Commodification and medicalization of menopause: women's experiences with hormone replacement therapy
Bibliographic record
Abstract
My research investigates the power relations involved in the medicalization and commodification of menopause and the many interests at stake beyond the health of women. My historical analysis of the construction of menopause through a postcolonial lens includes a historical review of menopause that contextualizes women's experiences of menopause within social relations of gender, race and class and political, economical and socio-cultural structures. I trace the historical processes by which White Eurocentric knowledge gained dominance in Canada and the privileging of White Eurocentric biomedical knowledge that leaves unrepresented those who do not belong to the dominant group. Biomedical knowledge can then be seen as an expression of power relations. I document how biomedical discourse presented as the view of menopause suppresses other forms of menopause knowledge as well as how women's bodies can become sites for the operation of colonial power through dominant knowledge. An analysis of my interviews with currently practicing biomedical physicians discloses how their approaches to menopause both reproduce and challenge a medicalized understanding as they work within the confines of biomedicine and the health care system. My analysis of interviews with 20 women offers a way in to discuss: (1) how women engage with dominant menopause discourses---the ambiguities, concerns, challenges, and the rejecting, buying into and modifying of these discourses; (2) how power relations of race, class and gender organize the conditions for women's menopause constructions; and (3) the everyday details of the exploitation of women's menopausal bodies through commodification for profit. I advocate for state health care changes to conceptualize menopause as normality rather than as abnormality. Individual women themselves cannot make all the changes by accepting lifestyle and personal health responsibility discourses. I discuss the dismantling of the hegemony of biomedical knowledge through multiple approaches to menopause, acknowledging the challenges of dealing with the power and interests of the pharmaceutical industry and the biomedical communities. I propose research investigating women's embodiment of menopause through and with their bodies, exploring why certain menopause discourses are more important to some women than others, and inquiring into the silence around the difference of women's menopause experiences.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.009 | 0.015 |
| Meta-epidemiology (narrow) | 0.001 | 0.001 |
| Meta-epidemiology (broad) | 0.001 | 0.000 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.014 | 0.022 |
| Scholarly communication | 0.008 | 0.007 |
| Open science | 0.001 | 0.008 |
| Research integrity | 0.003 | 0.005 |
| Insufficient payload (model declined to judge) | 0.005 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".