Rethinking medicalization: unequal relations, hegemonic medicalization, and the medicalizing dividend.

Medicalization is an important theory that has been subject to numerous debates. Drawing on three varied datasets, we forward a relational approach to medicalization that responds to critiques while aiming to reinvigorate the theory with new concepts and questions. In contrast to prior process-based work, our relational approach argues that medicalization is best understood as an action or activity undertaken by specific groups or actors. We further suggest that unequal relations characterize medicalization. Specifically, we argue that 1) groups or actors receive a benefit from participating in medicalization, which we call the medicalizing dividend and, 2) an actor/group occupies a hegemonic position in medicalizing relations, reaping the largest dividend and constraining other actors. While we assert that pharmaceutical companies are currently hegemonic, we argue that their hegemony is not indefinite. We discuss how our approach facilitates links between medicalization and other theories, while outlining future steps for medicalization research.