Department of Sociology, William & Mary, Williamsburg, Virginia, USA.
Sociol Health Illn. 2023 Jan;45(1):196-212. doi: 10.1111/1467-9566.13563. Epub 2022 Oct 18.
The invisibilisation of social groups in health research and survey data is a source of medical uncertainty, long seen as a hallmark of the medical field. However, scholarship has not thoroughly assessed how medical uncertainty is structured by state-level processes and global health agendas, especially for people beyond the Global North. This article introduces invisibilised uncertainty as a type of medical uncertainty structured by global organisational and state-level priorities, which can invisibilise social groups and health problems from research and data collection, exacerbating medical uncertainty and health disparities for people worldwide. Based on 14 months of fieldwork in Thailand and in-depth interviews with 62 participants, the article illuminates how state-level processes and global clinical research agendas have structured knowledge gaps and uncertainties for Thai transgender women. As omissions in health research and data collection become embodied on a world scale, the article expands our understandings of how gendered health disparities are structured nationally and globally. It advances a sociology of medical ignorance by analysing the uneven landscape of holistic transgender health research, parsing how institutional dynamics can prioritise or invisibilise people and health issues in research and data, and structure uncertainties.
健康研究和调查数据中社会群体的隐形化是医学不确定性的一个来源，这种现象长期以来一直被视为医学领域的一个特点。然而，学术界尚未彻底评估国家层面的进程和全球卫生议程是如何构建医学不确定性的，特别是对来自全球北方以外的人群。本文提出隐形不确定性这一概念，即一种由全球组织和国家层面的优先事项构建的医学不确定性类型，这种不确定性会使社会群体和健康问题在研究和数据收集过程中变得隐形，从而加剧全球范围内人们的医学不确定性和健康差距。本文基于在泰国进行的 14 个月实地调查和对 62 名参与者的深入访谈，阐明了国家层面的进程和全球临床研究议程是如何为泰国跨性别女性构建知识空白和不确定性的。随着健康研究和数据收集的遗漏在全球范围内变得越来越明显，本文扩展了我们对国家和全球范围内性别健康差距是如何构建的理解。本文通过分析整体跨性别健康研究不平衡的格局，解析机构动态如何在研究和数据中优先考虑或隐形化人群和健康问题，并构建不确定性，从而推进了医学无知的社会学研究。
