Focus: Sex and Gender Health: A Case for the Demedicalization of Queer Bodies

The medicalization of queer bodies in the clinic and the lab is inexorably linked to the history of LBGTQ politics. Increasingly, activists and scholars are recognizing that while the natural origins of queer sexualities carry a certain political weight, invoking the naturalness of being “born this way” fails to articulate a more substantive challenge to the effects of unexamined cis- and heteronormativity on our social institutions. With this in mind, it is crucial to understand the way these biases operate in scientific research and healthcare so their impact on what we know and how we care can be addressed. It what follows, it will be shown that the medicalization of queer bodies not only fails to diminish these deep-seated biases from sexuality research and clinical practice, but that it also impedes care providers from addressing the healthcare disparities facing queer patients today.     

Intimate Territories and the Experimental Subject in Ladakh,India

Abstract

This paper explores the management of reproduction and sexuality as experimental political practice. In Leh District of India's Jammu and Kashmir State, vote bloc politics and a tenuous geopolitical context highlight the reproductive body's potential to maintain political and territorial control through demographic trends. Conflict between the Buddhist majority and Muslim minority is articulated partly through the regulation of fertility and sexuality. Population is described as a zero-sum game in which each side acquires or cedes territory; activists and religious leaders experiment with the body as a territorial tool. These projects collide with the hopes and fears of women and men considering love, marriage, pregnancy, and contraceptive use. This paper draws on research conducted in 2004 and 2007–2009 to explore how women's desiring and reproductive bodies are folded into geopolitical experiments, how women cope under this experimental regime, and the ways that they turn to a tactic of ‘not knowing.’     

FINDING AUTONOMY IN BIRTH

Over the last several years, as cesarean deliveries have grown increasingly common, there has been a great deal of public and professional interest in the phenomenon of women 'choosing' to deliver by cesarean section in the absence of any specific medical indication. The issue has sparked intense conversation, as it raises questions about the nature of autonomy in birth. Whereas mainstream bioethical discourse is used to associating autonomy with having a large array of choices, this conception of autonomy does not seem adequate to capture concerns and intuitions that have a strong grip outside this discourse. An empirical and conceptual exploration of how delivery decisions ought to be negotiated must be guided by a rich understanding of women's agency and its placement within a complicated set of cultural meanings and pressures surrounding birth. It is too early to be 'for' or 'against' women's access to cesarean delivery in the absence of traditional medical indications – and indeed, a simple pro- or con- position is never going to do justice to the subtlety of the issue. The right question is not whether women ought to be allowed to choose their delivery approach but, rather, taking the value of women's autonomy in decision-making around birth as a given, what sorts of guidelines, practices, and social conditions will best promote and protect women's full inclusion in a safe and positive birth process.     

Moral encounters: drawing boundaries of class,sexuality and migrancy in paid domestic work

I examine how migrant–national encounters are morally framed through boundary making based on intersections of class, sexuality, ethnicity and migrancy. Encounters are a fruitful lens for the study of the everyday politics of diversity and belonging. By focusing on encounters it is possible to analyse whether close contact does in fact reduce prejudice, as has been argued in research on cosmopolitan urbanism. I present the notion of contact space as a conceptual tool for such analysis, as well as examples of contact spaces in the private and public spheres. I use ethnographic data on the employment of domestic workers in Naples, Italy, to show that close contact does not alleviate prejudices in societies that offer little possibility of social advancement for migrant workers.     

The injustice of unsafe motherhood

This paper presents an overview of the dimensions of unsafe motherhood, contrasting data from economically developed countries with some from developing countries. It addresses many common factors that shape unsafe motherhood, identifying medical, health system and societal causes, including women's powerlessness over their reproductive lives in particular as a feature of their dependent status in general. Drawing on perceptions of Jonathan Mann, it focuses on public health dimensions of maternity risks, and equates the role of bioethics in conscientious medical care to that of human rights in public health care. The microethics of medical care translate into the macroethics of public health, but the transition compels some compromise of personal autonomy, a key feature of Western bioethics, in favour of societal analysis. Religiously-based morality is seen to have shaped laws that contribute to unsafe motherhood. Now reformed in former colonizing countries of Europe, many such laws remain in effect in countries that emerged from colonial domination. UN conferences have defined the concept of 'reproductive health' as one that supports women's reproductive self-determination, but restrictive abortion laws and practices epitomize the unjust constraints to which many women remain subject, resulting in their unsafe motherhood. Pregnant women can be legally compelled to give the resources of their bodies to the support of others, while fathers are not legally compellable to provide, for instance, bone-marrow or blood donations for their children's survival. Women's unjust legal, political, economic and social powerlessness explains much unsafe motherhood and maternal mortality and morbidity.     

The varied nature of women's sexuality: unresolved issues and a theoretical approach

During the 20th century there were clear indications that the socio-cultural suppression of women's sexuality had lessened, revealing a marked variability of women's sexual expression. In this article we review the recent literature to explore explanations for this variability. It is clear that we know little about the nature of sexual desire, and in particular, what it is that is desired. There is also now substantial evidence that vaginal response, as measured by vaginal pulse amplitude, is a relatively automatic response to perception of sexual stimuli, regardless of whether these stimuli are perceived positively or result in subjective arousal. This is considered as a possible mechanism that allows vaginal intercourse without pain, even when the woman is not sexually aroused. The roles of androgens and estrogen in women's sexuality remain uncertain. The evidence is, however, consistent with there being a testosterone-dependent component of women's sexuality that is more important for some women than others. Finally, a new theoretical model is presented that aims to resolve these uncertainties and that proposes different types of women's sexuality. Once we have a better understanding of “normal” female sexuality, in its various forms, our ability to develop effective treatments for women's sexual problems should improve.     

医学生突发公共卫生事件应对知信行调查

目的：了解医学生突发公共卫生事件相关知识、态度、行为现状,为制订干预措施提供依据。方法：采用多阶段抽样方法,共抽取某医学院1380名本、专科学生进行突发公共卫生事件知、信、行问卷调查。结果：突发公共卫生事件相关知识平均得分为（35.93±6.98）,总体知晓率为71.54%。其中女生高于男生（P=0.000）,本科生高于专科生（P〈0.000）,外省生源高于本省生源（P=0.001）,年级越高得分有增高的趋势（P=0.000）。40.8%的学生对突发公共卫生事件感到恐惧;80.0%的海医学生愿意了解突发公共卫生事件相关知识,并认为学校有必要开设相关课程及进行应急演练;仅有17.2%的学生曾和家人讨论过如何应对灾害事件,91.5%的学生从未与家人进行过逃生演练。结论：医学生对突发公共卫生事件相关知识掌握不全面,部分学生尚未建立正向的认知态度和健康的行为方式,学校应采取适当的方式加强突发事件知识和技能的训练。     

Open access :an opportunity for biomedical research

Open access within the scientific community depends on the scientific context and the practices of the field. In the biomedical domain, the communication of research results is characterised by the importance of the peer reviewing process, the existence of a hierarchy among journals and the transfer of copyright to the editor. Biomedical publishing has become a lucrative market and the growth of electronic journals has not helped lower the costs. Indeed, it is difficult for today's public institutions to gain access to all the scientific literature. Open access is thus imperative, as demonstrated through the positions taken by a growing number of research funding bodies, the development of open access journals and efforts made in promoting open archives. This article describes the setting up of an Inserm portal for publication in the context of the French national protocol for open-access self-archiving and in an international context.     

Guidelines for medical practice: 1. The reasons why.

Various external special interest groups are promoting attempts to better measure and control the performance of the medical profession, primarily to restrain costs. We can neither afford to ignore the rising costs nor reject efforts by provincial licensing authorities to improve supervision of the quality of care. Furthermore, there is increasing public interest in the outcome of medical treatment and a suspicion that some care may be unnecessary or inappropriate. Much of what physicians do is not based on impeccable or complete scientific evidence, and we have not established a method whereby science can consistently be translated into practice. Optimal practice patterns must be defined to improve the quality of care and to maximize the efficiency with which scarce resources are used. Careful scientific evaluation of data is particularly necessary with the arrival of new drugs and technology. Sensible, flexible guidelines produced by appropriate panels will help promote improved practice. Rigid standards must be avoided to allow for individual consideration and scientific innovation. The recognized difficulties of influencing clinical practice by precept or education and the problems imposed by rapidly changing scientific knowledge are two hurdles to be overcome. Licensing bodies must identify and enforce minimal standards, but optimal practice patterns are better devised by a broader segment of the profession. Intervention by third-party payers, as is prevalent in the United States, intrudes upon physician autonomy and reduces access to care. Physicians must support the development of guidelines for optimal medical practice based on the best existing data and focused on improving the quality of care.     

"Mixing" as an ethnoetiology of HIV/AIDS in Malaysia's multinational factories

Minah Karan, the stigmatizing label appended to Malay factory women in the 1980s, signaled a dangerous female sexuality that risked spreading beyond the factory gates and infecting Malaysia's idea(l)s of its traditional kampung culture. This article narrates how Minah Karan, as the former antihero of development, was reconstituted in the 1990s, with the government's labeling of factories as "high-risk settings" for HIV/AIDS. This is an ethnoetiology based not on any evidential epidemiological data but on the racial and gendered "mixing" that transpires behind factory walls: a fear that the "mixing of the sexes" means ipso facto "sexual mixing" among the races. The article demonstrates how importation of the high-risk label articulates at the local level the new and contested linkages, economic, religious, and scientific, constitutive of globalization. The pragmatic nature and imperatives of this high-risk process are discerned in factory women's accounts of how they negotiate the interactional imperatives of factory work, because transnational structures of productivity violate the social boundaries that have long connoted political stability, moral integrity, ethnic community, and individual safety. The article concludes by questioning whether ethnoetiologies, especially when they concern sexual networks, become social etiologies, because this would locate ethnoetiologies as central to conventional public health praxis rather than as ethnographic exotica in the margins.     

Paperwork,patronage, and citizenship: the materiality of everyday interactions with bureaucracy in Tamil Nadu,India

This article explores the material practices through which lower-caste and poor villagers engage with bureaucracy in contemporary India. We take documents and paperwork – such as ration cards and community certificates – as a ‘lens’ through which to explore how paper materiality is infused with the politics of power, patronage, and identity. The article brings ethnography from rural Tamil Nadu, South India, in conversation with two bodies of literature: one on the materiality of bureaucracy and one on the nature of political mediation in contemporary India. We demonstrate how everyday engagements with paperwork as well as processes of applying, form filling, and securing recommendations are constitutive of social and political relationships and, ultimately, of citizenship itself. Political mediation around paperwork and bureaucracy generates a hierarchy of citizens rather than equal citizenship for all, yet ordinary villagers transpire as anything but passive. Drawing on patronage networks, engaging in affective performances, and navigating a politics of identity, they actively negotiate access to the state in an attempt to claim their rights as citizens.     

Human oestrus

For several decades, scholars of human sexuality have almost uniformly assumed that women evolutionarily lost oestrus--a phase of female sexuality occurring near ovulation and distinct from other phases of the ovarian cycle in terms of female sexual motivations and attractivity. In fact, we argue, this long-standing assumption is wrong. We review evidence that women's fertile-phase sexuality differs in a variety of ways from their sexuality during infertile phases of their cycles. In particular, when fertile in their cycles, women are particularly sexually attracted to a variety of features that likely are (or, ancestrally, were) indicators of genetic quality. As women's fertile-phase sexuality shares with other vertebrate females' fertile-phase sexuality a variety of functional and physiological features, we propose that the term oestrus appropriately applies to this phase in women. We discuss the function of women's non-fertile or extended sexuality and, based on empirical findings, suggest ways that fertile-phase sexuality in women has been shaped to partly function in the context of extra-pair mating. Men are particularly attracted to some features of fertile-phase women, but probably based on by-products of physiological changes males have been selected to detect, not because women signal their cycle-based fertility status.     

Bodyscapes, Biology, and Heteronormativity

ABSTRACT   The term bodyscape encourages thinking about representation of bodies at multiple scales—from different bodies as they move through space to the microlandscape of individual bodily differences. A hegemonic bodyscape's representations tend to idealize and essentialize bodies' differences to reinforce normative ideas about a society's socioeconomic organization. But, a dominant bodyscape is never absolute. Bodyscapes that depart from or subvert hegemonic representations may simultaneously exist. In Western society, the biomedical bodyscape predominates in scientific understandings of bodily difference. Its representation of sex differences conveys heteronormative notions about gender and sexuality. Because the biomedical bodyscape frames studies of ancient bodies, investigators need recognize how their considerations of labor divisions, familial organization, and reproduction may situate modern (hetero)sexist representations deep within antiquity. To innovate analyses of socioeconomic relations, queer theory allows scholars to interrogate human nature. Doing so produces alternative bodyscapes that represent the diversity of past peoples' social and sexual lives. [Keywords: bodyscape, heteronormativity, queer theory, bioarchaeology, paleoanthropology]     

Anthropology, Demography, and the Search for a Critical Analysis of Fertility: Insights from Russia

The socialist and postsocialist contexts offer important challenges for anthropologists developing a critical analysis of fertility. The need for fertility studies to address class and gender inequities is often overlooked by postsocialist scholars, whose work is mired in responses to the socialist past and ongoing pronatalist campaigns. I examine the ways that fertility analysis has been used in national political struggles in Russia, and explain why supporters of democratic reforms and women's rights have neglected to address gender and class issues in their fertility studies. While Russian nationalists cite fertility decline as proof that market reforms threaten Russia's existence, defenders of neoliberalism draw on demographic transition theory to redefine fertility decline as a universal sign of socioeconomic development. Working with conventional demographic paradigms and a postsocialist cultural logic, Russian transition theorists simultaneously oppose pronatalist politics, support women's reproductive choice, and reproduce the limitations of liberal paradigms regarding the family, society, and public policy. This article shows how anthropological critiques of demographic transition theory can be expanded and nuanced by considering the ways this theory gets adapted to particular cultural logics and political contests. [Keywords: anthropology and demography, postsocialism, Russia, fertility decline]     

Sexuality, color, and stigma among Northeast Brazilian women

Despite its international image as a sexually free-spirited country, local attitudes toward morality of sexual behavior remain complex throughout Brazil, especially in rural areas and the conservative Northeast region. In addition, notwithstanding its official ideology of nonracism, African ancestry as judged through personal appearance (color) constitutes a significant social and economic disadvantage. Using Goffman's idea of "spoiled identity" as a starting point, I show how locals use sexual behavior as a multivocal symbol of moral status in women, and how spoiled sexual reputation interacts with other stigmatized statuses, especially color. I also consider how the acquisition of sexually stigmatized status jeopardizes women's well-being and that of their children. [Brazil, color, gender, sexuality, stigma, women]     

如何指导医学生撰写医学综述

医学综述是在全面、正确理解文献的基础上,对某一段时间内的某一研究专题进展进行客观总结和论述。学会撰写医学综述可以进一步加强学生对研究领域最新发展动向的了解,对医学生临床诊疗及科研能力的提高有着非常重要的意义。作者结合自身及其导师多年来指导医学生的教学经验,将医学综述的撰写方法技巧进行总结归纳,包括在综述的写作过程中如何正确的选择研究专题、科学合理的检索和整理文献以及最终将自己的见解准确表述等。     

Taste Tests: Pizza and the Gastropolitical Laboratory in Mumbai

Abstract

This article is about experiments in taste. Focused on the cultural politics of pizza in Mumbai, it highlights the visceral work required to naturalize consumer choice as a catalyst of social futures in contemporary India. It emerges out of interviews and observations among food marketers and among customers and workers in a pizza restaurant. Guided by the concept of ‘experimentality’ elaborated in medical anthropology and science and technology studies, the article reframes definitions of food in experimental terms through two ethnographic registers. The first narrative focuses on the marketing of pizza, and explains how marketers turned their restaurants into laboratories of cosmopolitan cultivation. The second narrative shows how laboring bodies become enrolled in that laboratory, as young adults recruited from low-income neighborhoods come to work at a pizza restaurant. Such experiments blur the lines between evidence and enjoyment, and ultimately add up to a revaluation of public eating itself.     

Making Science Accessible: A Semiotics of Scientific Communication

This article serves as a demonstration of how certain models of literary analysis, used to theorize and analyze fiction and narrative, can also be applied to scientific communication in such a manner as to promote the accessibility of science to the general public and a greater awareness of the methodology used in making scientific discovery. The approach of this article is based on the assumption that the principles of structuralism and semiotics can provide plausible explanations for the divide between the reception of science and literature. We provide a semiotic analysis of a scientific article that has had significant impact in the field of molecular biology with profound medical implications. Furthermore, we show how the structural and semiotic characteristics of literary texts are also evident in the scientific papers, and we address how these characteristics can be applied to scientific prose in order to propose a model of scientific communication that reaches the public. By applying this theoretical framework to the analysis of both scientific and literary communication, we establish parallels between primary scientific texts and literary prose.     

Complications of induced abortion

The abortion problem has been a major topic of debate for many years. Polish legislation permitting abortion has both supporters and opponents. It appears that both groups fail to fully recognize the risks of the various medical complications of induced abortion. A literature review of the complications of abortion shows that these complications are often underestimated by the public and the medical community. The review clearly demonstrates that abortion adversely affects women's health. Inflammation of the genital system is the most frequent complication. The ocurrence of complications increases as the term of the pregnancy advances. It is concluded that the public is not fully aware of the immediate danger and aftereffects of induced abortion. Wider popularization of the extensive body of scientific information regarding the risks of induced abortion might change current perceptions about the "safety" of abortion.