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PubMed1986

Gender identity and gender transposition: longitudinal outcome study of 32 male hermaphrodites assigned as girls.

The longitudinal case histories of 32 female-assigned male hermaphrodites aged 18 or older were indexed and abstracted for evidence of variables related to gender transposition, i.e., bisexualism, lesbianism, or sex reassignment to live as male. The prevalence of transposition was biased because of the referral of cases selected for reassignment. Childhood stigmatization, either subtle or blatant, because of the birth defect of the sex organs correlated with gender transposition (p less than .001) and was related to the age of feminizing surgery (p less than .05), which often coincided with the age of gonadectomy. Variables not significantly correlated with gender transposition were: neonatal ambivalence regarding the sex of announcement; feminizing or masculinizing puberty; presence or absence of mullerian organs; and gross family pathology. Physicians encountered no moral problem with sex reassignment as the chromosomal and gonadal sex were male.

Anti-Mullerian Hormone↗
PubMed1991

Obesity and socioeconomic status: a framework for examining relationships between physical and social variables.

Fatness and obesity are body characteristics which are both ascribed and achieved for adults. Socioeconomic status (SES) is the ranking of individuals within complex societies. In traditional societies a direct relationship between SES and fatness exists, while in modern societies there is an inverse association between SES and obesity for adult women but mixed patterns for other age/sex groups. A framework recognizing the difference between variables on the physical and social level of analysis needs to be used to examine the relationship between fatness (a physical variable) and SES (a social variable). Different mechanisms are involved in the causal pathways where SES influences obesity and obesity influences SES. SES influences obesity by education, income, and occupation causing variations in behaviors which change energy consumption, energy expenditure and metabolism. Obesity influences SES when the perception of obesity is interpreted through prejudiced beliefs, with subsequent stigmatization and discrimination limiting access to higher SES roles.

Age Factors↗
PubMed1993

Sociocultural aspects of blindness in an Egyptian delta hamlet: visual impairment vs. visual disability.

Through ophthalmological exams, structured interviews and participant observation, this study examines the experience of blindness in rural Egypt, and finds that villagers' subjective assessments of their vision differ substantially from ophthalmic measurements of their vision. Individuals with profound visual loss remain independent in their daily activities and contribute to their families' subsistence. While they may agree that they have "weak eyesight," they do not perceive themselves to be disabled. Stigmatizing attitudes that the blind are completely dependent and unable to fulfill their social roles further encourage those with decreased vision to deny the extent of their visual loss.

Adolescent↗
PubMed2001

Stigma and rejection: living with AIDS in villages in southern Thailand.

The problems that face HIV/AIDS patients are now fairly well documented. These include experiences of guilt, anger, grief, fear of abandonment, and potential economic hardship and marginalization due to others' fear of infection and associated stigma. However, limited attention has been paid to the effects of AIDS-related stigma on access to, and the provision of, health services. Understanding how the stigma of AIDS affects the processes and experiences of diagnosis, treatment, prevention, and care is critical to effective public health policy and the delivery of health care programs and medical services. In this article, we examine stigma as experienced by people with HIV and AIDS, and by their families, in village Thailand. We also identify areas for improvement pertaining to people with HIV/AIDS and other stigmatizing diseases.

Acquired Immunodeficiency Syndrome↗
PubMedDate not supplied

The use of aberrant medical humor by psychiatric unit staff.

The purpose of this study was to develop a grounded theory about the joking behaviors of psychiatric unit staff. Fifty nine staff members (Male = 23, Female = 36), ages 28-62, who worked in an urban, public facility were observed in unit meetings over a two year period. Data were analyzed using the constant comparative method. Participants used aberrant humor to deal with the basic social process of facing a series of ultimately unresolvable problems. The factors involved included the organizational context of the working environment, contact with a stigmatized patient group, and stressful staff-patient interactions which led to the erosion of a sense of professional competence and the resulting demoralization, resentment, and vengeful counteraction. Two major categories of joking emerged: whimsical and sarcastic humor. Six subcategories of humor also emerged: incongruous, bravado, self-mocking, discounting, malicious and gallows humor. Staff engaged in more sarcastic than whimsical humor. Findings support the need for professionals to recognize the potentially detrimental effects of joking behaviors on their treatment effectiveness.

Adaptation, Psychological↗
PubMed2006

Schizophrenia and violence: the perspective of women.

Violence against women is a major public health problem. Women with a diagnosis of schizophrenia suffer higher rates of violence compared with women without mental illnesses. Little research has focused on what it means for women to live with schizophrenia and a history of violence. This interpretive phenomenological study identified three themes of schizophrenia and violence: Being Stigmatized, Foreclosing a Future of Possibilities, and Finding Meaning in Symptoms. The results suggest mental health professionals should assess women with diagnoses of schizophrenia for violence and provide opportunities for trauma stories to be heard. These listening types of patient-centered interventions may promote recovery.

Adult↗
PubMedDate not supplied

Borderline personality disorder: gender stereotypes, stigma, and limited system of care.

In North America, there may be no other psychiatric diagnosis more laden with stereotypes and stigma than borderline personality disorder. People who live with this label--the majority being female--are often marginalized or denied access to mental health services. In this article, the author reviews the theoretical underpinnings of the diagnosis, as well as the stigmatizing practices and limited services for seriously ill persons with borderline personality disorder diagnoses. In light of this review, new directions for mental health practice, education, and research are proposed.

Attitude to Health↗
PubMed2002

What does it mean for youngsters to grow up in a lesbian family created by means of donor insemination?

In many countries fertility services still refuse to inseminate lesbian couples because they believe the child's welfare would be at stake. One of their concerns is that these children will be stigmatized because of their non-traditional family structure. In this follow-up study, we interviewed children from lesbian donor insemination (DI) families about how they present their 'non-traditional' family to people in their immediate social environment. We also explored whether or not children were teased or harassed about their lesbian family and whether or not coping with a non-traditional family constellation was reflected in their psychological well-being. According to this study, almost all children from lesbian DI families share the fact that they live in a two-mother unit spontaneously with close friends who react positively. Others are only informed about the non-traditional family structure when they ask questions about it. From the children's answers, we can conclude that for some peers it is hard to understand that someone can have two mothers without having a father somewhere. Compared with children from heterosexual families, these DI children are not more likely to be teased but they are more prone to family-related teasing incidents. However, introducing their non-traditional family into their peer group does not seem to interfere with their psychological well-being. Nonetheless, teachers indicate that children from lesbian families experience more attention problems compared with children from heterosexual households.

Attention Deficit Disorder with Hyperactivity↗
PubMed2000

Neurosurgery without shaving: indications and results.

The objective of the investigation was to prevent the stigmatizing effect of a totally or partially shaved head with openly visible signs of a head operation, easing the reintegration of the patient into his daily life. After extended surface cleaning with a colourless, regular skin disinfection liquid (undyed isopropanol/dibrom/propylenglycol solution) the hair was combed apart from the incision line before draping. Wound closure was performed as usual, taking care to remove meticulously hair from the wound. To aid closure we made use of a 20% chlorhexidine jelly that holds the hair away from the incision. A neomycin ointment served for sealing the wound surface, no further dressing being used. After 215 cranial neurosurgical operations, among them 63 for tumours, 33 stereotactic procedures 18 shunt, 55 for torticollis and 46 other operations performed without shaving the hair, we saw one wound infection (0.5%). This percentage corresponds very well to our general infection rate of 0.6%. All patients very much appreciated the offered opportunity and the result. If the objective is to give patients a psychological advantage by preventing a partially bald head we think one can safely refrain from the shaving procedure without risking a higher infection rate.

Brain↗
PubMed2004

Attitudes towards behavioural versus organic acquisition of brain injury.

PRIMARY OBJECTIVE: To investigate the public's attitudes towards survivors of brain injury in Northern Ireland. RESEARCH DESIGN: Four hypothetical vignettes were constructed to test how the acquisition of a brain injury impacted on people's attitudes. The stories of protagonists that they either acquired their injury through organic (e.g. haemorrhage) means or in some self-initiated (e.g. brawl) behaviour. The gender of the protagonists was varied to examine differences in attitudes to males and females. METHODS AND PROCEDURES: Adapted versions of the Prejudicial Evaluation Scale (PES) and Social Interaction Scale (SIS) were administered to 96 university students. MAIN OUTCOMES AND RESULTS: The data was analysed using three 2 x 2 between subjects ANOVAs and showed that there was no significant main effect of gender, a highly significant effect of injury on negative attitudes (F(1, 92) = 68.30, p < 0.001], amount of desired social interaction [F(1, 92) = 46.27, p < 0.001] and willingness to help [F(1, 92) = 44.66, p < 0.001]. CONCLUSION: The perception that an individual's behaviour contributed to their injury may lead to stigmatization and its negative consequences.

Adolescent↗
PubMedDate not supplied

AIDS prevention in low-incidence areas.

AIDS has been largely described as a problem of major urban areas. However, states in which there is a low incidence of AIDS are dealing with issues from somewhat different perspectives than high-incidence states. The terms "low incidence" and "high incidence" can be misleading: If one state compares its AIDS cases to another state, the comparison may indeed show a comparatively low incidence of AIDS. However, if the comparison is made with other diseases within the same state, a quite different picture may emerge. In low-incidence states, some individuals infected with human immunodeficiency virus (HIV) may seek medical care from physicians who have more experience in treating AIDS cases, both because of a perception of better medical care and less stigmatization. Although the numbers may be relatively small, the number of HIV/AIDS patients seeking care in large metropolitan areas may add to the health care burden already being seen in some parts of the country.

Acquired Immunodeficiency Syndrome↗
PubMedDate not supplied

Stigma or legitimation? A historical examination of the social potentials of addiction disease models.

This article presents a historical discussion of disease models of opiate addiction in the United States in the twentieth century. First, several approaches to defining disease are discussed. Then, the shifts in formulations of opiate addiction as a disease in the twentieth century in the U.S. are analysed in light of the preceding theoretical discussion. The period before 1920 is described as heterodox, as researchers attempted to develop scientific models of opiate addiction, while various medically legitimate and quasi-legitimate treatment approaches flourished in an unregulated marketplace. After 1920, a stigmatizing disease model of opiate addiction was based on a psychiatric formulation that linked chronic addiction with psychoneurotic deficits in certain individuals. After 1940, this model dominated medical and scientific thinking about opiate addiction for several decades. After 1970, enormous changes in the demographics of drug use forced changes to the prevailing model of addiction. A new focus on behavioral aspects of addiction allowed the creation of a nonstigmatizing Parsonian disease model.

History, 20th Century↗
PubMed2006

Street-level effects of local drug policy on marginalization and hardening: an ethnographic study among chronic drug users.

This study focuses on the effects of increased enforcement on marginalization of and quality of relations between chronic drug users in the region of Parkstad Limburg (The Netherlands). Data were mainly gathered by ethnographic community fieldwork, verified by interviews with key informants and supported by a survey sample of 100 drug users. The results show direct effects of repression on stigmatization and marginalization of drug users, and on the availability of drugs. More indirect effects are the hectic reactions of drug users and dealers, greater visibility of drug users in public places, and increased tensions in and deterioration of relations between the drug users. The impact of the increased enforcement on reports of drug-related nuisance in general population surveys and on police control is also discussed.

Anthropology, Cultural↗
PubMed1990

Alcoholism in lesbians: developmental, symbolic interactionist, and critical perspectives.

Alcoholism is a significant health concern for lesbian women, with an incidence rate perhaps three times that of the general population. The relationships among the development of alcoholism in women, the experience of stigmatization, and the complex facets of lesbian identity and lesbian community are explored. This exploration provides for a more comprehensive and critical analysis of alcoholism in lesbians. As a phenomenon of women's health, alcoholism is examined using the perspectives of developmental theory, symbolic interactionism, and critical theory. The author offers insights and implications for health care, research, and theory building.

Alcoholism↗
PubMedDate not supplied

Caring for lesbians in a homophobic society.

Lesbians and gays have suffered for centuries from stigmatization by homophobic, heterosexual people in Western society. It is critical for health care providers to have an understanding of alternative life-styles and the unique health concerns of homosexual people in order to provide sensitive and knowledgeable health care. Lesbian health issues such as assessing the sexual orientation of lesbians, parenting issues, lesbian battering, and the older lesbian woman are discussed. My intent in writing this article is to increase the sensitivity, knowledge, and awareness of health care providers caring for lesbians in a homophobic society.

Female↗
PubMedDate not supplied

Power and the politics of abuse: rethinking violence in Filipina-Australian marriages.

In this paper we take as a starting point the perceived high prevalence of domestic violence in marriages between Filipino women and Australian men. In in-depth interviews and structured questionnaires with service providers and with Filipinas married to Anglo-Australian and Filipino men the issue of underreporting physical and emotional violence was a recurring theme. We explore the relationships of power that characterize these marriages, the changes in balance of power that result from the externalization of anger, physical and verbal violence, and stigmatization of domestic violence experienced by Filipinas individually and in the community. We suggest that social disapproval and stereotypical representations of Filipina-Australian marriages in Australian society, and the consequent shame experienced by Filipinas, has led to underreporting of emotional and physical abuse.

Adult↗
PubMedDate not supplied

Lesbians and cancer support: clinical issues for cancer patients.

In this article, I discuss clinical issues addressed while conducting support groups for lesbians with cancer. For group participants, issues relating to sexual orientation affected comfort levels with treatment interventions, communication with health care providers, ability to obtain emotional support, and coping. For example, assistance in information processing, decision making, and emotional support during treatment are typically provided by spouses of individuals with cancer. However, many women reported experiencing additional anxiety because of their decision to reveal their sexual orientation to medical providers. Fear of stigmatization and the possibility of compromised care contributed to anxiety about disclosure of sexual orientation. Whenever possible, differences in women's experiences based on race are also highlighted. The findings can begin to inform our assessment, problem conceptualization, and treatment approaches for lesbians with cancer.

Adaptation, Psychological↗
PubMedDate not supplied

Adults mourning suicide: self-reported concerns about bereavement, needs for assistance, and help-seeking behavior.

This study empirically characterized the experiences of 227 adult next-of-kin as they mourned suicides that had occurred in New York City during 1997. Next-of-kin reported psychosocial problems including family difficulties, comorbid stressors, psychiatric symptomatology, and unresolved bereavement. Professional intervention was the most frequently reported need and the most frequently reported type of desired help. In terms of actual receipt of assistance, participants reported having received help from families, friends, and communities as well as from professionals. Although some next-of-kin had not sought help because they felt able to cope without assistance, others encounted barriers to receiving desired help. These findings warrant increased and sustained community outreach to this population. Recommendations include public education regarding de-stigmatization of suicide and the needs of the suicidally bereaved, enhancement of internal and external coping supports, facilitation of access to both professional and community help, and better coordinated and more culturally appropriate services.

Adult↗