Disease and health care is historically constituted; in other words, what is considered “disease” or what is given attention (research/funding/etc) changes over time. This is especially the case when we take gender into context. For example, there was a time when “female hysteria” Links to an external site. was an actual medical diagnosis. Yep. Do some research on the history of health, disease, and health care (including research methods) and “historicize” gendered health. For example, you may want to trace the history of women’s exclusion from clinical medical research Links to an external site. and its implications on women’s health. Another historical example of tracing how health needs to be considered in historical context could include the problematic history of transgender identity and health concerns and the DSM Links to an external site. A final good example would be to consider the history of forced sterilizations Links to an external site. in the US. That would lead to some very interesting (and disconcerting) intersectional historical research!
The field of disease, healthcare, and medical research is undeniably historically constituted, evolving over time in response to shifting societal norms, ideologies, and understandings of health. Gender plays a pivotal role in this context, with historical narratives reflecting both the progress and the persistent challenges in gendered health. This essay explores the historical context of gendered health, with a focus on the exclusion of women from clinical research, the evolving understanding of transgender identity, and the dark history of forced sterilizations in the United States.
Historically, women’s health was marred by the exclusion from clinical medical research. This exclusion stemmed from early beliefs that women were more biologically complex and, therefore, less predictable for research purposes. The “male as the default” approach led to skewed knowledge, with medications and treatments often designed primarily for men. This gender bias in research had significant implications, as it resulted in the underrepresentation of women’s health concerns, misdiagnoses, and inadequate treatment options. It was not until the 1990s that legislation mandated the inclusion of women in clinical trials, leading to more equitable research outcomes.
The evolving understanding of transgender identity has posed unique challenges in healthcare. Historically, transgender individuals faced discrimination, pathologization, and limited access to gender-affirming care. The Diagnostic and Statistical Manual of Mental Disorders (DSM) classified gender dysphoria as a mental disorder, stigmatizing transgender individuals. However, over time, increased recognition of transgender rights and identities has led to a more progressive perspective in healthcare. The depathologization of gender identity and the broader availability of gender-affirming care represent positive shifts in gendered health.
A disconcerting chapter in the history of gendered health is the practice of forced sterilizations in the United States. Historically, marginalized communities, including people with disabilities and women of color, were disproportionately subjected to forced sterilizations. This policy aimed at controlling reproduction with disastrous consequences, violating human rights and bodily autonomy. It reflects how societal norms and eugenics ideologies influenced healthcare practices and ethics, leaving a dark legacy.
The historical context of gendered health highlights the dynamic nature of healthcare and disease. The exclusion of women from clinical research, the evolving understanding of transgender identity, and the history of forced sterilizations are emblematic of the complex and shifting narratives in gendered health. Recognizing these historical developments is crucial for understanding the current state of gendered health and working toward more equitable and inclusive healthcare systems. Efforts to dismantle discriminatory practices and promote gender-affirming care reflect progress, yet the historical lessons underscore the importance of remaining vigilant in the quest for equitable and compassionate healthcare for all.
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