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Capitulo II: Marco Teórico

2.1 Promoción Farmacéutica

2.1.2 Promoción dirigida a los médicos

2.1.2.3 Publicidad

As an adequate political response to gender pluralism, some form of liberal toleration is more acceptable than direct political recognition of gender beliefs or practices. To investigate the option of toleration further, we need a more precise notion of it. Ferretti and Lægaard (2013) specify that tolerance possesses

(1) an ‘objection component’ or ‘reason for interference’ consisting in some negative judgement on the part of one agent towards the beliefs or practices of another, a judgement which disposes the former agent to suppress, prohibit or otherwise interfere with the latter; (2) a power component consisting in the first agent actually being able to interfere with the latter; and (3) an ‘acceptance component’ or ‘reason for non- interference’ consisting in some positive judgement on the part of the first agent which overrides the disposition to interfere. (224)

The ‘power component’ has a central position in the notion of tolerance. In the above characterisations, it should be understood broadly. If it were not, we might think that those who possess no political power to interfere with co-citizens’ beliefs or practices cannot truly exercise toleration.69 As Ferretti and Lægaard point out, however, this

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An individual or group – as Williams notes (1996, 19) – does not need to have access to power to be intolerant: it is intolerant if it would suppress other beliefs or practices if it had the power to do so. And, presumably, one might say that the individual is tolerant if she would not suppress the beliefs or practices she objects to even if, counterfactually, she did have the power to do so (subjunctive tolerance). However, the case of political toleration is not the same when considering gender minorities in which the exercise of power is crucial, as we are dealing, on the one hand, with political power as already expressed in law and policy, and, on the other hand, with social power, which is also, in fact, already broadly exercised. As Ferretti and Lægaard state (2013, 225), “holding minority status consists in being the object of negative

component includes not only overt political power but also social power (2013, 228). This is an important point for my exposition, as I will argue that the notion of public toleration of gender concerns itself with overriding dispositions to employ gendered social power to interfere with gender non-conforming beliefs or practices, while state gender neutrality – the requirement that the state not evaluate from a public standpoint particular gender beliefs and practices, or justify its policies within the framework of particular conceptions of gender – eliminates the political power to do so. Gendered social power can be exercised by individual citizens through social sanctions – not always conscious – such as ignoring people or assigning to their needs or requests lower priority than those of the gendered majority, or, generally, treating them with disrespect as ‘deviant’. Such actions will have social or moral effects on gender non-conforming persons, particularly, a lower sense of self-confidence and self-respect. Alternatively, gendered social power can be exercised by state officials, legislators, and judges. It can take many of the same forms as those of the individual citizen, and with the same effects, but, additionally, may have legal and political consequences. However, the decisions made by these officials may not be directly related to gender: gendered social power will often be implicit.

I will distinguish both these forms of gendered social power from gendered political power. By gendered political power, I mean the legal and political endorsement of the

attitudes and asymmetrical power” [My emphasis]. Carter (2013, 196) specifies, moreover, that subjunctive tolerance considers tolerance simply as an attitude or disposition whereas toleration as a practice involves the actual (not merely subjunctive) power to interfere.

Prevalent Gender Structure. However, gendered political power is not limited simply to legal statutes, case law, or government policies. It is extended to encompass what might be called ‘public space’ in a more physical sense, for example, the way citizens are spatially segregated on the grounds of gender within public buildings.

Besides the ‘power component’, there is an ‘objection component’ and an ‘acceptance component’ to tolerance. I have little to say about the ‘objection component’ and will only remark that the ‘reason for interference’ which it implies may not be rationally justifiable to all co-citizens. Rather than basing itself upon rational argument, it may even be more akin to an impulse to interfere based on various negative emotional reactions towards gendered differences in comportment or appearance. In an ideal society, perhaps the objection component would not exist. However, current levels of discrimination, as well as resistance to legislation incorporating transgender rights, make its existence more than plausible. As regards the ‘acceptance component’ and the ‘reasons for non- interference’ implied in it, we can understand its operation in various ways. It is the exercise of power, above all, that is restrained in the exercise of tolerance, not judgments or feelings. The latter are merely overridden. Restraint of power can be self-restraint of one’s own power, motivated by ethical or political reasons, without regard for political or social sanctions. For example, the conviction that all persons possess equal dignity and have a right to their gender beliefs and practices would be one such reason. Prudential reasons, however, may also provide the restraint. For example, the decision to desist from the exercise of power because of the threat of legal sanctions to oneself would be another reason for non-interference.

Correspondingly, a liberal political order might support tolerance of gender pluralism between citizens in two ways.70 Firstly, it could provide citizens with a ‘reason for non- interference’ by legally prohibiting discriminatory or persecuting interventions by some citizens who disapprove of gender non-conforming beliefs or practices. The threat of sanctions, however, does not necessarily elicit any ‘positive judgement’ of the first agent with regard to the second agent whose beliefs and practices she objects to. Rather, the ‘positive judgement’ is reflexive – the objecting citizen values her own political freedoms, and so abstains from putting interference into practice. Reasons such as these might effectively serve the purpose of ‘stabilising’ the full political inclusion of gender non-conforming persons once this has been attained (Galeotti 2002, 109–112), but these reasons do not include the moral reason of recognizing those who do not conform to the prevalent gender rules as free and equal citizens or persons. So a second way the liberal political order might provide citizens with a ‘reason for non-interference’ with gender pluralism, is by publicly recognizing the value of political personhood, encapsulated in principles of equality and liberty. This is more in line with respect-toleration, alluded to earlier (Forst 2014; Firretti and Lægaard 2013). Public institutions in this second scenario provide a recognitive political climate that enables mutual respect and fosters tolerance among citizens.

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It might be claimed that the state ‘disapproves’ of gender non-conforming beliefs and practices if its legislation and policies favour the Prevalent Gender Structure. The way I formulate tolerance requires that the reason for objecting to, or disapproving of, a given practice not be eliminated but simply overridden by another reason. The only way gendered law and policies can become just in the face of gender pluralism is that they be changed or abrogated. Thus, the purported ‘disapproval’ (and any reason for it) vanishes, and is not simply overridden. I thus prefer to speak of the ‘politically tolerant liberal state’ as one that – through policy and law – fosters tolerance between citizens, taking into account asymmetries of gendered social power. It does not – strictly speaking – exercise tolerance itself. On the debate on whether, and in what sense, a liberal state can be called ‘tolerant’, see Balint (2012) and Jones (2012), and references therein.

In practice, the democratic liberal state might provide both moral and prudential ‘reasons for non-interference.’ In the case of gender non-conforming beliefs and practices, what I call ‘political toleration’ would thus involve, at least

provision of reasons for non-interference in the gender beliefs and practices of others through i) the public recognition of equal citizenship and ii) the imposition of legal sanctions on those who do so interfere.

This is not, of course, meant to be an exhaustive characterisation of what liberal toleration might require. In fact, as long as public recognition of the Prevalent Gender Structure, that is, gendered political power, remains, the above requirements may not go very far in addressing marginalisation and the hegemonic power of existing gender ascription and scripting. The liberal state should not, on the one hand, publicly endorse the Prevalent Gender Structure – thereby marginalizing gender non-conforming persons – while, on the other, maintaining that it affirms the equal rights and citizenship of gender non-conforming persons (as in the requirement i) above). For if it were to do so, its policies would, in this case, be working at cross purposes. So, in addition to providing some of its citizens with reasons for non-interference in the beliefs and practices of gender non-conforming persons, the liberal state should be gender neutral in a way I will presently explain. Additionally, social asymmetries of power between genders may decrease the social standing of gender non-conforming persons to such an extent that the resulting attrition of self-respect may bring with it limited access to rights that are formally guaranteed in non-discrimination laws. In the next section I take a closer look at state gender-neutrality and at a form of toleration aimed at mitigating the negative effects of asymmetries of gendered social power on self-respect.

3.5

Countering Gendered Social Power and Eliminating Gendered

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