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Redefining masculinity - Men's repair work in the aftermath of prostate cancer treatment. 重新定义男子气概——前列腺癌治疗后男性的修复工作。
IF 3.6 2区 医学 Q1 Social Sciences Pub Date : 2021-07-01 Epub Date: 2020-09-22 DOI: 10.1080/14461242.2020.1820367
Jelmer Brüggemann

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.

前列腺癌的治疗有很多潜在的副作用,比如勃起障碍、性高潮减弱和尿失禁。这些都是身体上的变化,可能会挑战占主导地位的男性理想。在这篇文章中,我用Persson的修复工作来描述男性是如何处理这些副作用的,并且我描述了他们的修复工作在男性气概方面引发的麻烦。我分析了对11位接受过前列腺癌治疗的瑞典男性的采访,发现这项工作有三种方式。身体修复工作引出了男人恢复身体功能的工作,通常通过医疗技术。关系修复工作描述了与(潜在的)他人的关系如何塑造男性的身体和性关注,以及关系重新定义这些关注的方式。年龄标记作为修复强调了年龄如何被用于重新定义关于男性和衰老身体的规范,无论是与自己还是与他人。分析强调了男性的修复工作是多方面的,并且是在男性气质,医学和老年的主导话语的背景下进行的。这种修复工作的分析对于研究在治疗副作用和年龄增长的情况下男性气概是如何构建的有价值。
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引用次数: 3
Social class, teachers, and medicalisation lag: a qualitative investigation of teachers' discussions of ADHD with parents and the effect of neighbourhood-level social class. 社会阶层、教师和医疗滞后:教师与家长讨论ADHD的定性调查以及社区社会阶层的影响。
IF 3.6 2区 医学 Q1 Social Sciences Pub Date : 2021-07-01 Epub Date: 2020-09-22 DOI: 10.1080/14461242.2020.1820364
Zachary Simoni

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.

虽然医学社会学家已经探索了教师如何帮助注意力缺陷多动障碍(ADHD)的医疗化过程,但调查社区层面社会阶层的作用的工作却很少。本文有两个主要目的。首先,探索教师如何与家长讨论多动症,其次,了解这些讨论如何根据社区水平的社会阶层而有所不同。为了达到这些目标,我运用了扎根理论并采访了34位小学教师。紧急主题描述了以下过程:(a)具体化ADHD的生物学原因,(b)证据收集,(c)隐性诊断。研究结果表明,上层社会地区的教师在与家长讨论多动症时跳过了过程中的某些步骤,或者很容易处理好每一步。下层阶级地区的教师遇到了障碍,影响了儿童接受教师偷偷诊断的可能性,从而减少了与医疗专业人员会面和接受医疗干预的可能性。研究结果解释了不同社区社会阶层对ADHD药物使用的差异,并有助于解释社会阶层的社会再生产。通过建立有关文化资本和心理健康素养的文献,我将“医疗化滞后”概念化为医疗化过程和社会阶层的社会再生产的组成部分。
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引用次数: 5
Care to sleep? Daily caregiving and sleep problems in an ageing European population. 想睡觉吗?欧洲老龄化人口的日常护理和睡眠问题。
IF 3.6 2区 医学 Q1 Social Sciences Pub Date : 2021-07-01 Epub Date: 2020-07-04 DOI: 10.1080/14461242.2020.1787187
Vera van de Straat, Barbara Willems, Piet Bracke

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.

在我们老龄化的人口中,非正式照顾越来越普遍,进入非正式照顾者的角色通常标志着一个重要的生命历程转变。对这种转变的调整被认为对睡眠问题的发生很重要。因此,本研究旨在确定成为日常照顾者与睡眠问题之间的关系,照顾状态的变化是否与睡眠问题的变化有关,以及与其他社会角色的交集如何影响这种联系。根据欧洲健康老龄化和退休调查(N= 32791)第1、2、4、5和6波的数据,分析显示,与不提供日常护理的人相比,现在和以前的日常护理人员都更有可能报告睡眠问题。当评估睡眠问题的改变时,向日常护理的转变似乎伴随着睡眠问题的增加。此外,即使是停止照顾的人也比那些从不每天照顾的人经历更多的睡眠问题,这表明照顾的遗产。在就业状况方面没有发现差异,但开始照顾孩子的女性比男性更容易出现睡眠问题。
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引用次数: 0
Troublemaking in hospitals: performed violence against the healthcare professions in China. 医院闹事:对中国医疗专业人员实施暴力。
IF 3.6 2区 医学 Q1 Social Sciences Pub Date : 2021-07-01 Epub Date: 2020-06-12 DOI: 10.1080/14461242.2020.1779105
Tianyang Liu, Xiao Tan

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.

“一闹”指的是发生在中国医院里的一种暴力行为,包括由患者亲属和/或“一闹”团伙领导的有组织的骚乱。根据媒体对易闹的报道,我们认为易闹现象将医院变成了“权力竞技场”,在这里,患者、易闹团伙、医生、政府机构和医院管理层之间发生了对道德和政治资源(资本)的争夺。本文考察了两个相互关联的规则,这两个规则对于理解“易闹”中参与者的局部策略至关重要:“公开规则”和“风险规避规则”。我们还认为,“稳定”的政治话语已被中国政府官员和公立医院在调解社会纠纷时内化。同时,易闹演员也用这种话语创造性地适应了社会反抗,表现在他们倾向于用表演干扰来追求物质或符号补偿。
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引用次数: 7
Not your unicorn: trans dating app users' negotiations of personal safety and sexual health. 不是你的独角兽:跨性别约会应用用户对个人安全和性健康的谈判。
IF 3.6 2区 医学 Q1 Social Sciences Pub Date : 2021-03-01 Epub Date: 2020-11-22 DOI: 10.1080/14461242.2020.1851610
Kath Albury, Christopher Dietzel, Tinonee Pym, Son Vivienne, Teddy Cook

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.

这篇文章反映了14位澳大利亚跨性别约会应用程序用户在使用应用程序时的安全感(和不安全感),以及他们的性保健经历。我们在“数字亲密关系”的跨学科领域的背景下探索应用程序的使用和医疗保健,考虑到数字技术和技术使用的文化既塑造了与性和性别有关的更广泛的专业和文化规范。借鉴Preciado的[(2013)]。色情时代的性、毒品和生命政治。在“药物色情化”的框架下,该分析旨在将参与者被卫生专业人员和其他应用程序用户“看到”和“知道”的经历置于背景下。我们的研究结果表明,约会应用程序和性健康服务都依赖于简化的分类和分类系统,这些系统强化了对性别和性行为的二元理解,以促进数据管理和信息共享实践。然而,这些分类和过滤技术也可以帮助跨性别应用程序用户避免骚扰,建立亲密关系,并寻求适当的医疗保健。
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引用次数: 12
Waiting to be seen: social perspectives on trans health. 有待观察:跨性别健康的社会视角。
IF 3.6 2区 医学 Q1 Social Sciences Pub Date : 2021-03-01 DOI: 10.1080/14461242.2020.1868900
Christy E Newman, Anthony K J Smith, Elizabeth Duck-Chong, Son Vivienne, Cristyn Davies, Kerry H Robinson, Peter Aggleton
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引用次数: 10
Expanding and improving trans affirming care in Australia: experiences with healthcare professionals among transgender young people and their parents. 扩大和改善澳大利亚的变性人确认护理:在变性年轻人及其父母中与医疗保健专业人员的经验。
IF 3.6 2区 医学 Q1 Social Sciences Pub Date : 2021-03-01 Epub Date: 2020-11-13 DOI: 10.1080/14461242.2020.1845223
Clare Bartholomaeus, Damien W Riggs, Annie Pullen Sansfaçon

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.

获得医疗保健对许多跨性别年轻人及其家庭来说非常重要,这涉及到与医疗保健专业人员的互动。虽然跨性别确认模式在澳大利亚的儿科性别诊所使用,但这并不意味着所有跨性别年轻人和他们的父母都会经历他们接受的确认治疗。本文考虑了跨性别年轻人(11-17岁)及其父母与澳大利亚性别诊所内外的医疗保健专业人员的经历和观点。在澳大利亚的两个州对父母和孩子进行了10次定性访谈。与医疗保健专业人员有关的主要主题是:医疗保健专业知识和肯定程度的不同,服务质量取决于个人医疗保健专业人员,缺乏连接的服务和转诊途径。讨论探讨了从研究结果中产生的具体问题,这些问题建议对医疗保健专业人员进行培训,以便更好地提供变性人的临床护理。
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引用次数: 22
Transgender health: on a world scale. 跨性别健康:在世界范围内。
IF 3.6 2区 医学 Q1 Social Sciences Pub Date : 2021-03-01 DOI: 10.1080/14461242.2020.1868899
Raewyn Connell

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.

在世界范围内了解跨性别健康需要将性别充分概念化为具体的社会结构,并认识到全球知识经济中的不平衡。对于大多数后殖民世界的跨性别群体,确定了四组主要的健康问题:在暴力和疾病面前生存,在实践中维持跨性别生活,面对包括民粹主义抬头在内的压力,以及使过渡有效。在世界大部分地区,熟悉的专业卫生保健模式不足以解决这些问题;社会行动和组织是必需的。
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引用次数: 14
'A little bubble of utopia': constructions of a primary care-based pilot clinic providing gender affirming hormone therapy. “乌托邦的小泡泡”:一个以初级保健为基础的试点诊所的建设,提供性别确认激素治疗。
IF 3.6 2区 医学 Q1 Social Sciences Pub Date : 2021-03-01 Epub Date: 2020-12-20 DOI: 10.1080/14461242.2020.1855999
Alex Ker, Gloria Fraser, Theresa Fleming, Cathy Stephenson, Anny da Silva Freitas, Richard Carroll, Thomas K Hamilton, Antonia C Lyons

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.

为跨性别者和非二元性别者提供性别确认激素治疗是性别确认医疗保健的一个快速发展的领域。虽然研究表明通过跨学科的初级保健模式提供性别肯定激素治疗的好处,但对服务使用者和提供者如何构建他们对肯定方法的理解知之甚少。在本文中,我们提出了四名服务用户和四名医疗保健专业人员谈论在新西兰奥特罗阿提供性别肯定激素治疗的初级保健试点诊所的话语分析结果。参与者在他们的谈话中使用了病理、时间和代理的概念,将诊所构建为个人环境,为服务用户提供了时间来做出自己的健康决定,同时将医院构建为非个人的,等待时间很长。管理临床医生决策的最佳实践指南的评估驱动性质被构建为限制用户的代理。研究结果强调了将性别肯定激素治疗与其他非疾病类型的医疗保健相结合的持续重要性,并提出了通过积极的医疗保健方法实现这一目标的新方法。
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引用次数: 5
Support for parents/carers of primary school aged gender diverse children in England, UK: a mixed-method analysis of experiences with health services. 对联合王国英格兰不同性别小学学龄儿童的父母/照料者的支助:对保健服务经验的混合方法分析。
IF 3.6 2区 医学 Q1 Social Sciences Pub Date : 2021-03-01 Epub Date: 2020-12-22 DOI: 10.1080/14461242.2020.1857656
Bridgette Rickett, Katherine Johnson, Helen Ingle, Martel Reynolds

This paper presents findings from a UK mixed-method study that aimed to understand parents/carers' views and experiences of support received from health services for primary school age (4-11) gender diverse children and their families. Data was collected via an e-survey including 10 open-ended questions with 75 parents/carers addressing experiences with (i) primary health services, including general practice (GP) clinics and child and adolescent mental health services (CAMHS) (ii) specialist gender identity development services (GIDS) (iii) non-health related support including transgender groups and online resources. Findings are organised into four themes: 'journey to health service provision', 'view on health services used', 'waiting' and 'isolation'. Discourses about gender diversity, childhood and the validity of trans healthcare shape parental experiences, including their desire for better information, more certainty in healthcare pathways and more expedient access to support services to reduce anxiety, distress and isolation. The emotional costs of waiting are compounded by the material costs of accessing the limited number of specialist services. Experiences could be improved through ensuring GPs and CAMHS are better prepared, expanding access to trans-specific support groups for those caring for children and young people, and exploring the provision of school-based support for gender diverse primary-age children.

本文介绍了英国一项混合方法研究的结果,该研究旨在了解父母/照顾者对小学学龄(4-11岁)性别不同的儿童及其家庭从卫生服务部门获得的支持的看法和经验。数据是通过一项电子调查收集的,其中包括对75名父母/照顾者的10个开放式问题,涉及以下方面的经验:(i)初级卫生服务,包括全科医生诊所和儿童和青少年心理健康服务(CAMHS); (ii)专业性别认同发展服务(GIDS); (iii)非卫生相关支持,包括跨性别群体和在线资源。调查结果分为四个主题:“卫生服务提供之旅”、“对使用卫生服务的看法”、“等待”和“隔离”。关于性别多样性、童年和跨性别医疗保健有效性的论述塑造了父母的经历,包括他们希望获得更好的信息、更确定的医疗保健途径,以及更方便地获得支持服务,以减少焦虑、痛苦和孤立。等待的情感成本与获得数量有限的专业服务的物质成本相结合。可以通过以下方式改善经验:确保全科医生和CAMHS做好更充分的准备,为那些照顾儿童和年轻人的人扩大跨性别支持小组的机会,并探索为性别多样化的小学年龄儿童提供基于学校的支持。
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引用次数: 2
期刊
Health Sociology Review
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