Health and Medicine

Gender & Society in the Classroom: Health and Medicine

Organized by: Margaret Waltz, Case Western Reserve University
Updated by: Erielle Jones, University of Illinois – Chicago

This section contains articles published in Gender and Society over the past two decades. Ordered chronologically, this guide covers topics including medicalization, reproduction, childbirth, stigma, and physician training. An overarching theme of these articles is how medicine and health influences and, in some ways, constructs our experience of gender while our gender also influences our health.

Ice, Erin; Sanyu A. Mojola; Nicole Angotti; F. Xavier Gómez-Olivé; and Brian Houle. 2022. “Making Sense of Troubled Livelihoods: Gendered Expectations and Poor Health Narratives in Rural South Africa.” Gender and Society 36(5):735-763.
When men and women cannot attain idealized gendered forms of economic provision and dependence, how do they make sense of this perceived failure? In this article, we posit that poor health narratives serve as a gendered tool to make sense of inadequate livelihoods, even when that inadequacy is attributable to structural conditions. We draw on survey and life-history interview data from middle-aged and older rural South Africans. The survey data show that even after adjusting for biometrically measured health differences, working-age (40–59 years) men report poorer health when they are unemployed, and women (age 40+) and pension-age men (age 60+) report poorer health when they live without household earners. Life-history interviews show parallel patterns: When their economic circumstance is not troubled, individuals regularly minimize health concerns; conversely, when they have a troubled livelihood, individuals draw on poor health to explain it. When women and men cannot perform idealized gendered practices in the family, poor health becomes a tool to reduce the resulting cognitive dissonance. Poor health narratives recast perceived gender failures to an individualized, biological explanation. Our study illustrates how the epidemiological context can be a resource that forestalls a redefinition of gender norms when the gender order is in crisis.

Young, Yvette; Miles O. Kovnick; Nguyen Huu Minh. 2022. “Gendered Exposure, Gendered Response: Exposure to Wartime Stressors and PTSD in Older Vietnamese War Survivors.” Gender and Society 36(5):704-743.
Growing numbers of women in militaries worldwide, coupled with vast segments of women within war-affected populations globally, raise questions about gender as it structures trauma exposure, posttraumatic stress disorder (PTSD), and other mental health consequences of war. In this study, we investigate the gendered associations between early-life wartime stress exposures and PTSD symptoms in older adulthood using data from the 2018 Vietnam Health and Aging Study, a unique data set documenting multiple dimensions of health and wartime stress exposures within a sample of older adults who occupied diverse roles during the American war in Vietnam. Our results indicate that the severity of recent PTSD symptoms is significantly and positively associated with the severity of wartime stress exposure among both men and women. Vietnamese men’s social positions, particularly their predominance in combat, exposed them to more numerous war-related stressors. However, Vietnamese women experience a greater PTSD penalty associated with some wartime stress exposures, likely due to the burden of protecting family in wartime and incorporation into military and paramilitary roles with lesser preparation, training, and support than men. We conclude that women who survive major wars, both as soldiers and civilians, bear a significant burden of armed conflict’s lasting toll upon mental health.

Thornton, Courtney, & Jennifer A. Reich. 2022. “Black Mothers and Vaccine Refusal: Gendered Racism, Healthcare, and the State.” Gender & Society 36 (4): 525–551.
Vaccine refusal has increasingly been the focus of public health concern. Rates of children who are up to date on vaccines have declined in recent years, and vaccine refusal has been implicated in disease outbreaks. Most research on children who are not fully immunized identifies white affluent mothers as most likely to opt out by choice and Black mothers as more likely to face structural barriers that limit access to vaccines for their children. In this paper, we analyze social media posts and online discussions among Black mothers to better understand their concerns about vaccines. Unlike white women who reject vaccines as a personal choice, Black mothers express unique concerns about the role of the state in their lives. Specifically, some Black mothers using social media view vaccines as a white technology and claim that white women have greater freedom in opting out of vaccines without the same risks to their families. They describe efforts to strategize interactions with pediatricians and other healthcare providers who can report them to social service agencies or block access to welfare and nutritional benefits for their families if they refuse vaccines. Black women’s experiences with structural gendered racism in interactions with healthcare and education systems shape vaccine decisions and should be taken seriously.

Islam, Asiya. 2022. Plastic Bodies: Women Workers and Emerging Body Rules in Service Work in Urban India.” Gender & Society, 36(3): 422-444
Drawing on the narratives of young lower-middle-class women employed in cafés, call centers, shopping malls, and offices in Delhi, India, in this paper I identify malleability or “plasticity” of the body as an important feature of contemporary service work. As neophyte service professionals, young women mold themselves to the middle-/upper-class milieu of their workplaces through clothes, makeup, and body language. Such body plasticity can be experienced as enabling: Identifying with the image of the “New Indian Woman,” young women enter the bourgeoning service economy. However, they also experience this body plasticity as threatening; bodily changes to meet the requirements of work can, at times, feel inauthentic as well as be read as promiscuous by others. I draw attention to how women appraise plastic bodies as both generative of change and a site of labor discipline, thus offering insights into the relationship among bodies, social inequalities, and contemporary service work.

Nazareno, Jennifer; Cynthia Cranford; Lolita Lledo; Valerie Damasco; and Patricia Roach. Between Women of Color: The New Social Organization of Reproductive Labor” Gender & Society, 36(3): 342-367
In this article, we examine citizenship inequalities in paid reproductive labor. Through an analysis of elder care in Los Angeles, California, based on interviews with Filipina home care agency workers and owners, we delineate citizen divisions made up of two interlocking dimensions. The longstanding U.S. welfare state abdication of responsibility for elder care for its citizens generates a racialized, gendered citizenship division that facilitates another citizenship division between women of color. The outsourcing of elder care by the government to the private sector including small business in the ethnic economy allows Filipina immigrants with legal citizenship to become middle-women minorities who hire undocumented Filipinas to provide care for white, middle-class, older adult women and their families. Through this new social organization of reproductive labor, responsibility is directed away from the state and generating tensions between women of color with different legal statuses. Our findings show how racialized, gendered inequalities are reinforced through this new social organization of reproductive labor but also demonstrate potential for undermining intersecting inequalities.

Kolehmainen, Marjo. 2022. “Postfeminist Versions of Equality? An Analysis of Relationship and Sex Counseling Practices in Finland.” Gender & Society, 36(1): 63–87.
Relationship and sex counseling are pivotal components of the “therapeutization of society,” which has been identified and widely examined as a key transformation of 21st-century modern Western societies. The particular understandings of gender and sexuality that circulate in those practices contribute to the wider everyday conceptions of intimate life and are thus important to investigate from a feminist perspective. Combining insights from studies on therapeutic cultures, research on intimate relationships, scholarship on postfeminism, and affect theory, this article taps into the often ambivalent ways in which gender equality and sexual rights are articulated in relationship and sex counseling practices. My data are derived from an ethnographic investigation of relationship enhancement events in Finland. Equality was widely supported at these events, but there was no consensus regarding what desirable equality actually looked like. My analysis identifies several contradictory patterns in the data. First, there are statements to the effect that equality has “gone too far.” Second, many experts express tokenized critiques yet remain invested in depoliticizing views. Third, there are acts of resistance that embrace diversity and expand everyday understandings of gender and sexuality. I argue that these patterns constitute a postfeminist sensibility, thus complicating the belief that Nordic countries are exceptionally supportive of equality.

Flores, Glenda M., and Maricela Bañuelos. 2021. “Gendered Deference: Perceptions of Authority and Competence among Latina/o Physicians in Medical Institutions.” Gender & Society 35 (1): 110-135.
Prior studies note that gender- and race-based discrimination routinely inhibit women’s advancement in medical fields. Yet few studies have examined how gendered displays of deference and demeanor are interpreted by college-educated and professional Latinas/os who are making inroads into prestigious and masculinized nontraditional fields such as medicine. In this article, we elucidate how gender shapes perceptions of authority and competence among the same pan-ethnic group, and we use deference and demeanor as an analytical tool to examine these processes. Our analysis underscores three main points of difference: (1) gendered cultural taxation; (2) microaggressions from women nurses and staff and; (3) the questioning of authority and competence to elucidate how gendered racism manifests for Latina/o doctors. Taking demonstrations of gendered deference and demeanors are vital to transforming medical schools and creating more inclusive spaces for all physicians and patients. Conclusions are based on experiences reported in interviews with 48 Latina/o physicians and observation in their places of work in Southern California.

Frizzell, Laura C., Mike Vuolo, and Brian C. Kelly. 2021. “Integrating Theories of Gender and Sexuality with Deviance: The Case of Prescription Drug Misuse During Sex.” Gender & Society 35 (5): 691-718.
Social scientists have expended substantial effort to identify group patterns of deviant behavior. Yet beyond the ill-conceived treatment of sexual minorities as inherently deviant, they have rarely considered how gendered sexual identities (GSIs) shape participation in deviance. We argue for the utility of centering theories of gender and sexuality in intersectional deviance research. We demonstrate how this intentional focus on gender and sexuality provides important empirical insights while avoiding past pitfalls of stigmatizing sexual minorities. Drawing on theories of hegemonic masculinity, emphasized femininity, and minority stress together with criminological general strain theory, we demonstrate how societal expectations and constraints generate strains among GSI groups that may lead to distinctly patterned deviance, using the case of prescription drug misuse during sex. We employ thematic analysis of 120 in-depth interviews with people who misuse prescription drugs, stratified by GSI. We identify six themes highlighting distinct pathways from strain to misuse during sex for different GSI groups: intimacy management, achieving sexual freedom, regulating sexual mood, performance confidence, increased sense of control, and managing sexual identity conflict. In this article, we demonstrate the empirical and theoretical importance of centering gender and sexuality in deviance research and provide a roadmap for theoretical integration.

Laster Pirtle, Whitney N., and Tashelle Wright. 2021. “Structural Gendered Racism Revealed in Pandemic Times: Intersectional Approaches to Understanding Race and Gender Health Inequities in COVID-19.” Gender & Society 35 (2): 168-179.
The pandemic reveals; the novel coronavirus (COVID-19) pandemic has brought the historically rooted inequities of our society to the forefront. We argue that an intersectional analysis is needed to further help peel back the veil that the pandemic has begun to reveal. We identify structural gendered racism—the totality of interconnectedness between structural racism and structural sexism in shaping race and gender inequities—as a root cause of health problems among Black women and other women of color, which has been amplified during the pandemic. We show that women of color occupy disadvantaged positions within households, occupations, and health care institutions, and therefore face heightened risk for COVID-19 and lowered resources for mitigating the impact of the deadly virus. Intersectional analyses and solutions must be centered to also reveal, we hope, a new way forward.

Gonsalves, Tara. 2020. “Gender Identity, the Sexed Body, and the Medical Making of Transgender.” Gender & Society 34 (6): 1005-1033.
In this article, I argue that the medical conceptualization of gender identity in the United States has entered a “new regime of truth.” Drawing from a mixed-methods analysis of medical journals, I illuminate a shift in the locus of gender identity from external genitalia and pathologization of families to genes and brain structure and individualized self-conception. The sexed body itself has also undergone a transformation: Sex no longer resides solely in genitalia but has traveled to more visible parts of the body, implicating racialized aesthetic ideals in its new formulation. The re-imagining of gender identity as genetically and neurologically inscribed and the expanding locus of sex correspond to an inversion of the relationship between gender identity and the sexed body as well as shifts in medical jurisdiction. Whereas psychiatrists in the 1960s, ’70s, and ’80s understood gender as stemming from genital sex, the less popular idea that gender identity precedes the sexed body has gained traction in recent decades. If gender identity once derived from the sexed body, the sexed body must now be brought into alignment with gender identity. The increasing legitimacy of self-defined gender identity, the expanding definition of racialized sex, and the inversion of the sex–gender identity relationship elevates the role of surgeons in producing racialized and sexed bodies.

Littlejohn, Krystale E. 2013. “It’s Those Pills That Are Ruining Me”: Gender and the Social Meanings of Hormonal Contraceptive Side Effects.” Gender & Society 27 (6): 843-63.
Almost half of pregnancies in the United States are unintended, despite the availability of highly effective forms of birth control. Women often cite side effects as a reason for stopping hormonal birth control, and most research on the topic comes from a medical perspective. In this study, the author analyzes hormonal contraceptive side effects from a social perspective that highlights the link between cultural messages about gender and women’s contraceptive behavior. Drawing on data from interviews with 88 women, the author argues that the gendered emphasis on women’s appearance and emotionality shapes women’s perceptions about the seriousness of hormonal contraceptive side effects, like weight gain and emotional volatility, and their propensity to stop use as a result. Contrary to understandings of side effects as a purely medical aspect of use, the gender analysis elucidates the ways that particular side effects are imbued with social meaning that can undermine women’s goals to prevent pregnancy.

Mann, Emily S. 2013. “Regulating Latina Youth Sexualities Through Community Health Centers: Discourses and Practices of Sexual Citizenship.” Gender & Society 27 (5): 681-703.
This article examines the regulation of Latina youth sexualities in the context of sexual and reproductive health care provision. In-depth interviews with health care providers working in two Latino-serving community health centers are analyzed for how they interpret and respond to the sexual and reproductive practices of their low-income Latina teen patients. The author finds that providers emphasize teenage pregnancy as a social problem among this population to the exclusion of other dimensions of youth sexualities and encourage Latina girls’ adherence to a life course trajectory that conforms to middle-class, heteronormative ideals as a solution to this problem. By relying on such understandings, providers construct meanings of sexual citizenship that require participation in bourgeois heteronormativity. These findings suggest that Latino-serving community health centers, their providers, and their teen patients could benefit from questioning the assumptions that inform providers’ appraisals of Latina youth and developing a more inclusive approach to Latina youth sexualities beyond a discourse of pregnancy prevention. Such efforts could allow community health centers to actively participate in disrupting the structural inequalities that shape their young patients’ lives. 

Johnson, Katherine M., and Richard M. Simon. 2012. “Women’s Attitudes Toward Biomedical Technology for Infertility: The Case for Technological Salience.” Gender & Society 26 (2): 261-89.
Research has consistently revealed gender differences in attitudes toward science and technology. One explanation is that women are more personally affected by particular technologies (e.g., biomedical interventions), so they consider them differently. However, not all women universally experience biomedical technologies. The authors use the concept of technological salience to address how differences in subjective implications of a technology might explain differences in women’s attitudes toward biotechnology. In a sample of U.S. women from the National Survey of Fertility Barriers, the authors examine how women with and without a biomedical barrier to fertility evaluate biotechnology for infertility, which, the authors argue, reflects differences in technological salience. For women with a biomedical barrier, various experiences, beliefs, and values impacted their attitudes; yet, most of these did not affect attitudes if women had not experienced a fertility barrier. Results suggest that technological salience contextualizes women’s attitudes toward these biotechnologies and may also have broader implications for other biotechnologies. 

Springer, Kristen W. 2010. “Economic Dependence in Marriage and Husbands’ Midlife Health: Testing Three Possible Mechanisms.” Gender & Society 24 (3): 378-401.
Prior research suggests that midlife husbands have worse health when they earn less than their wives; however, the mechanism(s) for this relationship have not been evaluated. In this study, the author analyzes 1,319 heterosexual married couples from the Health and Retirement Study to explore three theoretically grounded mechanisms. The author begins by assessing two well-established family relations theories (economic resource and marital dissatisfaction) to explore the mediating effect of marital power and relationship quality. The author then draws from gender relations theory, multiple masculinities literature, and cognitive dissonance research to test the possibility of a male breadwinner mechanism. The results demonstrate that family relations theories are insufficient explanations but provide strong support for the male breadwinner mechanism. Specifically, being the secondary earner is harmful for the health of highest-income men—who historically have the strongest expectation of male breadwinning. These findings suggest that stereotypes about male breadwinning can be dangerous for men’s health. 

Brubaker, Sarah Jane. 2007. “Denied, Embracing, and Resisting Medicalization: African American Teen Mothers’ Perceptions of Formal Pregnancy and Childbirth Care.” Gender & Society 21 (4): 528-52.
Teens’ experiences with reproductive health care have been ignored by both the “social problems” moral discourse on teen pregnancy and feminist critiques of medicalization. These perspectives are both gendered and racialized in ways that marginalize African American teen mothers. Interview data with 51 poor African American teen mothers suggest that their reproductive experiences occur within very different contexts than those that have inspired feminist criticisms of medicalization. Before their pregnancies, teens are largely denied access to formal health care services and reproductive information and knowledge, and once pregnant, like adult women, they alternately embrace and resist specific aspects of medical care. Their perspectives provide insights into women’s experiences with the formal medical system from an understudied social location, and their narratives expand our understanding of how women’s and girls’ sexuality is socially constructed as problematic and managed, controlled, and regulated in particular ways depending on their social locations. 

Lichtenstein, Bronwen. 2004. “Caught at the Clinic: African American Men, Stigma, and STI Treatment in the Deep South.” Gender & Society 18 (3): 369-88.
The literature on gender and health typically addresses behavioral patterns when discussing men’s attitudes to health. Few of these studies explore men’s anxieties or presentations of self in relation to health problems, particularly for stigmatizing conditions such as sexually transmitted infections (STIs). Through direct observation and focus group interviews of health workers, clients, and students, this study explores African American men’s attitudes toward attending STI clinics in the Deep South. The men’s concerns about STI clinics center on realistic health or stigma-related concerns. Using a gender-relational analysis, three main sources of fear are identified in relation to attending the clinics: Gender anxiety (attacks on masculinity), social anxiety (damage to social reputation through stigma), and racial anxiety (AIDS as genocide). These fears present a barrier to STI care for African American men. 

Giuffre, Patti A., and Christine L. Williams. 2000. “Not Just Bodies: Strategies for Desexualizing the Physical Examination of Patients.” Gender & Society 14 (3): 457-82.
Health care professionals use strategies during the physical examination to stay in control of their feelings, the behaviors of their patients, and to avoid allegations of sexual misconduct. To investigate how health care practitioners desexualize physical exams, the authors conducted 70 in-depth interviews with physicians and nurses. Three desexualizing strategies were general ones, used by both male and female health care providers, and were employed regardless of the characteristics of the patients: engaging in conversation and nonsexual joking, meeting the patient clothed before the exam, and using medical rather than colloquial terms. Six strategies were used only in specific contexts or were used primarily by men or women. These gendered strategies include using a chaperone, objectifying the patient, empathizing with the patient, joking about sex, threatening the patient, and looking professional. The authors conclude that desexualizing the exam is gendered and, in some contexts, (hetero) sexualized. Using certain strategies bolsters stereotypes about gender and heterosexual relationships in the hospital. 

King, Leslie, and Madonna Harrington Meyer. 1997. “The Politics of Reproductive Benefits: U.S. Insurance Coverage of Contraceptive and Infertility Treatments.” Gender & Society 11 (1): 8-30.
Recent changes in access to contraceptive and infertility treatments in the state of Illinois, and across the United States more generally, have heightened class cleavages in access to reproductive health care benefits in the United States. Using data gleaned from government testimonies, public documents, and telephone interviews, the authors found that poor women have broad access to contraceptive coverage but very little access to infertility treatments, while working-and middle-class women have increasingly broad coverage of infertility treatments but spare coverage of contraceptives. These findings suggest that while the extreme measures of the eugenics movement are less frequently in evidence, class differences in access to reproductive services lead to an equally dualistic, albeit unstated, fertility policy in the United States: encouraging births among working- and middle-class families and discouraging births among the poor, particularly those on Medicaid. 

Markens, Susan. 1996. “The Problematic of ‘Experience’: A Political and Cultural Critique of PMS.” Gender & Society 10 (1): 42-58.
This article examines a select sample of popular magazines and self-help books to address the question: How is premenstrual syndrome (PMS) constructed discursively as a legitimate disease worthy of medical attention and public discussion? The author finds that some women have been active participants in the construction of PMS as a medical disease. In dparticular, she finds that accounts of women’s experiences of premenstrual symptoms figure prominently in the rhetorical legitimation of PMS as a medical phenomenon in the popular press and self-help books. At the same time, the author examines the gendered assumptions about gender, health, and normality that underlie how women’s “experiences” are incorporated into the construction of PMS. In particular, she asks whose experience is part of the medical legitimation of premenstrual symptoms and argues that the case of PMS illustrates the need for feminists to problematize biological as well as social experiences. 

Tiefer, Leonore. 1994. “The Medicalization of Impotence: Normalizing Phallocentrism.” Gender & Society 8 (3): 363-77.
Today, phallocentrism is perpetuated by a flourishing medical construction that focuses exclusively on penile erections as the essence of men’s sexual function and satisfaction. This article describes how this medicalization is promoted by urologists, medical industries, mass media, and various entrepreneurs. Many men and women provide a ready audience for this construction because of masculine ideology and gender socialization. While there may be some advantages to this construction, there are major disadvantages to men in terms of the inevitable failure of the promised perfectible erection and the perpetuation of a falsely universalized and biologized vision of sexual experience. Any sexual interests of women in other than phallocentric sexual scripting are denied.