School of Foreign Languages, Central China Normal University, No. 152 Luoyu Road, Hongshan District, Wuhan, 430079, HB, PR China.
School of Foreign Languages, Peking University, No. 5 Yiheyuan Road, Haidian District, 100871, Beijing, PR China.
Soc Sci Med. 2024 Jun;350:116927. doi: 10.1016/j.socscimed.2024.116927. Epub 2024 May 1.
Previous research shows that men who experience erectile or sexual dysfunction may feel uncomfortable discussing their sexual experiences in face-to-face clinical encounters. Part of the reason is the stigma and embarrassment associated with discussing private sexual matters. This study examines how e-patients, or more precisely advice-seekers, and doctors communicate about sexual dysfunction in online medical consultations (OMCs). We conducted a Theme-Oriented Discourse Analysis of relevant OMCs on CH Doctor, a Chinese medical consultation website, to understand how individuals with perceived sexual dysfunction articulate their conditions and how doctors on the platform respond and provide recommendations to these individuals. Our analysis reveals that OMCs afford advice-seekers a place to openly discuss their sexual health issues and gain empowerment from doctors who assist in mitigating the associated social stigma. Upon detailed discourse analysis, however, we find that individuals seeking advice often interpret their sexual experiences as symptoms of illness that requires medical intervention. In response, doctors tend to validate these advice-seekers' preliminary self-diagnoses by treating their conditions as medical issues and characterizing them as psychosocial problems caused by stress and anxiety. Aligning with a critical sociological perspective that views sexual dysfunction as socially constructed problems referenced against dominant norms of sexual functioning, we argue that the medicalization and psychologization of certain sexual behaviors by doctors and advice-seekers discursively reinforce and legitimize essentialist views of hetero-coital sexual interaction. Such views reify penile-vaginal intercourse and ejaculation as the only standard, successful, and desirable form of sexual activity. This may further induce fear and anxiety among adult men whose sexual behaviors do not realistically align with these norms.
先前的研究表明，患有勃起功能障碍或性功能障碍的男性在面对面的临床就诊中可能会感到难以讨论自己的性经历。部分原因是与讨论私人性问题相关的耻辱感和尴尬感。本研究考察了电子患者（更确切地说是寻求建议者）和医生如何在在线医疗咨询（OMC）中讨论性功能障碍。我们对中文医疗咨询网站 CH Doctor 上的相关 OMC 进行了主题导向的话语分析，以了解被认为存在性功能障碍的个体如何表达自己的状况，以及平台上的医生如何回应并向这些个体提供建议。我们的分析表明，OMC 为寻求建议者提供了一个公开讨论性健康问题的场所，并从协助减轻相关社会耻辱感的医生那里获得了权力。然而，经过详细的话语分析，我们发现寻求建议的个体往往将自己的性经历解释为需要医疗干预的疾病症状。作为回应，医生往往通过将这些寻求建议者的状况视为医学问题，并将其描述为压力和焦虑引起的心理社会问题，来验证这些寻求建议者的初步自我诊断。与将性功能障碍视为参照主导性功能的社会建构问题的批判社会学观点一致，我们认为，医生和寻求建议者将某些性行为医学化和心理化，在话语上强化和合法化了异性恋性行为的本质主义观点。这种观点将阴茎阴道交和射精视为唯一的标准、成功和理想的性行为形式。这可能会进一步引起不符合这些规范的男性的性恐惧和焦虑。
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