Negotiating Gender in Medicine
Sociologist Coutinho-Sledge explores experiences of patients.
A new addition of the sociology department, Piper Coutinho-Sledge specializes in gender studies, the sociology of the body, and critical health studies. A confirmed academic, Coutinho-Sledge holds an M.S. in natural resources from the University of Vermont and an M.A. and Ph.D. in sociology from the University of Chicago.
The Wrong Body?
My research has looked at people navigating the medical systemspecifically people who have the wrong body for particular kinds of medical care.
How do, or dont, bodies and gender go together? And when youre looking for care that presumes a particular kind of body and gender identity, how do you present?
Say, you go to the gynecologist. The gynecologist isnt automatically thinking, Ah, the person in the exam room is a cisgender woman with this kind of body and these kinds of concerns. These thoughts arent at the forefront, but they shape the interaction.
So I started thinking about other situations where peoples identities and bodies might create some kind of trouble for a medical interaction.
What about transgender men seeking to access and then actually participate in preventive gynecological care? And what about people with cancers that affect body parts but dont make sense medically? Cisgender men who have breast cancer and cisgender women who have been diagnosed with breast cancer and make the choice to have a bilateral mastectomy, who decide that this is what I want to do with their body even when its not medically necessary.
The Theory of Experience
I talked to people all over the country and a few abroad who got treatment here. I asked them to imagine they were writing a booka novel or a memoir or a screenplayabout their experience with cancer and to start by describing that opening scene.
The idea was to find out about both the experience and their theory of the experiencethat is, how they construct it. Then I develop my theory of everybodys experience and put them all together.
The general story is that people participating in medical care have to rethink their identity and what their bodies mean, and they have to do so in a context shaped by certain ideas about genderstereotypes and normative ideas. For example, those ideas influence whether doctors recommend surgery or not.
In some cases, the medical profession tries to help you manage. So, when cis-gender men get mammograms, the staff will say things like Ill try to find you a gown that doesnt have flowers on it. In effect, theyre saying, I understand youre a man so Im going to do these things that make you still feel like a man.
Whereas women who chose to have mastectomies but not reconstruction dont often hear, Oh, I understand this. Were going to help you. For those women, their social supports can help them make sense of their experience. They have people around them saying, I support you and love you, no matter what. Were going to work through this. It doesnt make it easy, but they have social supports that are helping them manage this. A lot of the people who chose reconstruction talk about I didnt want to do this to my partner. Maybe if I werent married, I wouldnt worry about reconstruction but I dont want to upset this intimate partner. I dont want to upset my kids. I dont want to embarrass them at the beach.
Everybody is negotiating these issues in medicine, whether we know it or not. Id say that theyre happening in other realms as well. Even if were not paying attention, were dealing with this same negotiation about our bodies and our identities.
Add Women and Stir
As a masters student in Natural Resources at the University of Vermont, I worked with Cecilia Danks, who needed a grad student to do a feminist analysis of community-based forestry.
Within forestry, women are especially marginalized, and community-based forestry aims to bring in their voices and those of other marginalized populations. The idea is that, if you just bring them in, its all going to be better. But theres more to gender than add women and stir.
What came of the analysis is an article in Gender, Work & Organization that looked at the trajectory of gender in these organizations. How can we use gender norms and stereotypes to change the gendered organization of an industry? My argument was, while standpoint theory tells us that bringing in different perspectives is useful, we need to take it a step further. We need to do more than bring in the women; we need to incorporate normatively feminine values.
Published on: 03/16/2017