1This edited volume explores interactions between health and gender across nine chapters representing a variety of disciplines. What impact do health status, illness, or biomedical categories have on gender roles and relationships? How does gender condition preventive attitudes, perceptions of risk, the experience of pathologies, and relationships to care and treatment? In responding to these questions, the book pursues two ambitions, which are set out in the introduction by Anastasia Meidani and Arnaud Alessandrin. The first is to replace binary essentialist thinking, which is widespread in the biomedical approach, with dynamic intersectional analysis of the imbrications of gender trajectories and health pathways. The second is to offer a non-naturalizing vision of gender and health, drawing on insights from a diversity of thematic, theoretical, geographic, and disciplinary perspectives. The introduction takes a very instructive look at the contributions and pitfalls of the different conceptual frameworks that have predominated in the study of the relationships between health and gender across time and theoretical currents: categorical thinking, post-structuralist feminist theory, relational approaches, intersectional analysis.
2The book is then organized into three thematic parts, each consisting of three chapters. The first deals with the experience of cancer. In the first text in this section, Pierre Aïach examines the phenomenon commonly known as the ‘gender paradox’ with regard to mortality, in particular from cancer: namely, that mortality is lower in women than men despite higher prevalence and less favourable socio-economic positioning. Aïach seeks to shed light on this apparent paradox by analysing social conditions, notably employment trajectories and sociocultural dispositions that precede the observed differences in cancer outcomes. Next, Brigitte Esteve-Bellebeau offers a philosophical reflection on gender identity in the face of treatment protocols and cancerinduced damage to the body, based on observations in a clinical context. She describes successive breaks in representations of self as a sexed body at different stages in the process: when the diagnosis is communicated, during medical treatment, and, finally, during remission. The first part ends with a sociological text by Anastasia Meidani which, based on observations and interviews in an oncology clinic, highlights the force of sexed perceptions both in patients’ experience and in the medical treatment of the disease. Meidani describes, for example, how stereotyped figures of women as ‘exhausted’ (by life) but ‘strong’ in the face of illness, and of men who are ‘robust’ (in life) but ‘weakened’ by illness, contribute to differentiated clinical responses to pain reported by women and men.
3The second part of the book deals with reproductive health and sexuality, with three chapters each taking an original approach. The first is devoted to the management of reproductive toxicant risks in the workplace. Based on company monographs and sociological interviews, Emilie Legrand and Anastasia Meidani explain that outside the period of pregnancy, these risks are almost entirely concealed at all levels of prevention policy. Female employees themselves strongly underestimate these risks, which runs against the widespread idea of an almost ‘natural’ female prudence in the face of health risks. The study of the combined effects of gender, age, and cohort, but also socio-occupational status, career implications, and parental status, helps to explain women’s concealment, and even denial, of these risks. In the next chapter, Virginie Rozée presents an analysis of the conditions of surrogacy in India based on an in-depth ethnographic survey. Rozée shows that the practice of surrogacy is now an integral part of a globalized system for the management of the reproductive capacity of women, who seek to improve their living conditions through an exceptional financial opportunity. An intersectional approach sheds light on interacting axes of domination (linked to gender, socio-economic status, and the primacy given to the wishes of the intended parents and to biomedical power) to which pregnant women are subjected throughout a process in which they are assigned the place of ‘silent bodies’. The second part concludes with a text by Meidani and Alessandrin on sexuality after age 60. While men’s and women’s relationships to sexuality have been converging, there remain significant gender differences in behaviour with advancing age.
4The final part of the book focuses on bodies and the work of bringing them into conformity that begins as soon as they deviate from social, aesthetic, medical, or gender expectations. In a study of bariatric trajectories and representations of obesity, the semiologist Marielle Toulze reveals the obstacles obese women encounter in their pathway towards surgery, but also the forms of circumvention of the multiple normative injunctions and medical dietetic prescriptions to which they are supposed to adhere. At the end of this trajectory, many women nevertheless end up considering the use of bariatric surgery as a failure, which reveals a lack of ‘will’ to take charge of their own situation. In the following chapter, Alain Giami analyses the epistemological stakes of sociodemographic and epidemiological studies on trans identities in various Western countries. Giami shows that it is possible to develop methodological tools that reflect the evolution and diversification of gender identifications, taking into account the forms of individuals’ own chosen forms of identification. The book closes with a contribution from Erik Schneider, psychiatrist and psychotherapist, on intersex children. Schneider highlights the impact of gender norms on the health of, and medical care for, these children. In contrast to ‘normalizing’ approaches and the psychiatrization of trans identities, he proposes a ‘non-suspicious’ approach to supporting these children (and their parents) in their trajectory of self-determination.
5In conclusion, this book reflects the dynamism of what is now a thriving field of research. However, its disciplinary diversity and the heterogeneity of the themes explored give the impression that it lacks overall unity. It is also regrettable that issues of ethno-racial belonging and migration are not further addressed. But the contributions, which are largely original and based on firsthand data, convincingly show how questions of gender pervade all areas and stages of individuals’ health trajectories.
