Negotiating Gender in Medicine

Sociologist Coutinho-Sledge explores experiences of patients.

A new addition of the sociology department, Piper Coutinho-Sledge specializes in gender studies, the sociology of the body, and critical health studies. A confirmed academic, Coutinho-Sledge holds an M.S. in natural resources from the University of Vermont and an M.A. and Ph.D. in sociology from the University of Chicago.


The Wrong Body?

My research has looked at people navigating the medical system鈥攕pecifically people who have 鈥渢he wrong body鈥 for particular kinds of medical care.

How do, or don鈥檛, bodies and gender go together? And when you鈥檙e looking for care that presumes a particular kind of body and gender identity, how do you present?

Say, you go to the gynecologist. The gynecologist isn鈥檛 automatically thinking, Ah, the person in the exam room is a cisgender woman with this kind of body and these kinds of concerns. These thoughts aren鈥檛 at the forefront, but they shape the interaction.

So I started thinking about other situations where people鈥檚 identities and bodies might create some kind of trouble for a medical interaction.

What about transgender men seeking to access and then actually participate in preventive gynecological care? And what about people with cancers that affect body parts but don鈥檛 make sense medically? Cisgender men who have breast cancer and cisgender women who have been diagnosed with breast cancer and make the choice to have a bilateral mastectomy, who decide that this is what I want to do with their body even when it鈥檚 not medically necessary.

The Theory of Experience

I talked to people all over the country and a few abroad who got treatment here. I asked them to imagine they were writing a book鈥攁 novel or a memoir or a screenplay鈥攁bout their experience with cancer and to start by describing that opening scene.

The idea was to find out about both the experience and their theory of the experience鈥攖hat is, how they construct it. Then I develop my theory of everybody鈥檚 experience and put them all together.

The general story is that people participating in medical care have to rethink their identity and what their bodies mean, and they have to do so in a context shaped by certain ideas about gender鈥攕tereotypes and normative ideas. For example, those ideas influence whether doctors recommend surgery or not.

In some cases, the medical profession tries to help you manage. So, when cis-gender men get mammograms, the staff will say things like I鈥檒l try to find you a gown that doesn鈥檛 have flowers on it. In effect, they鈥檙e saying, I understand you鈥檙e a man so I鈥檓 going to do these things that make you still feel like a man.

Whereas women who chose to have mastectomies but not reconstruction don鈥檛 often hear, Oh, I understand this. We鈥檙e going to help you. For those women, their social supports can help them make sense of their experience. They have people around them saying, I support you and love you, no matter what. We鈥檙e going to work through this. It doesn鈥檛 make it easy, but they have social supports that are helping them manage this. A lot of the people who chose reconstruction talk about I didn鈥檛 want to do this to my partner. Maybe if I weren鈥檛 married, I wouldn鈥檛 worry about reconstruction but I don鈥檛 want to upset this intimate partner. I don鈥檛 want to upset my kids. I don鈥檛 want to embarrass them at the beach.

Everybody is negotiating these issues in medicine, whether we know it or not. I鈥檇 say that they鈥檙e happening in other realms as well. Even if we鈥檙e not paying attention, we鈥檙e dealing with this same negotiation about our bodies and our identities.

Add Women and Stir

As a master鈥檚 student in Natural Resources at the University of Vermont, I worked with Cecilia Danks, who needed a grad student to do a feminist analysis of community-based forestry.

Within forestry, women are especially marginalized, and community-based forestry aims to bring in their voices and those of other marginalized populations. The idea is that, if you just bring them in, it鈥檚 all going to be better. But there鈥檚 more to gender than add women and stir.

What came of the analysis is an article in Gender, Work & Organization that looked at the trajectory of gender in these organizations. How can we use gender norms and stereotypes to change the gendered organization of an industry? My argument was, while standpoint theory tells us that bringing in different perspectives is useful, we need to take it a step further. We need to do more than bring in the women; we need to incorporate normatively feminine values.

Published on: 03/16/2017