خرید و دانلود نسخه کامل کتاب Bodily Subjects Essays on Gender and Health, 1800–2000 – PDF

The arc of this collection proceeds through a series of site-specific case studies to demonstrate the way health is refracted by gender and how “health” itself is open to a myriad of interpretations determined by Introduction B a r b a r a B r o o k e s , W e n d y M i t c h i n s o n , T r a c y P e n n y L i g h t 4 Bodily Subjects class, race, ability, and expertise. By demonstrating how these interpre- tations are chronologically and geographically specific, our intention is to promote further research on gender and health. Taken together, the essays in this volume address the multiple meanings of health over time and place. Health has too often become a concept whose meanings we assume to understand. Historical case studies suggest the way defini- tions of health are saturated in cultural meaning. Health, therefore, has been defined by the ability to look or act in whatever way was considered normal; in turn, normal was almost always gendered. The topics of health and gender have generated a vast range of schol- arship from authors in a multitude of disciplines but only rarely have they been considered together. Women’s health and women in the health professions have been the focus of two major collections, Judith Walzer Leavitt’s Women and Health in America (1984) and Rima Apple’s Women, Health, and Medicine in America (1990). These collections were preceded by Edward Shorter’s A History of Women’s Bodies (1982) and succeeded by a number of significant studies such as Ornella Moscucci’s The Science of Woman: Gynaecology and Gender in England 1800–1929 (1990), Wendy Mitchinson’s The Nature of their Bodies: Women and their Doctors in Victorian Canada (1991), and Barbara Duden’s The Woman Beneath the Skin: A Doctor’s Patients in Eighteenth Century Germany (1991). Since that time there has been an outpouring of books on the body in various aspects but a lack of scholarship on the relational understand- ings of health, that is, how the “normative” state of health is deeply gendered.3 That “normative” state has become an idealized one that very few people can meet. The 1948 World Health Organization (W H O ) defini- tion of the concept of health was “a state of complete physical, mental and social well-being and not merely the absence of disease or infirmi- ty.”4 As Daniel Callaghan pointed out, through that definition human happiness became “one more medical problem, to be dealt with by scientific means.”5 It also led to “health as a condition of ideology as well as longevity” that masks inequalities and has the potential to indi- vidualize wider social problems. 6 This critique has been developed fur- ther by Jonathan Metzl and Anna Kirkland in Against Health: How Health Became the New Morality.7 The way in which that idealized state works in popular culture is explored in Cheryl Krasnick Warsh’s recent collection Gender, Health, and Popular Culture: Historical Perspectives (2011), which covers a variety of topics on the transmission of health information and popular Introduction 5 representations of the body. Together, that collection and this one re- flect the widening of understandings about the compass of health and interest in it. Many topics in both would not have been thought of as under the rubric of health history even a decade ago. While the Warsh collection focuses on the popular culture aspect of twinning gender and health, the focus of Bodily Subjects is less on popular culture and more on the way gender identity was reinforced over time by different meanings of health.8 To take but one example, in antebellum America, to be a man in working class communities was to be a manual worker and to be a worker required an able body. A man who chose not to work was, by definition, unhealthy. Good health was, therefore, synonymous with manhood. Celia Roberts has noted that “the history of biological bodies is important precisely because it shows … the lack of separation between scientific representations and the materiality of bodies.”9 Brigitte Fuchs’ examination of the gendering of bones in nineteenth-century central Europe indicates how representations of the body are social and cultural constructions resulting from scrutiny by “health” professionals. Similarly, Antje Kamp analyzes how a new medical specialty – that of andrology – arose to attend to the fertility of otherwise healthy men in post-war Germany. Bodies, then, were redefined through the work of medical specialists working with particular gendered frameworks. In their research, the international contributors to this volume have interrogated how embodied meanings of health changed over two cen- turies of Western culture embracing three continents. They have done so from a variety of historical perspectives, from the legal to the popular, using different methodologies, from close readings of medical texts to quantitative analysis of Poor Law records. Their histories are influenced by different theoretical concepts, from social control to cultural histo- ry’s attention to “the making of meaning,” that is, how women and men in the past, to use Mary Fissell’s words, “made sense of their lives, of the natural world, of social relations, of their bodies.” 10 Our authors use a range of sources, including medical texts, found interviews, research reports, advertisements, men’s magazines, and the ephemera of health activists. The perspectives, methodologies, theoretical influences, and sources used are determined by the topics that the authors have inves- tigated, all of which reflect the current expansiveness of the history of health. Evident in the explorations around embodiment are the ways that class and race often influence how health and illness are understood for women and men, and how dominant discourses and 6 Bodily Subjects subversive ones illuminate what is considered “natural” or “normal” in different times and places. Collectively, the chapters point to the ways that gender influences well-being and its perception, demonstrating the intersectionality that is evident when studying the history of gender and health. Bodily Subjects contributes to the history of medicine and health, as well as cultural, gender, and health studies. Gender has become a concept that is central to analysis in the humanities and social sciences. This one word serves to encapsulate a complex symbolic system through which the attributions “masculine” and “feminine” come to be embodied so that, “through social and cultural practice,” they have “become integral to customary ways of thinking, feeling and acting.” 11 Complicated by class, ethnicity, religion, and age, gender is a lens through which those who look at the past seek to understand it. In the early years of gender studies, the goal was to eliminate the way in which the two-sexed model essentialized the body into two binary forms – men and women – by examining the meaning of masculinity and femininity and what being male or female signi- fied. 12 Wendy Mitchinson’s study of pharmaceutical advertisements for appetite suppressants, for example, finds that women were depicted as sedentary overeaters while men were depicted as active overeaters. These simple depictions worked within layers of cultural expectations of the appropriate roles of women and men in 1950s and 1960s Canada. Catherine Gidney’s study of students in Canada from 1900 to 1960 suggests how an emerging emphasis on “healthy” personal development held out seeds of new possible futures for women. The meanings of masculinity and femininity, therefore, are contingent and contested and influence understandings of health, a matter overlooked when the focus is on women’s health in isolation. The authors represented in this volume work within a relational understanding of gender in that ideas about normative behaviour for one sex have implications for ideas about normative behaviour for the other. While much of the scholarly work on the meaning of gender has been discursive in its approach, focusing on the way language makes mean- ing such as the nineteenth-century understanding of women as “the sex,” the corporeality and materiality of bodies cannot be dismissed.13 Both meanings, whether discursive or corporeal, strike at the heart of the meaning of health.14 Gender can reflect how and why people became ill, why they were perceived to be ill, and how differently they were judged and judged themselves when they were. A I D S was first understood, as Natalie Gravelle analyzes, as a disease of homosexual Introduction 7 men, hence no thought was given to providing services for women. Women activists worked to shift this perspective so that women sufferers might receive treatment. By exploring gender and health as inextricably linked entities in the nineteenth and twentieth centuries, the essays in the collection add to our understanding of the systemic role gender played and continues to play.15 The World Health Organization has recognized the significance of gender and health in suggesting that gender norms and values “give rise to gender inequalities” that have an impact on “health status and access to health care.” It gives the example of a teenage boy dying in an accident because of peer pressure to take risks and the example of women, in some communities, who may not receive health care because they are unable to travel alone to clinics. 16 Both are examples of how gender, health, and identity are enmeshed. History is replete with such exam- ples of the way specific gender norms in time and place influence well- being, and this collection attempts to explore some of these. When heterosexuality is normative, for example, ideas about health serve as a form of “moralization” prescribing the boundaries of acceptable behav- iour for the young, a topic explored in the chapter by Anika Stafford and Mona Gleason. The editors of the collection are mindful of how such history lives in the present and carries into the future. The historiography of health is rich and complex and in many respects follows the changing nature of the discipline of history itself. The mod- ern beginning of scholarship in medical history was in the study of med- icine as a profession and the “great” men who practised it. Challenged by scholars such as Henry E. Sigerist, the history of medicine became more interpretive and contextualized. With the emergence of social and feminist history new queries about medicine, its power, and its in- fluence came to the fore. That power and influence is still recognized by medical sociologists today. As Juanne Nancarrow Clarke argues, “The physician is not only a scientist but also a moral decision-maker. Medicine can legitimate the illness it diagnoses on the condition that the patient adopts the ‘sick role’ prescribed by the doctor. Medicine defines what is deviant from health and also how the patient is to react to that defini- tion. Illness is legitimated deviance insofar as it has been identified by the physician and the appropriate steps are taken by the patient to get well