10.6092/issn.2038-3460/17441
The paper explores how humans intra-act with self-tracking technologies, reconfiguring the plurality of expert and lay knowledge. In particular, the current contribution presents an empirical analysis of the use of apps to manage menstrual periods. The article is positioned at the crossroad between three literatures: actor-network theory; new relational materialism; and a sociomaterial perspective on the medical field as relates to self-tracking practices. These approaches contribute to pay attention on the processes of embodiment and embodied knowing situated into sociomaterial practices. The aim is to explore how the body learns “to be affected” through the material entanglements between humans and apps, and how selftracking technologies are engaged and provide support for processes of embodied knowledge. Research findings draw attention to how interviewees intra-act with apps for menstrual tracking, along an imaginary continuum at whose opposite points we can find – on the one hand – minimal engagement with the knowledge inscribed in the app and – on the other – an affective engagement with the knowledge suggested by the app. This continuum shows the overlapping intra-actions that perform embodied knowledge about how women fertility, subordinate to the various historical stereotypes, works.
application/pdf
2038-3460
17441
2
en
Letizia Zampino
https://creativecommons.org/licenses/by-nc-sa/2.5/
Tecnoscienza – Italian Journal of Science & Technology Studies
intra-actions
Self-tracking Technologies and the Menstrual Cycle: Embodiment and Engagement with Lay and Expert Knowledge
Text.Serial.Journal
https://tecnoscienza.unibo.it/
10
Essays
2020-01-30
2023-06-26
2020-01-30
2023-10-09
31-52
TS
Letizia Zampino
2019
10.6092/issn.2038-3460/17441
31
Sapienza University of Rome
2038-3460
2
intra-actions
en
52
Self-tracking Technologies and the Menstrual Cycle: Embodiment and Engagement with Lay and Expert Knowledge
https://tecnoscienza.unibo.it/article/download/17441/16291
10
                                                                              Essay
Self-tracking Technologies and the
Menstrual Cycle: Embodiment and
Engagement with Lay and Expert
Knowledge
Letizia Zampino
Sapienza University of Rome


     Abstract: The paper explores how humans intra-act with self-tracking
     technologies, reconfiguring the plurality of expert and lay knowledge. In
     particular, the current contribution presents an empirical analysis of the use
     of apps to manage menstrual periods. The article is positioned at the
     crossroad between three literatures: actor-network theory; new relational
     materialism; and a sociomaterial perspective on the medical field as relates to
     self-tracking practices. These approaches contribute to pay attention on the
     processes of embodiment and embodied knowing situated into sociomaterial
     practices. The aim is to explore how the body learns “to be affected”
     through the material entanglements between humans and apps, and how self-
     tracking technologies are engaged and provide support for processes of
     embodied knowledge. Research findings draw attention to how interviewees
     intra-act with apps for menstrual tracking, along an imaginary continuum at
     whose opposite points we can find – on the one hand – minimal engagement
     with the knowledge inscribed in the app and – on the other – an affective
     engagement with the knowledge suggested by the app. This continuum shows
     the overlapping intra-actions that perform embodied knowledge about how
     women fertility, subordinate to the various historical stereotypes, works.

     Keywords: self-tracking practices; embodiment; body; engagement; humans
     and non-human actors; intra-actions.

     Submitted: February 15, 2019 – Accepted: November 11, 2019

     Corresponding author: Letizia Zampino, DiSSE – Dipartimento di Scienze
     Economiche e Sociali, Via Salaria, 113, 00198 Roma, Italy. Email:
     letizia.zampino@uniroma1.it




TECNOSCIENZA
Italian Journal of Science & Technology Studies
10 (2) pp. 31-52 - ISSN 2038-3460                 2019
www.tecnoscienza.net
32                                                         Tecnoscienza - 10 (2)

1. Introduction

    Digital technologies offer new possibilities for monitoring, measuring
and visualising bodily and everyday wellbeing, potentially encouraging
the development of new forms of engagement between human and non-
human actors. The range of these technologies is vast: apps available for
downloading to mobile devices such as smartphones; wearable
technologies such as Google Glass and Fitbit; and sensors embedded in
devices that can record both an individual’s biometric information (e.g.,
body temperature, heart rate, blood glucose, etc.) and, in the smart city,
various aspects pertaining to the health of that environment (e.g., air
pollution, traffic, etc.) (Bianchieri et al. in Corbasiero and Ruspini 2016;
Lupton 2013; 2015; 2016; Maturo and Setiffi 2016; Pantzar and
Ruckenstein 2015). Self-tracking technologies allow users to monitor and
document a great deal of daily information, practices and activities:
calorie intake, fitness, weight, mood, sleep, reproductive health, chronic
disease, healthy environment, and so on. Everyday practices and
activities, as well as bodily functions, are transformed through these
devices into data, with the potential to derive statistical analyses and
graphical representations.
    The aim of this paper is to explore how humans intra-act with self-
tracking technologies, reconfiguring the plurality of expert and lay
knowledge (Barad 2003; Latour 2005). In particular, the current
contribution presents an exploratory empirical analysis of the use of apps
to manage menstrual periods. Self-tracking apps for the menstrual cycle
are intended to map and transform everyday symptoms, mood and body
indicators into data – statistics and graphs – in order to visualise
correlations and predict fertile moments, premenstrual syndrome and
future menstrual windows (Lupton 2015).
    Menstruation history is linked to a body of tacit knowledge (Polanyi
1967) based on myths, taboos and gender discrimination, often justified
by medical research on hormonal biological changes (Delaney et al.
1988). In the sociological health literature, there has been extensive
discussion on the transformation of symptoms and mood relating to
menstruation into medical problems, with the emergence of the category
‘premenstrual syndrome’ (PMS). 1 Medicalisation is a complex and
multidirectional process 'by which nonmedical problems become defined
and treated as medical problems, usually in terms of illness and disorders'
(Conrad 2007, 4). In many societies, for example, PMS does not exist.
This implies that medical knowledge is socially constructed, because a
disorder is not “ipso facto a medical problem” (Conrad 2007, 146).
Moreover, feminist scholars have highlighted how medical knowledge is
based on the assumption of male physiology as normative, with the
consequence that women’s bodies and experiences are particularly
susceptible to the medicalisation process (Bird et al. 2010).
Zampino                                                                   33
    The paper is constructed around two concerns: (1) how the body
learns “to be affected” through the material entanglements between
humans and apps, and (2) how self-tracking technologies are engaged and
provide support for processes of embodied knowledge.
    First, this article outlines the theoretical-interpretative framework,
drawing on actor-network theory (Latour 2005; Law 1992); new
relational materialism, with particular reference to the feminist onto-
epistemology of Barad (2003; 2007); and a sociomaterial perspective on
the medical field as relates to self-tracking practices (Lupton 2018). These
approaches have the common interest in the body, and together they
contribute to pay attention on the processes of embodiment and
embodied knowing through sociomaterial practices. Secondly, it
reconstructs the debate around the use of digital data by second and third
parties with the scope to surveillance and shape the habits and the bodily
information of citizens.
    Then, research findings draw attention to how women interviewed
intra-act with apps for menstrual tracking, along an imaginary continuum
at whose opposite points we can find – on the one hand – minimal
engagement with the knowledge inscribed in the app and – on the other –
an affective engagement with the knowledge suggested by the app.
    Finally, the discussion of empirical findings highlights these two forms
of engagement by which the embodied knowledge of the menstrual cycle
is back through material engagements between humans and apps.


2. Embodiment and Self-Tracking Technologies

    Self-tracking practices are reconfiguring our experience of
embodiment, our relationships and our meanings of body through
various practices of quantification. Self-tracking technologies have given
rise to Quantified Self-movement (QSm), founded in 2007 by two editors
of Wired, Gary Wolf and Kevin Kelly. The QSm motto is ‘self-knowledge
through numbers’, to underscore the capacity of data to become a mirror
reflecting imperceptible bodily functions, activities and practices
otherwise taken for granted (Wolf 2009). According to Pantzar and
Ruckenstein (2015), the voluntary self-tracker considers the data thereby
derived to be more credible and objective than his or her own sensations
and subjective experiences. Self-trackers experiment on their bodies
through the emergence of ‘personal analytics’, i.e., practices that typically
aim for self-optimisation (Moretti and Morsello 2017). Personal analytics
practices transform human bodies into data with the purpose of reflecting
in an objective way on themselves, others and on daily life.
    Most particularly, self-tracking technologies are designed to be used
in synergy with the body. This underlines the new intimacies of bodies
and objects (Viseu and Suchman 2010). According to Knorr-Cetina
(1997), objects take part in the co-constitution of social performances, in
34                                                         Tecnoscienza - 10 (2)

which they have situated meanings and uses. The author posits an object-
centred sociality, underlining a growing orientation towards objects as
sources for thinking about Self, forms of relational intimacy, shared
subjectivity and social integration.
    Adopting a materialist perspective allows us to see the body as flows
of heterogeneous sociomaterial elements that are relational and dynamics.
The sociomaterial approach implies that the social and the material are
co-constituted, namely that the nature and the culture are entangled. The
humans are always situated in assemblages of heterogeneous elements,
that have an agential capacity to affect producing power and resistance,
tensions and ambivalences. A central aspect of the sociomaterial
assemblages is that the matter is itself performed by the sensing and
embodied knowing, showing the engagement of people with forces,
things, bodies and other entities as entanglements of more-than human
worlds (Barad 2003; Latour 2005; Law 1992)
    We are immersed in assemblages where we learn to use the body to
become sensitive to the materiality. As Latour (2004, 205) underscores,
“to have a body is to learn to be affected, meaning ‘effectuated’, moved,
put into motion by other entities, human or nonhuman” (original
emphasis). The materiality is able to render the body sensitive to the
differences of the world. The body feels and it moves. It is not finishing
with the skin, but it encounters, tastes, hearings, smells other material
elements. It is affected by the ‘effects’ of the knowledge, which is
embedded and embodied within practices, by which we do experience of
time and space. The body is enacted in various ways, continually being
constructed through processes of incorporation and exclusion (Mol and
Law 2004). Reciprocally, the body shapes how practices are done, and
practices produce new responses across the process of producing sensible
knowing in which body do not have determinate boundaries, rather it is
co-constituted as an entanglements of relational and dynamics agency
(Latour 2005; Lynch and Cohn 2016).
    From a feminist materialist perspective, matter acts in assemblages in
which human subjects are entangled with technologies (Lupton 2018).
Boundaries between humans and non-human, as Barad (2003; 2007)
argues, are not naturally given but rather historically co-constructed. The
author proposes using the term ‘intra-action’ instead of ‘interaction’ in
order to take into account the mutual constitution of humans and non-
humans. This term is a way to reconsider the ability to act within
relationships and not outside of them. In this regard, she uses the form
“agential realism” to keep attention on the process in which the agency of
subjects and objects acts symmetrically in the production of social and
material worlds. The body emerges in ongoing discursive-material
practices: “‘We’ are not outside observers of the world. Nor are we
simply located at particular places in the world; rather, we are part of the
world in its ongoing intra-activity […] we know because we are of the
world” (Barad 2003, 29-30).
Zampino                                                                  35
    Self-tracking technologies may be considered as objects of knowledge
(Knorr-Cetina 1997) that are invested with expert and tacit knowledge
related to embodied knowing that is multi-situated at the same time in
materialities and discourses, but also in personal bodies and in their
experiences. The intra-actions as bodily/materiality articulations perform
various modalities of embodiment mediated by conventions and
traditions. The term ‘embodiment’ enables a discussion of how the
dichotomies mind/body and nature/culture are blurred in the materiality
of the bodies. Adopting Scheldeman’s (2010, 145) definition of
embodiment as “the way we live life ‘embodied’: with and through our
bodies” allows us to regard embodiment as a process by which the lived
body becomes a material-discursive phenomenon that comes to matter in
the mutual constitution of entangled agencies. The aim is not to extend
subjectivity to things. As Suchman (2008) emphasises, humans and non-
humans are not necessarily constituted one another in the same way.
Agency does not pre-exist separately, instead, “agency – and associated
accountabilities – reside neither in us or nor in our artefacts, but in our
intra-actions” (Suchman 2008, 8).
    Digital is material itself that becomes part of ongoing entanglements
across a range of everyday activities and practices that combine diverse
types of knowledge and capture our everyday spatiality. Here, self-
tracking practices help us see not only the entanglements amongst things,
people and data, but also and how these come back through new
sociomaterial forms embedded in the ongoing self-knowledge process
(Pink and Fors 2017; Sumartojo et al. 2016).
    Agency is relational and distributed through intra-actions and
entanglements of people with technologies. Particularly, humans and
apps work together in generating human-app assemblages (Lupton 2018),
in which knowledge emerges as a doing situated and enacted within and
across humans and nonhumans. In our case, apps for menstrual cycle
inscribe assumptions about users and what they will do with the apps,
that have been designed in order to suggest knowledge about how the
body should be working. However, humans and nonhumans generate
together agential capacities and forces that are continually reconfigured as
part of the lived experience (Lupton 2018). Apps directed at monitoring
the body inscribe knowledge that can be reconfigured through the daily-
human-use of the app. The process of reconfiguration draws attention to
how inscribed knowledge can suggest different ways to think about the
body. People who do not meet the inscription associated with the
imagined uses can activate different ways of tinkering with the ongoing
process of embodiment and selfhood.
36                                                          Tecnoscienza - 10 (2)

3. Surveillance in a Datafied Space

    The use, online and offline, of digital technologies leaves traces of
personal preferences, choices, habits and so on. These small data,
generated with and through digital technologies, are often aggregated
into big data, and thus become commercially profitable for second and
third parties. Some scholars (Kitchin and Dodge 2007, 2011; Kitchin
2014) have highlighted several important implications and issues
concerning access to and control of small data. Most designers and
developers of apps are very unclear about how the data are gathered,
analysed and then used in terms of becoming a kind of ‘dataveillance’ to
generate predictive health scores for users as well as preferences and
choices for shaping human behaviours (Beer and Burrows 2013;
Bossewitch and Sinnreich 2013; Boyd and Crawford 2012; Kitchin 2014;
Mann and Ferenbok 2013). The term ‘dataveillance’ is used to indicate
the systematic employment of digital data to surveil and monitor the
practices and activities of individuals or groups of people (van Dijck
2014). Thus, for example, a smartphone becomes an assemblage of
personal information, algorithms, websites, platforms, manufacturers and
retailers, policymakers, software and hardware developers, etc. It is a
black box that renders invisible the process of dataveillance by which the
personal information thereby gathered can easily be analysed and
grouped into discrete categories (Lyon 2002).
    When citizens voluntarily collect and share their personal data and
evaluations of various aspects of their social life and urban environment,
they contribute to various scientific research projects and policymaking.
They become data gatherers from below with the emergence of a
‘datafied space’, that provides a set of possibilities for how and where
things can (or cannot) materialise. Some persons choose to participate in
scientific research projects, collecting data that are quite important for
scientists. These initiatives directly involve citizens who collect health
indicators from their local environment, themselves or a combination of
both. Cities and bodies become expanded laboratories in which citizen-
scientists take on a crucial role for scientific and governmental
organisations in the empirical phase of collecting observations and
measurements for free (Coletta et al. 2018; Kitchin 2014).
    In particular, Jennifer Gabrys (2014) underscores the emergence of
new practices of subjectification through various uses of digital
technologies. Citizens can monitor and evaluate their own wellbeing and
environment, becoming sensitive to various aspects of life. According to
Gabrys, there is a distribution of relational power in the city, where
citizens are not just surveilled: they can also control their spaces with the
emergence of new practices of citizenship.
    Dataveillance has become a salient topic for theoretical reflection
about self-tracking practices. Herein, this theoretical framework is
Zampino                                                                 37
presented in order to illustrate the complexity around the analysis of how
digital data are embedded into more-than-human practices. However, the
focus of this contribution is on the sociomaterial entanglements between
humans and apps.


4. Methodological Issues

    The development of Web 3.0 – the ‘intelligent Web’ that uses
semantics, natural language, data-mining and machine learning in order
to provide a more productive and intuitive user experience – is
intensifying the production of data on different aspects of everyday life.
Some authors refer to this explosion of digital data as a 'data deluge'
(Savage and Burrows 2007) that brought the opportunity to rethink
everyday practices and routines in a datafication process by which human
behaviours, emotions and social relations are recorded and converted into
numbers (Roberts et al. 2016).
    Fifteen semi-structured interviews had been carried out with women
who utilize the app to manage menstrual periods. The semi-structured
interview is a performative research method that can produce knowledge
through the relationship between interviewee and interviewer (Law
2009). During the sessions, the interviewee became an ally in the process
of questioning and opening the black box of the knowledge inscribed in
the app (De Vita et al. 2016, 510; Sciannamblo 2017). This follows the
suggestion of Mazzei (2013) that the interview yields sociomaterialist
insights that can be thought of as an assemblage in which participant
voice “is produced in an enactment among researcher-data-participants-
theory-analysis” (p. 739).
    The interviews were conducted with fifteen Italian women aged
between 15 and 46 years, three of which were done via Skype. Lasting
between fifty and sixty minutes, they were audio recorded and verbatim
transcribed in order to analyse how apps for the menstrual period are
embedded in the user’s bodily knowledge. The interviews was intended
to examine four principal concerns: (1) the choice of application; (2) the
relationship between body and menstrual period; (3) the sharing of
personal data with other users, parents, friends, partners; and (4) the
sensibility about issues of privacy. The interviews were additionally
enriched by using the app in real time in order to join the story of use at
the practice of use.
    Following an abductive approach, the analysis of the interviews aimed
at generating creative, causal links and descriptions of particular
empirical instances (Timmermans and Tavory 2012). Adopting an
abductive analysis suggests entering the field with a theoretical
framework that becomes the basis for developing creative and novel
theoretical insights throughout the research process.
38                                                             Tecnoscienza - 10 (2)

          In other words, abduction is the form of reasoning through
      which we perceive the phenomenon as related to other
      observations either in the sense that there is a cause and effect
      hidden from view, in the sense that the phenomenon is seen as
      similar to other phenomena already experienced and explained in
      other situations, or in the sense of creating new general
      descriptions (Timmermans and Tavory 2012, 171).

    The analysis captures two forms of engagement between human and
non-human actors. The following sections draw attention to how
interviewees intra-act with apps for menstrual tracking, along an
imaginary continuum at whose opposite points we can find – on the one
hand – minimal engagement with the knowledge inscribed in the app and
– on the other – an affective engagement with the knowledge suggested
by the app. This continuum shows the overlapping intra-actions that
perform embodied knowledge about how reproductivity works.


5. Minimal Engagement

    Women have to learn to control personal cyclical spotting that is
different in duration and flow. Keeping track of the cycle’s length
through a diary and calendar, as tacit knowledge suggests, requires a
certain amount of time and commitment (with the purpose of estimating
future periods). The app translates the necessity of managing the
beginning and the end of the period as a means of deriving an automatic
prediction of future menstrual phases.
    The example that appears through the various interviews relates to the
need for an automatic memorandum that offers the possibility of
eliminating thinking about the cycle from the daily agenda. This is the
principal cause of engagement in the materiality of the app. For example,
Adele explains how she has used it:

          I started using it because I’m a big mess and I often forgot to
      mark it on the calendar… even with the app I'm a mess, but with
      the app I tend to be less [because] when I think that the period is
      coming, I open the app and check the previsions. So, I use it to
      know easily when the period is back. Let’s say, so I can organize
      me… (Adele, age 46)

   The app supports human organisation. It is easy to note the beginning
and end of the period, because the smartphone is already incorporated in
our lives. The app automatically organises the messy calendar to visualise
the chronology of the cycle through ‘objective data’ that can be used to
manage all the inconvenience linked with monthly spotting. For example,
Zampino                                                                               39
Chiara recounts how she has decided to replace the paper agenda with a
digital one:

               It happened that I was at a conference and the cycle arrived
          unexpectedly. I mean, I did not remember it properly... but it was
          quite problematic because I had to present my research in
          public… hence, there were several factors of annoyance and then I
          thought that... I mean, if I note down in the diary then I forget to
          check, maybe I'm not looking. And I thought this thing of the
          app... that is, the thing that I find useful is that it has a calendar so
          if I click on the calendar, I visualize the whole chronology of my
          cycle since I downloaded it. (Chiara, age 38)

    The diary needs to be fixed and the notes have to be checked. In
contrast, the app easily creates statistics and provisional data on the basis
of biological data collected by the woman. Self-tracking practices bring
back the material aspects of menstrual cycle, rendering the body sensitive
to the differences of biological changes. The body is translated in digital
information, even if the woman does not record all the informational
demands of the app. The following extracts pay attention to the different
ways through which the women interviewees embed the app in their lives
on the basis of different outlooks and necessities. It depends on their
knowledge about how reproduction works, so on engagement with the
knowledge inscribed in the materiality of the app.
    For example, Jasmina does not understand why she should record her
mood, symptoms and temperature, her cervical position or mucus
amount. She does not know how this information can be useful to create
a more reliable prediction of fertility and ovulation windows. It is
interesting to underscore that she opens the black box of statistics and
average menstrual and fertile windows only during the interview.
Statistics and averages are produced on the basis of a chronological
report of past menstruations. These functions produce data that can be
visualised only if the user tinkers with the app in order to understand
how it works. Before that, Jasmina had never tinkered with the app and
she did not know that it could be used to record all that information. She
says:

              We can see it… that is, I don’t really like this app, but I’m
          accustomed to use this one. See, you can record symptoms, mood,
          test results, contraceptives used… all these things, a little bit
          weird… maybe… let see, reports, predictions, chronology, sexual
          activities, temperature? Symptoms? Let’s see, it tells you how
          many times you recorded this symptom in the past thirty days. I
          mean, it does graphs, too. But, I don’t know… why I have to
          record all these data? Maybe I didn’t invest time to understand
          why I should to collect these data… (Jasmina, age 27)
40                                                             Tecnoscienza - 10 (2)

    In this case, the interview become an ally in the intra-actions between
the interviewee, knowledge of her fertility and the knowledge inscribed in
the app. This extract shows the minimal engagement of Jasmina in the
materiality of the app. She had not questioned the knowledge inscribed in
it because she only needed a memorandum of the beginning and end of
the menstrual window.
    Minimal engagement with the knowledge inscribed in the app also
depends on the gender stereotypes linked to menstruation. It emerges
that menstruation is a ‘thing’ that needs to be made invisible through the
materiality of the app. Chiara recounts that, when she downloaded the
app, she looked for one that did not seem to be obviously a program to
track periods:

          The icon is violet with a drawing of the number twenty-eight. I
      think that is regarded as the menstrual period’s length. By the way,
      I was looking for an app that didn’t look like female stuff for
      menstrual period… I just felt weird that someone could see stuff
      for my period on my smartphone. So, when I chose it, I thought
      about the icon, too. (Chiara, age 38)

    Another example that underlines the impact of gender stereotypes
about use of the app is the consideration that reproductive knowledge
becomes an issue only if a woman is seeking to become pregnant.
Contraception is based on methods such as the pill and condoms that
ensure protection without worry about the regular change that occurs in
the female reproductive system. Each cycle can be divided into three
phases: follicular phase, ovulation and luteal phase. These changes can be
altered using hormonal birth control such as contraceptive pills. The use
of these contraceptives is not linked to the need to think about hormonal
changes. Acknowledgment of the ovulation phase is considered over-
information because, as Palmira says, it is not necessary to know our
hormonal changes when you can employ ready-for-use contraception:

           I don’t understand… I mean, there is written fertile and
      ovulation window. I mean, I know that in the ovulation period you
      could have some spotting. Or maybe… I remember that spotting
      should be between the two phases. However, since I don’t want to
      get pregnant, I am not interested to understand these things. I
      mean, I don’t want to get pregnant, so I am not interested if I am
      fertile or not. Maybe it is very useful for women who want to get
      pregnant. (Palmira, age 20)

   The richness of this extract shows that the interviewee has not
questioned the medical knowledge inscribed in the app. She has confused
knowledge about fertility and ovulation and uses the interviewer’s
presence to tinker with the artefact. The materiality of the app provides
the possibility of using it to better comprehend one's individual
Zampino                                                                         41
sensibility. Palmira is subordinated at the historical stereotypes about
menstruation seen as a reproductive business that can become an issue
only while trying to get pregnant. Until that time, it is important to know
cycle length to understand if it is regular or not and, consequently, to
control it.
    Here, it is possible to underscore that even minimal engagement in the
intra-action with the app can produce knowledge reconfiguration. The
knowledge reconfiguration gives rise, for example, to greater awareness of
one's cycle length. Even if the app is used only for noting the beginning
and the end of menstruation, its capacity to produce averages and
predictions can enhance and extend knowledge of the user’s own cycle, as
Palmira explains:

              I knew that my cycle was coming because that I had a
          traditional backache, so I didn’t need the app. But I realized that
          my period was irregular, and I thought ‘let me understand how
          much it is random’. Then I began to use the app in order to
          understand my irregularity. And I had realized through the
          average produced by the app that my period is about 35 days long.
          So, I utilized it just to understand my period’s irregularity… my
          friends are so regular, they don’t need the app. (Palmira, age 20)

    This extract shows how minimal engagement produces minimal
knowledge reconfiguration. The minimal reconfiguration knowledge is
linked to awareness of the cycle’s length. Now Palmira knows that her
cycle is 35 days long. However, she is convinced that her period is
irregular only because it is not 28 days long, even though medical
knowledge affirms that menstruation is regular if it occurs anywhere
along a 21- and 35-day cycle. In this sense, Palmira has not questioned
her knowledge that is linked to the myth of regularity that defines a cycle
as normal only if it is 28 days long.
    Here, self-tracking practices show how the materiality and sociality act
symmetrically producing different uses of the app in everyday spaces. The
materiality of statistics and graphs produces different means embedded in
the knowledge about one's own cycle, which at the same time act in the
ways in which the app is used.


6. Affective Engagement

    This section shows how the entangled agency between humans and
non-humans can produce overlapping forms of intra-action by which
both personal and expert knowledge are reconfigured. Here, attention is
directed to the form of engagement embedded within reflexive tinkering
with the expert knowledge suggested by the app. The agency of the app
emerges through its capacity to make visible how fertility should work on
42                                                               Tecnoscienza - 10 (2)

the basis of the data recorded by women. The body is broken down into a
series of symptoms such as acne, back pain, headache, change in mood,
identifying traces of sociomateriality left by statistics and graph.
    The principal characteristic of affective engagement is recognising that
the working of the app depends on biological knowledge that becomes
visible in the concrete daily experience. The body is ‘learning to be
affected’ through tracking some symptoms. The interviewees are
becoming more sensitive to recognising various changes in their bodies as
linked to menstrual phases. Even if they know their menstrual symptoms
and mood, the app provides proof of such connections. In this regard,
Maia says:

           At first, I recorded symptoms and other things because I
       wanted to understand. I mean, I thought: ‘Maybe these symptoms
       such as headache and back pain are regular, maybe they reappear
       in the same way’. So, I kept a note. But now, I’m sick of recording
       this information. I just don’t really have time for the app, either.
       But sometimes I record it if I have a bad headache or particularly
       strong pain. Then if it occurs again, I can say: ‘Well! It was
       because of my cycle!’ […] I mean, I like to know when I am in the
       max period of fertility because I know that it is linked to some
       symptoms, like spotting, etc. I like to know if they are linked to my
       cycle or not. (Maia, age 26)

    Here, Maia collides with the suggestion to recognise PMS in some
symptoms in her daily mood. She uses the app to track her symptoms and
emotion, but this does not mean that she records all the information
suggested by the app. To the contrary, she just tests her bodily knowledge
to confirm some connections. After that, she embeds the app in a
reflexive underutilisation, because she recognises when her mood or
various symptoms are linked to her cycle; for this reason, she does not
always feel the need to record that information. We can note how intra-
actions between humans and non-humans translate agential capacities
and forces by a setting of uses that take into account the materiality and
sociality of the lived experience.
    As a counterpoint, Adele monitors symptoms to confirm that she is on
the threshold of menopause. In this case, the app is a repository of traces
that make it possible to join to demonstrate an assumed awareness. She
recounts:

           …seeing how much time, how many days my periods last, the
       amount of flow, on which days it is concentrated. Those are data I
       come back to. In fact, it is through the app that I have understood
       that my cycle has become shorter—for example, from 28 days to
       25 or 26 days. When you can visualize this through statistics, you
       have a different awareness and possibly you are surer about your
       body. Indeed, among other things, it is more useful for giving me
Zampino                                                                            43
          knowledge about my body. Because I have a coil, I have no
          problem controlling my cycle from that point of view, to control
          my fertility or not, or rather to become pregnant or not. Let’s say,
          I’m quite… Yes, the app gives me further knowledge of my body,
          how it changes and how it is changing. (Adele, age 46)

   This extract shows the agential relationship between humans and non-
humans. The agency of the non-human actor lies in its capacity to
produce personalised statistics that are reconfigured through self-tracking
practices embedded in everyday activities. Some interview extracts show
that women often play with the app even just for short periods or for
some needs, such as when Ada was trying to get pregnant:

              It helped me because I more or less knew my fertile days.
          Obviously, it’s not one hundred per cent sure! There must also be
          some luck. We succeeded immediately. I was pregnant by the
          second month! So, I don’t know if it was the accuracy of the app
          or luck […] I recorded the times we had sex, so I could see more
          or less the two days in which I got pregnant, which were the two
          days close to my ovulation day. (Ada, age 31)

   Ada knows how fertility works, pointing out that she is not sure about
the accuracy of the information the app provides her. Maybe, if she had
not used the app she would have obtained the same result. However, it
gives her support in determining when she is in the fertile window,
becoming an ally in her aim of getting pregnant.
   If, in the previous extract, attention is on the possibility of visualising
ovulation days, in the next the app can help to visualise how fertility
works; as such, it can organise dates and thereby play an active part in
contraception dynamics based on the use of a condom. Ofelia explains:

               I mean, before using the app, I didn’t have exact control over
          at-risk days for having sex. I mean, I know that there are other
          ways of knowing that, because [name of app] doesn’t discover
          anything. However, it’s so much simpler with it. The cycle comes,
          and I just sign in, that usually it’s already foreseen. Moreover,
          there is the possibility to track symptoms and… Look how
          beautiful! You can track everything, even acne. But, when I have a
          partner, I often need to know if I will be in my period or not in
          order to organize, you know... I mean, it’s simpler to organize.
          Obviously, if you use a contraceptive method, you don’t stop
          using it. But, I mean, it can be useful, that is, it’s better to know.
          So, you are even more aware of your body than your relationships.
          (Ofelia, age 25)

   Ofelia has biological knowledge about how a woman’s body works,
and she recognises this knowledge in the app’s materiality. She knows
that the prediction of fertility and ovulation windows depends on
44                                                               Tecnoscienza - 10 (2)

biological mechanisms that could be calculated manually with the use of a
calendar; however, she had never calculated her ovulation days prior to
obtaining the app. Ofelia’s affective engagement is embedded in her
reproduction experience of a 25-year-old university student who thinks
about her reproduction only in order to avoid pregnancy. The app is
considered an enhancement to the use of the condom, becoming a
contraceptive itself.
    The same function can be used in different ways, as suggested by
Chiara’s experience. Chiara is 38 years old with high investment in her
academic career. She has postponed having a child, thinking that one day
she will satisfy her need for motherhood. But now that her reproductive
life is approaching the menopause phase, she knows there is a high
probability that she will fail in her desire to have a child. Here, the
function of visualising the ovulation window becomes a way of reflecting
on the body in relation to reproductive and sexual life, as Chiara explains:

           My awareness has changed regarding a whole series of things!
       For example, since I was not trying to get pregnant – at this
       precise moment, I don’t even have a partner […]. I never even
       thought about using the Knaus-Ogino method as a contraceptive.
       The whole story of when I’m ovulating, I mean, awareness of when
       I was ovulating, I would have preferred not to have this awareness.
       […] I don’t know how to explain… the app doesn’t produce any
       kind of changes. It’s not that… It’s the fact that displaying certain
       types of information makes it hard not to think about it. So, for
       example, since I’ve been using this app, every time it tells me
       ‘today is a fertile day’ I’m thinking, ‘another day of my life that
       hasn’t been used’. I don’t change my mind or do different things,
       but… (Chiara, age 38)

   Here, Chiara embeds the visualisation of ovulation windows
materialised through statistics and graphs in her ideas about motherhood.
She sees the averages and the forecasts as unfertilised eggs. In this sense,
the use of the app is embedded in her thoughts about fertility, ovulation,
motherhood and gender discrimination regarding PMS definition. She
says:

          For example, when I take the pill and the app tells me ‘You’re
       ovulating’, I think ‘What a fool!’, I mean, it’s not very rational
       […]. Then it says ‘PMS’, which I imagine means premenstrual
       symptoms. But I think this is a sexist thing, as it never occurred to
       me to record whether I had symptoms. (Chiara, age 38)

   It is interesting that Chiara uses human language to make fun of the
app. She tinkers with the non-human actor with complaints about the
definition itself of PMS, since recording symptoms and mood reproduces
and thereby keeps alive sexism and taboos around the female period.
Zampino                                                                 45
    In this second engagement form, the body comes to matter within an
effective engagement between human and non-human actors. The agency
of the app performs the recognition of some bodily elements otherwise
taken for granted. On the other hand, the women interviewed tinker with
the suggested knowledge about how the body should work. The result is
an affective engagement of apps and bodies, which become more
sensitive to understanding menstrual phases.


7. Discussion and Conclusion

    The two forms of engagement analysed in previous sections are
considered as a continuum whereon overlapping intra-actions can
produce different experiences of embodiment.
    Tracking menstrual cycles can bring back the materiality of hormonal
changes. Analyses of these engagements illustrate how bodies learn into
dynamic assemblages in which, reciprocally, body shapes how practices
are done, and practices produce new responses performing the body in
both social and material ways (Lynch and Cohn 2016). The result is that
self-tracking practices emerge as part of ongoing process across a range of
everyday activities, combining diverse types of knowledge.
    The first form of engagement embeds the necessity to control the
beginning and the end of menses on the basis of biological knowledge
that, inscribed in the materiality of the app, provides an algorithmic
memorandum. The second implies a reordering of the knowledge
suggested by the app, rendering alterations within the body affected at
the various meanings that could express hormonal changes. This
interpretation is sustained by the difference that emerges from the
interviews between inscribed knowledge and suggested knowledge. In the
first case, interviewees recount how they use the app, describing it as a
black box that produces predictions about the next menses. They have
not questioned how tracking menstruations could be the result of a
materiality that incorporates biological knowledge about how the
menstrual cycle should work and, as well, developers’ assumptions about
users and how they should use the app. Self-tracking practices replace the
use of pen and calendar, becoming part of the women's tacit knowledge
about bodies and menstruation (Polanyi 1967; Scheldeman 2010). In the
second case, women tell about how they tinker with the device, seen as a
repository of inscribed knowledge that suggests different ways to think
about their relationships and, further, meanings of their own body-as-
lived. Here, menstrual tracking becomes part of the process by which
body ‘learns to be affected’ by entanglements of humans and nonhumans
(Latour 2004).
    The two forms of engagement assume diverse nuances in thinking
about the body. The extracts of the first form analysed describe a
46                                                        Tecnoscienza - 10 (2)

confused knowledge about fertility subordinate to the various historical
stereotypes. Here, it is important to know cycle length to understand if is
regular or not (and thereby control it). Some of the interviewees do not
care about how the app works, since they do not know all its functions;
they use the interviewer’s presence as an ally to understand the
knowledge inscribed in it. The extracts of the second form describe the
process by which knowledge inscribed in the app becomes a way to think
about fertility, ovulation, motherhood, PMS and gender stereotypes. In
this case, the visualisation of ovulation and fertility windows is embedded
into daily experience whereupon the body is continually reconfigured as
part of the lived experience (Lupton et al. 2018).
    Regarding this point, it is important to note that the interviewees
emphasise the difficulty of trusting in the suggested knowledge. The
dynamics of ovulation remain invisible, and for them a graph or an
average cannot represent the reality of the biological mechanism. The
interviewees underscore the challenge of recording all the information
requested by the app, even though it allows them to reflect on some
connections otherwise taken for granted. Here, we can see how the
boundaries between humans and non-humans are co-constructed and
tied to heterogeneous elements. So, rather than delineate what capacities
are human or technological, analysing self-tracking practices as embodied
knowing helps capture how humans and app act together in the
construction of entangled agencies.
    This interpretation is also sustained by the examples presented in the
section on affective engagement with the materiality of the app. Even
though the application suggests knowledge and practices, women play
with it even for just a few moments or periods or, alternatively, for
specific necessities, such as when Ada was trying to become pregnant.
She knows that she would maybe have obtained the same result without
the app’s use, but it becomes an ally in the acknowledgement of her
ovulation phase. In particular, even though self-tracking technologies are
designed to act in synergy with the body in order to produce reliable
data, the extracts analysed reveal the mutual translation between what the
app suggests monitoring and what the woman actually tracks. It is
important to draw attention to the constant renegotiation between how
the app should be utilised and how it is used in real-life experience. As
we have seen, agency is relational since the app enacts expert knowledge
that acts to produce graphs and statistics. At the same time, women
record only that information considered useful in the economy of their
everyday lives. Here, we can see the process by which the agency of
subjects and objects act symmetrically, producing data that are co-
constructed into human-app assemblages (Barad 2007; Law and Mol
1995; Lupton 2018).
    The intra-actions between interviewees and apps standardize
symptoms as acne, tender breasts, bloating, feeling tired, mood changes
across the materiality of graphs and statistics. The affective engagement
Zampino                                                                 47
with the materiality is able to render the body sensitive to recognise some
menstrual signs, which emerge as the result of intra-actions between
knowledge inscribed in the app and tacit knowledge embedded in human
corporeality. As Maia said, knowledge inscribed in the app suggests that
tracking symptoms and signs can derive demonstrable proof of the
connection with one's upcoming menstruation. In addition, the affective
engagement in one's cycle and its fulsome implications can be embedded
into not using of some functions in order to contrast, as Chiara explains,
the assumptions inscribed in the app. She tracks just the beginning and
the end of menstruation because she complaints about the definition of
PMS, since recording symptoms and mood is a way of sustaining sexism
and taboos around the female period.
    Even if self-tracking practices produce data that women voluntarily
collect in a fragmented way contrary to the real developers’ design, they
can be a resource for governments and markets (Kitchin and Dodge
2011; Kitchin 2014). The body is transformed into digital data through
practices that people enact within power relations that exist into
assemblages of humans and nonhumans.
    Power is based on surveillance, incorporated in the governance of
citizenry and internalised by actors. Analysing self-tracking practices
means observing how policymakers and health authorities alike could
gather personal information and create discrete categories (Lyon 2002).
In our case, data on fertility, ovulation and the menstrual cycle, produced
through an app, can be used not only by employers, but also by
governments, to monitor the state of pregnancy and, further, estimate the
duration of maternity leaves for female workers2.
    However, subjects are not just surveilled, they also respond and
reconfigure the dominant ideas and norms of environment. The spaces of
everyday life become expanded laboratories in which individuals take
part in the dynamic of power relations through a range of different
practices (Gabrys 2014; Coletta et al. 2018). Here, self-tracking practices
emerge as a way to enact different meanings of the body's engagement in
the ongoing process of subjectification. This engagement comes back into
diverse materiality ways as the product of overlapping intra-actions
between humans and nonhumans, in which digital technologies are
situated into practices that enact a knowing embodied.
    Adopting a sociomaterial lens suggests analysing the self-tracking
practices as part of entanglement of people and technologies, showing
how the experience of menstrual cycle tracking is an embodied, more-
than-human practice. This allows to pay attention on the complexity and
heterogeneity of uses that often differ from their expected utilization,
rather than trapping such experiences within discourses that emphasise a
range of issues relating to data surveillance.
48                                                               Tecnoscienza - 10 (2)

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   1
     Even if the focus of this contribution is not on the constitution of PMS as a
medical syndrome, it is interesting to note that this term is frequently used,
especially in the public debate, to report or justify a mixture of somatic and
Zampino                                                                         51


psychological symptoms related to changes in the ovarian hormone levels that,
notwithstanding an understanding of its exact etiology is still poorly described
and documented. In some cases, PMS ends up being used as a means of
questioning the capacity of women to manage and participate as co-equals to men
in prestigious economic and political positions (Rittenhouse 1991). Symptoms are
categorized as physical, psychological and behavioral. Physical symptoms include
fatigue, edematous sensation, sinus sensitivity, headache, weight gain, muscle
pain; behavioral and psychological symptoms include irritability, nervousness,
mood swings, sadness, depression, hypersomnia or insomnia, decreased
concentration.
2
  Particularly the press is beginning to emphasise that app’s developers could sell
data to second and third parties. For an overview, it is interesting to quote the
articles   available    on     the   subject:   https://www.washingtonpost.com/
technology/2019/04/10/tracking-your-pregnancy-an-app-may-be-more-public-
than-you-think/?noredirect=on&utm_term=.7833e7e2ec3f;                https://www-
.internazionale.it/video/2019/07/23/app-mestruazioni-marketing.
