THE COURSE
Medical sciences’ corporeal framework emphasizes anatomy and physiology, and sex and gender differences in body vulnerability, such as men with high levels of psychological distress being more vulnerable to ischemic heart disease mortality. The sciences ‘medicalized’ bodily experiences and maintain body/mind and nature/culture dualisms, often reducing our experiences to men’s and women’s corporeal distinctiveness. Further, by medicalizing our understanding of bodily experiences, medicine gains power. When the ‘pain’ (not the ‘burn’) of a workout is treated with a numbing pharmaceutical drug, medicine reaffirms control of bodily and cultural experience. This course recognizes that medicine is a social institution within patriarchal society and that our bodies are one site of gender. Most of the time, our bodies remain largely unproblematic and taken-for-granted gender sites. But when our bodies encounter ‘difficulties’ or ‘resistance’ of some kind – from the experience of overexertion, interrupted sleep, the corporeal consequences of embarrassment, a morning’s dehydration following an evening of drinking, the displeasure of the reflection in the mirror – we become aware of the connection between the social and corporeal. But does this ‘understanding’ also remain true of sick and painful bodies, or do we abandon the sociological and take-up the medicalized point-of-view of that attributes our bodily experiences as corporeal betrayal?
This course urges us to step-back and perceive our bodies as gendered sites and carefully investigate the ways that medicine is gendered and influences our body experiences. We will investigate why the masculine image of the physician remains so strong when so many women are practicing medicine; why men exceed women in rates of ‘premature’ death yet, until their early death, report less illness, less disability, and fewer psychiatric symptomology; and, why women’s bodily experiences are regularly perceived as directed by internal forces – either organic or psychosomatic – while men’s are said to be tied to their work and social environments. This course is designed to examine some of the distinct relationships between gender and medicine.
LEARNING OBJECTIVES
- To appreciate the many ways that ‘personal troubles’ can be understood as ‘public issues,’ such as why women are becoming harmed by hypertension and coronary heart disease or why men’s depression remains unnoticed and understudied.
- To appreciate how biography and culture are interdependent, such as in the ways women’s reproduction and sexuality are body experiences framed by society’s knowledge, or why men’s ‘hardiness’ has become individually sculpted rather than part of industrial society.
- To appreciate the sociologies of the body, medicine and gender.
- To recognize medicine and gender as powerful social institutions.
REQUIRED TEXTS
Cassell, Joan. 2000. The woman in the surgeon's body. Harvard University Press.
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 Edson, Margaret. 1999. W;t. Dramatists Play Service. |
Figert, Ann E. 1996. Women and the ownership of PMS. New York: Aldine de Gruyter. |
Geller, Jeffrey, & Harris, Maxine 1994.  Women of the asylum. New York: Doubleday. |
Lorber, Judith, & Moore, Lisa. 2002.
Gender and the social construction of illness. Thousand Oaks: AltaMire. |
ADDITIONAL READINGS
There are many journal articles and/or book chapters assigned and available through Electronic Reserve. The authors and titles are designated on the syllabus. You are advised to print all the articles/chapters and keep them in a binder.
ACADEMIC HONESTY & CLASS POLICY
Academic Honesty: In an academic institution, few offenses against the community and the integrity of the faculty-student relationship are as serious as academic dishonesty. No ethic is more important to academic integrity than scrupulous use of, and documentation of, sources used. Improper use of others’ work (whether obtained from printed, electronic, or oral sources) is a violation of academic standards, and violations of academic integrity undermine trust and will be severely penalized. Because many people learn best when they learn together, of course you are encouraged to discuss the readings, concepts, and assignments with other members of the class. But you are also expected to present your own original work. Plagiarism, fabrication, cheating, and collusion are violations of academic integrity. The Department of Sociology and Anthropology adheres to the College’s policy on academic honesty. If you are unfamiliar with the College’s policy, consult the College Catalogue (pp. 12-14).
Class Policy: All exams are to be taken and papers submitted as scheduled. You are responsible for all class materials – lectures, readings (including those not discussed directly in class meetings), information from collaborative projects, films, and for all assignments.
COURSE REQUIREMENTS
The requirements for this course include participation (5%), two take-home midterm exams (first worth 15%, second worth 20% of the course grade), a cumulative, in-class final exam (worth 30%), and a semester research project and paper (worth 30%). In sum, the requirements are:
(1) attend classes prepared, having read the assigned material beforehand
(2) complete two take-home midterm exams
(3) submit a prospectus for the research project & paper
(4) develop an individually-authored research paper
(5) take a comprehensive, in-class final examination
Participation and Attendance
The course is based on both lecture & discussion and class attendance is expected. Missing class once every other week is unacceptable and will affect your grade. I expect you to have read & thought about the materials prior to class and participate actively in discussion. The success of this course depends upon how engaged students are in working with the ideas and the extent to which all of you participate. The reading assignments often provoke and encourage reflection and reconsideration of one’s opinions and beliefs. You are encouraged to ask questions, make comments, bring up a reading, compare course materials to newspaper or magazine articles, and bring these ideas to the attention of the class. Simply put, preparation and active participation are pivotal to the success the course and spirit of the class.
Read the assigned materials for themes, oddities, public policy issues, unanswered questions, new ideas, troubling conclusions, alternative interpretations, and things that arouse feelings. Class sessions never permit enough time to thoroughly discuss the readings. To get the most out of each class session, reading beforehand and think about the reading(s) are absolutely essential. Questions to think about while you are reading:
1. What are the author’s main arguments or hypotheses?
2. What evidence does the author present in support of her or his arguments?
3. What are some implications of the author’s arguments or findings?
4. What are the strength’s and weaknesses of the author’s arguments or research?
5. Do you agree with the author’s conclusions? Why or why not?
Examinations
Two take-home midterm examinations will be distributed eight days before each is due: due dates are February 16 and March 23. You will be responsible for 7-10 page papers for each exam. The midterms will cover all assigned materials to that point of the course and comprise 15% and 20% of the course grade, respectively. Each midterm will consist of no more than two essays, and each is designed to evaluate your ability to use course materials as you systematically analyze issues we have been addressing.
The final exam will be a comprehensive in-class “open book” exam. The exam will cover all the assigned readings. It will entail a series of short answer questions and two essays. The final is worth 30% of the course grade.
Semester Research Project & Paper
Imagine the objective was to develop a visual project – a poster – that demonstrated the ways in which women’s treatment in sports medicine clinics is presented to the buying public. The poster would be a synopsis of your research paper, and the paper summarizes a semester’s research. That research would include a thorough review of existing research, an analysis of the data collected (e.g., your observations of how young and older women are differentially treated in sports medicine clinics, or your interviews with young and older women athletes, or, your collection of the advertising found in sport magazines), and a discussion of your findings in terms of the study’s strengths and weaknesses.
This assignment involves a literature review and original research yielding a 15-20 page manuscript that combines some of the literature reviewed with your original research. The project & paper are designed to provide you the freedom to select one topic/issue which is of interest to you and to study it in some depth. For students interested in medical studies, medical sociology, gender studies, or gerontology, the research itself makes studying issues of gender and medicine much more intriguing. You will come away from the research with a deeper understanding, a sense of ownership of your scholarship, and an opportunity to present your original work at the annual Academic Conference.
Early in the semester (by the beginning of the fourth week, February 12) you are expected to have already consulted with me outside of class. Next, a 3-4 page prospectus of the project, with an annotated bibliography of at least eight journal articles you will likely use as references in the final paper, is due no later than March 12, and this prospectus is worth 5% of the course grade. The final paper is due April 30 and is worth another 25% of the course grade. Additional guidelines will be posted on Blackboard and discussed during (one of) the office visit(s). You are encouraged to consult me more than the one time.
Late papers will be penalized; remember, this is a semester long assignment and working on it continuously is expected.
COURSE OUTLINE
Part I. Gender & Medicine as Social Institutions
 Course Organization and Orientation (Janurary 17)
Most common medical conditions are influenced by gender and there are few areas of medical practice where a gendered perspective does give increased insight. How has gender embodied medicine, and how has medicine embodied gender? What can you expect to do in this course, and to gain?
 Hegemony of Biomedicine -- The (Dying) Patient in Modern Hospitals (January 22-24)
The hospital as a stage, the “medical gaze,” the contemporary meanings of dying and death: Does the culture of biomedicine still expect physicians to step from their backstage lives and adapt to the front stage rules which hail scientific achievement and ritualized physician-patient relations, expect patients to forego decision-making and comply with medical advice, create a chasm between medical orthodoxy and subjective experience, and thereby turn people into modernity actors?
Jan 22: Patients’ experiences of physicians’ work places
Edson, W;t
Guest facilitator and lecturer: Helen Whall, Professor of English
Jan 24: Death brokering 
Edson, W;t (continued)
Rier, “The missing voice of the critically ill” (ER)
Timmermans, “Death brokering: Constructing culturally appropriate
deaths” (ER)
 The Medical Culture (January 29)
How do physicians manage life and death decisions or the stresses of treating patients who cannot be cured? Is technical performance as equally important as “joining the club”?
Jan 29: Acquiring the medical gaze
Smith &. Kleinman, “Managing emotions in medical school: Students’ contacts
with the living & the dead” (ER)
Anspach, “The language of case presentation” (ER)
Davenport, “Witness the medical gaze” (ER)
Freund et al., Chapter 9, Health, illness, and the social body (recommended, ER)
 The Meanings of Health & Illness (January 31 – February 5)
Often noted is the distinction between disease and illness – between a biophysiological phenomenon that affects the body and the social context that accompanies or surrounds bodily experiences. Is there such a thing as “health;” a commonly accepted definition of illness; a distinction between disease and illness?
Jan 31: Wedding medicine and the (gendered) body
Turner, “The history of the changing concepts of health and illness” (ER)
Freund et al., Chapter 6, Health, illness, and the social body (ER)
Lupton, “The social construction of medicine and the body” and/or
Lupton, “The body in medicine” (ER)
Feb 5: Sex embodiment: sometimes stigmatizing, sometimes mainstreaming
Lorber, “Believing is seeing: Biology as ideology” (ER)
Martin, “The egg and the sperm: Howe science has constructed a romance based on
stereotypical male-female roles” (ER)
Schiebinger, “Skeletons in the closet: The first illustrations of the female skeleton in
eighteenth-century anatomy” (ER)
Kessler, “The medical construction of gender” (recommended, ER)
 The Paired Institutions (February 7-12)
In the early 1970s, Zola argued that “medicine is becoming a major institution of social control, nudging aside, if not incorporating, the more traditional institutions of religion and law.” Gender scholars recognize that social practices are embodied. How has gender embodied medicine, and how has medicine embodied gender? [This pair of questions is examined throughout the remainder of the course.]
Feb 7: Medicine & gender as social institutions
Zola, “Medicine as an institution of social control” (recommended, ER)
Conrad, “Medicalization & social control” (ER)
Lorber & Moore, Gender and the social construction of illness, Chapter 1
Rosenfeld & Faircloth, “Medicalized masculinities: The missing link?” (ER)
Feb 12: Gender embodiment and mainstreaming
West & Zimmerman, “Do gender” (ER)
Martin, “Gender as a social institution” (strongly recommended, ER)
Schooler & Ward, “ Average Joes: Men’s relationship with media, real bodies, and
sexuality” (ER)
Part II. Evidence of Medicalization and Biomedicalization
 Gendered Epidemiology (February 14)
If men and women failed to embody health practices and medicine differently, we would find equal evidence of illnesses. But we largely find differences. And if medicine failed to be gendered, we would find equal evidence of care; but….
Feb 14: Demography of health and illness
Lorber & Moore, Gender and the social construction of illness, Chapter 2
 First midterm due (noon, February 16)
 Masculinities and Well-Being (February 19-21)
Does the pursuit of masculinity have invisible health costs? Does manhood pivot on the embodiment of contradictions, such as taking health risks but striving to present a healthy body? Are men’s lives shortened by gender practices?
[We shall consider contemporary attitudes toward the male body. Please bring in a copy of a male ‘lifestyle’ magazine e.g. Men’s Health, GQ, Maxim to class.]
Feb 19: Warning: Masculinity can be dangerous to your health
Sabo, “Masculinities and men’s health” (ER)
Courtenay, “Constructions of masculinity and their influence on men’s well-being” (ER)
Riska, “From Type A man to hardy man: Masculinity and health” (ER)
Feb 21: (Dis)embodying gender
Real, “Men’s hidden depression” (ER)
Loe, “Fixing broken masculinity” (ER)
Potts, Grace, Gavey, & Vares, “‘Viagra stories’: Challenging ‘erectile dysfunction’” (ER)
Wall & Kristjanson, “Men, culture and hegemonic masculinity: Understanding the
experience of prostate cancer” (recommended, ER)
 Femininities and Well-Being (February 26-28)
Women’s health movement activism has improved the care of women patients, made physicians aware of the uniqueness of women’s bodies and selves and treatment needs, and changed the power inequalities inside medicine. But in everyday life, women’s health and well-being remains contained by gendered politics and practices.
Feb 26: Body awareness and health
McCready et al., “Breast self-examination and breast awareness: A literature review” (ER)
Anthony & Ratcliff, “Women and body image” (ER)
Gimlin, “Cosmetic surgery: Beauty as commodity” (ER)
Conrad, “The shifting engines of medicalization” (recommended, ER)
Feb 28: A different body: Body enhancement or mutilation
Morgan, “Women & the knife: Cosmetic surgery & the colonization of women’s
bodies” (ER)
Kaw, “’Opening’ faces: The politics of cosmetic surgery and Asian American women” (ER)
Lorber & Moore, Gender and the social construction of illness, Chapter 6
 Spring Break (March 5-7)
 Gender and Psychiatric Medicalization (March 12-14)
The medical model generally assumes something has gone wrong with the brain or the cognitive capability of someone affected with a mental disorder. Imagine, instead, a mental disorder as a social construction, built on human judgments of “mad” v. “bad” v. “normal.” Social evaluation is central rather than peripheral to the concept of mental disorder and normalcy. Why does gender have a close association with normalcy and disorder?
Mar 12: Institutionalization of wives
Ussher, Women’s madness, Chapter 1 (ER)
Warran, Madwives, Chapter 1 (recommended, ER)
Film: Means of Grace
Mar 14: Women and psychiatry
Geller & Harris, Women of the asylum, preface, forward, 1-10, 11-29, testimony by Beecher,
87-105, stories by Brinckle & Gilman, 169-186, account by Russell, 247-262,
choice one account, the epilogue
Kangas, “Making sense of depression: Perceptions of melancholia in lay narratives”
(recommended, ER)
Mar 19: Biomedicalization, medical management and women’s biology
Martin, “Medical metaphors of women’s bodies: Menstruation and menopause” (ER)
Figert, Women and the ownership of PMS, Chapters 1-3, skim Chapter 4
Mar 21: Femininity as disease
Figert, Women and the ownership of PMS, Chapters 5-7
Lorber & Moore, Gender and the social construction of illness, Chapters 5
 Second midterm due (noon, March 23)
 Two Diseases/Illness Experiences (March 26-28)
The experience of chronic, debilitating illness is, of course, as gendered as the experience of acute, infectious disease. So too is the treatment. How has the gendered meaning of certain chronic illnesses been shaped by the populations most affected, the diagnosis, and the treatment(s) suggested?
[Please bring in pharmaceutical advertising and/or web page commentaries that address some of the moral, social and medical interpretations of HIV or a disability.]
Mar 26: HIV/AIDS
Lorber & Moore, Gender and the social construction of illness, Chapter 7
Mar 28: Disability
Lorber & Moore, Gender and the social construction of illness, Chapter 4
Charmaz, “The body, identity, and self: Adapting to impairment” (ER)
Part III. Gendered Spaces
Apr 2: The experiences of women as physicians -- Guest lecturer: Carol Richardson
Morantz-Sanchez, “The ‘connecting link’: The case for the woman doctor in 19th-century
America” (ER)
Lorber & Moore, Gender and the social construction of illness, Chapters 3
Palepu & Hebeert, “Medical women in academia: The silences we keep” (ER)
Schneider & Phillips, “A qualitative study of sexual harassment of female doctors
by patients” (ER)
 Easter Break (April 5-9)
Apr 11: Medicine & surgery: Embodying masculinity
Pringle, Sex and medicine: Gender, power and authority in the medical profession, Chapter 4 (ER)
Cassell, The woman in the surgeon’s body, Chapters 1-3
Apr 16: Embodying the ethos of surgery
Cassell, The woman in the surgeon’s body, Chapters 4-6
Apr 18: The greedy institution
Cassell, The woman in the surgeon’s body, Chapters 7-9
Apr 23: Gendered nursing
Pringle, Sex and medicine: Gender, power and authority in the medical profession, Chapter 8 (ER)
Porter, “Women in a woman’s job: The gendered experience of nurses” (ER)
Apr 25: Men in nursing
Evans & Frank, “Contradictions and tensions: Exploring relations of masculinities in the
numerically female-dominated nursing profession” (ER)
Evans, “Cautious caregivers: Gender stereotypes & the sexualization of men nurses’ touch”
O’Lynn, “Men, caring and touch” (ER)
Apr 30: Wrapping up
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