day with a thank you, rather than see a need to question the medical and social institutions that she has been pushed, prodded, and produced through. Lurking behind the bubble-gum pink positivity of this narrative is a familiar message—perhaps we wouldn’t have gotten cancer in the first place if we had just smiled more. This sentiment seems to be exclusively reserved for breast cancer due to the gender ideology surrounding the disease. Imagine demanding the same cheery, gracious demeanor from say a firefighter or veteran who survived lung cancer from 9/11 or toxic burn pits.

Another consequence of this imagined breast cancer survivor is its reliance on trans-exclusive logic. It is important to note that trans men and women, non-binary folx, and cis men also get breast cancer. However, in part due to the gendered narratives associated with the disease, these communities often suffer additional harms as their hermeneutic marginalization may lead them to misunderstand their own risk, to not receive equal treatment or adequate resources by healthcare providers, and to be alienated from support communities.Footnote ¹¹ Moreover, the dominant narrative can actively block their understanding of their identity as survivors. As Jain laments when trying to reconcile their experience “in the sea of pink designed precisely to ‘heal’ by restoring and recuperating a presumed ‘lost’ femininity … There is simply no subject position available for cancer butch” (Reference Jain2013, 521).

Barbara Ehrenreich notes in “Welcome to Cancerland,” that much of the cheery, pink-fueled, teddy-bear-infested cancer culture serves to depoliticize breast cancer awareness. She writes, “the effect of this relentless brightsiding is to transform breast cancer into a rite of passage—not an injustice or a tragedy to rail against, but a normal marker in the life cycle, like menopause or graying hair” (Ehrenreich Reference Ehrenreich2001, 49). As part of this depoliticization, pink-washed breast cancer culture also works to shape women’s understanding of their own cancer experience. Analyzing personal survivor narratives from message boards and interviews, Ehrenreich notes that they

To be clear, I do not want to deny that a confrontation with one’s mortality can be a site for self-reflection and meaning-making. Rather, I agree with Lorde that it requires an honest confrontation as “self-scrutiny and an evaluation of our lives, while painful, can be rewarding and strengthening journeys toward a deeper self” (Lorde Reference Lorde2020, 50). As she writes,

This is one of the many reasons I agree with Medina (Reference Medina, McIntyre, McHugh and Olasov2022, Reference Medina, Dieleman, Rondel and Voparil2017) that we need to cultivate epistemic practices of resistance that continually interrogate the social imagination. As without critical engagement, the meanings of even the most liberatory and powerful narratives will be co-opted in support of systems of oppression over time. For example, one could argue that the image of the warrior survivor, so dominant today, was originally conjured by Lorde. Referring to the Prime Minister of Israel, who wore an eyepatch, she writes,

For Lorde, the image of the warrior was a call for visibility and political action. However, rather than serve as her call for solidarity or racial justice, today, the imagined warrior finds a home alongside slogans such as “fight like a girl,” while women “race for a cure” or to “save second base.” The result is millions of individuals on their own journey toward the salvation of survivorhood rather than a collective struggle against environmental racism or factory farming.Footnote ¹² Beyond the focus on the individual, breast cancer survivors as an imagined collective are still in many ways defined by socially enforceable boundaries and who those boundaries operate to exclude. In the case of Lorde, as much of her language is infused with her experience as a woman who loves women, mourning the loss of her breast, it can tend to be cloaked in images of essential femaleness and naturalness. Queer theorist Eve Kosofsky Sedgwick experienced a sense of dissonance around these associations during her own treatment, writing “One of the first things I felt when I was facing the diagnosis of breast cancer was, ‘Shit, now I guess I really must be a woman.’ … In the day-to-day experience so far of living with and fighting breast cancer, meanwhile, I feel inconceivably far from finding myself at the center of the mysteries of essential femaleness” (Reference Sedgwick1992, 202–4).

Lorde’s warrior survivor also relies on a sort of virtuous bravery (i.e., mastectomy as battle scar) which assumes an enemy not of one’s own making. While this is a liberatory narrative when politicized, once depoliticized and co-opted it can become a way to alienate and divide oppressed groups. To understand the implications of this, it is important to remember that one of the ways in which breast cancer awareness and activism defines itself is against the frame of the 1980s AIDS epidemic.Footnote ¹³ Sedgwick recalls her discomfort during an “evening of wit, wisdom, and storytelling for lesbians,” when the speaker suggested that the reason there was less research money for “our” disease was due to the supposed riches being dedicated to “theirs.” She writes:

With the dominant breast cancer survivor narrative in view, in the next section, engaging Katharine Jenkins’s account of gender identity (Reference Jenkins2016, Reference Jenkins2018) I examine the ways in which gender identity power operates through the narrative. I argue that even a woman who rebels against normative conceptions of how her body “ought to be,” will still be constrained by the same identity power she seeks to subvert. Put another way, she will be defining herself in relation to the very normative constructions which she is rebelling against.

4. Scripted selves: identity power and the image of woman

According to Fricker, dominant narratives wield identity power, a form of social power that can operate positively or negatively, to produce or constrain action: it can both construct and distortFootnote ¹⁴ one’s sense of self (Reference Fricker2007, 55). In this section I want to examine one form of identity power wielded by the dominant breast cancer survivor narrative—gender identity power. There are many identity-based accounts of gender, however, I find Katharine Jenkins’s account to be the most helpful for this analysis.Footnote ¹⁵ Jenkins has argued that woman can best be understood as a person who is constantly negotiating and navigating her way through a socially constructed map that is formed by some relation to both gender as class and gender as identity (Reference Jenkins2016).Footnote ¹⁶ More recently, she has come to refer to this as the norm-relevancy account of gender identity (Reference Jenkins2018). She contrasts her conception with her understanding of both Jennifer McKitrick’s (Reference McKitrick2015) and Talia Mae Bettcher’s (2017) accounts of gender identity. Whereas for McKitrick, gender identity is a disposition to behave in social contexts in ways that are perceived as gendered, and for Bettcher, self-identification is all that is needed, the key difference in Jenkins’s account is the fact that someone experiences certain gender norms as relevant to them (Reference Jenkins2018). It is this focus on experience (and more importantly, the interaction between experience and identity) that I want to get at in my analysis.

On Jenkins’s definition, negotiating internalized norms of femininity is not necessarily synonymous with accepting them. Rather, she says, we understand ourselves in relation to these socially constructed norms whether we comply with them or not. She illustrates her theory using the example of body hair. Let’s say that woman “A” removes hers and woman “B” chooses to let hers grow. As woman “A” lines up with the dominant norm of how her body “ought to be,” she will move through the world classed as a woman in a way that may avoid social censure. Woman “B,” however—even though what she’s doing is the same as what most men do—as she’s classed as a woman, she may be subject to social censure. With this model in view, we may think of woman “B” as a rebel—someone who intentionally defies normative conceptions of gender. My concern, however, is that if we take identity power into account, then both woman “A” and woman “B” are still only able to understand themselves—whether positively or negatively—in relation to this socially constructed map. Thus, even if a woman comes to conceive of herself as the type of person who rebels against, or does not conform to, a certain expectation of how her body “ought to be,” she is still subject to the same identity power she seeks to subvert.

To illustrate how Jenkins’s theory works, we can examine a concrete example from Lorde’s experience. After her mastectomy, Lorde encountered two women who encouraged her to wear a breast prosthesis made of lambswool. The first was a cheery volunteer who told Lorde that she would feel much better about her own body if she wore it. However, after trying it on, Lorde decided she felt better—and more like herself—without it. She returned to her breast surgeon’s office feeling confident in her own skin and one-breasted body: this was deemed unacceptable. A nurse pulled Lorde aside to chastise her for not wearing the prosthesis, saying, “You will feel so much better with it on … besides, we really like you to wear something, at least when you come in. Otherwise, it’s bad for the morale of the office” (Reference Lorde2020, 52). If we understand the “morale” in question as a desire to maintain confidence in this socially constructed normative gender map, we can see that Lorde, classed as a woman, received social censure once her body was deemed “non-compliant.” In other words, even though Lorde was in a space surrounded by women encountering the same embodied experience, acting in a way that acknowledged that honestly, was deemed less important than maintaining the image of a “normal” two-breasted body. This of course is no less absurd than insisting that the Emperor’s new clothes are looking fabulous, despite what we can see and know to be the case.

Six years later, when dealing with breast cancer now metastasized to her liver, Lorde notes that from the moment she entered the doctor’s office, the doctor proceeded to infantilize her “with an obviously well-practiced technique” (Reference Lorde2017, 111). She writes,

With Lorde’s experience in view, we can begin to see how gender and racial identity power operate within and through the dominant breast cancer survivor narrative—rewarding those who comply with expectations aligned with the normative conception of how their body “ought to be” and obscuring, censuring, and policing those who do not.

Breast cancer treatments—and the practices designed to hide said treatments—have evolved from the lambswool prosthesis of Lorde’s time. However, the identity power wielded by the breast cancer survivor narrative remains the same. Despite the sheer ubiquity of the experience—one in eight women in the US will be diagnosed with an invasive breast cancer in her lifetimeFootnote ¹⁷ —survivors are socially directed to physically “pass” as if nothing has happened. Lorde’s fears surrounding “the dangerous fantasy” of breast reconstruction have been realized and advances in genetic testing have spurred a new category of previvors—women who undergo bilateral mastectomies, breast reconstruction, and remove their ovaries to mitigate the risk of developing breast cancer in the future.Footnote ¹⁸

With the physical manifestations of treatment socially concealed, we are likewise kettled into a particular understanding of our experience that maps onto a predetermined story—one that equates being a survivor as being “back-to-normal,” and being “normal” as adhering to socially imagined feminine norms (e.g., white, cis, heterosexual). As noted earlier, as a result of the identity power wielded by the dominant breast cancer survivor narrative, I believe survivors are subject to hermeneutical injustice. Hermeneutical injustice operates within and through socially imagined resources, such as concepts and narratives, and results in “having some significant area of one’s social experience obscured from collective understanding” (Reference Fricker2007, 155). Its distinctive harms can impact an individual’s ability to communicate her experience to others: it can also render an experience unintelligible to oneself, creating a particular kind of identity harm. In the case of this latter harm, there is not a conceptual lacuna waiting to be named, but rather an entangled web of narratives, images, and meaning to be dismantled. Fricker provides an account of this dismantling in her exposition of identity harms (Reference Fricker2007, 165–66). She examines the protagonist in Edmund White’s autobiographical novel, which tells the story of a boy who is gay growing up in the 1950s, and the various ways in which he must untangle his own experience against layers of social narratives that are stacked against him. The only conceptual resources available to him at the time were bogeyman narratives of “The Homosexual,” cloaked in images and language of illness, sin, and perversion. In White’s story, he is ultimately able to overcome the power that this narrative holds on him through an act of hermeneutical rebellion—a psychological move that enables him to overthrow these internalized, yet false, hermeneutical constructions of his social identity. To be clear, the act of hermeneutical rebellion is not a refusal of his social identity, but rather it is an act of creating his own meaning associated with that identity, apart from the harmful images and language that have been pushed upon him.

White’s story serves as an exemplar for Fricker’s understanding of an identity-related harm, as she defines an identity harm as an instance when “a person’s very sense of their own identity comes to be shaped by the negative meanings structuring the social space” (Fricker and Jenkins Reference Fricker, Jenkins, Garry, Khader and Stone.2017, emphasis mine). By contrast, I do not believe identity-related harms require the meanings structuring the social space to be negative. Rather, in the case of breast cancer survivors, I want to call attention to the ways in which identity power operates through narratives that may be understood to have positive social meanings. In contrast to White’s identity struggle against images and language of illness and sin, for example, the “Breast Cancer Survivor” is often cloaked in virtuous images and language of bravery and resilience.

Havi Carel and Ian James Kidd (Reference Carel and James Kidd2017) have called attention to issues of epistemic injustice within contemporary healthcare settings, aiming to open “an epistemic space for the lived experience of illness” (Fricker Reference Fricker, Kidd, Medina and Pohlhaus2017; Carel and Kidd Reference Carel and James Kidd2017:16). They have argued, in my opinion correctly, that norms of medicalized and professionalized language, along with material constraints (i.e., limited time, staffing, budget), often leave patient testimony to be misunderstood, dismissed, or not solicited at all. However, my concern is that, even when patients are consulted for open-ended testimony in their own words, unless the underlying identity power shaping their understanding is critically self-examined, their testimonies risk reinscribing the same social narratives that can lead to further hermeneutical marginalization for some. For example, the “Breast-Q” is a “rigorously developed patient-reported outcome measure” created to track the psychological, physical, and sexual well-being of post-reconstruction women.Footnote ¹⁹ It boasts being designed through “concept elicitation interviews” with 48 women, and then tested in focus groups with 58 more. The result of this socially constructed process, however, is that the questions are worded in such a way that makes certain normative assumptions—namely that every survivor’s desired outcome for the look and feel of her breasts should be some mix of normal and feminine. Here are just a few examples from the questionnaire: “With your breast area in mind, in the past two weeks how often have you felt: Confident in a social setting? Of equal worth to other women? Self-confident? Feminine in your clothes? Accepting of your body? Normal? Like other women? Attractive?”Footnote ²⁰ There is a distinct lack of language for a survivor to understand her transformed body in a way that disrupts these normative assumptions. As Lorde writes:

As Jenkins’s account of gender identity has helped to illuminate, even a woman who rebels against those norms which she experiences as relevant (e.g., for breast cancer survivors, the feminine norm of a two-breasted body) will still be constrained by the same identity power she seeks to subvert. A different kind of rebellion is needed, one which will loosen the grip identity power holds on her construction of self. In the next section, following Lorde’s thread that a woman’s perception of her own body can offer an alternative to a normative understanding of oneself, I analyze my embodied experience of breast cancer as wayfinding toward a different conceptual framework. I consider Donna Haraway’s myth of the cyborg as a model for a kind of rebellious narrative, highlighting the political possibilities this type of conceptual resource could engender.

5. The uses of absurdity: a cyborg rebellion

The uses of anger in liberating practices have been well documented by Lorde and others—the uses of absurdity less so. Lorde described her day-to-day experience of living with cancer as “a thirsty atonal combination of the mundane and the apocalyptic … Drastic life-changes laced together with the eternal ordinary.” (Reference Lorde2017, 130). When undergoing cancer treatment—whether living with cancer, dying with cancer, becoming a survivor, or surviving somewhere in between—the experience, with all of its contradictions and contraindications is, possibly above all, absurd.

As a breast cancer survivor and post-mastectomy woman, I, like Lorde, had a single mastectomy on my right breast. Unlike Lorde, I underwent a multi-stage breast reconstruction. I also continued systemic treatment including chemotherapy and hormone therapy for several months and years respectively. The particulars of my own case illustrate two points. First, many permutations of breast cancer exist which lead to varied treatments and experiences. Second, changes to our bodies and identities can extend, both physically and temporally, well beyond that of mastectomy. During modern breast cancer treatment, injections, amputations, and implantations redraw the lines between nature and technology, between oneself and other, not just day by day, but millisecond by millisecond. One injection transformed my body from “young and fertile” to “post-menopausal crone”; another from “all-natural” to “radioactive”; a few CCs of saline and my “breast” would inflate cartoonishly from a B to an E cup. Over the course of treatment, the identities staring back at me in the mirror shifted dramatically—a chic movie star rocking a headscarf and oversized sunglasses; an extraterrestrial staring wide-eyed through clear glasses frames; a young boy heading to the ball game; an aging car mechanic with male pattern baldness. All this is to say that I understand why Sedgwick called her own experience “an adventure in applied deconstruction” (Reference Sedgwick, Price and Shildrick1999). She writes,

Lorde warned that reconstruction is a “dangerous fantasy,” as it enables the painful realities of breast cancer and mastectomy to remain hidden from society and keeps survivors invisible to one another. This of course is true; however, I am never fooled.Footnote ²¹ My implant is different from the rest of my body. I am acutely aware of its presence. This object—this deviation from how my body, classed as a woman, “ought to be”—has made the ways that my “compliant” body moves through the social world visible to me, in some ways, for the first time. My right breast is stronger than my left breast. When someone bumps into me, my left breast recedes, it changes form, it accommodates; my right breast retains its place, it pushes back. When I lift something heavy, my left breast just sits there, soft, and smooth. My right breast clenches, the muscle tightening around it. When my body heats up in the night, my right breast maintains its cool.

As medicine and technology have evolved, so have the epistemic guardrails needed to contain the myriad changes our bodies go through. In certain instances, deviations from the norm run up against modern policing and tracking, where specifics may be condensed onto identification cards, requesting social permission for our body’s non-compliance.Footnote ²² For example, during treatment I was issued a series of three identification cards that narrated my condition to various strangers. The first two were temporary cards, designed presumably for security professionals, to assure them that, despite radioactive isotypes still lingering throughout my body after mapping my sentinel lymph nodes or a magnetic metal port being tucked behind a pocket of muscular tissue where my breast once was, that inside me there were “men” and “science” at work, and not to be alarmed. The third card included a serial number corresponding to the manufactured, warrantied, silicone blob embedded in my chest. A database keeps track of this part of my body, and a nameless representative calls from time to time to check on its structural integrity or alert me to any safety recalls.Footnote ²³

Somewhere in between the somber tone that people used to whisper about the cancer cells multiplying inside my body, the hyper-femininity of the baby pink surgical bra and candy striped hospital gowns, my bald head and eyebrow-less face, and the ridiculousness of trying to explain to a TSA agent that my breast is not a bomb, an absolute absurdity emerged—all of which only became more pronounced when trying to map varying versions of my hairless, breastless, radioactive, warrantied body onto an image of a survivor that I did not recognize. In other words, a dissonance emerged between the experience and the dominant hermeneutical constructions “ganging up to overpower its nascent proper meaning” (Fricker Reference Fricker2007, 166). In Fricker’s terms, this would place me, along with Lorde and Sedgwick, in the elusive category of an epistemic rebel.

Attending to the language employed by rebels, we can see that becoming a survivor may not be the linear process that the dominant narrative would have us believe. It can be “an adventure in applied deconstruction”—an absurd embodied experience of temporal identities that blur boundaries between illness and health, technology and nature, and normative conceptions of woman. To accommodate the plurality of these experiences, I suggest Donna Haraway’s cyborg narrative as an alternative (Reference Haraway2016). Cyborg narratives can provide “a way out of the maze of dualisms in which we have explained our bodies and our tools to ourselves,” as the ironic myth is “about the tension of holding incompatible things together because both or all are necessary and true” (Reference Haraway2016, 66–67). A cyborg narrative does not demand a return to womanhood in all its imagined wholeness or naturalness. Rather, it provides conceptual tools to interpret the experience of mastectomy and reconstruction in a new way—something created by science, implanted in a woman’s body, rewritten to become an emancipatory project.

To reiterate, as I have shown with Lorde’s “warrior survivor,” even liberatory narratives are susceptible to being co-opted by the forces that shape the dominant social imagination. For breast cancer survivor narratives, this means that they will tend toward white, cis, heteronormative conceptions of femininity, as well as ableist conceptions of what is deemed a “healthy” body. Thinking through Haraway, Jillian Weise reminds us in her important critique the “Common cyborg,” that the cyborg metaphor can be diluted when it is detached from the everyday struggles and systemic constraints faced by disabled and medicalized individuals (Weise Reference Weise2018). For breast cancer survivors then, a cyborg survivor identity is shaped not only through our resistance to normative narratives but also by our entanglement with medical, social, and economic systems that often seek to control and commodify our experiences. A cyborg survivor body does not obscure or hide the systems of domination that produce it, as they are the same systems which it renders visible: the same systems the cyborg rises against. As Haraway puts it, cyborgs are after all “the illegitimate offspring of militarism and patriarchal capitalism … But illegitimate offspring are often exceedingly unfaithful to their origins” (Reference Haraway2016, 57). Cyborg narratives can serve as a site of political resistance by creating a space to allow survivors to build identities that can not only tolerate but invite in the absurdities and contradictions of the lived experience of breast cancer. There is no “return to wholeness” for the cyborg survivor, and if there is any sage wisdom to be earned, it is about the systems, structures, and companies that produced them—not about the need to smile or pass. Fricker suggests that “finding something potentially authoritative to be absurd gives one critical courage” and that “one hermeneutical rebellion inspires another” (Reference Fricker2007, 167). For the cyborg survivor, the idea of returning to “normal” becomes absurd, because the absurdity of “normal” has been exposed. This reframing may provide the critical courage to examine, for example, the absurd ways in which women’s bodies are produced outside of breast cancer treatment and society’s unwillingness to bring similarly embodied experiences into conversation with one another. Actor Embeth Davidtz recalled her own realization of this hypocrisy when she decided to show her mastectomy scars in a sex scene. She said, “My reps were all like, ‘Why would you do this? You don’t want to be thought of as some sort of freak.’ I just said, ‘Look, I don’t see myself that way.’ This is a town where almost everybody’s breasts have been sliced, diced, manipulated, and put back together.”Footnote ²⁴ A cyborg survivor narrative can juxtapose, on the one hand, post-mastectomy reconstruction and chemotherapy weight loss and hair loss, and on the other hand, breast augmentation, eating disorders, and waxing. The possibilities opened up by this type of narrative can be summed up as follows—a cyborg narrative does not need the same epistemic guardrails or policing found in the dominant narrative, as its aim is rebellion and not control.Footnote ²⁵

I want to address some potential objections and implications of what disrupting the dominant breast cancer survivor narrative could mean for survivors’ ability to understand their own experience as well as for breast cancer awareness and advocacy in the future.

One may object, saying that breast cancer survivors do not need narratives that rebel against binaries or blur boundaries, rather they need a singular, hopeful narrative to sustain them through the experience. While I agree that a positive outlook and hope for the future are helpful during treatment, the hope that the dominant survivor narrative offers is false. This can cause survivors shame, leading them to self-silence when their experience does not meet the expectations of the narrative. What is often true is that after treatment depression and anxiety can be constant—whether from side effects of ongoing hormone therapy or late onset from previous chemotherapy, or due to post-traumatic stress disorder from the diagnosis and surgery itself. Cyborg narratives provide alternative conceptual resources that could make it easier for survivors to narrate their complicated experiences to themselves, developing the critical courage needed to defy normative expectations and reach out for help.

One may argue that disrupting the dominant breast cancer survivor narrative in this way could have a negative impact on awareness and advocacy—that the mismatched experience of a few outliers is a small price to pay for one of the most successful fundraising campaigns in modern medicine. On the contrary, I believe cyborg narratives could help move breast cancer advocacy away from pink-washed marketing toward political justice. Lorde asked what would happen if an army of one-breasted women descended upon Congress demanding “the use of carcinogenic, fat-stored hormones” be removed from our food supply (Reference Lorde2020, 9). Today, known endocrine disruptors such as phthalates and parabens are used widely, especially in products targeted to women (Harley et al. Reference Harley, Berger, Kogut, Parra, Lustig, Greenspan, Calafat, Ye and Eskenazi2019), and emerging research has tied beauty products disproportionately marketed to and used by Black women to uterine cancer (Chang et al. Reference Chang, O’Brien, Keil, Gaston, Jackson, Sandler and White2022). While overall survival rates for breast cancer have improved significantly since Lorde’s time, racial disparities have increased as well: today, Black women are 41 percent more likely to die from breast cancer than white women, and more than twice as likely if they are older than 50.Footnote ²⁶ In fact, as of 2019, breast cancer became the leading cause of cancer death for Black women.Footnote ²⁷ Lorde also saw clearly the entanglements of capitalism, colonialism, and racism, when she wrote of self-care as an act of political warfare. She writes, “Battling racism and battling heterosexism and battling apartheid share the same urgency inside me as battling cancer” (Reference Lorde2017, 115). She notes that in 1986 government research grants to the National Cancer Institute were cut by the exact amount illegally turned over to the contras in Nicaragua. “One hundred and five million dollars. It gives yet another meaning to the personal as the political” (Reference Lorde2017, 132–33). Today, we can draw a similarly direct line into the significant budget cuts the current administration has made to cancer research that will disproportionately harm the most marginalized and spending increases to fund violent oppression, suppression, and military intervention both inside and outside of the US.

The dominant survivor narrative obscures systemic causes and issues of breast cancer by amplifying the individual’s journey from her original sin of genetics or lifestyle through the redemption of survivorship. By contrast, cyborg survivor narratives can make these intersecting systems of oppression visible, allowing survivors to see themselves, each other, and the systems in which they are implicated, without the distorting effects of baby-pink-colored lenses. This visibility is a precondition for any meaningful solidarity and political action to take place.

Perhaps now we can reimagine Lorde’s army, adding to its ranks a collective of cyborg survivors—formed through an ongoing hermeneutical rebellion against the dominant breast cancer survivor narrative, and indeed other narratives that keep us socialized into silence and separate from one another. Such a rebellion requires attending to the plurality of experiences which render a boilerplate narrative absurd. And it requires using these stories as the epistemic building blocks to both seek out and imagine conceptual resources that enable individuals to construct their identities positively apart from the identity power wielded by dominant narratives.