婦女健康與“醫療化”：以停經期／更年期為例

Medicalization of Women's Health: Menopause/Climacteric as an Example

10.6255/JWGS.1998.9.145

張玨(Chueh Chang)；張菊惠(Chu-hui Chang)

婦女健康 ； 更年期 ； 醫療化 ； 女性荷爾蒙補充治療 ； women's health ； menopause ； medicalization ； hormone replacement therapy

婦女與兩性學刊

9期（1998 / 04 / 01）

145 - 185

繁體中文

健康照護是北美、紐澳、歐洲等國第二波女性主義思潮中備受關注的議題，「醫療化」則是婦女健康運動中最常被批判的議題。現今雖然婦女得以獲得健康照護，但卻無法確保能否掌控自己的健康。醫療專家宰制女體，並否絕婦女有參與決定自身生活的權力。甚而，醫療化的事件侵入婦女的日常生活，將健康婦女變成病人的角色。此外，大部分之衛生資源亦投注於醫療處置之研發，鮮少公共經費支持婦女健康促進。 在台灣，「醫療化」議題是受到忽視的。政府、民眾以及醫療界甚少提及此重要議題，甚至宣稱透過醫療化而使得婦女獲得較好的健康照護。有鑑於台灣醫療化議題所受到的忽視與研究不足，作者嘗試以更年期為例，檢視其是否在現存的台灣社會中有被醫療化的現象。 研究者以多元交叉檢視方法，使用下列之資料進行醫療化之檢視。(1)1993年與1997年之婦女更年期態度問卷調查。(2)1996至1997年關於荷爾蒙之報紙報導的內容分析。(3)深入訪談兩位婦產科女醫師與兩位中年婦女，關於女性荷爾蒙之使用。 研究結果顯示更年期確實有醫療化的傾向，醫師大力倡導女性荷爾蒙補充治療之好處，而忽略其禁忌與副作用之告知，婦女亦開始相信更年期是一種病。如果台灣從現在開始從事婦女健康運動，此議題仍有討論與爭辯之空間。我們需要有更多集體性的行動以改變社會，進而促進婦女健康，亦需要更多醫療化之社會層面與文化層面的基礎研究。

Health care was a major concern of second wave feminists in Northern America, Australia, New Zealand and Europe. ”Medicalization” has been one of most frequently critic issues in women's health movement. In nowadays, although women can obtain healthcare but they do not ensure to control over their health. The medical professional's domination denies of the right that women themselves should participate in important decisions about their own lives. Much worse, ”medicalization” even invades into women' daily life, and makes all healthy women become patients. Few public funding supports women's health promotion, most money goes to the medical treatment development. The issue of ”medicalization” has been neglected in Taiwan. All the government, the public (women),and the medical field rarely mentioned about this important issue. They even claim that they provide better health care through medicalization. Due to the negligence and inadequacy on the issue of ”medicalization” in Taiwan people, the authors took the new emerging issue” the menopause” to examine on whether it was medicalized or not in current Taiwan society. Based on the multimethods triangulation analysis, the authors used the following data to delineate the medicalization. (1) Two questionnaire surveys on the women's menopausal attitudes conducted in 1991-1992 and 1997. (2) Content analysis of the newspaper's titles reported on menopause and hormone during Jan, 1996 to Dec, 1997. (3) In-depth interviews of two female gynecologists and two female patients. Results showed that there did have a tendency of ”medicalization” on ”menopause”. The physicians were interested in promoting the effectiveness of hormone therapy but neglected the side effects. The women tended to believe that menopause was a disease. There are still rooms for discussion and debates, if we here in Taiwan do care for women's health and make it a significant political reality. We need to take more collective action to promote women's health through consciousness raising and policy reform. We need more studies on medicalization to avoid medical abuses.

1. 陳美霞(2011)。台灣公共衛生體系市場化與醫療化的歷史發展分析。臺灣社會研究季刊，81，3-78。
2. 傅大爲、成令方(2004)。初論台灣泌尿科的男性身體觀。臺灣社會研究季刊，53，145-204。
3. 林秀玉、辛旻靜(2017)。大學生對人工生殖科技的接受度與觀點。科學教育學刊，25(S)，463-484。
4. 盧孳艷、楊舒琴(2000)。台灣婦女停經的身體政治。The Journalof Nursing Research，8(5)，491-502。
5. 張菊惠、張玨(2003)。男性更年期研究的回顧。臺灣公共衛生雜誌，22(2)，97-107。
6. 張玨(2003)。更年期婦女健康是公共衛生政策的議題。臺灣公共衛生雜誌，22(4)，245-250。
7. 張天韻(2003)。男性的月經文化：建構與行動。應用心理研究，17，157-186。
8. (2018)。絕經的歷史研究－從「更年期」一詞談起。新史學，29(4)，179-223。
9. (2023)。臺灣的性別與醫療、公衛研究：一個個人的回顧。近代中國婦女史研究，42，185-210。