Platform Biosensing and Post-Genomic Relatedness

How does direct-to-consumer genetic testing alter our perceptions of health, reproduction, families and futurity? DNA genotyping is a form of biosensing concerned with genetic risks, susceptibilities and relatedness. This chapter argues that genotyping services such as 23andMe prompt us to take seriously the platform realities of biosensing. DNA genotyping platforms attempt to aggregate data on an unprecedented scale, to anchor the significance of DNA variations for health and kinship, and to connect DNA variations to health practices and health futures. The biosensors commonly used in DNA genotyping are microarrays. Their architecture and the scale of data they produce are prototypes of scientific big data. The internet platforms and products associated with direct-to-consumer DNA genotyping embody a personalizing approach to health and medicine, even though the connections between underpinning scientific findings concerning genomic variation and clinical interventions or treatments are mostly tenuous. At the same time, because the significance of the million or so variations reported in a typical DNA genotype is mostly undefined, the data has led to many attempts to create new connections, to experiment with novel collective forms of analysis and treatment, and to build new relations between biology, medicine and everyday life.

Fertility Biosensing

Fertility- and hormonal- biosensing are becoming increasingly widespread across the global North. Multiple devices and apps, and their associated platforms, are used to track menstruation and ovulation, to measure sperm count, and to monitor hormonal changes associated with pregnancy, menopause and gender transition. Such practices are, we argue, changing the way users - and arguably many non-users - experience their bodies, their sexualities and their sex/gender. The relevant platforms collect and collate data from millions of devices, producing, in some cases, very large data sets about particular bodily events across huge numbers of users. This data has commercial value and is of interest to a wide variety of researchers. Whilst the practices of fertility- and hormonal-biosensing may increase users’ understanding of their bodies and thus resonate with feminist discourses on the significance of self-knowledge, we show in this chapter that they do not typically effect (let alone contest) conventional biomedical or scientific knowledge or practices. Fertility and hormonal-biosensing practices, we argue, remain quite limited as vectors of social change because of their conventional understandings of bodies and their failure to engage with the politics of platformisation.

Biosensing in Old Age

How does biosensing reach into the lives of older people living at home? Here we examine care monitoring systems for older people, or telecare, as this has become known. We focus in particular on the wearable falls detector, an alarm device which triggers, it is claimed, when a person trips or falls. We explore findings from ethnographies of home telecare and from citizens’ panel debates on how individuals and families live with such systems, and how falls detectors are constructed as workable. Following individuals' interactions with telecare we question the notion of self-tracking, preferring the term dys-tracking as better reflecting their relationship with automated devices. Falls detectors are technically highly complex, collecting data difficult to interpret. Ageing bodies are invariably assessed as low functioning and intrinsically at risk. Views from our citizens’ panels however, show a more active and imaginative constituency where practices of self-care exist alongside remote-care systems.

Conclusion: What Might Biosensing Do?

Biosensing in all its forms has strong connections to the promise-horizon of the ‘soon.’ But stories of failure, disappointment and limitation abound. We need to bring the body – or the bio in all its senses – full centre when discussing biosensing platforms. Moving across the life course - from childhood, through the so-called ‘reproductive years’ into older age, we have highlighted the significance of geographical, historical and social location. Biosensing may be about health for many people but as yet has little to do with biomedicine. Yet it has the potential to change human bodies and lives, in barely imagined ways. Policy makers and practitioners of all kinds could do well to devote time and resources to listening to and engaging with ‘the word on the street,’ as filtered through social science. People of all ages and backgrounds are thinking about, using and/or encountering biosensing, and they have much to say about it.

Introduction: What Does Biosensing Do?

Biosensor devices and biosensing practices emerge where health experience, scientific and medical knowledges and online platforms meet. In a synoptic discussion, we map some of these meetings and introduce the approach to health biosensing followed in this book. Our approach questions pervasive elementary assumptions about bodies, time and measurement. It expands to include a gamut of biosensings by comparing experiences of different life events, ranging from conception to ageing. We flag some of the significant institutional and regulatory problems in aligning scientific and clinical knowledges around biosensors. And we describe the volatile mixing of devices, data science, marketing and social networks on contemporary health platforms in terms of the cultural logics of biosensing.

Biosensing Stress

Stress is a notoriously slippery concept and experience: something many of us talk a lot about, and have a strong physical sense of, but which is difficult to grasp scientifically or medically. Human stress responses are complex and can be traced in multiple physical processes and changes, as well as in mental and emotional life. Attempts to biosense the physical signs of stress are inevitably bound up with these complexities, and reflect the multiple uncertainties of contemporary science and clinical medicine on this issue. Despite this, devices to monitor stress are increasingly available and are being taken up in various contexts, including workplaces such as the military and financial trading. In this chapter we explore how biosensing platforms articulate ‘stress’ and suggest how these devices and platforms might be used to further a bio-psycho-social understanding of human and non-human life.