Matthew Kohrman's
Bodies of Difference: Experiences of disability and Institutional advocacy in the making of modern China

book cover, showing hand-operated tricycle style wheelchairs used by polio survivors in ChinaA Book Review by:
Paul R. Bohman
Technology Coordinator, Kellar Institute for Human disAbilities
George Mason University
January 2006
Submitted January 2006 to International Sociology Review of Books (in press)

Matthew Kohrman shows his flair for drama and his penchant for storytelling right from the opening sentence of Bodies of Difference: Experiences of Disability and Institutional Advocacy in the Making of Modern China:

One day in the spring of 1968, a body dropped from a third-floor window at Beijing University. On the way down, it bounced off a steel guide wire, flipped, and thudded to the ground. A crowd of people quickly congregated. At first no one did anything except look at the young man and the point toward the window of the physics building from where he fell. Moments later, the twenty-four-year-old man regained consciousness and began to call to those around him for medical treatment. Still nobody came to the man's aid… (p. 1)

This opening passage sounds as if it could have been lifted straight from a crime drama, a murder mystery, or a pulp fiction novel. It was not. Despite the mystery and intrigue, Kohrman's book is an ethnographic treatise about the emergence of the modern concept of disability in China in the closing decades of the twentieth century. Kohrman chronicles a specific period of time in China's history, but this book is not a historical retelling of events in the conventional sense. It is an exploration of the ways in which the physical human body is integral to the concept of self, and to expressions of socio-political power. In Kohrman's words, "this book pertains to bodiliness, alterity, and the lives of a large number of people who reside in the People's Republic of China" (Preface, p. x) and "about the formation of state bureaucracy" (Preface, p. xxi) around these concepts.  Kohrman draws on the fields of anthropology (he is an assistant professor of cultural and social anthropology at Stanford University), sociology (including both gender studies and disability studies), political philosophy, and, to a lesser extent, psychology and biomedicine.

Ethnography is a form of storytelling, and Kohrman is keenly aware of his role as a storyteller. In fact, every chapter begins with a biographical vignette drawn from his many interviews. Like any good storyteller, he refrains from immediately revealing the full significance of events such as the young man's fall described at the beginning of the book (and at the beginning of this review). He reveals just enough of each story to capture the readers' initial interest and then begins to interweave the stories with the analytical prose of the critical medical anthropology he is developing. For example, in the first chapter we learn that the young man's fall was not introduced merely as a literary device. The young man was Deng Pufang, son of Deng Xiaoping, China's top government official from the late 1970s to the mid 1990s. Deng Pufang's fall from the third story window resulted in his paralysis and marked the beginning of his odyssey to improve the situation for people with disabilities in China. Deng would go on to form the China Disabled Person's Federation, a new governmental bureaucracy that would be instrumental in giving people with disabilities basic legal rights and benefits as members of a newly created protected social class. Kohrman invokes Max Weber's ideas on the formation of bureaucracies, which provide three typologies of domination: charismatic, traditional, and rational/legal. It was the charisma and political status of Deng Pufang (or, more specifically, the political status of his father) which allowed for the formation of the Federation in the first place. In order to outlive the organization's founder, Weber would say the organization had to engage in the "routinization of charisma" (p. 88) by evolving to emulate one of the other typologies of domination. The author provides a critique of the limitations of Weber's typologies while at the same time recognizing their usefulness as a starting point for understanding the socio-political power of organizations and the link between these organizations and charismatic leadership.

The formation of the Federation was no small matter in Chinese history. The very concept of "disability" had to be invented in the process, at least in the modern sense of the term. The word canji emerged as the word of choice to describe people with disabilities, though, as Kohrman explains, this word was not in common usage, and its many nuances differentiate it somewhat from its English language translation. These nuances are steeped in Chinese culture and social constructs. More often then not, canji is a term used to apply to males who are, to use a more disparaging term, quezi, which can be translated as lame, broken, or otherwise physically imperfect. The semantic association of canji and maleness occurs because of the cultural expectation that men should be strong, virile, and symbolically—if not literally—capable of empowering and strengthening the Chinese race and the Chinese nation-state in accordance with the Maoist ideology of "continuous revolution" (p. 185). The Chinese do not as frequently associate women with the term canji, despite census data showing that a slight majority of people fitting the legal definition of canji are in fact women. This is not to say that women escape the stigma of disability categorization. It merely reflects the a priori lower political and cultural status of Chinese women. Chinese families still generally associate male children with family honor through progeny and patriarchal political power.

Throughout his analysis, Kohrman seeks to look past the face value of words and events. He views the formation of the Federation as a watershed event in the process of ensuring legal rights for people with disabilities in China, but he does not celebrate its emergence without also counting its cost. Kohrman notes that the Federation, under Deng Pufang's leadership, provided legal legitimacy to a dispossessed population and provided them with forms of social security and welfare previously unavailable to them. Nevertheless, in the final analysis, the Federation is another governmental bureaucracy built upon and within the same centralized, male-dominated, paternalistic structure that "reinforced not only party-state authority but also, ironically, many of the very power relations that had been marginalizing people who, by one means or another, were understood to be canji" (p. 87). Very few of the Federation employees had disabilities themselves, despite Deng Pufang's frequent intonations "that the disabled must always be part of the Federation's 'flesh and blood'" (p. 108). Kohrman speculates that the preponderance of able-bodied employees is due in part to "administrative efficacy" (p. 109)—which is both a concept of expediency and a perceived need to be led by individuals who literally embody the ideal of strong leadership—and in part to protect the institution as a party-state entity by limiting any potentially subversive activism or advocacy within the organization by employees with disabilities. Many Federation employees did not have a genuine interest in disability issues and treated people with disabilities paternalistically. Despite the Federation's mission, it was built upon "ableist" precepts, wherein "bodily differences resulting in a perceived lowering of one's functional level are 'problems' (biomedical pathologies) which need to be ameliorated as quickly as possible" (p. 94). The biomedical model of disability is often at odds with the social-cultural model of disability now preferred by many in the field of disability studies, since the biomedical model delegitimizes a population by categorically defining it as abnormal, defective, and somehow less than complete.

The emergence of the Federation actually weakened some of the existing grassroots organizations. Kohrman tells how a small group of polio survivors began to meet together in 1982 as the Disabled Youths Club, inspired in part by the United Nations' International Year of Disabled Persons the previous year. This club began to dissolve in the late 1980s largely because the newly-formed Federation began to co-opt some of the reasons for the group's existence. In fact, several of the club's members were recruited to work for the Federation or otherwise became involved in the Federation's larger political goals. Unfortunately, the Federation and the Disabled Youths Club were two entirely different kinds of organizations, and the growth of one did not correlate positively with the growth of the other. As important as the Federation's work might have been, it introduced a level of bureaucratized impersonality and formalism which displaced the level of solidarity and camaraderie developed among friends in the Club. Years later, many members still harbored a sense of disillusionment and disappointment over the dissolution of the Disabled Youths Club.

One of the more interesting chapters is the one Kohrman saved for the end of the book. In this chapter, Kohrman examines disability in light of Chinese cultural views on marriage. Statistically, 45% of canji men age 30-44 never married, compared with 7% of the general male population. In a dramatic contrast, only 4% of canji women are unmarried compared with 0.5% of the general female population (p. 180). The vast disparity in conjugal rates between canji men and women harks back to the difference in cultural expectations for the two genders. The shame and incompetence associated with male disability is for many an insurmountable barrier to fulfilling the strong Chinese cultural imperative to marry and have a family. Both the pressure to marry and the difficulty experienced by canji men seeking to be married are so widely recognized that the Federation sponsors social activities with the express purpose of helping canji men find spouses. When a canji man marries, this is seen by many as perhaps the highest form of legitimization possible, and is reason for feeling relief that this man has not failed in life. Canji men who are still single or who never marry often face acute emotional pain and ostracism by community and family members. The stories Kohrman shares in this chapter are especially poignant.

Bodies of Difference turns a sympathetic eye toward an often-neglected category of minority: people with disabilities. Kohrman's analysis is specific to China, and includes enough cultural background to firmly ground his study in that context. At the same time, his attempt to find meaning in the events and processes associated with the emergence of canji as both a personal, embodied cultural construct and as an impersonal, bureaucratic socio-political construct engage the reader in a larger dialogue that transcends the geographic specificity of the Chinese concept of disability. "Canji," states Kohrman, "signifies a piece in a much broader and expanding field of unmet moral responsibility, one that demands far greater attention. Untold multitudes are suffering today worldwide under the weight of difference, whatever its exact form" (p. 212). He sees disability as one, but certainly not the only, form of difference, and argues that the way in which people perceive difference and treat those who are different is a vital component of interpersonal and institutional ethics and morality.

The book explores an important and sensitive topic with corresponding respect and dignity. Kohrman does not treat the subject lightly or patronizingly. In fact he continually criticizes those who do. He deftly deconstructs definitions and assumptions, including his own, in order to understand underlying themes or incongruities. He looks beyond the obvious and does his best to take nothing for granted as he sifts through large amount of historical evidence, interview data, and his own astute cultural observations. To his credit, he manages to unite these disparate sources of information into a cohesive whole that is as intellectually enlightening as it is emotionally meaningful. Though Kohrman's interpretations are his own, and are subject to reexamination and reinterpretation by others in the field, he treats the subject matter with impeccable scholarship and erudition, making his case clearly and comprehensively. This volume is a valuable contribution to the fields of critical medical anthropology, disability studies, gender studies, and Chinese studies.

Book citation: Kohrman, M. (2005). Bodies of difference: Experiences of disability and institutional advocacy in the making of modern China . Berkeley and Los Angeles, California: University of California Press.

Pages: 285 (including index)
Cover price: US $60.00 (hardcover); US $24.95 (paperback)
ISBN: 0520226445 (hardcover); 0520226453 (paperback)

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