Medicalization, Natural Childbirth and Birthing Experiences

Although much of the early sociological and feminist analysis of medicalization focused on reproductive issues and childbirth, attention has moved away from this topic over time as new conditions have become subject to the medicalization process. At the same time, one of the major concepts within this analytical framework, the dichotomy of 'natural' versus 'medical', has not been sufficiently problematized. In this article, we call for a renewed examination of the medicalization of childbirth from a critical perspective that neither takes for granted the meaning of this dichotomy, nor presupposes feminist perspectives or those of privileged groups of women. We revisit sociological frameworks and feminist critiques of medicalization, specifically around childbirth, and review scholarship that addresses their limitations. We propose a research agenda that goes beyond the traditional assumptions about 'natural' and 'medical' childbirth and examines more closely how medicalization processes both shape and conflict with women's subjective experiences of childbirth.     

Women's sexual desire: a feminist critique

This paper offers a critical feminist analysis of the biomedical conceptualization of women's sexual desire. The five major features of the biomedical model of female sexual desire examined and critiqued are: 1) use of the male model as the standard, 2) use of a linear model of sexual response, 3) biological reductionism, 4) depoliticalization, and 5) medicalization of variation. A "New View", an alternative to the biomedical model, is offered for reconceptualizing women's sexual problems. This analysis concludes with recommendations for feminist-based biopsychosocial research.     

Guilty or not? A path model of women's sexual force fantasies

This study estimated a path model of women's forceful sexual fantasies. Constructs examined were childhood sexual abuse, feminist beliefs, sexual guilt, erotophilia, and sexual experience. The study clarifies how these factors mediate one another in relationship to forceful sexual fantasies, and is first to examine the effects of feminist beliefs on forceful sexual fantasy. Adult women (N = 261) participated by completing an online survey. A path from sex guilt to forceful sexual fantasy, mediated by erotophilia, was found, wherein low levels of sex guilt and high levels of erotophilia were found to predict forceful sexual fantasy. A direct path between childhood sexual abuse and forceful sexual fantasy was also found. The resulting model is discussed in relation to previously-proposed theories on the role of force in women's sexual fantasies.     

Women's sexual desire: A feminist critique

This article offers a critical feminist analysis of the biomédical conceptualization of women's sexual desire. The five major features of the biomedical model of female sexual desire examined and critiqued are (a) use of the male model as the standard, (b) use of a linear model of sexual response, (c) biological reductionism, (d) depoliticalization, and (e) medicalization of variation. A “New View,” an alternative to the biomédical model, is offered for reconceptualizing women's sexual problems. This analysis concludes with recommendations for feminist‐based biopsychosocial research.     

CONSTRUCTING RAPE: FEMINISM,CHANGE, AND WOMEN'S EVERYDAY UNDERSTANDINGS OF SEXUAL ASSAULT

The cultural and legal meaning of rape has changed dramatically over the past 30 years as the feminist movement has challenged traditional constructions of sexual violence and offered an alternative construction of the meaning of rape. The transformation of rape into a social problem has brought increased attention to the subject in both popular and academic realms. Despite the growing body of research and theory on sexual violence, little inquiry exists into women s everyday constructions of rape and the degree to which such constructions have been influenced by the feminist movement. This article uses a constructionist framework to examine the everyday understandings of rape held by a diverse sample of women. Data gathered through an open-ended survey instrument were analyzed to reveal both interesting similarities and significant differences in the ways women of different ages, races, and personal histories define and interpret the phenomenon of rape. By examining these data, the extent to which the feminist reconstruction of rape has influenced women s everyday assumptions is examined, and the role of differences among women in perceptions of rape is explored. The findings presented in this article have implications for theories of social problems, for feminist discourse, and for the application of research on rape in applied settings.     

Personal and Political: A Feminist Perspective on Researching Physical Disability

Feminist theory and methodology have much to offer in understanding how disability research has been experienced as alienated research by disabled people. However, feminist research has failed to apply its principles to disability and disabled women's subjective reality has found no place in mainstream feminist work. The paper identifies the challenges for feminism in addressing the interests and reality of disabled women, asserting that it is not helpful to focus on 'double disadvantage'. Disability research itself has much to learn from feminist methodology, in particular the principle of making the personal political. The role of non-disabled researchers as allies of disabled people is discussed, and the importance of research which turns the spotlight on the way in which non-disabled society oppresses disabled people. Finally, it is asserted that disability research and politics are of general relevance because the experience of disability is an integral part of a society characterised by fundamental inequalities and ideologies which divide people against each other.     

Female sexual pain disorders and cognitive behavioral therapy

Female sexual pain disorders are prevalent and have a deleterious effect on women's well-being. Because there are psychological elements to this pain, cognitive-behavioral therapy (CBT) may be a viable treatment alternative, particularly when compared to more physically invasive treatments such as surgery or medication. This article provides a critical analysis of research studies in this area by evaluating each study in detail, identifying gaps in the research base, and providing directions for future study. For the most part, all of the studies reviewed in this article found CBT to be effective. However, CBT modalities with minimal therapist direction or interaction were found to be problematic. In addition, there may be other noninvasive treatment types that are equally or more effective, such as biofeedback or supportive psychotherapy.     

FEMINISM, TECHNOLOGY AND THE INFORMATION SOCIETY Learning from the past, imagining the future

This article examines second wave and post-second wave feminist writing about the possibilities of (contemporaneously) new information and communication technologies. A number of texts by key authors, including Shulamith Firestone, Valerie Solanas, Cynthia Cockburn, Donna Haraway and Sadie Plant, are examined in light of the social and political context of their time of writing as well as in relation to 'mainstream' information society theorists such as Daniel Bell and Manuel Castells. The main focus is on how these authors understand the transformative potential of technologies, and attention is drawn to the swings between optimism and pessimism about the role of technology for a feminist political agenda. The role and nature of manifestos are also explored, and the question of whether it is time for another feminist technology manifesto is raised. The article concludes by posing some methodological and theoretical challenges of developing an anti-essentialist (in relation to both gender and technology), politically engaged and relevant feminist research agenda that takes seriously both lived experience and structures of power. The footnotes are an experiment in autobiographical writing in which I make explicit my own connection to this literature and the politics of these debates.     

Women’s Accounts of Heterosexual Experiences in the Context of Menopause

ABSTRACT

A number of biomedical models of female sexuality have emerged during the past few decades, and these have been challenged by feminist theorists who have tended to focus on the influence of contextual issues that mediate women's sexual experiences. In this article, a qualitative analysis of accounts relating to heterosexual experiences obtained from 25 menopausal women in Ireland through in-depth interviews is presented and considered in light of existing theoretical perspectives on sexuality. The average age of women in the sample was 54.2 years, and a diverse range of socioeconomic backgrounds was represented. We found that in describing their contemporary sexual experiences, contextual issues were brought heavily to bear as participants drew on discourses of personal history and biography, including previous relationships, to explain their current sexual experiences. However, a few women foregrounded physiological and biological reasons associated with hormonal changes to explain alterations in their sexual relationship, although overall, these were featured to a far lesser extent compared with their prominent position in biomedical menopause literature. A dominant feature of data was the influence of the discourse of the male sex drive, and many women explained their lesser interest in sexual activity compared with that of their partner in terms of men's nature. The findings suggested that for participants, anxiety around sexuality was socially produced either through the expectation to satisfy a partner, or by dominant discourses that defined sexual engagement as “healthy” and sexual apathy as “unhealthy.”     

The politics of private woman and public man

Summary Four themes run throughout this article. First, the tendency within male-stream analyses of political activity to exaggerate the extent of differences between women and men, and the recovery through feminist analysis of an unacknowledged political dimension underlying distinctive elements of women's experience.Second, the need to interrogate more rigorously the theoretical terrain on which the feminist engagement with the standard writings has taken place, particularly the unreflected emphasis upon the opposition between private woman and public man. Mapping political/ apolitical and male/ female onto the public/private divide encourages silence on boundaries of the political within the public sphere. It fails to address the political nature of the private, and implies that women are defined exclusively by the private sphere and men not at all.Third, the importance of re-examining men's political capacity, and distorted concepts and criteria of the political developed without sensitivity to gender. Male-stream writings misrepresent male political capacity by failing to recognize the parameters of men's political response - its parochialism and partiality, as well as the extent to which it is, like women's, reflective of private experience. Whether in political analysis or practical politics, it will not do to treat men's concerns, or policies formulated largely through traditionally male institutions, as the stuff of which politics is made.Fourth, the recognition that myopic visions of the political underlying misrepresentations of women's and men's political capacity are reproduced in many accounts of the relation between the private and the public, the personal and the political. Against such short-sighted views of politics, it is crucial to assert that the boundary between private and public arenas does not mark the limits of the political, and indeed is itself constructed through political process.     

TOWARD A SYNTHESIS OF FEMINIST AND DEMOGRAPHIC PERSPECTIVES ON FERTILITY

In explaining fertility and reproduction and emerging patterns of childbearing, both demographers and feminists have centered their thinking on women's status (economic and social), women's changing roles and life experiences (increased labor force participation, increased availability of reproductive options, declining marriage rates in many parts of the industrialized world, and the centrality of women to development), and women as agents in micro- and macrolevel changes in family, fertility, and economic change. Although demography has recently begun to integrate feminist perspectives into fertility explanations, there is not yet a synthesis of feminist theoretical insights with demographic questions. Drawing from recent thinking on global and national political and policy challenges in the less and more developed worlds, to the epistemological shifts in knowledge of reproduction/mothering, to changes in the technologies of reproduction, this article moves toward an integration of feminist and demographic perspectives on fertility.
…far from the economic dependence of women working in the interests of motherhood, it is the steadily acting cause of a pathological maternity and a declining birthrate.
Charlotte Perkins Stetson, Women and Economics , 1899     

AMBIGUOUS IDENTITY IN AN UNAMBIGUOUS SEX/GENDER STRUCTURE:

This article explores bisexual identity as an ambiguous social category within the dominant dualistic sex/gender structure. The article documents the stigmatization of the bisexual category in the discourse of both the Religious Right and lesbian feminist communities, then examines the impact of dual stigmatization on bisexual women, who often see bi identity as disrupting the dominant sexual binary. Drawing from interviews with bisexual women, the article argues that bisexual women's discourse on sexual subjectivity does not escape the influence of binary structures, although it does at times reconfigure the binary along the queer/nonqueer and bisexual/monosexual axes. While the bisexual identity category may work as a discursive stabilizing device during the sex/gender crisis provoked by the AIDS epidemic, its politicization by bi feminists also allows the category to be strategically deployed for feminist and queer political projects.
At the present time, the regions where the grid is tightest, where the black squares are most numerous, are those of sexuality and politics; as if discourse, far from being that transparent or neutral element in which sexuality is disarmed and politics pacified, is in fact one of the places where sexuality and politics exercise in a privileged way some of their most formidable powers.
-Michel Foucault
No wonder people think we [bisexual women] are all sleazy.
-Bisexual woman     

Masculinity and Sexual Violence: Assessing the State of the Field

Despite strong evidence that men perpetrate most acts of sexual violence, little is known about the factors that lead some men to commit such harmful acts. A growing body of feminist scholarship has begun to explore this question, although the disciplinary and geographic breadth of these studies has prevented the development of a cohesive research agenda. This literature review contributes to this task by reviewing the major theoretical contributions to the study of masculinity and sexual violence, detailing some of the ways in which sexual violence aids in the production of masculine individuals, groups, and states. Taken as a whole, we argue that this body of scholarship views sexual violence as a mechanism through which social constructions of masculinity are produced and reproduced, although the forms that this violence takes vary by context. We conclude with a discussion of some of the theoretical and empirical limitations of this research and consider the implications of these findings for public policy.     

Navigating uncertainty,employment and women’s safety during COVID-19: Reflections of sexual assault resistance educators

COVID-19 affects women in ways unique to the impacts of structural inequalities related to gender, sexuality, disability, race and socioeconomic status. In this article, we reflect on our own experiences of the pandemic, as feminist students, workers and sexual assault resistance educators located in a Canadian post-secondary setting. Situating ourselves within feminist responses to sexual violence prevention, as facilitators of the Enhanced Assess, Acknowledge, and Act (EAAA) sexual assault resistance education programme for university women, we reflect on the impacts of the COVID-19 pandemic on our work as EAAA facilitators in our Canadian university. We explore the theoretical possibilities that critical disability theory and queer theory present to the EAAA programme, and argue that incorporating concepts from these frameworks will complement the goals of the EAAA programme and improve inclusivity of queer, trans and disabled participants. We conclude with a look into the future by anticipating the impacts of COVID-19 on our future work.     

Assessing physical, sexual, and psychological violence perpetrated by intimate male partners toward women: a Spanish cross-sectional study

There have been many studies on the impact of intimate partner violence (IPV) on women's health, there being agreement on its detrimental effect. Research has focused mainly on the impact of physical violence on health, with few studies assessing the effect of sexual and psychological violence. Furthermore, there are many differences in the way violence experienced by women is assessed. While some researchers use available instruments, others develop their own questionnaires. This article gives detailed information about physical, sexual, and psychological violence, lifetime history of women's victimization, and aspects of women's behavior and feelings obtained with the questionnaire used in a Spanish cross-sectional study. Our results corroborate that IPV is not homogeneous, it being necessary to ask women about each type of violence they have experienced. Furthermore, to accurately assess the impact of IPV on women's health, it is necessary to control for other variables that also have detrimental effects on health.     

Medicalizations and demedicalizations of sexuality therapies

This article complicates recent discussions about the expanding zones and influences of medicalization and biomedicalization on sexuality and sex therapy by contextualizing them with competing nonmedicalizing trends. These latter developments include an escalating nonexpert commercial sexuality sector on the Internet, as well as a long history of anarchic and democratizing social politics, such as "the counterculture" and "free love movements." What these nonmedicalizing trends have in common is the view of sexual problems and solutions as far broader than sexual dysfunctions and sex therapies, a belief in the social determinants of individuals' sexual experiences, and a deep concern regarding the socially harmful consequences of medicalization. With the quantity of sexuality information and advice available to the public through the Internet only likely to expand, a long era of clashing claims about relations between sexuality and health and about the role of expertise in sexual life can be foreseen.     

Effects of Mindfulness-Based Therapies for Female Sexual Dysfunction: A Meta-Analytic Review

Mindfulness-based therapy (MBT) represents a potentially efficacious treatment for female sexual dysfunction (FSD). A number of recent trials assessing MBT for FSD have been published, but we are aware of no existing meta-analysis synthesizing these results. We conducted a literature review to identify all published trials of MBT for FSD. References of retrieved studies were searched and key authors were contacted with requests for complete but unpublished trials. Eleven trials, including a total of 449 participants, were identified. Two of these studies were under review at the time of the current analyses. Four trials utilized wait-list controls. All aspects of sexual function and subjective sexual well-being exhibited significant improvement during MBT, with effect sizes generally moderate. Controlled effect sizes versus wait list were of similar magnitude in most cases; however, they did not reach statistical significance for multiple outcome measures. Results for some outcomes were consistent with possible publication bias. For some outcomes, larger effect sizes tended to be reported in studies requiring participants to be in a romantic relationship or studies providing individual (versus group) therapy. MBT may be an efficacious intervention for FSD. However, important limitations of the current literature and future directions for research are discussed.     

From desire to disease: human papillomavirus (HPV) and the medicalization of nascent female sexuality

This article critically examines the proliferation of information on the human papillomavirus (HPV) vaccination as integral to contemporary processes of medicalization that take the young female body and her nascent sexuality as its primary object and target. We suggest that the recent introduction of voluntary HPV vaccination for girls, in North America and elsewhere, constitutes a form of neomedicalization (Batt & Lippman, 2010 ) that links risks for future disease (cervical cancer) with the transmission of a common, sexually transmitted infection (HPV). Informed by findings from a critical discourse analysis of Canadian English newspapers, magazines, and public information about HPV vaccination, our interest is on how the emergence of sexual relationships becomes constructed as a time fraught with risks to future health, and that must be managed through biotechnological intervention (vaccination). We suggest that this configuration of medicalization, rather than demarcate a new category of abnormality that can be treated with pharmaceutical or medical intervention, positions the emergence of sexuality itself as the basis of risk and pathologization. The article concludes by considering the implications of this form of medicalization for constructions of female sexuality and sexual health education.     

Genito-Pelvic Pain Through a Dyadic Lens: Moving Toward an Interpersonal Emotion Regulation Model of Women’s Sexual Dysfunction

Researchers and clinicians alike widely acknowledge the inherently interpersonal nature of women’s sexual dysfunctions given that both partners impact and are impacted by these difficulties. Yet theoretical models for understanding the role of interpersonal factors in women’s sexual dysfunctions are severely lacking and have the potential to guide future research and inform more effective interventions. The most widely studied sexual dysfunction in women that has espoused a dyadic approach by including both members of affected couples is genito-pelvic pain/penetration disorder (GPPPD). In this article we use the example of GPPPD to introduce a novel interpersonal emotion regulation model of women’s sexual dysfunction. We first review current knowledge regarding distal and proximal interpersonal factors in GPPPD. Then, we describe our theoretical model and consider relevant pain and sex-related research on emotion regulation processes—emotional awareness, expression, and experience—in the context of GPPPD, including sexual function, satisfaction, and distress. Next, we review how existing theories from the fields of chronic pain and sex and relationships research have informed our model and how our model further builds on them. Finally, we discuss the implications of our model and its applications, including to other sexual dysfunctions in women.     

The coloniality of the gaze on sexual violence: a stalled attempt at a South Africa - Rwanda dialogue?

ABSTRACT

In South Africa and Rwanda, the issue of sexual violence has been catapulted into the public sphere in politically charged post-conflict contexts. This article chronicles some of the theoretical, practical and ethical dilemmas that the writer has faced while contemplating research on rape law formation and reform in Rwanda, with an acute awareness of being a Black feminist from a country known to many as one of the rape capitals of the world. Feminist discourses around sexual violence may be grounded in political convictions that this historically invisible aspect of women’s oppression should be spotlighted and included in agendas for criminal and social justice. The writer contends that while feminist scholarship in its plurality is to be commended for stressing the importance of power relations in research, scholars are still not always sensitive to how inter- and intra-group power disparities may adversely affect the interaction between the researchers and researched and the nature of the research itself. Inter-group power disparities may also adversely affect the interaction between researchers themselves. Decolonial thought may provide lenses to make these power disparities even more visible, but it is difficult to say whether decolonial approaches can establish the terms for a more equitable engagement between all the parties concerned.