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Purpose – The purpose of this chapter is to theorize the relationship between diagnosis and medicalization through an examination of the medicalization of childhood gender variance and the Gender Identity Disorder of Childhood diagnosis.
Methodology/approach – The chapter examines textual data (published clinical and research literatures, and critiques of the diagnosis appearing in a range of venues) to track how childhood gender variance is medicalized over time and the role of diagnosis in that medicalization.
Findings – While diagnosis certainly plays a role in shoring up medicalization, this case study reveals the many ways in which diagnoses may also become key tools in attempts to curtail medicalization.
Research limitations/implications – As a case study, the findings are not generalizable to all diagnoses. As a study of an instance of the medicalization of deviance, these findings may be particularly applicable to analogous cases.
Social implications – These findings show the sometimes tenuous nature of medicalization processes, and the social uses of diagnoses in those processes.
Originality/value of paper – This chapter sheds light on a relationship that is often assumed to be unidirectional (e.g., that the formation of diagnosis results in increased medicalization), and answers calls for a more nuanced sociology of diagnosis, including greater attention to the relationship between diagnosis and medicalization.
The medicalization thesis derives from a classic theme in the field of medical sociology. It addresses the broader issue of the power of medicine – as a culture and as a profession – to define and regulate social behavior. This issue was introduced into sociology 50 years ago by Talcott Parsons (1951) who suggested that medicine was a social institution that regulated the kind of deviance for which the individual was not held morally responsible and for which a medical diagnosis could be found. The agent of social control was the medical profession, an institutionalized structure in society that had been given the mandate to restore the health of the sick so that they could resume their expected role obligations. Inherent in this view of medicine was the functionalist perspective on the workings of society: the basic function of medicine was to maintain the established division of labor, a state that guaranteed the optimum working of society. For 20 years, the Parsonian interpretation of how medicine worked – including sick-role theory and the theory of the profession of medicine – dominated the bourgeoning field of medical sociology.
This chapter takes a critical look at the sociological notion of ‘medicalisation’ in relation to recent trends and developments in neuroscience, neurotechnology and…
This chapter takes a critical look at the sociological notion of ‘medicalisation’ in relation to recent trends and developments in neuroscience, neurotechnology and society, taking memory, medicine and the brain as our prime focus and the disease category of mild cognitive impairment (MCI) as our empirical case study. Five relational nexuses in particular are identified as relevant to these developments and debates, namely the bio-psych nexus, the pharma-psych nexus, the selves-subjectivity nexus, the wellness-enhancement nexus, and the neuroculture-neurofuture nexus. We show that developments in memory medicine and the shifting boundaries of cognitive health, as embodied and expressed in the case of MCI, shed further valuable light on these issues and the interconnectivity of these relational nexuses. As an emergent disease and susceptibility category, MCI illuminates not only the fuzzy boundaries between normal and abnormal cognitive functioning, but also the working of neuroscientific, neurocultural and pharmacological interests, which, in this case, are already claiming MCI as the next locus of enhancing the mind and optimising aging. Thinking both within and beyond medicalisation challenges us to find new ways to critically understand the ideas about life and health as they travel, translate or migrate from (neuro)scientific and clinical spheres to cultural life and patient experience.
Purpose – To examine debates within the transgender rights movement over the GID diagnosis in order to demonstrate how diagnosis can be resisted as a source of stigma and…
Purpose – To examine debates within the transgender rights movement over the GID diagnosis in order to demonstrate how diagnosis can be resisted as a source of stigma and social control at the same time that it is embraced as a means of legitimating experience and gaining access to resources, including medical services.
Methodology/approach – This chapter draws on qualitative data from: in-depth interviews with transgender rights activists and advocates, participant observation in transgender health care and activism settings, and content analysis of print and web-based materials on transgender health.
Findings – Transgender rights activists and advocates overwhelmingly reject the pathologization of gender variance. However, some actors advocate complete demedicalization, while others advocate diagnostic reform. Actors' advocacy for each position is influenced by the perceived costs versus benefits of diagnosis.
Social implications – The findings of this research shed light on the multiple and often contradictory effects of diagnosis. Diagnoses can both normalize and stigmatize. They can function to allow or deny access to medical services and they can support or act as barriers to legal rights and protections. Understanding these contradictory effects is essential to understanding contests over diagnosis, including the contemporary debate over GID.
Originality/value of paper – Through examination of an intra-constituent contest over diagnosis, this research demonstrates the need to distinguish medicalization from pathologization and illustrates the importance of examining the multiple and contradictory effects of diagnosis, both in and outside of medical settings.
Purpose – The chapter examines the historical pattern of interconnections between drug policy, research, and treatment in light of recent theoretical developments in the…
Purpose – The chapter examines the historical pattern of interconnections between drug policy, research, and treatment in light of recent theoretical developments in the medicalization thesis advanced in the sociology of medicine.
Methodology/approach – The chapter uses interpretive methods to examine how the social construction of addiction as a “chronic, relapsing brain disorder” converges with or diverges from the conceptual framework offered by sociological theorists of medicalization and biomedicalization.
Findings – The approach adopted shows how the meanings of the bio/medicalization of addiction shifted and circulated within and beyond the institutions developed to respond to drug addiction as a hybrid social, medical, and biomedical condition during the 20th century.
Social implications – Bio/medical frameworks for addiction are the outcome of historical attempts to influence public attitudes and develop effective methods to treat and prevent this “disease” in ways that would positively affect the quality of life of people living with addictions.
Originality/value – This original contribution addresses both strengths and limitations of bio/medical models, assessing how their influence has changed over time.
This chapter draws on qualitative interviews to examine how Bhutanese refugees interact with norms around mothering and childbirth. Since these women have birthed and…
This chapter draws on qualitative interviews to examine how Bhutanese refugees interact with norms around mothering and childbirth. Since these women have birthed and reared children in Bhutan and/or Nepal, as well as in the United States, their stories help to explore how the implications of medicalization differ for individuals by race, class, and nation, with a unique cross-comparative lens. In particular, the respondents uniquely identify epidurals as an important medical intervention, simultaneously increasing their autonomy while subscribing to neoliberal mothering. This research furthers our understanding of neoliberal mothering and medicalization by showing a nuanced script that illuminates social processes, resistance, and internalization through an intersectional and cross-cultural lens.
Medicalization is the increasing social control of the everyday by medical experts. It is a key concept in the sociology of health and illness because it sees medicine as…
Medicalization is the increasing social control of the everyday by medical experts. It is a key concept in the sociology of health and illness because it sees medicine as not merely a scientific endeavor, but a social one as well. Medicalization is a “process whereby more and more of everyday life has come under medical dominion, influence, and supervision” (Zola, 1983, p. 295); previously these areas of everyday life were viewed in religious or moral terms (Conrad & Schneider, 1980; Weeks, 2003). More specifically, medicalization is the process of “defining a problem in medical terms, using medical language to describe a problem, adopting a medical framework to understand a problem, or using a medical intervention to ‘treat’ it” (Conrad, 1992, p. 211). Sociologists have used this concept to describe the shift in the site of decision-making and knowledge about health from the lay public to the medical profession.
The purpose of this paper is to draw attention to the work of sociologists who laid the foundation for queer and crip approaches to disability and to address how queer and…
The purpose of this paper is to draw attention to the work of sociologists who laid the foundation for queer and crip approaches to disability and to address how queer and crip theory has and can help to re-conceptualize our understandings of health, illness, disability, and sexuality.
This paper is an examination of historical moments and prominent literature within medical sociology and sociology of disability. Sociological and popular understandings of disability and sexuality have often mirrored each other historically. Although this literature review focuses primarily on medical sociology and disability studies literature, some works of scholars specializing in gender studies, sexuality, literature, history, and queer studies are also included
In this paper, I argue that the medicalization and pathologization of human differences specifically as it pertains to sexuality and disability within the medical sociological literature have led to constructionist, social model, and feminist critiques. It is these critiques that then laid the foundation for the development of queer and crip theoretical approaches to both disability and sexuality.
Crip and queer approaches to disability provide a clear call for future sociological research. Few social science scholars have applied queer and crip approaches in empirical studies on disability. The majority of work in this area is located in the humanities and concerned with literary criticism. A broader array of empirical work on the intersection of sexuality and disability from queer/crip perspectives is needed both to refine these postmodern theoretical models and to examine their implications for the complex lived experience that lies at the intersection of sexuality and disability. In queering disability and cripping sexuality and gender, we may be able not only to more fully conceptualize disability, sexuality, and gender as individual social categories, but also to more fully understand the complex intersection of these social locations.
Purpose – To explore the ideological effects and social control potential of diagnostic biopsychiatry and encourage the sociology of diagnosis to retain key insights of early medicalization scholarship.
Methodology – As the sociology of diagnosis emerges from medicalization, it is imperative that the new sub-specialty retains the critical edge of the early scholarship. With this in mind the paper reviews key aspects of the medicalization thesis, emphasizing the links between medical definitions and social control processes (e.g. Conrad, 1992; Conrad & Schneider, 1992; Zola, 1972). Based on this review scholars are urged to be mindful of the “diagnostic imaginary” -- a way of thinking that conceals the presence of the social in diagnoses, and which closes off critical analysis of the existential-connectedness and political nature of diagnoses.
Findings – The paradigm shift from dynamic to diagnostic psychiatry in DSM-III opened the door to a new biomedical model that has enhanced American psychiatry's scientific aura and prestige. With the increased presence and ordinariness of diagnoses in everyday life, an illusory view of diagnoses as scientific entities free of cultural ties has emerged, intensifying the dangers of medical social control.
Social implications – By illustrating that diagnoses are cultural objects imbued with political meaning, the ideological effects and social control potential of diagnostic biopsychiatry may be mitigated.
This chapter explores processes of stratification in reproductive healthcare and considers the ways in which mechanisms of inclusion/exclusion shape reproductive…
This chapter explores processes of stratification in reproductive healthcare and considers the ways in which mechanisms of inclusion/exclusion shape reproductive opportunities and experiences. First, I consider the process of “selective inclusion” among sexual minority women. This examination questions the schisms that exist within the sexual minority population in regard to their visibility and legibility in medical, scientific, and public health discourses and constructions of reproductive health. The second process I examine is that of “exclusionary inclusion” among substance using pregnant women who have been collectively deemed “bad breeders” by medical and state authorities and whose reproduction is explicitly monitored, regulated, and criminalized. The final process I discuss is “side-stepping inclusion” which describes the healthcare and consumer decisions of women who circumvent medicalized childbirth experiences by employing the services of a midwife for their pregnancy and birth care. This chapter examines how medicalization, biomedicalization, and de-medicalization dynamically work together to expand and delimit inclusionary processes, emphasizing the spectral and interconnected quality of these processes. By exploring various processes of inclusion that shape reproductive experiences of these disparate and differentially marginalized populations, this chapter provides a conceptual and critical meditation on the ways in which “respectable reproduction” is deployed in reproductive care. In considering these processes of inclusion and the ways in which they are co-produced by medical discourses and practices, scholars may more clearly grasp some fundamental mechanisms of stratification in reproductive healthcare and knowledge production.