Health Sociology Review最新文献

The discrimination faced by people understood to have alcohol or other drug addictions has been the subject of extensive research, with many studies documenting experiences of stigma within healthcare services. Building on this literature, we examine the role of stigma in shaping the healthcare expectations of people seen as affected by alcohol and other drug addictions. Our analysis draws on recent theorisations of stigma as a process of social production to analyse in-depth, qualitative interviews with 20 people who had recently attended an inpatient withdrawal management service. Participants describe as exceptional forms of care that are often taken for granted by other members of the community. We argue that routinised experiences of discrimination work to constitute basic care as exceptional. This finding is significant for two reasons: (1) people who consume alcohol and other drugs often have complex healthcare needs and already encounter obstacles to accessing the care they need, and (2) by positioning people who consume drugs outside the purview of healthcare, this dynamic obstructs their fundamental right to care. We conclude by reflecting on the implications of these findings for those who are often positioned as not entitled to high quality healthcare.

Treatments for prostate cancer have many potential side effects such as a loss of erection, weaker orgasms, and incontinence. These are all bodily changes that may challenge dominant masculine ideals. In this article, I use Persson's repair work to describe how men tackle these side effects, and I describe the trouble their repair work elicits in terms of masculinity. I analyse interviews with eleven Swedish men, all treated for prostate cancer, and show that such work is done in three ways. Bodily repair work elicits the work men do to restore bodily functions, often through medical technologies. Relational repair work describes how relations with (potential) others shape men's bodily and sexual concerns, and the ways relations redefine such concerns. Age marking as repair emphasises how age is used in the redefinitions of norms about masculinities and aging bodies, both in relation to oneself and others. The analysis highlights how men's repair work is multifaceted, and is performed against the backdrop of dominant discourses on masculinity, medicine and old age. The analysis of such repair work is valuable to research on how masculinity is constructed in the light of treatment side effects and older age.

While medical sociologists have explored how teachers aid the medicalisation process of Attention Deficit Hyperactivity Disorder (ADHD), there is a paucity of work investigating the role of neighbourhood-level social class. This paper has two main aims. First, to explore how teachers discuss ADHD with parents, and second, to understand how these discussions differ based upon neighbourhood-level social class. To achieve these aims, I utilise grounded theory and interviews with thirty-four elementary school teachers. Emergent themes describe the following process: (a) reifying biological causation of ADHD, (b) evidence gathering, and (c) furtive diagnosis. Findings suggest teachers in upper-class areas skipped steps in the process or easily managed each step while discussing ADHD with parents. Teachers in lower-class areas were met with barriers that affected the likelihood of children receiving a furtive diagnosis from teachers, thus reducing the likelihood of meeting with a medical professional and receiving medical intervention. Findings explain disparities in medication use for ADHD by neighbourhood-level social class and help to explain the social reproduction of social class. By building on the literature regarding cultural capital and mental health literacy, I conceptualise 'medicalisation lag' as integral to the medicalisation process and to the social reproduction of social class.

Informal caregiving is increasingly common in our ageing population and entering the role of informal caregiver generally marks an important life course transition. The adjustment to such transitions is considered important for the onset of sleep problems. Therefore, this study aims to establish how becoming a daily caregiver is associated with sleep problems, if changes in caregiving status are related to changes in sleep problems and how intersections with other social roles affect this association. Based on data from waves 1, 2, 4, 5 and 6 of the Survey of Health Ageing and Retirement in Europe (N=32,791), the analyses show how both current and former daily caregivers are more likely to report sleep problems than those not giving daily care. When change in sleep problems is assessed a transition to daily caregiving appears to be accompanied by increased sleep problems. Moreover, even individuals who ceased giving care experience more sleep problems than those who never gave care on a daily basis, which suggests a legacy of caregiving. No differences are found regarding employment status, but women who start giving care are more likely to experience sleep problems than their male counterparts.

Yi Nao describes a type of violence displayed in Chinese hospitals which involves organised disturbances led by patients' relatives and/or Yi Nao gangs. Drawing on media reports of Yi Nao, we argue that the phenomenon of Yi Nao transforms hospitals into 'power arenas' in which a struggle over moral and political resources (capital) takes place between patients, Yi Nao gangs, doctors, government agencies, and hospital management. Two interrelated rules that are crucial to understanding the ad hoc local strategies of the actors involved in Yi Nao are examined: the 'publicity rule', and the 'rule of risk-avoidance'. We also argue that the political discourse of 'stability' has been internalised by the officials in the Chinese government and public hospitals in mediating social disputes. At the same time, Yi Nao actors use this discourse to creatively adapt to social resistance, as reflected in the disposition to use performative disturbance in pursuit of material or symbolic compensation.

This article reflects on 14 Australian trans dating app users' accounts of feeling safer (and less safe) when using apps, as well as their experiences of sexual healthcare. We explore both app use and healthcare in the context of the interdisciplinary field of 'digital intimacies', considering the ways that digital technologies and cultures of technological use both shape and are shaped by broader professional and cultural norms relating to sexuality and gender. Drawing on Preciado's [(2013). Testo junkie: Sex, drugs and biopolitics in the pharmacopornographic era. The Feminist Press] framework of 'pharmacopornographisation', the analysis aims to contextualise participants' experiences of being 'seen' and 'known' by health professionals and other app users. Our findings indicate that both dating apps and sexual health services rely on reductive systems of sorting and categorisation that reinforce binary understandings of genders and sexualities in order to facilitate data management and information sharing practices. Yet these same sorting and filtering technologies can also help trans app users avoid harassment, form intimate connections and seek appropriate healthcare.

Access to medical care is significant for many transgender young people and their families, which involves interactions with healthcare professionals. While a trans affirming model is used across Australian paediatric gender clinics, this does not automatically mean that all transgender young people and their parents experience the care they receive as affirming. This article considers the experiences and views of transgender young people (aged 11-17) and their parents in relation to healthcare professionals inside and outside of gender clinics in Australia. Ten qualitative interviews were conducted with parent-child dyads in two Australian states. Key themes relating to healthcare professionals were: differing levels of healthcare professional knowledge and affirmation, quality of service is dependent on individual healthcare professionals, and lack of connected services and referral pathways. The discussion explores specific issues arising from the findings that suggest implications for training for healthcare professionals so as to be better equipped to provide trans affirming clinical care.

Understanding transgender health on a world scale requires an adequate conceptualisation of gender as an embodied social structure, and an awareness of imbalances in the global economy of knowledge. Four major clusters of health issues are identified for trans groups in the majority, postcolonial world: staying alive in the face of violence and disease, keeping a trans life afloat in practice, facing pressures including rising populism, and making transitions work. Familiar models of professional health care are not adequate to these issues across much of the world; social action and organising are required.

The provision of gender affirming hormone therapy for transgender and non-binary people is a rapidly developing area of gender affirming healthcare. While research indicates the benefits of providing gender affirming hormone therapy through interdisciplinary primary care-based models, less is known about how service users and providers construct their understandings of affirmative approaches. In this paper, we present findings from a discourse analysis of four service users' and four healthcare professionals' talk about a primary care-based pilot clinic providing gender affirming hormone therapy in Aotearoa New Zealand. Participants employed notions of pathologisation, time, and agency in their talk to construct the clinic as a personal setting which gave service users time to make their own health decisions, while constructing hospitals as impersonal with lengthy wait times. The assessment-driven nature of best practice guidelines that governed clinicians' decision-making was constructed as constraining users' agency. Findings highlight the ongoing importance of aligning gender affirming hormone therapy with other non-disease types of healthcare, and suggest new ways for achieving this through affirmative approaches to healthcare.