Society for Medical Anthropology

Medical Anthropology Quarterly (MAQ)

International Journal for the Analysis of Health

 

Vol. 21, No. 3: September 2007

 

editorial

• Horizons and Transitions: Past, Present, Future
  Mark Luborsky, Andrea Sankar

presidential statement

• Medical Anthropology at the Intersections
  Marcia C. Inhorn

articles

"Susceptibility Genes and the Question of Embodied Identity"
Margaret Lock, Julia Freeman, Gillian Chilibeck, Briony Beveridge, Miriam Padolsky

• Drawing on an assumption of the co-construction of the material and the social, late-onset Alzheimer's disease (AD) is used as an illustrative example to assess claims for an emergent figure of the “individual genetically at risk.” Current medical understanding of the genetics of AD is discussed, followed by a summary of media and AD society materials that reveal an absence of gene hype in connection with this disease. Excerpts from interviews with first-degree relatives of patients diagnosed with AD follow. Interviewees hold complex theories of causation. After genetic testing they exhibit few if any subjective changes in embodied identity or lifestyle. Family history is regarded by interviewees as a better indicator of future disease than is genetic testing. We argue that, even when molecular genetics are better understood, predictions about complex disease based on genotyping will be fraught with uncertainty, making problematic the concept of individuals as genetically at risk when applied to late-onset complex disease.
  

“Showing Roughness in a Beautiful Way”: Talk about Love, Coercion, and Rape in South African Youth Sexual Culture
Kate Wood, Helen Lambert, Rachel Jewkes

• Sexual violence within as well as outside sexual relationships has far-reaching public health and human rights implications and is a continuing focus of popular debate, media coverage, and research in postapartheid South Africa. Partly because it has been shown to affect individual vulnerability to HIV/AIDS, sexual violence has in recent years become framed as a global public health issue. International research efforts to document the scale of this personally and politically sensitive problem can encounter conceptual, definitional, and methodological difficulties that anthropology is well placed to assist in alleviating. This article offers an ethnographic exploration of the spectrum of practices relating to sexual coercion and rape among young people in a township in the former Transkei region of South Africa. Contextualizing meanings of sexual coercion within local youth sexual culture, the article considers two emic categories associated with sex that is “forced”: ukulala ngekani: “to sleep with by force” or ukunyanzela: “to force,” both usually used to describe episodes occurring within sexual partnerships; and ukudlwengula, used to describe rape by a nonpartner or stranger. The article discusses the semantic content of and differences between these two key categories, demonstrating that encounters described as “forced sex” encompass not only various forms of sexual coercion but also, particularly in the narratives of young men, instances of more consensual sex. Of importance, in turn, in defining an act as “rape” rather than as “forced sex” are the character of the relationship between the two parties and interlinked ideas relating to exchange and sexual entitlement, love, and the importance of “intention,” violation, and “deserving” victimhood.
  

"A Rose by Any Other Name? Rethinking the Similarities and Differences between Male and Female Genital Cutting"
Robert Darby, J. Steven Svoboda

• In this article, we offer a critical examination of the tendency to segregate discussion of surgical alterations to the male and female genitals into separate compartments—the first known as circumcision, the second as genital mutilation. We argue that this fundamental problem of definition underlies the considerable controversy surrounding these procedures when carried out on minors, and that it hinders objective discussion of the alleged benefits, harms, and risks. We explore the variable effects of male and female genital surgeries, and we propose a scale of damage for male circumcision to complement the World Health Organization's categorization of female genital mutilation. The origins of the double standard identified are placed in historical perspective, and in a brief conclusion we make a plea for greater gender neutrality in the approach to this contentious issue.

"The Meaning of the Present: Hope and Foreclosure in Narrations about People with Severe Brain Damage"
Eleonor Antelius

• In this article, I consider narratives told within a clinical setting. I argue that personnel in a day center for people with acquired brain damage are constantly involved in narrating about the disabled participants. The negotiation of who the participant is, and foremost will be, is in constant negotiation in regard to issues of hope. I further argue that hope is a meaning-making process and, as such, it has been defined as crucially connected to time. Hope has been said to enable a connection between the present and the future, because action taken in the present could bring about (positive) change in the future. However, I show that hope, in relation to narratives told about people with severe disabilities that are considered “incurable,” must be understood within a realm of narrative foreclosure. Time seems to have lost the openness of its horizon for these people, and a narrative that tells of immediacy rather than chronology is created, resulting in hope being established within the present.
  

public policy statement

• Alcohol, Drug, and Tobacco Study Group Takes a Stand: The WHO Framework Convention on Tobacco Control: An Urgent Call for U.S. Ratification
  Alcohol, Drug, and Tobacco Study Group