Department of Sociology, Vanderbilt University, Nashville, TN 37235, USA.
Sociol Health Illn. 2010 May;32(4):613-30. doi: 10.1111/j.1467-9566.2009.01233.x.
This paper compares the histories of male circumcision in the United States and Great Britain to explicate the theoretically important, yet inadequately specified, processes of demedicalisation and remedicalisation. Circumcision became medicalised to a similar extent, through similar processes, in both countries before World War II. However, by the 1960s, circumcision was almost completely demedicalised in Britain and almost universal in the US, where it became partially demedicalised after the 1970s. Medical professionals and insurance/healthcare systems drove demedicalisation in both countries; in the US, grassroots activists also played a critical role, while medical community 'holdovers' and parents resisted demedicalisation. Recent research linking circumcision to HIV prevention and deaths following religious circumcision are differentially likely to produce remedicalisation in the two nations, given differences in circumcision prevalence, HIV epidemiology, insurance/health systems, activism opportunities, and status of religious groups. Research on (de/re)medicalisation should theorise the life cycle of medicalisation, explore comparative cases, and attend more closely to medical holdovers from previous eras, prevalence and duration of medicalised practices, and barriers to promoting non-medical interpretations.
本文通过比较美国和英国男性割礼的历史,阐述了去医学化和再医学化这两个理论上重要但尚未得到充分说明的过程。在第二次世界大战之前,割礼在这两个国家都以类似的程度、通过类似的过程被医学化。然而,到了 20 世纪 60 年代,割礼在英国几乎完全去医学化,而在美国几乎普遍存在,20 世纪 70 年代后,割礼又部分去医学化。医疗专业人员和保险/医疗保健系统推动了这两个国家的去医学化;在美国,基层活动人士也发挥了关键作用,而医疗界的“遗留人员”和家长则抵制了去医学化。鉴于两国割礼率、艾滋病毒流行病学、保险/医疗体系、活动机会和宗教团体地位的差异,将割礼与艾滋病毒预防和宗教割礼后死亡联系起来的最新研究更有可能在这两个国家产生再医学化。关于(去)医学化的研究应该从理论上探讨医学化的生命周期,探索比较案例,并更加关注前一时期遗留下来的医学问题、医学化实践的流行程度和持续时间,以及促进非医学解释的障碍。