Braksmajer Amy
a School of Nursing , University of Rochester , Rochester , New York , USA.
Women Health. 2018 Apr;58(4):419-433. doi: 10.1080/03630242.2017.1306606. Epub 2017 Apr 7.
Given the prominent role of medical institutions in defining what is "healthy" and "normal," many women turn to medicine when experiencing pain during intercourse (dyspareunia). The medical encounter can become a contest between patients and providers when physicians do not grant legitimacy to patients' claims of illness. Drawing on interviews conducted from 2007 to 2008 and 2011 to 2012 with 32 women experiencing dyspareunia (ages 18-60 years) and living in New York City and its surrounding areas, this study examined women's and their physicians' claims regarding bodily expertise, particularly women's perceptions of physician invalidation, their understanding of this invalidation as gendered, and the consequences for women's pursuit of medicalization. Women overwhelmingly sought a medical diagnosis for their dyspareunia, in which they believed that providers would relieve uncertainty about its origin, give treatment alternatives, and permit them to avoid sexual activity. When providers did not give diagnoses, women reported feeling that their bodily self-knowledge was dismissed and their symptoms were attributed to psychosomatic causes. Furthermore, some women linked their perceptions of invalidation to both historical and contemporary forms of gender bias. Exploration of women's struggles for medical legitimacy may lead to a better understanding of the processes by which medicalization of female sexuality takes place.
鉴于医疗机构在界定什么是“健康”和“正常”方面的突出作用，许多女性在性交时感到疼痛（性交困难）时会求助于医学。当医生不认可患者关于疾病的说法时，医患之间的交流可能会变成一场较量。本研究基于2007年至2008年以及2011年至2012年对32名居住在纽约市及其周边地区、患有性交困难（年龄在18至60岁之间）的女性进行的访谈，考察了女性及其医生关于身体专业知识的说法，特别是女性对医生否定态度的看法、她们将这种否定视为性别化的理解，以及这对女性寻求医疗化的影响。绝大多数女性寻求对其性交困难进行医学诊断，她们认为医生会消除对其病因的不确定性，提供治疗方案，并允许她们避免性行为。当医生没有给出诊断时，女性表示感觉自己对身体的认知被忽视，症状被归因于心身原因。此外，一些女性将她们对被否定的看法与历史和当代的性别偏见形式联系起来。探索女性争取医学合法性的斗争可能有助于更好地理解女性性行为医学化的过程。
