Cyborgs are all around us. A few enthusiastic futurists push the boundaries of medical practice by performing at-home body modifications. As a teenager, I wanted to be one of them. I was most tempted by the idea of adding a sense by implanting a magnet in my finger and feeling the ebb and flow of electricity. Others put an RFID/NFC chip into the webbing between finger and thumb, allowing them to unlock doors, make payments, and prove their identity.

The most audacious body augmentations are pioneered by two groups: hobbyist enthusiasts and people navigating disabilities. The enthusiasts often want to expand the range of what we see as human. People navigating disabilities, however, feel that they are forced to become inventors to navigate a world that is hostile to their body and prefers they reshape it into a more expected form. The disabled inventors are making a case that our idea of what is human doesn’t include everyone who is human.

But, in any doctor’s office, other augments are available, stripped of their transgressive thrill because of their wide adoption. Every assistive device for a disabled person poses a question: Does this tool meet users in their particular need, or is it a demand disguised as a gift: “Fit this shape, or else”? Do we prefer to interact with a cyborg who resembles our narrow idea of what a human should look like rather than see our neighbours as they are?

Alan Jacobs has posited a set of three axioms underlying what he terms a “gnostic capitalist” view of the body, what we demand of it, and how far it can be stretched to meet our expectations.

Jacobs sees these axioms as the fundamental assumption of modern theories of gender identity, but I see them also powerfully shaping the experiences of people who have no experience of gender dysphoria—or at least not one that would be ameliorated by gender transition. Instead, many women experience a different kind of dysphoria—they do not believe they are not women, but they observe that their womanhood is not welcome in the world.

Most of the famous transhumanists are male, but most of the practicing transhumanists are women. When the world makes demands of women that are impossible to fulfill, we are offered ways to “fix” our bodies. Unaugmented, many women find that female bodies and female fertility are expected to be standardized and made “safe” to be welcome in the world.

Assistive devices and transhumanist modifications are offered to women as a way to more successfully navigate a world that isn’t willing to accommodate them as they are. In Jacobs’s terms, the body of a woman has no rights—the woman is welcome provided she can make the differences and perceived deficiencies of womanhood disappear.

Moving through the world as a woman means encountering all the ways the built world has not anticipated our presence. As Caroline Criado-Perez chronicles in Invisible Women: Exposing Data Bias in a World Built for Men, the world is the wrong shape for women. We can’t reach the pedals in cars at the “standard” seat setting and have to pull ourselves forward until we’re too close to the airbag. We’re the expected users of kitchen counters, but the standard height is calibrated for the comfort of someone much taller than the average woman. New medicines are often tuned to male weights, leaving us at risk of a too-high dose.

For many of these problems, each woman kludges her own solutions. But when it comes to motherhood, there’s a lot of money in selling a tool or augmentation to “restore” someone to the “kingdom of the well.”

Being a woman is not, legally speaking, a recognized disability. The exception is postpartum, when, in the United States, recovery from pregnancy is classified as a temporary disability for the purpose of allowing mothers to claim unpaid leave under the Family Medical Leave Act. Our laws frame the capacity to give birth and nurture a child as an incapacity to keep pace with what we expect of a median human and worker.

Breast pumps and their related paraphernalia offer an uneasy compromise. The portability of a breast pump allows women more flexibility—it lets the tie between mother and child stretch. But the question hanging over the tool is, Who is the intended beneficiary of that extension?

In Designing Motherhood: Things That Make and Break Our Births, Michelle Millar Fisher and Amber Winick explore the design of the built world and tools that are allegedly intended to support women as mothers. They identify the breast pump as “a design that epitomizes the struggles of people who continue to be told they can (and should) ‘have it all.’ . . . It is a contested object, for some representing freedom of choice and for others manifesting the unrelenting pressure to breastfeed at all costs.”

For some women, the pump expands the horizons of their world. Instead of staying within arm’s length of their baby, especially during the first few months, they can see friends, take a long walk, even travel away from home overnight. For some fathers, pumped milk or formula is a welcome tool, because it allows them to share care responsibilities they might otherwise miss. With stored milk (or formula) a father can take middle-of-the-night responsibilities and can have the tender experience of a milk-drunk baby dozing in his arms.

For these women, the tool is a gift—it’s a mobility aid. They might echo the rhetoric of wheelchair users who object to descriptions like “wheelchair bound” or “confined to a wheelchair.” As Karin Willison writes in her blog, Free Wheelin’, “A wheelchair gives me something, and takes nothing away. . . . Without my wheelchair, I would be bound and confined. With it, I am free.”

The medical model of disability sees a physical difference or impairment as the cause of a person having difficulty moving comfortably through the world and fully participating in society. The social model of disability looks at the interface between a person’s capacities and the choices made in designing the built world. Instead of assuming people with a disability or a notable difference must alter themselves in order to successfully navigate the world, the social model asks, How can the world be better designed to accommodate a broad range of people?

Curb cuts are one of the now-ubiquitous accommodations to wheelchair users. Instead of the drop to the curb being a problem they are expected to solve, the gentle slope enables free movement. The design change helps a broader range of people than just the ones who need it most; parents with strollers, elderly people with unsure steps, and someone pushing a heavily laden dolly all benefit from the tiny ramp.

A difficult default can remain dominant for a long time, as long as each individual who encounters it finds that she can just barely contort herself to adapt to what’s demanded of her. It is the people who cannot reshape themselves to suit the demand who have to either push back or face total exclusion from a particular place or service.

For many women who consider themselves “normal,” the indignities of bad design feel like bad luck, not a structural injustice. Every day, on exam tables throughout the world, women place their feet in stirrups for gynecological exams, for IUD insertions, for births. Doctors are often slightly apologetic for the discomfort (“I know, no one likes this part,” one told me) or they proudly point out the small improvement they’ve made (socks drawn over the chilly metallic footrests). None of my doctors has ever proposed a different way to approach a checkup.

But in the 1970s a group of midwives circulated Table Manners: A Guide to the Pelvic Examination for Disabled Women and Health Care Providers. The pamphlet showed a range of alternative positions, intended to accommodate the broad range of women a doctor might be treating. Instead of contorting into stirrups, a woman might put her feet together and let her knees fall to the side in a diamond position. Another woman might lie on her side and have someone help her lift one leg.

Midwife Stephanie Tillman recommended the publication in an interview included in Designing Motherhood. As she explained to the authors, she didn’t see these alternatives as reserved for the impossible cases: “We can always find a modified position. And if those options are available for people whose bodies cannot get into what is considered the standard position, why are we not offering that for everyone? Why can’t we say, ‘What position would be most comfortable for you? Let’s try it out’?”

Tillman hopes to see midwives and doctors adapt to the specific women they see; by expanding the tools available, they can better meet women in their individuality. But sometimes increased flexibility is used against women. Many tools are engineered to make women more adaptable to the world, not to reshape the built world to suit women.

A doctor’s office and tools are more often designed for the convenience of the doctor, not the patient. A breast pump is another intimate tool that appears to be designed for the needs of a hidden end user—not the mother but her boss. A breast pump attenuates the claim a child makes on its mother. A breast pump does not cry. It does not interrupt. It is (allegedly) hands free. It comes with an off switch. A child demands; a breast pump is available on demand.

It is easier for an employer to point to all these seeming efficiencies and offer the mother less: pump later, pump less often, pump in a dark storage closet or hidden in your car or the toilet. In a survey of mothers working outside the home (sponsored in 2020 by companies that sell breast pumps, lactation pods, and milk-bank services), a quarter of women said that they didn’t have a dedicated space to pump at work.

If the baby were at work, it would be obvious that the child’s hunger cannot be put off forever. Alone with a pump, the mother suffers from unjust demands silently, as her breasts engorge and plugged ducts fester into mastitis. If the baby were visible, it would be obvious you can’t lock a vulnerable person in a closet. But the mother, no less valuable, is more easily mistreated.

The fierce need of the baby makes a stronger claim than a grown-up can. The baby doesn’t know or respect the boss’s exploitative demands—its cry is parrhesia: prophetic speech and a call to repentance. The baby’s voice may be unwelcome, but no just society can be built on untruth. The baby, wordless, makes the cry of Amos: “Let judgment run down as waters, and righteousness as a mighty stream.”

The urgent insistence of a baby is part of what allows a mother’s milk to let down. At the after-report on MIT’s 2014 breast pump hackathon, Catherine D’Ignazio of the Center for Civic Media noted that the baby is not simply a recipient of milk but an active participant in facilitating nursing. “Babies are really cute and knead breasts while they nurse, which encourages let-down; let-down and oxytocin also respond to sounds and sights of babies cooing and crying.” By contrast, however well-engineered the suction, “pumping is an inorganic, medicalized, generally unpleasant process, often taking place in a stressful, time-crunched environment that does not encourage let-down.”

At the hackathon, participants considered ways to make pumps work more like babies. Pumps might have attachments that knead the breast rhythmically, or they might come with reminders to look at pictures of your baby, to remind your body of the person who is absent. Each addition might help ease the burden of pumping, but there is no way for the mechanical to substitute for the communal.

Some suggestions for how to restore what is rewarding about nursing were more unsettling. A few teams considered adding “social sharing or even ‘gamification’ aspects to the pumping process.” There’s a sourness to asking women to distance themselves from the real end of nursing and to opt into a different, artificial reward system. Give up the care of a baby and the natural rewards of that process—a surge of oxytocin, the soft pressure of a little hand on your arm, the eager, delighted scrabbling of your child as you unsheathe your breast—and turn to your phone instead for the acquisition of badges, exhortations to beat your score, the dopamine hits of push notifications or likes on a social network.

A better suggestion drew on an older kind of social network. One developer suggested holding Tupperware-party-inspired gatherings where a number of moms in a community could come together to compare the fit of different flanges. They’d get to handle the tools, compare their experiences, and learn who in their neighbourhood they might be able to ask for help. Instead of clicking though a catalogue, they’d get to connect to a community. It’s a model adopted by groups like La Leche League, which brings breastfeeding mothers together to nurse together and compare notes on latching or biting difficulties.

While products push toward standardization, these community circles expose the wide range of normal. They suggest that difficulties aren’t always solved by finding (or inventing) the right tool for the job, but sometimes by finding the right person to provide support. Or the solution might lie in solidarity with many people who reject an unjust compromise and demand the job change.

One mother who offered feedback to the MIT hackathon for breast pumps appreciated the effort but felt the designers were solving the wrong problem. She wrote,

She wasn’t against breast pumps in theory, and neither she nor I would deny that they can be helpful for many women. The child has a unique claim on the mother, but a child’s need is too great to be satisfied by one parent (or even two) alone. Pumps and other tools can help the mother and child expand the circle of who cares for them both. However, a sexist society will tend to capture whatever good they produce for the benefit of someone other than mother and child. A world that cannot accommodate children will not accommodate mothers.

When we treat the person as a mind trapped in a body, we have little patience with those unwilling or unable to purchase a fix for their embodied existence. Often, the disembodied model of human that we’re asked to fit suits no one. If our image of what it means to be human is false, every single person is rendered socially disabled and plays catch-up with assistive tools. In The Internet Is Not What You Think It Is, philosopher Justin E.H. Smith argues that the algorithms of social media push us to become what they find easiest to recognize:

If much of our life online is mediated through computers and algorithms, we find the web easiest to navigate the more we can translate ourselves to resemble a computer talking to other computers. At a much lower level of intensity, many people make this accommodation when facing a phone tree—“Option one,” I say, in an overarticulated, flat-affected voice. I want to speak to the computer in its tongue, since it’s easier for me to give way than for it to adapt to me.

Smith isn’t against technology broadly, or the internet specifically. The central thesis of his book is that the internet offers us the same (sometimes Faustian) bargains we have sought throughout history. He offers a rough heuristic for judging a tool, drawing on the example of duck calls and decoys in duck hunting.

By this metric, many assistive devices for mothers fail the test. They are explicitly designed to remove the need for attention, to change care from a contemplative activity to a task that can be subsumed into work that is treated as more “productive” than the literal production of milk.

To resist this impulse, the designers of Mamava, lactation pods that can be installed in public places or workplaces, wanted to offer the women who used them a sense of spaciousness. Christine Dodson, a co-founder of Mamava, explained to the authors of Designing Motherhood, “The consideration was around designing a space that didn’t make the person using it feel like they were being shut away. It’s a choice, not a necessity, to hide human lactation.” She wanted to avoid linking discretion and shame. The pods are larger than “necessary” because the designers wanted to create a space that felt welcoming, not minimally functional. They were willing to jettison some functionality (an earlier design included a plumbing hookup) in order to increase accessibility. The pods don’t have running water to wash pump parts, but they can be placed anywhere, no chance to dismiss them with “Well, we can’t run an extra water line into the airport concourse.”

The pods are a partial victory, enclosing a small dignified island in a hostile world. They are sold to businesses as a way to make a legally compliant space where a mother can exist as a mother, with the rest of the building able to remain unaccommodating, the need shunted away into its special spot.

But the nature of a child is to get into trouble, to expand their claim on the world around them, to make it clear that nothing will remain safe from them forever. The tools we use must not be designed from a perspective of contempt for our creation or our Creator. They may be finely machined or jury-rigged, removable or implanted, tailored or standardized, but they fail us as users if they are designed to solve the problem of being human, rather than to help us live out our vocations as humans made in the image of God. A tool can cushion the pressures of unjust demands, but those demands must be confronted, especially by those who feel them least. Disgust with humanity is corrosive, never more so than when yielding to it becomes the norm. The task of mothers, and of us all, is to demand that the world be restored so it welcomes us all as we are, fearfully and wonderfully made.