Gender medicine: its historical roots.

Gender medicine as a subject began with Bernadine Healy's 1991 article 'The Yentl Syndrome' which showed that women had worse outcomes following heart attacks since their symptoms are different from men. Since then gender-specific clinical research protocols have been progressively included so that evidence for guidelines can be better informed such that women are then less disadvantaged and care become more personalised. This paper traces back the historical roots of gender bias in medicine in Western culture, which is reflected in the pictorial arts and writings of each historical period, beginning with Hippocrates. It describes the changes that have led to attempts at improving the place of women, and the treatments of disease, on an equal footing with men, precipitated by Healy's paper.

[Health Education for Men by the Federal Centre of Health Education: A Contribution to the Presentation of Men as unaware of Health? (1970-1990)]. / Männerspezifische GesundheitsaufkIärung durch die BZgA: Ein Beitrag zur Verfestigung des Gesundheitsdefizitdiskurses? (1970-1990).

This article offers a close consideration about the gender-specific contents of health education campaigns in the Federal Republic of Germany from 1970 to 1990. By using educational publications issued by the Bundeszentrale für gesundheitliche Aufklärung (BZgA), it is shown which breaks and continuities emerged and which kinds of role models are thereby conveyed. Whereas the health education of the 1950s and 1960s was characterised by a didactical approach towards men and women, this changed as from the 1970s. By deconstructing exemplary education campaigns and including internal files of the BZgA, it can be shown, that the societal discourse on the feminism in the FRG contributed to the fact, that during the 1970s the switch has been made to an increased use of positive role models. However, within the men-specific health education there was no break; the health deficiency discourse was still applied in many and diverse ways in order to describe male health behaviour and knowledge.

[Masculinity and Meat Consumption--Historical Approchaes to a Current Health Issue]. / Männlichkeit und Fleischkonsum--historische Annäherungen an eine gegenw rtige Gesundheitsthematik.

In current health debates meat is often discussed as a health risk. Statistically, men consume more meat than women. Therefore they often appear as an especially vulnerable risk group. Based on current discussions about an increased health risk for men because of an above-average consumption of meat, this paper outlines aspects of the historical development of the relationship between masculinity and meat consumption from the 19th to the 21st century and emphasizes the importance of cultural constructed gender expectations for the eating habits of many men.

[A history of men's health--on the origin of a field of research]. / Männergesundheitsgeschichte--Zur Entstehung eines Forschungsfeldes.

This contribution traces the conditions surrounding the emergence and development of a new field of research since the millennium. It primarily presents research initiated by the Stuttgart Institute for the History of Medicine: starting with the (re)discovery of sources and the setting up of bodies of sources for a gender-sensitive, patient-oriented history of health (autobiographies, diaries, correspondence) it moves to issues such as health lifestyles, workers' masculinity, the use of medical services, health experiences during particular stages of life such as childhood or youth, as well as prevention, healthcare, mental health and the gender gap in life expectancy. In conclusion the article discusses possible theoretical frameworks and perspectives.

[Accident cause masculinity?--Gender-related issues of accident victims between prevention and coping in Kaiserreich and Weimarer Republik]. / Unfallursache Männlichkeit?--Geschlechterspezifische Aspekte bei Arbeitsunfallopfern zwischen Prävention und FolgenbewäItigung in Kaiserreich und Weimarer Republik.

Occupational accidents in industrial workplaces are a specific health problem for man. Therefore it seems adequate to use masculinities as a category of research in this field. For the Kaiserreich and the Weimarer Republik it shows that male workers relating to their danger awareness and behavior, prevention, accident causes and coping strategies are settled in an area of conflict between a hard workplace environment and the family. On the basis of health practices of the accident victims it appears that there are different forms of labor masculinities. They have an important influence on all levels of an occupational accident from the endangerment to the success of the treatment. Through a critical use of the category academic void can be shown and alternative explanatory models can be offered.

[Migrants' masculinity and health. Taking care for one's health and coping with sickness of German migrants in the US in 19th and early 20th centuries]. / Männlichkeit und Gesundheit im Kontext von Migration. Praktiken der Gesundheitsfürsorge und KrankheitsbewäItigung deutscher Migranten in den USA im 19. Jahrhundert und frühen 20. Jahrhundert.

In 19. and early 20. centuries several million emigrants from German speaking countries entered the United States of America. How migrants coped with sickness, how they preserved their health and to which ressources and institutions of help they had access is yet an academic void. Using Ego-documents--letters, autobiographic texts and diaries--of near-illiterate men this paper will analyse 'healthy lifestyles' and practices of coping with sickness and contrast them with recent research findings in the field of 'mens' health'. Thereby the recent concept of ,male health-idiots' will be challenged in historical perspective.

["Should the staff's attitude towards the patients remain unchanged, I will not guarantee anything." Protest masculinity and coping of "rebellious patients" at the Heidelberg University Psychiatric Hospital on the eve of deinstitutionalization]. / "Sollte sich die Einstellung des Personals gegenüber den Patienten nicht ändern, garantiere ich für nichts mehr!" Protestmännlichkeit und KrankheitsbewäItigung von "aufsässigen Patienten" der Psychiatrischen Universitätskinik Heidelberg am Vorabend der Psychiatriereform.

This article analyses the illness experiences of male patients from the Heidelberg University Psychiatric Hospital during the protests against Psychiatry in the year 1973. Protest is one of the most important expressions of masculinity in socially disadvantaged men, such as men with mental disorders. The analysis of 100 medical records shows that some patients tried to construct themselves as men in a way that was explicitly motivated by antipsychiatric ideas: They questioned psychiatric authority, behaved "sexually inappropriate", or used drugs. On the eve of psychiatric reform in West Germany those patients were well aware that the alternative--complying with the treatment--would put them at considerable risk. In addition to the usual inference of hegemonic or normative masculinities as risk-factors, the behavior of those ,,rebellious patients" has to be interpreted as individual coping strategies.

["But there are also men!" Gender-specific health education and prevention in the GDR from the 1950th to the 1970th]. / "Männer gibt es doch auch!" Geschlechterspezifische Gesundheitserziehung und Prävention in der DDR in den 1950er bis 1970er Jahren.

The notions of femininity and masculinity in the GDR health propaganda and their effects on the health consciousness and behaviour of the population in the GDR are the key topics of this article. The main questions of the first part are, if women and men were equally represented in educational materials and had to fulfil the same norms and expectations. The second part deals with ego-documents, primarily petitions to the Ministry of Health, as well as reports and evaluations from the local health authorities that shall help to answer the questions of male and female health behaviour. Additionally they can provide an insight into the views and actions of patients. Other factors such as the educational level, matters of milieu and regional peculiarities that have impact on the health status and behaviour will be discussed at the end of the article.

A historical perspective on the male sexual case history.

The contemporary sexual medicine case history is grounded in the Biopsychosocial Model and its recognition that the past influences one's current interpretation of symptoms. However, the thread of this model can be found throughout the case studies of the early pioneers of sexology. These early investigators began with examinations of homosexual men, slowly moving toward awareness that male sexuality comprises a continuum, while striving to place sexual behavior in a biologic context. Their perspectives served to establish the groundwork for the emerging construct of sexuality and helped shape current methods for identification of sexual function concerns.

Historical revolutions in sex therapy: a critical examination of men's sexual dysfunctions and their treatment.

History, recent and ancient, presents innumerable methods intended to ensure or restore male sexual performance. Although these methods have regularly claimed to be "revolutionary," they have often been remarkably similar, and of questionably efficacy. This article provides a critical account of key historical trends in the treatment of male sexual dysfunctions in order to contextualize and critique the current treatment field. The author uses historical analysis to contextualize contemporary sex therapy techniques, arguing that even clinically verified contemporary revolutions, such as the advent of Viagra and similar drugs, may not present broadly efficacious standalone cures. Using critical historical analysis to illustrate the limitations of single-method treatments, the article argues for the value of comprehensive, biopsychosocial therapy methods. A common tendency--to seek a 'magic bullet' solution to sexual dysfunctions--is apparent throughout history, the author argues. While Viagra differs biomedically from historical treatments, it may appeal to the same logic, raising the question of whether it constitutes a truly revolutionary development in treatment. The article concludes with a set of recommendations regarding the implementation of biopsychosocial practice in sex therapy.

Limited access: gender, occupational composition, and flexible work scheduling.

The current study draws on national data to explore differences in access to flexible work scheduling by the gender composition of women's and men's occupations. Results show that those who work in integrated occupations are more likely to have access to flexible scheduling. Women and men do not take jobs with lower pay in return for greater access to flexibility. Instead, jobs with higher pay offer greater flexibility. Integrated occupations tend to offer the greatest access to flexible scheduling because of their structural locations. Part-time work is negatively associated with men's access to flexible scheduling but positively associated with women's access. Women have greater flexibility when they work for large establishments, whereas men have greater flexibility when they work for small establishments.

Backstage discourse and the reproduction of white masculinities.

This article documents the shared patterns of private white male discourse. Drawing from comparative ethnographic research in a white nationalist and a white antiracist organization, I analyze how white men engage in private discourse to reproduce coherent and valorized understandings of white masculinity. These private speech acts reinforce prevailing narratives about race and gender, reproduce understandings of segregation and paternalism as natural, and rationalize the expression of overt racism. This analysis illustrates how antagonistic forms of "frontstage" white male activism may distract from white male identity management in the "backstage."

"Hating the sin but not the sinner": a study about heterosexism and religious experiences among black men.

This article explored the religious experiences of nine Black men who are married (to a woman) and have sex with men (BMMSM). These men do not refer to themselves as men on the down low but self-identify as heterosexual. Using data collected in 2005 in South Carolina, the authors examined the complex relationship of homosexuality and the Black Church. Specifically, they examined the notion of coping with same-sex behavior, concealment, and its impact on BMMSM. Findings from the thematic analysis suggest that men found ways to manage their religious traditions and same-sex behaviors. This research presents an opportunity to locate and access a hidden population. The authors found a pervasive experience of growing up in social and family environments that expose them to heterosexism.

Social mobility and reproduction among nineteenth-century Colorado silver prospectors.

Popular cultural convention holds that, for those with enough gumption, the American frontier was a land of unparalleled opportunity. However, careful research throws doubt on the universality of this convention. Thus, the authors explore factors that increase or decrease opportunities for upward mobility in frontier towns. The authors' longitudinal study of late nineteenth century silver prospectors in Gothic, Colorado, demonstrates that while enthusiastic prospecting in Gothic did not lead to upward social mobility, it did provide enhanced reproductive opportunities.

From convicts to colonists: the health of prisoners and the voyage to Australia, 1823-53.

From 1815, naval surgeons accompanied all convict voyages from Britain and Ireland to the Australian colonies. As their authority grew, naval surgeons on convict ships increasingly used their medical observations about the health of convicts to make pointed and sustained criticisms of British penal reforms. Beyond their authority at sea, surgeons' journals and correspondence brought debates about penal reform in Britain into direct conversation with debates about colonial transportation. In the 1830s, naval surgeons' claims brought them into conflict with their medical colleagues on land, as well as with the colonial governor, George Arthur. As the surgeons continued their attempts to combat scurvy, their rhetoric changed. By the late 1840s, as convicts' bodies betrayed the disturbing effects of separate confinement as they boarded the convict ships, surgeons could argue convincingly that the voyage itself was a space that could medically, physically and spiritually reform convicts. By the mid-1840s, surgeons took the role of key arbiters of convicts' potential contribution to the Australian colonies.

The declining retirement prospects of immigrant men.

We compare the retirement prospects of immigrant men with their native-born counterparts. Using data from the Survey of Labour and Income Dynamics, we estimate a significant gap of 43 percent in private pension income and 30 percent in private pension contributions between immigrants and the native born. The gap in public pension incomes is negligible and reduces the overall pension gap, but only partially. Furthermore, the pension income and contribution gap is significantly larger for more recently arrived immigrant cohorts, consistent with evidence of weaker earnings for this group. We provide age profiles of pension income and contributions and discuss problems in interpreting the results without adjusting for age. Controlling for age and earnings differences, immigrants are still about 11 percent less likely to make contributions to a private pension program, but there is no difference in the contribution rates out of earnings of those who contribute. Recently arrived immigrants are significantly less likely to make contributions to a private pension program and appear to be neglecting private pension contribution opportunities more than earlier immigrants and the native born, which may have adverse implications for Canada's public retirement programs.

Queer(ed) risks: life insurance, HIV/AIDS, and the "gay question".

In 2004 the Association of British Insurers (ABI) issued its second Statement of Best Practice on HIV and Insurance. This prohibited use of the "gay question" (employed by some underwriters in application forms for life insurance to identify heightened risk of infection with HIV), in response to growing criticism that the practice was actuarially unreliable, unfair to gay men, and unnecessary, given the availability of alternative "behaviour-based" risk criteria. While the overhaul of this controversial practice is clearly a victory for gay (male) identity politics, this paper argues that the interests of gay men seem to have dominated at the expense of a more far-reaching critique of the industry's evaluation of infection risk. It contends that a more radical (or "queerer") challenge is needed which can better understand and address the injustices created by criteria for appraising risk of infection that still remain in place.

Health, sexuality and place: the different geographies of HIV-positive gay men in Auckland, New Zealand.

This paper employs interview narratives alongside participant-led photography and caption writing to examine the different daily geographies of 15 HIV-positive gay men in Auckland, New Zealand. Difference for these men is rooted in both their HIV status and their sexuality, and this difference has implications for their engagement with the world at a range of spatial and temporal scales. Giving voice to such experiences begins to answer calls for geographers to consider more deeply the connections between health, sexuality and place.

Coping versus grieving in a "death-accepting" society: AIDS-bereaved women living with HIV in Indonesia.

The aim of this study was to understand how AIDS-bereaved women in Indonesia cope in a society where death is believed to be fated. Data analyses were conducted based on the women's interview transcripts and journal entries. Each of the women experienced at least three traumatic life events. The most challenging experience was learning that they have contracted a disease they regarded as associated with prostitution. Given the short lapse of time between their husbands' deaths and learning about their seropositivity, biographical disruption appeared to have acted as an 'analgesic', while concerns to protect their children seemed to have triggered biographical reinforcement. This phenomenon may have brought about a positive bereavement outcome. Specific counselling programmes for women affected by HIV/AIDS are needed, but emphasis should first be placed on improving their wellbeing and their perception of stigma.