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To determine gendered patterns of preventive medical care (physical and dental/optical) use among pan-ethnic U.S. Asian and Latino adults.

Using National Latino and Asian American Study (2004) data, we apply Andersen’s (1995) Behavioral Model of Health Services Use to assess how preventive care use among Asian and Latino men and women varies as a function of predisposing, enabling, and need-based characteristics. We explore whether adjustment for these factors mediates gender disparities in both physical and dental/optical check-ups, and test whether certain factors operate differently among men versus women.

A higher proportion of women reported a routine care visit last year, especially among Latinos. Adjusting for predisposing, enabling, and need-based factors explained the gender difference in reporting a dental/optician check-up, but not a physical check-up, among both Asian and Latino adults.

Our findings illustrate how gender patterns in routine care use differ by race/ethnicity, and highlight the fundamental importance of enabling characteristics (especially health insurance and having a regular doctor) for shaping routine care use between men and women, both Asian and Latino. Limitations of this chapter are that the data are cross-sectional and were collected before the implementation of the Affordable Care Act, and measures are self-reported.

This chapter focuses on Asian and Latinos because they represent the fastest growing minority populations in the United States, yet few studies have evaluated gender differences in preventative health care use among these groups.

This chapter provides an introduction to the volume along with a brief review of literature on gender, women’s health concerns, and other social factors in health and health care services.

Literature review.

The chapter argues for the importance of greater examination of gender, women’s health concerns, and social factors in health and health care services.

Reviews the issues of gender, women, and social factors and previews this book.

Purpose: We respond to a call for studies of “embodied experiences of stigma in context” by investigating how transgender embodiment shapes perceived needs for access to and experiences of “sex-specific” cancer screenings (SSCS) (e.g., breast and prostate exams, Pap smears) in the North American healthcare system.

Design/Methodology/Approach: We analyze data from semistructured interviews with a diverse sample of 35 transgender-identified adults. Based on thematic narrative analysis, we explore four themes in relation to embodiment: discrimination; discomfort and hyperawareness of genitalia; strategic reframing and active management; and SSCS health care encounters as positive and gender affirming.

Findings: In relation to SSCS, transgender individuals experience discrimination, do emotion work, and actively manage situations to obtain needed health care, and sometimes forego care because barriers are insurmountable. Health care providers' responses to transgender embodiment can disrupt health care encounters, but they can also facilitate access and create opportunities for affirmation, agency, advocacy, and new forms of interaction. Embodiment- and gender-affirming interactions with health care providers, which varied by gender, emerged as key influences on participants' experiences of SSCS.

Research Limitations/Implications: Our sample primarily includes binary gender-identified individuals, and while our interview guide covered many topics, the SSCS question did not explicitly reference testicular exams.

Practical Implications: Cancer prevention and detection Cancer prevention and detection require health care professionals who are prepared for differently embodied persons. Preventive cancer screenings are not “sex-specific”; they are relevant to individuals with medically necessary needs regardless of gender identity or embodiment.

Social Implications

Originality/Value: Few medical sociologists have focused on transgender embodiment. Findings enhance our understanding of how transgender embodiment and minority stress processes influence access to needed SSCS.

Women have been discriminated against throughout history. Despite international efforts, there remain significant inequalities between men and women. In some countries women are still deprived of fundamental human rights. This article looks at the published literature on gender as it affects individual vulnerability and risk, and planning, organisation and delivery of health care, with specific focus on the mental health and learning disabilities literature. It acknowledges the important differences between the life experiences and social realities of men and women with learning disabilities, and discusses them in the context of recent government policy and guidance. It calls for urgent gender‐specific research to understand the key issues facing men and women with learning disabilities, and a rights‐based approach to access to education, health care and a competent and informed workforce.

This chapter will initially review some health care system issues with a focus on the US health care system. It will then review some of the sociological literature about race/ethnicity, immigration, socioeconomic status (SES) and gender and how these factors link to health and health care. In addition, the chapter will serve as an introduction to the volume and will briefly review the contents of the other sections and chapters in this volume.

This chapter provides both an introduction to the volume and a brief review of literature on women, gender, and health and health-care services as well as racial/ethnic minorities in the same areas.

The chapter argues for the importance of greater examination of women, issues of gender, and racial and ethnic minorities in health and health-care services.

The chapter reviews the issues of women and racial and ethnic minorities and previews this book.

Previous research shows differences between women and men in utilization of facilities of health care (FHC) across the general population in a number of countries. In this chapter, we focus on the capability to use FHC, because it refers to an individual freedom to choose between alternative FHC directed to restore or to improve own health in situations of health needs. Based on several empirical studies and on the insights of the capability approach, we propose that there are cross-national differences between women and men in the capability to use FHC, and that these differences are due to gender differences in the extent of educational skills, and due to differences in the extensiveness of social security policies across countries. The objective of this study was to question these propositions.

We tested the hypotheses using the data from the European Social Survey (in a sample of 38,992 respondents from 22 countries) which we analyzed performing multilevel analyses.

The findings show that in Central, North, West, and East European countries, women have more capabilities to use FHC than men. They suggest that the low-skilled women in Central, North, and West European countries have higher level of the capability to use FHC than women with more educational skills.

The findings do not specify which particular social program or policy is more effective in enhancing women’s capability to use FHC.

This chapter focuses on women’s freedom or the capability to use FHC.

Racial and ethnic minorities utilize less healthcare than their similarly situated white counterparts in the United States, resulting in speculation that these actions may stem in part from less desire for care. In order to adequately understand the role of care-seeking for racial and ethnic disparities in healthcare, we must fully and systematically consider the complex set of social factors that influence healthcare seeking and use.

Data for this study come from a 2005 national survey of community-dwelling Medicare beneficiaries (N = 2,138). We examine racial and ethnic variation in intentions to seek care, grounding our analyses in the behavioral model of healthcare utilization. Our analysis consists of a series of nested multivariate logistic regression models that follow the sequencing of the behavioral model while including additional social factors.

We find that Latino, Black, and Native American older adults express greater preferences for seeking healthcare compared to whites. Worrying about one’s health, having skepticism toward doctors in general, and living in a small city rather than a Metropolitan Area, but not health need, socioeconomic status, or healthcare system characteristics, explain some of the racial and ethnic variation in care-seeking preferences. Overall, we show that even after comprehensively accounting for factors known to influence disparities in utilization, elderly racial and ethnic minorities express greater desire to seek care than whites.

We suggest that future research examine social factors such as unmeasured wealth differences, cultural frameworks, and role identities in healthcare interactions in order to understand differences in care-seeking and, importantly, the relationship between care-seeking and disparities in utilization.

This study represents a systematic analysis of the ways individual, social, and structural context may account for racial and ethnic differences in seeking medical care. We build on healthcare seeking literature by including more comprehensive measures of social relationships, healthcare and system-level characteristics, and exploring a wide variety of health beliefs and expectations. Further, our study investigates care seeking among multiple understudied racial and ethnic groups. We find that racial and ethnic minorities are more likely to say they would seek healthcare than whites, suggesting that guidelines promoting the elicitation and understanding of patient preferences in the context of the clinical interaction is an important step toward reducing utilization disparities. These findings also underscore the notion that health policy should go further to address the broader social factors relating to care-seeking in the first place.

Purpose – In this chapter, I set out to unexcise the messiness of maternalisms and disparities in women's health care by addressing narratives about reproductive trauma. I ask, what might it mean to analyze the interaction between the medical industrial complex and women who experience reproductive trauma as a social practice, one that is constitutive of gender socialization and the medicalization of women's bodies in the American nation-state? I accomplish responding to the question by addressing a vastly underresearched and underaddressed pregnancy complication Hyperemesis Gravidarum (HG).

Methodology/Approach – First, I thread posts from supportive online reproductive trauma forums to weave thematic narratives about and the impacts of HG. Next, I review biomedical literature in order to probe potential etiology. Third, I share my debilitating experiences with HG – reproductive traumas – to interrogate dominant androcentric biomedical discourse of pregnancy culture, maternalisms, maternal ideology, and epistemic violence.

Findings – Our knowledge about HG continues to be murky and unresolved, leaving many pregnant people – namely women – untreated.

Research limitations/implications – I call on the absence of contemporary protective sociocultural structures that provide support and care – gendered health-care disparities – for women during pregnancy, labor and delivery, and postpartum in order to advocate reproductive trauma is a viable and normal expression in the context of misogynist social scripts.

Originality/Value of the Chapter – My hope is to raise the volume on narratives of pregnancy trauma and reproductive experience using HG as a case study and my intention is to argue gender is a salient factor in health-care disparities.