Dirty Bodies, Dirty Secrets, Dirty Earth: Transforming Restrictive Perspective of Menstruation and Women's Lives through Alternative Menstrual Products (骯髒的身體，骯髒的秘密，骯髒的地球：藉由另類生理期用品 (月亮杯) 轉換月經和女性生活的限制性視角)
Menstruation is a biological process affecting millions of women around the globe on a monthly basis. Although women’s experiences of their menses are idiosyncratic and context specific, dominant discourses on sanitation, pollution, and secrecy surround menstruation. This negative portrayal devalues women, as it stigmatizes their bodies, alienating them from themselves and those around them. Menstrual poverty (the inability to purchase sanitary menstrual products), combined with this secrecy, prevents some women from attending school or work – further alienating them. Conventional menstrual products often reinforce these dominant symbolisms (secrecy, dirtiness) while adding to environmental degradation.
Women-founded companies have begun to address the negativity surrounding menstruation through developing reusable menstrual cups, eliminating the costs of monthly menstrual products, the labor/risks involved in reusable pads and cloths, and the discomfort of bulky menstrual protection substitutes, while providing a sanitary product that is better for the environment and women's empowerment. Today more than 70 companies produce menstrual cups around the globe, all with unique messages on how their cup will improve the lives of women and change negative understandings of menstruation.
This three year Einstein Grant project funded by the Taiwanese Ministry of Science and Technology (2/2020-1/2023 - MOST 109-2636-H-038-003) aims to explore what messages these various companies portray and how these messages are positioned within broader concerns for the local context; how women perceive these concerns, how they experience using a menstrual cup, and, ultimately, how this use alters their experience of menstruation; last, how broader social dynamics are being transformed through the production and use of menstrual cups.
Shaw, Malissa Kay (in progress) Modern but taboo: Em/Disempowering discourses of Menstrual Cups, to be submitted to Gender & Society.
2. Women's Experiences of Gynecological Examinations
Under-Medicalization of Preventative Gynecological Screening: Exploring Women's and Gynecologists' Experiences of Routine Pelvic Examinations in Taiwan (預防性婦科篩檢的醫療化不足: 台灣婦女與婦科醫師的常規骨盆腔檢查經驗)
There is a discrepancy between the over-medicalization of pregnancy screening and birth practices and the under-medicalization of preventative gynecological screening practices in Taiwan. The technocratic value placed on certain medical interventions (e.g. genetic disease inheritance, assisted conception, and in-utero fetal surgery) over that of others has direct implications for women's health, in regards to both excessive intervention as well as limited care. Despite government initiatives in Taiwan to increase certain women's health preventative screening practices, specifically cervical cancer screening, quantitative studies indicate that screening remains irregular and underused by certain segments of society.
This study funded by the Taiwanese Ministry of Science and Technology (108-2410-H-038-003) aims to explore women's experiences of routine pelvic examinations in Taiwan, providing a qualitative, experiential dimension to this phenomenon while addressing the reasons why there is a gap in the over/under-medicalization of women's health. Theoretically speaking this study will contribute to the debate on medicalization, adding focus to a yet to be explored aspect of the phenomenon – under-medicalization. Additionally, using women's personal experiences as the lens to explore this phenomenon, will also provide insights for improving medical practice in the Taiwanese healthcare system, demonstrating how patients' needs can be better addressed through the existing infrastructure and what adaptations are required to accomplish better health outcomes.
This is a qualitative study, consisting of various stages including: semi-structured interviews with gynecologists and nurses in OBGYN wards and with members of women's health organizations, in-depth interviews with a diverse population of women who have experience undergoing pelvic examinations in Taiwan, and qualitative observation of pelvic examinations.
Shaw, Malissa Kay (in progress) Seeking professionalism: Women’s interactions with gynecologists in the Taiwanese healthcare system, to be submitted to Qualitative Health Research
3. Experiences of Assisted Reproductive Technologies
Assisted reproductive technologies (ARTs) are not innate medical tools, rather they are cultural specific artifacts that both shape and are shaped by the contexts in which they are utilized. Using this conceptualization of ARTs (biomedical technologies in general), I conducted a 10 month clinical ethnography that explored couples' and medical staffs' perceptions of utilizing ARTs in two fertility clinics in Bogota, Colombia. Before this ethnography was conducted there was limited research on ARTs in Latin American and none in Colombia.
My research revealed a context of limited legal regulation, and high competition and lack of collaboration between fertility specialists due to the nature of private medicine. These factors placed constrains as well as opportunities on both medical professionals and patients as they struggled to determine their position within the treatment process.
Tracing the experiences of women in infertility treatment chronologically, my analysis of this data explores how women knowledge was established and renegotiated through productive power fields that relationally incorporated embodied, personal knowledge, and authoritative medical expertise. Women adapted to constraints posed by medical professionals, the treatment processes, and social norms in both active and passive ways to create and assert their ever-transforming agentive capacities. In these processes, they were constantly reflecting on, and renegotiating their position in the treatment process, as well as in their social lives more broadly.
Drawing on, and seeking to contribute to, literature on agency in ARTs from across the world, particularly literature that considers agency as a process co-established by the constraints it confronts, this study makes two key arguments: First, that agency in Colombian ART clinics is defined as reflection and renegotiation, rather than as something which occurs at a singular moment of reflection and renegotiation. Second, that this negotiated process is constrained, but not contained. In other words, agency is a process that looks both backwards and forwards. Women and couples incorporated different personal histories and embodied knowledge into negotiating the treatment process and constraints they encountered, and adapted their experiences of ART treatments to other aspects of their lives, negotiating constraints that reach beyond the clinical setting.
Shaw, M.K. (under review) Embodied agency: Experiencing assisted conception as integrated beings, submitted to Body & Society
4. Perceptions of Stem Cell Research and Therapy
Healthcare Professionals' Perceptions of Stem Cell Research and Therapy and the Impact on Students' Learning
This project funded by Chang Gung Memorial Hospital (CDRPG3H0021) explores healthcare professionals' diverse perceptions of the rapidly developing field of stem cell research and therapy in Taiwan, and how their perceptions impact medical students' and trainees' learning. This is a multi-stage qualitative study that consists of a systematic literature review on healthcare professionals', healthcare students', patients', and donors' perceptions of stem cell research (the protocol for the review is registered with PROSPERO, CRD42018103627); semi-structured interviews with experts working in the field of stem cell research and therapy and healthcare professionals who engage with such therapies; observation of classroom and clinical training involving stem cells; and focus group discussions with medical students and trainees who have undergone classroom and clinical training related to stem cell therapy.
This study aims not only to contribute to our wider understanding of how stem cells are perceived by various groups and the factors that influence their perceptions, but also how new biomedical developments are received by the medical community and incorporated into learning activities. This study will also shed light on the concept of the 'hidden curriculum' as we explore what underlying or embedded notions about stem cells are ingrained in the messages educators and clinicians pass onto their students.
Henry F. Amey, Lynn V. Monrouxe, Mojca Babovic, Malissa Kay Shaw (in progress) Healthcare professionals', students', patients' and donors' perceptions of stem cell research: A systematic Review, to be submitted to Social Science and Medicine.
Amelia Rachel Chichester, Malissa Kay Shaw, Mojca Babovic, Lynn V. Monrouxe (in progress) Perceptions of healthcare professionals, healthcare students, patients and donors on stem cell therapy: A systematic review, to be submitted to Medical Education.