In the opening pages of her newest book, the reader can sense Shelley Tremain's kairotic urgency to revolutionize current philosophical approaches to disability. Like a poetic refrain, Tremain repeatedly laments the deplorable, marginalized position that both philosophies of disability and disabled philosophers hold in our universities. The depreciated position of disability, she argues, is the result of mainstream philosophers' assumptions that disability is and has always been "a natural human disadvantage…[and therefore a] politically neutral human characteristic" (viii). Disability and impairment, according to these philosophers, are self-evident, biological occurrences with no philosophical merit to them as they are immutable, natural facts. This perspective, Tremain argues, has allowed dangerous power structures, like ableism, sexism, and racism, to flourish in philosophy departments. She asserts that disabled scholars, and indeed the discipline of philosophy widely, deserve better, and that de-centering philosophical assumptions and repositioning disability as a rich critical site of inquiry will open up philosophical thought to new and fruitful challenges. This in turn will broaden the boundaries of the discipline and strengthen the ethics and critical purchase of its scholars.

The first step to actualizing this goal, according to Tremain, is to deconstruct the very concept of impairment itself. One of Tremain's chief objectives in writing this book, then, is to prove, though meticulous philosophical reasoning and analysis, that impairment, instead of being a biologically self-evident (and therefore boring) aspect of the human body, is actually a highly structured, regulated, and contextualized apparatus in society. For Tremain, there is nothing biological or natural about impairment; it is the product of highly ingrained power structures throughout history that seek to normalize certain bodies and abnormalize others in the service of the state. This antifoundationalist approach to impairment, while highly destabilizing, is exceedingly necessary, as it will, according to Tremain, dismantle long-held ableist assumptions in philosophy and its tributary schools of thought, such as bioethics.

How do we implement this reconceptualization? Tremain argues Foucault's theories on power-knowledge relations and neoliberal subjectification are a promising foundation for de-biologizing impairment and thus reframing disability as a philosophically rich subject. To this end, Tremain's book repeatedly exposes current shortcomings in philosophical thought, then fills in those gaps with a feminist philosophical perspective of disability that uses Foucault as scaffolding.

After establishing her framework, Tremain then turns to feminist disability scholars to show how certain accepted lines of thinking within our discipline ought to be re-investigated, and in some instances completely re-structured, if this aforementioned shift in philosophical thinking about impairments and the disabled body is to manifest. Tremain shows through her Foucauldian analysis how past and present work in feminist disability scholarship has actually contributed to this view of impairment as a naturally occurring entity in the body. For example, she argues that policies like the ADA and the British Social Model (BSM) of disability, which have been widely used in disability scholarship and advocacy, actually work as normalizing power structures that "contribut[e] to the production of the 'person with an impairment' that it is claimed to merely recognize and represent" (92). These policies, she argues, categorize, identify, and therefore construct the impairments. She posits that these impairments "onto which disabling conditions are imposed…should themselves be identified as products of knowledge-power that are incorporated into the self-understandings and self-perceptions of certain subjects" (93). In short, Tremain asserts that "impairment is performative" (93, emphasis in original). With this performative aspect in mind, Tremain picks apart the disability/impairment binary she has noticed in disability scholarship. In this binary, disability is the constructed result of the naturally occurring entity impairment, much like second wave feminism's sex/gender binary wherein gender is the constructed performance of sex (108). Tremain asserts that, while this binary thinking has served grassroots disability movements in the past, impairment should no longer be assumed to have a transnational identity or occur naturally in the body. She takes on heavy hitters Tobin Seibers and Rosemarie Garland-Thompson to prove this point.

Tremain recognizes that her critiques on feminist disability studies are revolutionary and may even seem anarchist to new materialists, cultural disability theorists, and feminists. For example, in chapter four, Tremain determinedly critiques feminist interpretations of a historical case wherein a disabled man is convicted of sexual inappropriateness with a child, which may sit uneasily with some readers. It definitely troubled me, not so much because she tries to justify the man's action, indeed she does not, she merely remarks how his disability never comes up in feminist discussions of the case. Rather, the analytical detail she goes into, which is necessary for a postructuralist interpretation, becomes rather disturbing when applied to this particular subject matter. Thus, in recommending this book, I feel compelled to make the reader aware of this potential trigger. Ultimately, though, Tremain's inexorable poststructuralist approaches nevertheless create the potential for us to envision new analytical possibilities for our scholarship including challenging government policy both past and present, informing bioethics and medical rhetoric, and reinvigorating our allyship and activism.

Philosophers, feminists, and disability scholars alike will benefit from engaging with Tremain's work and including her poststructuralist methodologies into their own scholarship. I also think this book would be especially fruitful in graduate seminars on disability philosophy, bioethics, cultural disability, or even the rhetoric of health and medicine. Instructors could also find this book useful in an upper-level undergraduate class, but I would suggest the instructor provide students with at least a crash course in Foucault and/or poststructuralism before having them read this book because she deals extensively with Foucauldian concepts like problematization, knowledge-power relations, discourse, genealogy, historicism and relativism, biopower, discipline and normalization, and neoliberalism. Already having a working definition of these concepts would help students feel less overwhelmed and better able to synthesize her arguments. When working from a perspective that assumes practically everything is constructed by discourse and nothing should be taken as immutable fact, as Foucault does, it is possible to get wrapped up in the intricate theory and labyrinthine argumentation. That being said, Tremain does a wonderful job of grounding her analysis in concrete examples with which feminist and disability scholars would be familiar.

One main concern I have with this book is that, in proving that impairment is constructed and naturalized through power discourse, Tremain argues that disabled people's behavior, performances, and self-conceptions are the product of the power structures into which they have been acculturated (76). I mostly agree with her, but in saying someone's understanding of their disability is the result of discourse, I don't feel she gives enough space to agency. She does not argue they are agency-less; on the contrary, she argues, like Foucault, that even though disability is constructed it is still real for the disabled person. As a cultural disability scholar, though, I feel she could have given a bit more space to performative impairment and agency's role within it. Her Dialogues on Disability series, wherein she interviews disabled philosophers, explores issues of identity and agency frequently, so I was surprised she did not devote more space to it here. Also, she briefly discusses pain and its role in impairment as a constructed apparatus, but I would have liked her to explore pain more thoroughly in her de-biologizing arguments, perhaps by bringing in other pain theorists like Elaine Scarry. I believe it would have strengthened this aspect of her argument. These critiques, however, are small in comparison to the grand scheme of what Tremain's work accomplishes.

Ultimately, this book intervenes effectively and necessarily in philosophy's regard of disability as a natural, and thus philosophically uninteresting, human trait. It also intervenes in disability studies by urging scholars to no longer see disability and impairment as transcultural and assumed identities, but rather as a highly contextual equation of history, genealogy, power relations, surveillance, and normalization. This approach, if we adopt it, could potentially revolutionize our theories of disability as a cultural artifact, personal identity, human trait, and political force. Tremain's work also further informs and strengthens our conversations about bioethics and ethical concerns over eugenic practices. Though this book is almost anarchist in its antifoundationalist approaches to disability and its relationship to power, society, and the individual, it promises to rebuild our understandings with greater sophistication, attention to detail and history, and a clearer sense of our purposes for the potentiality of our research to expose ableist practices and promote a more equitable societal makeup.

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