The Analyst, the Interpreter, and the Intruder: Genomics Labor Division and the Textures of the Clinical Genetics’ Specialty Controversy in Spain

Genomics integration into healthcare systems is a multilayered challenge. In Spain, the ordering of genetics in healthcare has been in the hotspot for decades due to a lack of consensus on how to order genetics specialties, the skills and knowledge required for different profiles, frictions between professionals’ roles in the clinic, and different ways of understanding contemporary genetics practice. Drawing on document analysis, interviews, and a descriptive survey with professionals working in genetics in Spain, this chapter delves into the controversy around clinical genetics to unpack expertise arrangements, genomics politics, and everyday tensions regarding genetics healthcare reordering. Through a historical contextualization of the Spanish situation and the figures of the analyst, the interpreter, and the intruder, the chapter attends to the tensions in the genomics labor division and healthcare organization. Inspired by feminist scholarship on knowledge politics, the chapter ends by reflecting on dissent and frictions in healthcare reordering as a way to cultivate genomics modesty amid multiple uncertainties in the field and a fragile public healthcare system. This work aims to shed light and activate a discussion on the challenges of genomics integration in national healthcare systems.