From inadequate care for the elderly, to macho politicians ripping up gender equality laws, to the large-scale global failure to ban fossil fuels, we are surrounded by different forms of structural carelessness. All of these problems are political issues: but they are also issues of care. Care has never been a focal point of the radical left. But what might looking at the problems of the present through this perspective give us?

Historically, care has been gendered and marginalized as women’s work. This gendered marginalization of care has been particularly pronounced for the working-class and people of color, who have had to share a more substantial part of the care burden whilst themselves being insufficiently cared for. We have seen this during the pandemic: front-line care workers have been dealing with particularly terrible conditions whilst being routinely financially exploited as a matter of course.

A key reason why this is the case is because of the historical dynamic between gender and care: a relationship which has its roots in traditional models of social reproduction that were shaped by patriarchal capitalism and imperialism. There is now an urgent, well-overdue need to disrupt this tired and exploitative historical model. We need to de-gender our models of care, whilst expanding and socializing them at every scale of life; to resist marketized, neoliberal models of structural carelessness — and to develop what we call forms of “universal care” and “promiscuous care” instead.

There is plenty of inspiration for better caring cultures and societies — more progressively gendered and more egalitarian — in both the past and present. Examples of how to do care better range from the movements of Ni Una Menos in Latin America to the global Women’s Strike; from recent responses to the Greek crisis and histories of AIDS activism in the US all the way to contemporary coalitions of care workers across the globe. Drawing on and amplifying these energies — and deepening our understanding of care — is key to addressing the care crisis.

Gender and care

Care has always been devalued because it has been largely seen as women’s work, which traditionally has gone unpaid and continues to be barely seen as work at all — routinely marginalized as unproductive. Yet, as most feminists have emphasized — even if the left has often been slow to prioritize it — care is the cornerstone of social reproduction, of everything that enables people to survive and reproduce themselves; hence it is essentially embedded within the economy.

Caring is symbolically gendered, but in today’s world — particularly in the Global North — where both women and men typically work long hours in paid jobs, there is a huge care deficit. It is met by a whole global care chain of predominantly poor, immigrant and non-white women who perform much of the caring work in richer countries. Thus, racism combines with traditional sexism and global inequality to further devalue caring.

Care work has also been undervalued, indeed often repudiated, because of widespread contempt and devaluation of so-called “dependency.” In symbolic terms, “manhood” has always presented itself as the very antithesis of dependency. This anachronistic gender cliche has oddly been strengthened by the last four decades of neoliberal exaltation of individual resilience, autonomy and productivity, all of which have profoundly deepened the disavowal of human fragility and dependence. From a neoliberal perspective, ideal citizens, male and female, must be tough and entrepreneurial: always self-sufficient, though encouraged to embrace self-care to keep themselves sleek and marketable.

We need to understand that the very notion of “care” overflows with paradoxes and ambivalence.

Such pathologizing of dependency helped to justify the deadly dismantling of welfare and the culling of public resources already mentioned. In the UK we have seen constant shaming heaped upon families who claim benefits, despite there being twelve times as much tax evasion in existence than benefit fraud. In the US the figure of the “welfare queen,” usually depicted by dominant culture as poor and Black, plays a similar role — even though proportionately more white than Black people receive government aid. There is much to say here about the contradictions of motherhood, as well as how they are further complicated by class and “race”: for mothers remain both the ultimate carers and eternal scapegoats, when the dangerous idealization of motherhood, as caring and selfless, all too easily flips over into mother-blaming.

We need to understand that the very notion of “care” overflows with paradoxes and ambivalence, often generating conflicting emotions which we usually choose to ignore.

Attending fully to someone’s needs often means confronting vulnerability and inevitable mortality. This makes care work very challenging, but also is another reason why it is often devalued, marginalized and has been traditionally relegated to women, or poorly-paid servants, and, today, to care assistants of many kinds. Carers have been deemed inferior precisely because they are doing this vital, tactile, visceral work of maintenance.

Avoiding the work of caring can enable those who turn their backs on it to disavow thoughts of their own inescapable fragility and inevitable mortality. Yet, we know that caring can be among the most meaningful and significant work we do. But we can only carry out the direct work of maintenance well if we have the time and resources to assist us, ideally knowing that what we do is genuinely valued as the heart of a compassionate and sustainable world. We need to realize that we will only begin to create a truly sustainable future for all living creatures, and the planet itself, once we expand our practices and language of care.

Caring must be understood as something that everyone is capable of doing. Boys need to be taught from a young age that hands-on caring and childcare are not the sole responsibility of women. Extensive paternity leave as well as maternity leave needs to be a right. Care needs to be no longer treated as an isolated, private activity, primarily the prerogative of underpaid or unpaid women, but rather as a multitude of practices with the potential to change all our interactions and transform the world around us.

Promiscuous Care

Expanding our existing repertoires of care in this way, by de-gendering it and expanding it outwards from the nuclear family, is what we call “promiscuous care.” There are many historical and contemporary examples we can look to for inspiration. One comes from the early days of the AIDS Crisis in the US in the 1980s and the care initiatives that emerged in response to it.

The AIDS crisis “officially” began in the US in 1981 with 121 people inexplicably dying of rare pneumonias and cancers. By 1995, the year the first effective HIV medications were introduced, that number had risen to a total of 300,000. The reason the numbers grew so much was precisely because the American government, medical establishment, pharmaceutical industry and wider public just did not prioritize care for people living with AIDS (PWAs) — most of whom were from marginalized social groups such as gay men, trans women, migrants and intravenous drug users. This meant that during this period resources were not mobilized quickly enough to meet the caring needs of PWAs, and as a result, many died needless, sudden and often gruesome deaths.

To deal with this catastrophic failure of care, a variety of different grassroots initiatives sprung up across the world. One of the most visible of these was ACT UP — the AIDS Coalition to Unleash Power — which described itself as a “diverse, non-partisan group of individuals united in anger and committed to direct action to end the AIDS crisis.” Uniting previously disparate social groups — gay men, lesbians, trans people, second wave feminists, people of color, IV drugs users — ACT UP led a multi-pronged strategy to deal with this failure of care.

In relation to medical care, ACT UP developed safe sex practices and educational materials to disseminate information about them. Members of ACT UP would also go into hospitals to care for PWAs not only because, in the early days of the crisis, medical staff would not attend to the needs of PWAs fearing the virus was airborne, but also because of the rejection of many LGBT+ individuals by their biological families. ACT UP agitated for quicker approval processes for potential HIV medications, and when they did not arrive were involved in setting up “buyer’s clubs” where people could access off-market drugs. They also set up clean needle exchanges so IV drug users could reduce the chances of contracting the virus.

ACT UP were also geniuses of creating political spectacles with the intention to convince different parts of society to care more about the people living at the front line of the AIDS crisis. ACT UP’s artistic wing Gran Fury produced a range of visual media including the iconic “Silence = Death” posters. Their Testing the Limits collective made activist videos that were broadcast on New York public television. They also staged a series of highly mediated direct actions that drew attention to the catastrophic lack of care that was endemic in the crisis. For instance, they invaded the New York Stock Exchange and hung a banner emblazoned with the words “Sell Wellcome” above the trading floor to protest the extortionate price that drug company Burroughs Wellcome was charging for HIV drugs. They also emptied the ashes of cremated PWAs on the White House lawn.

There were debates taking place in the gay community at the time over the role that sexual promiscuity played in the spread of the virus. On the one hand, mainstream gay leaders made the common-sense assumption that the more sex gay men had, the more they were likely to spread HIV. On the other, ACT UP member Douglas Crimp famously argued that precisely because post-Stonewall gay sexual cultures were “promiscuous” they “multiplied” and “experimented” with sexual practices beyond the penetrative sex that was one of the most common routes of HIV transmission. In this spirit we might call the multiplication and experimentation of forms of care developed by ACT UP “promiscuous care.” In our book The Care Manifesto we argue that we need to practice and develop this notion of promiscuous care by multiplying and experimenting with modes of caring beyond the shriveled forms of care that are hegemonic today.

Promiscuous care means caring more and in ways that remain experimental and extensive by current standards. It means multiplying who we care for and how. Building on historical formations of “alternative” care giving practices like those developed by ACT UP, we need to create a more capacious notion of care, building alliances across boundaries of perceived differences to create micro and macro caring initiatives. Like the coalition of groups that constituted ACT UP, an ethics of promiscuous care recognizes that we all have the capacity to care — not just mothers, and not just women — and that all our lives are improved when we care and are cared for, and when we care together.

Our common sense needs to change around who should be caring for who and with what resources.

What this means in practical terms is that our common sense needs to change around who should be caring for who and with what resources. We must normalize an egalitarian model of care where everyone — not just the feminized, racialized and hyper-exploited — can care for everyone, and that a radically democratic society must adequately resource these experimental caring arrangements. Childcare, elderly care and palliative care, must be taken seriously and not treated simply as commodities for generating profit in line with neoliberal capitalism. Just as the queer movement challenged the restrictive norms of hetero-patriarchial family, we must proliferate and expand our circles of care beyond our families and those designated as our fellow citizens — and, if we are to stop both the mounting border and environmental crises, we must also reimagine the stranger (or “the Other”) and the non-human world as if they were kin. Promiscuous care is a first step in normalizing the idea, or building the psychic infrastructure, of a new society that has universal care at its heart.