1
|
Stepanova V, Poppleton A, Ponsford R. Central and Eastern European Migrants in the United Kingdom: A Scoping Review of the Reasons for Utilisation of Transnational Healthcare. Health Expect 2024; 27:e14155. [PMID: 39044675 PMCID: PMC11266902 DOI: 10.1111/hex.14155] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2024] [Revised: 07/08/2024] [Accepted: 07/10/2024] [Indexed: 07/25/2024] Open
Abstract
BACKGROUND An estimated 2.2 million people from Central and Eastern Europe (CEE) live in the United Kingdom. It has been documented that CEE migrants underutilise health services in the United Kingdom and, as an alternative, seek healthcare in their home country. However, reasons for seeking healthcare abroad are not always clear. This review aims to identify the reasons for the uptake of transnational healthcare among CEE migrants resident in the United Kingdom. METHODS Informed by discussions with community members, medical stakeholders and academics, a systematic scoping review was undertaken following the nine-stage Joanna Briggs Institute framework for scoping reviews. A search strategy with MeSH terms, where relevant, was used and adapted in five academic databases, two grey literature databases and Google Scholar. Included records encompassed four concepts: migration, CEE nationalities, UK nations and healthcare utilisation, which were written in English and published between May 2004 and 2022. Data from the literature were coded, grouped and organised into themes. RESULTS A total of 16 publications fulfilled the inclusion criteria. There is evidence that some CEE migrants exclusively use healthcare services in the United Kingdom. However, many CEE migrants utilise healthcare both in the United Kingdom and their country of origin. Four themes were identified from the literature as to why migrants travelled to their country of origin for healthcare: cultural expectations of medical services, distrust in the UK NHS, barriers and transnational ties. CONCLUSION Push factors led CEE migrants to seek healthcare in their country of origin, facilitated by ongoing transnational ties. CEE migrants frequently combine visits to their country of origin with medical appointments. Utilising healthcare in their country of origin as opposed to the United Kingdom can result in fragmented and incomplete records of medications, medical tests and surgeries and risk of unnecessary treatments and complications. This review highlights the need for more targeted health outreach with CEE groups within the United Kingdom, as well as the need for further research on the impact of national events, for example, COVID-19 and Brexit, on transnational healthcare-seeking behaviours. PATIENT OR PUBLIC CONTRIBUTION The concept for this scoping review was informed by discussions with community members, medical professionals and academics, who identified it as a current issue. The results of this scoping review were discussed with healthcare stakeholders.
Collapse
Affiliation(s)
- Victoria Stepanova
- Faculty of Public Health & PolicyLondon School of Hygiene and Tropical MedicineLondonUK
| | | | - Ruth Ponsford
- Faculty of Public Health & PolicyLondon School of Hygiene and Tropical MedicineLondonUK
| |
Collapse
|
2
|
Rohden F. [New disputes and interventions in the female body: divisions between gynecology and plastic surgery]. HISTORIA, CIENCIAS, SAUDE--MANGUINHOS 2024; 31:e2024006. [PMID: 38597564 PMCID: PMC11000569 DOI: 10.1590/s0104-59702024000100006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/15/2022] [Accepted: 10/18/2022] [Indexed: 04/11/2024]
Abstract
This article analyzes the tensions and disputes between the fields of gynecology and esthetic plastic surgery, the specialties which are authorized to perform aesthetic female genital surgeries in Brazil. Documentary materials are used, including scientific articles from the 1990s onward and institutional websites. While gynecologists have remained more cautious, recommending the surgery only for functional reasons, plastic surgeons have been more influential in publicizing these procedures and emphasizing the aesthetic dimension. Beyond professional disputes, we debate whether this phenomenon needs to be understood in light of the growing emphasis on self-improvement via biomedical resources and gender imperatives.
Collapse
Affiliation(s)
- Fabíola Rohden
- Professora, Programa de Pós-graduação em Antropologia Social/Universidade Federal do Rio Grande do Sul. Porto Alegre - RS - Brasil
| |
Collapse
|
3
|
Zhang B, Gong J, He L, Khan A, Xiong T, Shen H, Li Z. Exosomes based advancements for application in medical aesthetics. Front Bioeng Biotechnol 2022; 10:1083640. [PMID: 36605254 PMCID: PMC9810265 DOI: 10.3389/fbioe.2022.1083640] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2022] [Accepted: 12/05/2022] [Indexed: 01/07/2023] Open
Abstract
Beauty is an eternal pursuit of all people. Wound repair, anti-aging, inhibiting hyperpigmentation and hair loss are the main demands for medical aesthetics. At present, the repair and remodeling of human body shape and function in medical aesthetics are often achieved by injection of antioxidants, hyaluronic acid and botulinum toxin, stem cell therapy. However, there are some challenges, such as difficulty controlling the injection dose, abnormal local contour, increased foreign body sensation, and the risk of tumor occurrence and deformity induced by stem cell therapy. Exosomes are tiny vesicles secreted by cells, which are rich in proteins, nucleic acids and other bioactive molecules. They have the characteristics of low immunogenicity and strong tissue penetration, making them ideal for applications in medical aesthetics. However, their low yield, strong heterogeneity, and long-term preservation still hinder their application in medical aesthetics. In this review, we summarize the mechanism of action, administration methods, engineered production and preservation technologies for exosomes in medical aesthetics in recent years to further promote their research and industrialization in the field of medical aesthetics.
Collapse
Affiliation(s)
- Bin Zhang
- College of Life Science, Yangtze University, Jingzhou, China
- Department of Clinical Laboratory, The Affiliated Drum Tower Hospital of Nanjing University Medical School, Nanjing, China
| | - Jianmin Gong
- College of Life Science, Yangtze University, Jingzhou, China
- Department of Clinical Laboratory, The Affiliated Drum Tower Hospital of Nanjing University Medical School, Nanjing, China
| | - Lei He
- Department of Clinical Laboratory, The Affiliated Drum Tower Hospital of Nanjing University Medical School, Nanjing, China
| | - Adeel Khan
- State Key Laboratory of Bioelectronics, School of Biological Science and Medical Engineering, National Demonstration Center for Experimental Biomedical Engineering Education, Southeast University, Nanjing, China
| | - Tao Xiong
- College of Life Science, Yangtze University, Jingzhou, China
| | - Han Shen
- Department of Clinical Laboratory, The Affiliated Drum Tower Hospital of Nanjing University Medical School, Nanjing, China
| | - Zhiyang Li
- Department of Clinical Laboratory, The Affiliated Drum Tower Hospital of Nanjing University Medical School, Nanjing, China
| |
Collapse
|
4
|
Rahman AE, Perkins J, Hossain AT, Banik G, Jabeen S, Wall S, Arifeen SE. Unpacking cesarean in rural Bangladesh: Who, what, when, and where. Birth 2022; 49:709-718. [PMID: 35347769 DOI: 10.1111/birt.12636] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/15/2020] [Accepted: 03/08/2022] [Indexed: 11/28/2022]
Abstract
BACKGROUND Bangladesh has experienced an alarming increase in birth through cesarean over the last decade. In this article, we examine rural Bangladeshi women's reporting of why they underwent cesarean, who proposed the cesarean, and when in the process, the decision for a surgical birth was made. METHODS We conducted a cross-sectional household survey of 2299 women in Kushtia district. Of these, 1233 who gave birth through cesarean completed a supplemental questionnaire. Descriptive statistics were used to report cesarean rates, which were disaggregated by sociodemographic characteristics and by antenatal care contacts with health services. We analyzed women's reported reasons for having a cesarean, when the decision was taken, and who proposed the intervention. FINDINGS Over half (54%) of women gave birth through cesarean. The proportion of cesareans was significantly higher among women with higher educational attainment, higher socioeconomic status, and increased antenatal care during pregnancy, particularly if this care was sought in private facilities (P < .05). Women reported that health service providers primarily proposed the cesarean (73%), followed by family members (21%) and finally, the birthing person themselves (6%). With respect to the reasons for cesarean, 34% of women reported nonmedical reasons (convenience and avoidance of labor pain), and 44% mentioned only medical reasons. Over half of the women reported that the decision to undergo a cesarean was made on the day of birth. CONCLUSIONS Women in rural Bangladesh often report avoidable reasons for cesarean. Better regulation of cesarean services in both public and private health services, as well as improved counseling of women with respect to cesarean indications and their consequences, is recommended.
Collapse
Affiliation(s)
- Ahmed Ehsanur Rahman
- International Centre for Diarrhoeal Disease Research, Dhaka, Bangladesh.,University of Edinburgh, Edinburgh, UK
| | | | | | - Goutom Banik
- Saving Newborn Lives, Save the Children, Dhaka, Bangladesh
| | - Sabrina Jabeen
- International Centre for Diarrhoeal Disease Research, Dhaka, Bangladesh
| | - Steve Wall
- Saving Newborn Lives, Save the Children, Dhaka, Bangladesh
| | - Shams El Arifeen
- International Centre for Diarrhoeal Disease Research, Dhaka, Bangladesh
| |
Collapse
|
5
|
Earp BD. Protecting Children from Medically Unnecessary Genital Cutting Without Stigmatizing Women's Bodies: Implications for Sexual Pleasure and Pain. ARCHIVES OF SEXUAL BEHAVIOR 2021; 50:1875-1885. [PMID: 31965452 DOI: 10.1007/s10508-020-01633-x] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/22/2019] [Revised: 01/04/2020] [Accepted: 01/08/2020] [Indexed: 05/21/2023]
Affiliation(s)
- Brian D Earp
- Yale-Hastings Program in Ethics and Health Policy, Yale University, New Haven, CT, 06511, USA.
- The Hastings Center, Garrison, NY, USA.
| |
Collapse
|
6
|
|
7
|
Murano MC, Slatman J, Zeiler K. How sociophenomenology of the body problematises the 'problem-oriented approach' to growth hormone treatment. MEDICAL HUMANITIES 2020; 46:2-11. [PMID: 30478090 DOI: 10.1136/medhum-2018-011548] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 10/30/2018] [Indexed: 06/09/2023]
Abstract
This article examines how people who are shorter than average make sense of their lived experience of embodiment. It offers a sociophenomenological analysis of 10 semistructured interviews conducted in the Netherlands, focusing on if, how, and why height matters to them. It draws theoretically on phenomenological discussions of lived and objective space, intercorporeality and norms about bodies. The analysis shows that height as a lived phenomenon (1) is active engagement in space, (2) coshapes habituated ways of behaving and (3) is shaped by gendered norms and beliefs about height. Based on this analysis, the article challenges what we label as the 'problem-oriented approach' to discussions about growth hormone treatment for children with idiopathic short stature. In this approach, possible psychosocial disadvantages or problems of short stature and quantifiable height become central to the ethical evaluation of growth hormone treatment at the expense of first-hand lived experiences of short stature and height as a lived phenomenon. Based on our sociophenomenological analysis, this paper argues that the rationale for giving growth hormone treatment should combine medical and psychological assessments with investigations of lived experiences of the child. Such an approach would allow considerations not only of possible risks or disadvantages of short stature but also of the actual ways in which the child makes sense of her or his height.
Collapse
Affiliation(s)
- Maria Cristina Murano
- Department of Culture and Communication, Linköping University, Linköping, Sweden
- Medicine, Science, Health and Society (Cermes3), School for Advanced Studies in the Social Sciences (EHESS), Paris, France
- Center for Bioethics, Children's Mercy Kansas City, Kansas City, MO, USA
| | - Jenny Slatman
- Department of Culture Studies, Tilburg University, Tilburg, The Netherlands
| | - Kristin Zeiler
- Department of Thematic Studies: Technology and Social Change, Linköping University, Linköping, Sweden
| |
Collapse
|
8
|
Medically Unnecessary Genital Cutting and the Rights of the Child: Moving Toward Consensus. AMERICAN JOURNAL OF BIOETHICS 2019; 19:17-28. [PMID: 31557092 DOI: 10.1080/15265161.2019.1643945] [Citation(s) in RCA: 43] [Impact Index Per Article: 8.6] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
|
9
|
Heise L, Greene ME, Opper N, Stavropoulou M, Harper C, Nascimento M, Zewdie D. Gender inequality and restrictive gender norms: framing the challenges to health. Lancet 2019; 393:2440-2454. [PMID: 31155275 DOI: 10.1016/s0140-6736(19)30652-x] [Citation(s) in RCA: 458] [Impact Index Per Article: 91.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/14/2018] [Revised: 03/01/2019] [Accepted: 03/06/2019] [Indexed: 02/07/2023]
Abstract
Gender is not accurately captured by the traditional male and female dichotomy of sex. Instead, it is a complex social system that structures the life experience of all human beings. This paper, the first in a Series of five papers, investigates the relationships between gender inequality, restrictive gender norms, and health and wellbeing. Building upon past work, we offer a consolidated conceptual framework that shows how individuals born biologically male or female develop into gendered beings, and how sexism and patriarchy intersect with other forms of discrimination, such as racism, classism, and homophobia, to structure pathways to poor health. We discuss the ample evidence showing the far-reaching consequences of these pathways, including how gender inequality and restrictive gender norms impact health through differential exposures, health-related behaviours and access to care, as well as how gender-biased health research and health-care systems reinforce and reproduce gender inequalities, with serious implications for health. The cumulative consequences of structured disadvantage, mediated through discriminatory laws, policies, and institutions, as well as diet, stress, substance use, and environmental toxins, have triggered important discussions about the role of social injustice in the creation and maintenance of health inequities, especially along racial and socioeconomic lines. This Series paper raises the parallel question of whether discrimination based on gender likewise becomes embodied, with negative consequences for health. For decades, advocates have worked to eliminate gender discrimination in global health, with only modest success. A new plan and new political commitment are needed if these global health aspirations and the wider Sustainable Development Goals of the UN are to be achieved.
Collapse
Affiliation(s)
- Lori Heise
- Department of Population, Family and Reproductive Health, Johns Hopkins Bloomberg School of Public Health, Johns Hopkins School of Nursing, Baltimore, MD, USA.
| | | | - Neisha Opper
- Department of Population, Family and Reproductive Health, Johns Hopkins Bloomberg School of Public Health, Johns Hopkins School of Nursing, Baltimore, MD, USA
| | - Maria Stavropoulou
- Programme on Gender Equality and Social Inclusion, Overseas Development Institute, London, UK
| | - Caroline Harper
- Programme on Gender Equality and Social Inclusion, Overseas Development Institute, London, UK
| | - Marcos Nascimento
- Programa de Posgraduação em Saúde da Criança e da Mulher, Instituto Fernandes Figueira-Fiocruz, Rio de Janeiro, RJ, Brazil
| | - Debrework Zewdie
- School of Public Health and Health Policy, City University of New York, New York, NY, USA
| |
Collapse
|
10
|
Aquino YSJ. "Big eye" surgery: the ethics of medicalizing Asian features. THEORETICAL MEDICINE AND BIOETHICS 2017; 38:213-225. [PMID: 28105531 DOI: 10.1007/s11017-017-9395-y] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
The popularity of surgical modifications of race-typical features among Asian women has generated debates on the ethical implications of the practice. Focusing on blepharoplasty as a representative racial surgery, this article frames the ethical discussion by viewing Asian cosmetic surgery as an example of medicalization, which can be interpreted in two forms: treatment versus enhancement. In the treatment form, medicalization occurs by considering cosmetic surgery as remedy for pathologized Asian features; the pathologization usually occurs in reference to western features as the norm. In the enhancement form, medicalization occurs by using medical means to improve physical features to achieve a certain type of beauty or physical appearance. Each type of medicalization raises slightly different ethical concerns. The problem with treatment medicalization lies in the pathologization of Asian features, which is oppressive as it continues to reinforce racial norms of appearance and negative stereotypes. Enhancement medicalization is ethically problematic because cosmetic surgery tends to conflate beauty and health as medical goals of surgery, overemphasizing the value of appearance that can further displace women's control over their own bodies. I conclude that in both forms of medicalization, cosmetic surgery seems to narrowly frame a complex psychosocial issue involving physical appearance as a matter that can be simply solved through surgical means.
Collapse
Affiliation(s)
- Yves Saint James Aquino
- Department of Philosophy, Faculty of Arts, Macquarie University, Sydney, 2109, NSW, Australia.
| |
Collapse
|
11
|
Wickström A. "I Hope I Get Movie-star Teeth": Doing the Exceptional Normal in Orthodontic Practice for Young People. Med Anthropol Q 2016; 30:285-302. [PMID: 26841360 DOI: 10.1111/maq.12247] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Orthodontics offer young people the chance to improve their bite and adjust their appearances. The most common reasons for orthodontic treatment concern general dentists', parents' or children's dissatisfaction with the esthetics of the bite. My aim is to analyze how esthetic norms are used during three activities preceding possible treatment with fixed appliances. The evaluation indexes signal definitiveness and are the essential grounds for decision-making. In parallel, practitioners and patients refer to self-perceived satisfaction with appearances. Visualizations of divergences and the improved future bite become part of an interactive process that upholds what I conceptualize as "the exceptional normal." Insights into this process contribute to a better understanding of how medical practices intended to measure and safeguard children's and young people's health at the same time mobilize patients to look and feel better. The article is based on an ethnographic study at two orthodontic clinics.
Collapse
Affiliation(s)
- Anette Wickström
- Department of Thematic Studies/Child Studies, Linköping University, Linköping, Sweden.
| |
Collapse
|
12
|
Edmonds A, Sanabria E. [Medical borderlands: engineering the body with plastic surgery and hormonal therapies in Brazil]. HISTORIA, CIENCIAS, SAUDE--MANGUINHOS 2016; 23:193-210. [PMID: 27008081 DOI: 10.1590/s0104-59702016000100012] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
This paper explores medical borderlands where health and enhancement practices are entangled. It draws on fieldwork carried out in the context of two distinct research projects in Brazil on plastic surgery and sex hormone therapies. These two therapies have significant clinical overlap. Both are made available in private and public healthcare in ways that reveal the class dynamics underlying Brazilian medicine. They also have an important experimental dimension rooted in Brazil's regulatory context and societal expectations placed on medicine as a means for managing women's reproductive and sexual health. Off-label and experimental medical use of these treatments is linked to experimental social use: how women adopt them to respond to the pressures, anxieties and aspirations of work and intimate life. The paper argues that these experimental techniques are becoming morally authorized as routine management of women's health, integrated into mainstream Ob-Gyn healthcare, and subtly blurred with practices of cuidar-se (self-care) seen in Brazil as essential for modern femininity.
Collapse
Affiliation(s)
| | - Emilia Sanabria
- Laboratoire Triangle & INSERM 15 Parvis René Descartes, Ecole normale supérieure de Lyon, Lyon, França,
| |
Collapse
|
13
|
The Poly Implant Prothèse breast prostheses scandal: Embodied risk and social suffering. Soc Sci Med 2015; 147:150-7. [DOI: 10.1016/j.socscimed.2015.10.068] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2015] [Revised: 10/28/2015] [Accepted: 10/29/2015] [Indexed: 11/17/2022]
|
14
|
Pickersgill M, Hogle L. Enhancement, ethics and society: towards an empirical research agenda for the medical humanities and social sciences. MEDICAL HUMANITIES 2015; 41:136-142. [PMID: 26260624 PMCID: PMC4717454 DOI: 10.1136/medhum-2015-010718] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 07/13/2015] [Indexed: 06/04/2023]
Abstract
For some time now, bioethicists have paid close attention to issues associated with 'enhancement'; specifically, the appropriate use and regulation of substances and artefacts understood by some to improve the functioning of human bodies beyond that associated with 'normal' function. Medical humanities scholars (aside from philosophers and lawyers) and social scientists have not been frequent participants in debates around enhancement, but could shine a bright light on the range of dilemmas and opportunities techniques of enhancement are purported to introduce. In this paper, we argue that empirical research into the notion and practice of enhancement is necessary and timely. Such work could fruitfully engage with-and further develop-existing conceptual repertoires within the medical humanities and social sciences in ways that would afford benefit to scholars in those disciplines. We maintain that empirical engagements could also provide important resources to bioethicists seeking to regulate new enhancements in ways that are sensitive to societal context and cultural difference. To this end, we outline an empirical agenda for the medical humanities and social sciences around enhancement, emphasising especially how science and technology studies could bring benefits to-and be benefitted by-research in this area. We also use the example of (pharmaceutical) cognitive enhancement to show how empirical studies of actual and likely enhancement practices can nuance resonant bioethical debates.
Collapse
Affiliation(s)
- Martyn Pickersgill
- Usher Institute for Population Health Sciences and Informatics, Edinburgh Medical School, University of Edinburgh, Edinburgh, UK
| | - Linda Hogle
- Department of Medical History and Bioethics, University of Wisconsin-Madison, Madison, Wisconsin, USA
| |
Collapse
|
15
|
Selvaggi G, Giordano S. The role of mental health professionals in gender reassignment surgeries: unjust discrimination or responsible care? Aesthetic Plast Surg 2014; 38:1177-83. [PMID: 25344469 DOI: 10.1007/s00266-014-0409-0] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2014] [Accepted: 09/29/2014] [Indexed: 11/28/2022]
Abstract
OBJECTIVE Recent literature has raised an important ethical concern relating to the way in which surgeons approach people with gender dysphoria (GD): it has been suggested that referring transsexual patients to mental assessment can constitute a form of unjust discrimination. The aim of this paper is to examine some of the ethical issues concerning the role of the mental health professional in gender reassignment surgeries (GRS). METHOD The role of the mental health professional in GRS is analyzed by presenting the Standards of Care by the World Professional Association of Transgender Health, and discussing the principles of autonomy and non-discrimination. RESULTS Purposes of psychotherapy are exploring gender identity; addressing the negative impact of GD on mental health; alleviating internalized transphobia; enhancing social and peer support; improving body image; promoting resilience; and assisting the surgeons with the preparation prior to the surgery and the patient's follow-up. Offering or requesting psychological assistance is in no way a form of negative discrimination or an attack to the patient's autonomy. Contrarily, it might improve transsexual patients' care, and thus at the most may represent a form of positive discrimination. To treat people as equal does not mean that they should be treated in the same way, but with the same concern and respect, so that their unique needs and goals can be achieved. CONCLUSIONS Offering or requesting psychological assistance to individuals with GD is a form of responsible care, and not unjust discrimination. LEVEL OF EVIDENCE V This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266.
Collapse
Affiliation(s)
- Gennaro Selvaggi
- Department of Plastic Surgery, Institute of Clinical Sciences, Sahlgrenska Academy, Sahlgrenska University Hospital, University of Gothenburg, Gröna Stråket 8, 41345, Gothenburg, Sweden,
| | | |
Collapse
|
16
|
Edmonds A, Sanabria E. Medical borderlands: engineering the body with plastic surgery and hormonal therapies in Brazil. Anthropol Med 2014; 21:202-16. [PMID: 25175295 PMCID: PMC4200605 DOI: 10.1080/13648470.2014.918933] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
This paper explores medical borderlands where health and enhancement practices are entangled. It draws on fieldwork carried out in the context of two distinct research projects in Brazil on plastic surgery and sex hormone therapies. These two therapies have significant clinical overlap. Both are made available in private and public healthcare in ways that reveal the class dynamics underlying Brazilian medicine. They also have an important experimental dimension rooted in Brazil's regulatory context and societal expectations placed on medicine as a means for managing women's reproductive and sexual health. Off-label and experimental medical use of these treatments is linked to experimental social use: how women adopt them to respond to the pressures, anxieties and aspirations of work and intimate life. The paper argues that these experimental techniques are becoming morally authorized as routine management of women's health, integrated into mainstream Ob-Gyn healthcare, and subtly blurred with practices of cuidar-se (self-care) seen in Brazil as essential for modern femininity.
Collapse
|