What is Medicalization?

Figure 1: Decrease in mortality rates as a result of vaccines

Medicalization occurs when a problem or behaviour is perceived and treated as a medical problem. Once a problem or condition is defined in medical terms, it allows professionals (such as physicians) to treat it with medical intervention. It is important to note that once "an entity.. is regarded as an illness or disease... it become[s] defined as [that disease]" (Conrad, 2007; 5-6)[1] Medicalization is a prime example of the social constructionism of illnesses and how it has and continues to reshape society and our understanding as well as knowledge of various diseases. Medicalization has allowed for success and advancements in medicine and health care while providing us with new findings and knowledge on the human body. Through medicalization, there has been a significant decrease in mortality rates as well as surgical deaths. The medicalization of conditions allows for medical studies, prevention establishment as well as proven treatments and cures for people who are suffering with diseases (see Figure 1.)

Risks with Medicalization

Medicalization follows a "biomedical model of disease that sees behaviours, conditions or illnesses as a direct result of malfunction within the human body." (Gitome et al. 2014; 25)[2] Despite the advantage of medical advancements and longer life expectancy, there are many disadvantages that arise from the medicalization of the human body such as the act of reducing an illness to strictly a medical condition and ignoring the social context of disease.[3] Furthermore, medicalization leads to the negative connotations when focusing on and using only biomedical language when explaining problems that are cultural, psychological and social. There is a lack in recognizing natural variations as a result of human individualism and promotes the notion of viewing humans as objects that require 'fixing.'

The medicalization of the human body establishes a medium for social control because those inflicted with the condition or disease suffer from being identified by it. A medical definition of "normality" is implanted and it separates the individual from their natural self. Gender is a large constituent when looking at medicalization as a form of social control. Women, in particular, have a higher chance of having their bodies used an object of medical intervention which results in "depriving [them] of [their] autonomy and changing [their] normal life processes."(Wieczorkowska. 2012)[4] Women's bodies have been criminalized by society over centuries through various forms of interventions (both medical and societal) which includes psychotropic medications, marriage, various forms of surgery as well as laws, disallowing women to make decisions about their own bodies.

The Female Body in History

Throughout history, women's bodies have always been perceived as inferior and therefore transgressing than that of men's. As a result of biological and physical differences in both the bodies of men and women, women were viewed as deviant. Natural occurring physical changes in a woman's body became pathologized and medicalized such as menopause, reproductive processes and forms of "treatment" were developed for control.

Figure 2: Male doctors looking down on a female patient.

In patriarchal dominant societies, control over women's bodies have resulted in the loss to basic human rights for women. Medicalization has allowed for legal and social control over women's lives. For example, if a woman did not want to get married or have any children, it demonstrated a mental instability and they were sent off to an asylum for treatment. These were rules that were created by societal norms and women who didn't want to follow these norms were forced to face diagnosis and treatments by men, further contributing to the gender inequality.

Demoralization of Women

There have been many instances in history when natural occurring processes in women's lives have been medicalized and resulted in them being treated as inferiors.

Religion and Hysteria

In ancient Egypt and Greece, there was a strong belief that hysteria was linked to the woman's uterus. The woman's uterus was perceived as a "rogue organ" able to move freely around her body resulting in a variety of side effects. Being the first mental disorder that was associated to women and "was cured with herbs, sex or sexual abstinence, punished and purified with fire for its association with sorcery and finally, clinically studied as a disease and treated with innovative therapies" (Tasca et al. 2012)[5] Women were considered to be witches or possessed and were condemned to death.

Figure 3.1: How a woman's uterus was perceived as a polluting factor in her health.
Figure 3.2: Manual stimulation as a form of treatment for hysteria.

These beliefs were not unique to Ancient Europe but also travelled to the West into North America. Theories of exorcisms provided a demonological side of medicine and resulted in the suffering of more women who were considered possessed. The Salem trials in Massachusetts in 1692 resulted in the death and detention of many women. Their symptoms included "barred eyes, raucous noises and muffled, uncontrolled jumps, sudden movements" (Tasca et al. 2012)[5] As a result of Puritanism beliefs and social conflicts, many women were tried and killed because of the lack of separation between religious beliefs and medicalization.

These beliefs were continued into the early 20th century however, the treatment shifted from torture and death to orgasms. Medical professionals would attempt to stimulate women to induce an orgasm. This was a highly controversial but was considered an effective diagnosis and method of treatment.[6] Women's sexual pleasure as well as body functions were medicalized, invading their human rights and being extremely unethical. Luckily, this behaviour is unacceptable today.

Mental Health

Throughout history, societal norms and expectations have limited women in their social roles. Women were regarded as 'home-makers' whose only purpose in life was to be a good daughter, wife and mother. These roles entailed the idea of a shy and submissive woman who devotes her life to her family and husband. Furthermore, if a woman displayed any other behaviour or emotion, she was instantly labelled as dysfunctional and treatment was sought. Natural feelings such as happiness, sadness, anger, or sexual desire were not considered normal and pathologized.

These are expressions and feelings that are often medicalized to date and associated with underlying mental health conditions. This roots from the societal construction of the belief that women are emotionally unstable as a result of the variations in women's hormones. They are perceived emotionally inferior to men and considered at a higher risk of experiencing mental health disorders, which is untrue.

Figure 3.4: Treatment advertisement for women expressing emotions "outside" the societal expectations.

Gender Gap in Medical Research

There is undoubtedly a large gender gap in medical research as females have been excluded from both biomedical, pharmaceutical and toxicology research. Biologically, women and men metabolize drugs differently because women's bodies undergo menopause, pregnancy, puberty. As a result of these biological differences, women have been labelled at risk for developing depression however, less "than 45% of animal studies on anxiety and depression use female lab animals." (Westervelt.2015)[7] Moreover, more women in USA are victims of cardiovascular disease yet, two thirds of the clinical trials are done on male subjects.[7] This gender gap has existed for many years and women have been stripped of their rights to their bodies in many scenarios by men.

Women and Reproductive Processes

Childbirth was medicalized during the Victorian Eraas pregnancy was considered "very dangerous." Due to the lack of proper health care and sanitation, many women lost their lives during childbirth thus childbirth was performed in a medicalized institution.

Though medicalization of childbirth may seem as a step towards progression, the intention for many husbands were to ensure the life of their heir. Furthermore, this stripped the woman who was bearing the child of her right to decide where she wishes to give birth and where she feels comfortable. Women were given heavy aesthetics to prevent participation in the delivery of their child. The heavy sedation interrupted in post-delivery care and health decisions for her baby. While the mother is sedated, she is unable to make decisions concerning further procedures nor intervene if there are any risks posed on the baby (such as medication or use of dangerous aids such as forceps.) There was no respect for the mother's desires nor consent.

Figure 4: An infant being surgically removed from the dead mother.

Even today, there is a large medical control during a woman's pregnancy and childbirth. From the beginning of her pregnancy, a woman is examined by her doctor in a clinical setting and continues to be examined over several appointments throughout her pregnancy. Generally childbirth is done in a hospital setting or strongly encouraged by medical professionals. Furthermore, though women now have a say and the option to take the epidural, being in the hospital environment results in nurses and doctors encouraging the use of the epidural, persuading the woman into taking the medications.

Despite the lack of choice that some women may face, the medicalization of both pregnancy and childbirth has been extremely positive. Infant, neonatal, and maternal mortality rates have significantly decreased as well. There are many options available for birth control, abortion, pain relief methods, midwives and doulas for women as well. However, we are all social beings who are influenced strongly by our surroundings therefore, many women still believe that the medicalized process of childbirth is safer than the biological event (Perinatal Services BC, 2016/2016)

Medicalization of Societal and Media Expectations

Figure 5: Even celebrities are critical of themselves and attempting to obtain the "perfect body"

Beauty is unique to the beholder as well as the culture we grow up in. Western media is a strong promoter of gendered and highly unrealistic portrayals and expectations of beauty. There is an expected image of beauty that is constantly being presented to women, forcing them to believe that is the ideal body and shape. Instead of promoting diversity and acceptance of ones beauty, emphasis is placed on certain proportions, hairstyle, makeup etc. Women are constantly inundated with these images, forcing them to consider achieving not only an unrealistic goal but also lowering their self-esteem.

All women are born with different builds and physiques that are purely based on their genetic makeup. Natural aspects of a woman's body are medicalized. Medical terms such as micromastia, macromastia and breast ptosis have been developed to describe women's breasts. Furthermore, "treatments" such as breast augmentation and reduction have been established, allowing women to "fix" their natural breasts. Moreover, surgeries such as liposuction are also presented to women who have given birth and are having difficulties losing weight .

Plastic surgery has increased with statistics revealing a "quarter of a million more procedures in 2018 than in 2017." (Townley.2019)[8] Medicalization has affected women's physical and mental health in many ways and continues to do so today. It is crucial for women to recognize how medicalization can be used a form of social control to prevent themselves from being influenced by medicalization and its negative impact.

Figure 5.1: The top 5 cosmetic surgery procedures done in 2018.

See Also

Medicalization

Medicalization of Child Birth

Medicalization of Pregnancy & Childbirth

Gender Differences in Body Image

References

  1. Conrad, Peter (2007). "The Medicalization of Society". ProQuest Ebook Central. 
  2. Serah Gitome, Stella Njuguna, Zachary Kwena, Everlyne Ombati, Betty Njoroge and Elizabeth A. Bukusi (September 2014). "Medicalization of HIV and the African Response". African Journal of Reproductive Health: 25–30 – via EBSCO Host. 
  3. Peter Conrad and Kristin K. Barker (2010). "The Social Construction of Illness: Key Insights and Policy Implications". American Sociological Association. 51: 67–79 – via JSTOR. 
  4. Wieczorkowska, Magdalena (2012). "MEDICALIZATION OF A WOMAN'S BODY - A CASE OF BREASTS". Przeglad Socjologiczny. 61: 143–172 – via ProQuest. 
  5. 5.0 5.1 Cecilia Tasca, Mariangela Rapetti, Mauro Giovanni Carta, Bianca Fadda (July 26th, 2012). "Women And Hysteria In The History Of Mental Health". Clinical Practice and Epidemiology in Mental Health. 8: 110–119 – via Clinical Practice and Epidemiology in Mental Health.  Check date values in: |date= (help)
  6. Maines, Rachel (1999). "The Technology of Orgasm: "hysteria," the Vibrator, and Women's Sexual Satisfaction". John Hopkins University Press – via Johns Hopkins University Press. 
  7. 7.0 7.1 Westervelt, Amy (April 25, 2015). "The medical research gender gap: how excluding women from clinical trials is hurting our health". The Guardian. 
  8. Townley, Chiara (March 17, 2019). "Cosmetic surgery is on the rise, new data reveal". Medical News Today.