Making and Treating Trans Problems: The Ontological Politics of Clinical Practices

This essay investigates a divergence between medical and autobiographical accounts of transexuality. By analyzing a letter to the editor in the journal Aesthetic Plastic Surgery that defends trans patients as a “special case” (Selvaggi and Giordano, 2014), I examine how medicine produces trans patients as a separate category of patients. The differential treatment paths of trans and nontrans people who pursue “gender-enhancing” medical interventions demonstrate a double standard that undermines claims to act in the best interest of the patient. Using the evidence of trans men’s accounts of themselves as well as research into the experiences of trans people from across the United Kingdom, Australia, and North America, I critique the medical management of transexuality and call on clinicians to rethink the treatment practices of trans medicine.     

Information and communications technology use in rural child welfare work

This study explores the impact of information and communications technology (ICT) use on rural child welfare practice using a technology-in-practice framework to derive the social structures that are instantiated by rural child welfare workers (CWWs) and to examine their agency as actors. ICT use was tracked, and interviews were conducted with rural CWWs who work with children and families to gain an understanding of and describe their day-to-day ICT use at the practice level. Findings demonstrate that CWWs enact social structures along four frames: bureaucratic structure, family centricity, ICT context and information–documentation culture. In terms of agency, CWWs not only are constrained by but also exert some influence on the social structures they enact through facilities (material resources), norms and interpretive schemes. These findings have implications for how ICT can be used to facilitate the CWW–client relationship and the need in rural areas for increased infrastructure to support CWWs.