Malterud K
University of Bergen, Department of Public Health and Primary Health Care, BERGEN, NORWAY
Why bother about our patients’ gender? And why focus on women? What is empowerment, and why should the family physician encourage empowerment of women patients? How can empowerment be enacted in a clinical context, and which are the pitfalls and challenges emerging when doctors intend to empower their women patients? Patients are persons in a sociocultural context where being a man or a woman makes a difference for life in general, and for health specifically. Health, illness, and health care are gendered, reflected by differences between men and women on mortality, morbidity, health care utilisation, and living conditions such as survival, sustenance, violence, reproductive rights, economy, and political influence. Such differences can be traced back to repressive structures analogous to those operating on race, class, sexuality, or age. Assumed a gender neutral discipline, yet a male dominated culture of knowledge, medicine produces and reproduces cultural stereotypes on women, enacted through clinical interaction. Empowerment implies acknowledgement of the strengths of the oppressed, and counteracting oppression. The doctor needs to recognize oppression-gendered and otherwise within and beyond the consultation. Admitting responsibility to oppose reproduction of oppressive interaction is the starting point of empowerment. Providing a safe space, where the patient's strong sides can be acknowledged and supported, while experiences of abuse and oppression may be shared, is necessary to develop clinical strategies for empowerment. Examples will be presented. Challenges related to biological essentialism, individualizing, neglect of political and structural obstructions, and professional tendencies to avoid power discourses, will be discussed.