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Controlling sickness: The political economy of gay men's health care

Joel I Brodsky, University of Nebraska - Lincoln

Abstract

This study presents basic empirical sociological research on gay men's health care in the United States, described in its social institutional context. A typology of gay men's relations with their physicians has been constructed historically by the synergistic development of sodomy laws and medical ideology, and its subsequent challenge by the gay liberation movement. When the patient's sexuality is treated as a sickness, the patient is "pathologized." Patients may also be "gay" or "hidden", depending on whether the patient's sexual preference is or is not known to his physician. In the past gay men have received much of their medical treatment without identifying themselves to their physicians, and so medical discourse about gay men ignores many of their everyday health concerns. The emergence of visible gay male patients originated in the treatment of conditions which implied that the patient had had sexual relations with another man. A health care research model of gay men as a minority group comparable to more visible minorities (racial and ethnic minorities and women) is proposed. Data were obtained by administering hour-long in-person interviews to a racially and socioeconomically diverse sample of 38 self-identified gay men recruited in a rural midwestern state. Both fixed-response and open-ended questions were used. Comparisons were made with a random sample of men from the 1985 Nebraska Annual Social Indicators Survey. The gay sample reported less insurance, poorer health, less satisfaction and less control over their health care than the comparison group. However, they utilized the health care system to a greater extent. A minority group model of gay male health care was largely supported. Openness with physicians was a significant issue for respondents, exacerbated by concerns about A.I.D.S. and insurability. Respondents encounter discomfort and lack of communication about sexual issues. Psychotherapies which patients experience as supportive may replace destructive "pathologized" relations; but physical health care providers remain "intimate strangers", authoritative, but not necessarily caring. A research program to better understand gay men's health care is proposed.

Subject Area

Sociology|Social structure

Recommended Citation

Brodsky, Joel I, "Controlling sickness: The political economy of gay men's health care" (1989). ETD collection for University of Nebraska-Lincoln. AAI9022987.
https://digitalcommons.unl.edu/dissertations/AAI9022987

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