The Social Construction of Gender in Medical Interactions: A Case for the Perpetuation of Stereotypes?

ABSTRACT

This paper focuses on the ways in which gender, conceived as the product of an ongoing social and cultural construction in and through communication processes, is accomplished during medical encounters and through the narratives produced within these interactions. The main objective is to examine: (1) when and by what devices gender becomes interactionally relevant; (2) the participants’ narratives on ‘gender issues’; (3) the interplay between the narratives produced and the forms of communication created, also considering which form may be more effective in challenging gender stereotypes and bias. Data are drawn from a corpus of self-administered audio-recorded interactions between a female gynecologist/midwife and pregnant patients. The consultations (half of them mediated, half not) took place in a city of North Italy; the patients (sometimes accompanied by the husband) are migrant women from North and West Africa. The main results show that: (1) at each stage of the examinations, an orientation to gender emerges, mainly through questions that display categorizations, category-bound activities, and cultural assumptions about gender: when referred to the patient, these devices often reproduce the traditional cultural model of femininity and, connected to this, the ‘normal’ (heterosexual and stable) intimate relationship as socially expected; (2) medical dialogue as patient-centered approach is the most recurrent form of interaction and often leads to a co-construction of narratives in which personal uniqueness is more relevant than gender roles, expectations, and stereotyped representations; when husbands are involved, however, the interactions seem to shift toward doctor-centered forms of communication, and this usually leads to asymmetrical and directive constructions of narratives about differentiated and traditional gender roles.