From James

Joanne Meyerowitz traces the emergence of trans-sexuality in the United States as a category of identity distinct from homosexuality and transvestism. She does a great job at showing how the phenomenon of trans-sexuality transformed understandings of the relationship among sex, gender and sexuality, not only in the medical and legal professions but also in the popular consciousness. Sex was no longer seen as the biological foundation of gender and sexuality but was thought to exist independently of them. Like gender and sexuality, Meyerowitz was able to show that sex has a history and her study complicates that understanding in important ways. Sex of object choice began to displace gender as the organizing principle of sexuality and sexual practice. She makes very clear that the reorganization of sexuality occurred unevenly and over a long period of time than we thought, and that it was mediated by a number of factors including race, class and as a nation. Meyerowitz also allows us to see that the construction of trans-sexuality as a distinct category of identity has played a critical role in the early understandings of sex. She raises many good points but also raises some questions. For example, it attributes to Jorgensen’s sex change to a larger role in transforming gender and sexual norms than warranted. Jorgensen reinforced the idea that femininity was expressed most “naturally” by female heterosexual bodies. However, it is a great additional to sex/gender history considering its views and rare study on the history of sex and its transformation.

From Jessie

Something that struck me about Joanne Meyerowitz’s How Sex Changed, was just the unique nature of the whole topic in comparison to many of the other medical themes we have read about this semester. The issue of gender in How Sex Changed takes on many dimensions including medical, psychological, physical, personal and social. It is interesting in this author’s story to see how society and psychiatry played a role in defining “normal” gender roles, and to see how these definitions conflicted with the understanding, and feelings of sane people. It is interesting how despite personal liberties in America, peoples minds and bodies are still such a contested ground, as though the individual body still remains the property of the larger society. Despite an individuals personal feelings, and opinions regarding their body or sexual orientation, science, medicine and psychology have all played a role in defining what normal sexual roles are. In the past it seems science, medicine, and psychology may have betrayed themselves to the will of society, rather then remaining unbiased and simply seeking the socio-biological foundations of sex. It seems many medical professionals carried societal biases with them and rather looked at the blurred lines of gender as a societal problem requiring repair.

The matter of medicine yielding to society, over doing unbiased research seems to represent one of the great challenges to medicine throughout many of the books we have read this semester. I find the idea that medicine yields to society to be full of conflict, because we look to medicine as an embodiment of science, and see that science should be unbiased, yet researchers have historically allowed their own biases to play into their research, even when their research subjects include the bodies and minds of real people. This all raises questions about how free we all are, and what role the medical-industrial complex has in shaping the lives of individuals.

Dan's Blog

Joanne Meyerowitz’s book is surprisingly accessible for a work that tackles the complex world of medicine (and its jargon), the abstract realm of sex/gender debates and theories, and the contentious social atmosphere that issues of transsexuality has and continues to bring to light. Having had little experience with this particular historical narrative, I was surprised to learn about Christine Jorgenson—particularly the year of her procedure. This was the most important aspect of the book for me. I never realized the debate around transsexuality had such a long and twisted history.

I found the chapter “From Sex to Gender” particularly useful. It helps to explain how various people came to define transsexualism differently, but also provides solid historical context for the shifting of American ideas of sex and gender. As Meyerowitz outlines how scientists “distinguished biological sex from the sense of a sexed self, which they labeled ‘psychological sex’ and later ‘gender’” one can’t help but become a little caught up in semantics; however Meyerowitz handles these difficulties well.

Personal Accountability

As Rothman discusses in Strangers by the Bedside medical accountability and ethics is such a complex idea.  At first glimpse one would think judging ethics on medical procedures and experiments (do no harm) would be rather straight forward but this obviously couldn't be further from the truth.  As Jesse points out without medical oversight doctors can do whatever they want (a rather scary idea indeed), but by masking doctors and researchers behind lawyers and paperwork only seems to insulate them from their patients.  This seems a lot like the one premise from Freakonomics stating that incentives make people do strange things with often unforeseeable consequences.  The part I've found most interesting thus far is how doctors experimented on relatives or people close to the family (in-laws maybe?).  How best to ensure medical oversight then knowing that if any mistakes were made your sons/daughters life could depend on it.  Would BP have been willing to have their children work on their oil rigs?  Would people interested in Fracking be willing to drill in their own back yards?  Something tells me no and maybe that should be a telling indicator...

From Jessie

While reading chapter 3 of Strangers at the Bedside by David J. Rothman I was disturbed by “acceptable” research practices after WWII. In the chapter Rothman say’s “surveys revealed a widespread conviction that ethical judgments were best left to the judgment of investigators” (P. 60). I found this statement disturbing, because it brought to mind a sociology book I read in the last two years called “The Sociopath Next Door” by Martha Stout. In “The Sociopath Next Door” Stout describes how, as many as 4% of individuals are unable to feel empathy, compassion, or ability to relate to other humans or animals. Simply based on the findings of Stout, whether or not psychopaths actually account for 4% of the population, would render Rothman’s finding very disturbing. If we could imagine a doctor having unlimited capacity to run tests on an individual without oversight, from some board of ethics, it is disturbing to think what might be deemed acceptable practice by the doctor lacking a conscience. If such a person were to run medical experiments, it is unlikely they would have any sympathy/empathy for whatever pain, or even death they might deal their patients. Without moral/ethical oversight such individuals could potentially harm the lives of hundreds or even thousands of individuals, and have claimed it all to be in the name of science.

From James

Blog Post for “Strangers at the Bedside”

This book was certainly well written and a valuable contribution to health care and bioethics. I have not had a whole lot of experience in studying or learning about bioethics, including topics such as human experimentation and organ transplants. I think is tremendous ability to tell the history of bioethics starts with his research and profession as a professor of social medicine. His well written study goes further into the realm of the social ramifications bioethics had on society and the response people and the health care field had on these topics. The one thing that I want to also comment on was the extensive research Rothman accumulated for this book. His research extends to many different primary and secondary sources and I think that this really made his book that more convincing and valuable. In particular, I found it interesting that he included Congressional hearings and records on this topic. I think when something goes to Congress it is that much more controversial and interesting. I found his ability to incorporate these findings into the book that much better to his narrative. A well written and profound book.

Blog Post for “On Speed”

I found this book to be very well written and detail oriented. Rasmussen really gives a full description and analysis of the rise of amphetamines and the destructive power that they can have over patients and people. I think he did a great job at describing not only the historical perspective of amphetamines, but the current scene and how certain drugs are being consumed and discussed today. His particular discussion of Adderall and Ritalin are convincing and interesting. I never knew the type of impact these amphetamines had on people, and especially the youth. I know many people who take Adderall and they take it like a vitamin or something. It seems like it is a part of their everyday routine and it is like they have become so consumed with it that it becomes second nature. Being a prospective high school teacher and having some experience in classrooms, I have become familiar with the phenomenon of Attention Deficit Disorder (ADD) within students and the school’s effort to combat it. It seems as if more and more students are getting prescribed to Adderall and it is something that is alarming and concerning in my opinion.

From Brienne

The Impact of Health Insurance and Liability Insurance on Physician Autonomy

Although the book does not focus too much on the impacts of insurance on physician sovereignty, it is an important issue that has direct impacts on physicians’ practice. I know one physician who, in the course of his 40 year career, spent more and more time completing paperwork for health insurance companies, trying to meet the differing requirements of both health insurance and government regulations within Medicare and Medicaid. He experienced frustration over concerns about being audited by government agencies or of not receiving payment due to some bureaucratic requirement that he was not aware of. In the final year of his practice in 2010, as he attempted to cut back on patients, the chief determinant of the final day his office remained open was the annual cost of liability insurance. While he would have loved to care for his longtime older patients, the volume could not justify the insurance expense.

The book focuses mainly on direct medical decision making, but there is a vast array of issues that impact a physician’s autonomy.