“Difference” as Mode of Resistance in Jane Austen’s Emma

This paper explores “difference” as a locus for changing power relations in Jane Austen’s major novel Emma. While Austen’s preoccupation with courtships has been under scholarly investigations, it has not been properly considered as a tool of resistance: one that strives to displace power from physical force to a discursive one. This displacement is a strategic struggle of middle-class ascendency over aristocracy in a changing English milieu. The study examines courtships within two Foucauldian frameworks. The first one is disciplinary that aims to regulate sexual practices like panopticon---an apparatus of power, producing normative/heterosexual identity through surveillance. Embedded in the first is the second approach that examines the very assumptions of the panoptic discourse through ‘micro techniques of power’. It is the ability of her characters (especially the female) to reject not only undesirable sexual advances but desirable proposals as well that transform their otherwise passive and docile bodies into subjects to be reckoned with. In doing so, Austen does transform signs of class and rank into forms of expression as a pre-requisite for any exchange. This paper is an attempt to look into the power dynamics in the novel from a different angle---the angle of difference impacted by power/knowledge and discourse. Two sites of contestation are analyzed: the first played between Emma Woodhouse and Mr. Knightly, and the second between Mrs. Elton and Jane Fairfax. This transformation can explicitly be viewed in her novel Emma. Foucauldian insights are certainly innovative to a well-read Austen.

Queer Healthcare Communication

Queer healthcare communication spans different literature and topic areas. The medicalization of queer bodies has historically and continues to influence how queer individuals interact and communicate within healthcare settings. Further, heterosexism is rampant within medical institutions that perpetuate the idea that all patients are heterosexual. Because of the influence of heterosexism, medical schools are designed to ignore queer bodies. If queer bodies are acknowledged, they are positioned as something exotic and not presented as a typical patient. Heterosexism is further communicated in patient and provider interactions by providers assuming their patients’ heterosexual identity and assuming all queer patients are promiscuous. In turn, queer patients may make decisions about their healthcare based on providers’ heterosexist attitudes. Providers who practice medicine have also demonstrated their limited knowledge about queer patients and how to care for them. The literature on discrimination of queer patients focuses more on how providers have used both verbal and non-verbal forms of communication. In looking at queer discrimination, queer invisibility demonstrates more covert functions of healthcare communication. Due to the invisibility of queer patients, disclosure becomes a site of interest for researchers. While some queer patients try to seek out queer-friendly providers, researchers have given recommendations on how healthcare providers can improve their queer competency. Finally, some notable topics within queer healthcare communication include queer pregnancy, HIV, and why transgender identity should be a separate topic as transgender people have their own healthcare needs.

Fragile Heterosexuality

Previous research demonstrates that membership of majority groups is often perceived as more fragile than membership of minority groups. Four studies ( N1 = 90, N2 = 247, N3 = 500, N4 = 1,176) investigated whether this was the case for heterosexual identity, relative to gay identity. Support for fragile heterosexuality was found using various methods: sexual orientation perceptions of a target who engaged in incongruent behavior, free-responses concerning behaviors required to change someone’s mind about a target’s sexual orientation, agreement with statements about men/women’s sexual orientation, and agreement with gender-neutral statements about sexual orientation. Neither participant nor target gender eliminated or reversed this effect. Additionally, we investigated multiple explanations (moderators) of the perceived difference in fragility between heterosexual identity and gay identity and found that higher estimates of the gay/lesbian population decreased the difference between the (higher) perceived fragility of heterosexual identity and the (lower) perceived fragility of gay identity.

A decline in patient disclosure of heterosexuality in the English General Practice Patient Survey: a longitudinal analysis of cross-sectional data

Background Persistent health inequalities in relation to both health care experiences and health outcomes continue to exist among patients identifying with a marginalized sexual orientation (MSO). Objective To compare the patterns of sexual orientation disclosure within primary care in England over a 5-year period. Methods Descriptive analysis of cross-sectional, repeat measure, fully anonymized survey data of adults responding to the General Practice Patient Survey (GPPS) January 2012 to 2017. Participants from each year varied between 808 332 (2017) and 1 037 946 (2011/2012). Results The analysis samples comprised between 396 963 and 770 091 individuals with valid sexual orientation data depending on the year. For males, heterosexual disclosure decreased consistently from 92.3% to 91.2% from 2012 to 2017. Male patients reporting gay, bisexual and/or ‘other’ sexual orientations increased from 3.1% to 3.9%. For females, a larger reduction in heterosexual disclosure was recorded from 94% to 92.5%. Those reporting as lesbian, bisexual and/or ‘other’ increased from 1.82% to 2.68%, with the largest increase seen in the reporting of bisexuality, which nearly doubled from 2012 until 2017 (0.56–0.99%). Conclusion We found a year-on-year decline in patients reporting a heterosexual identity and an increase in the proportions of people reporting being either gay, bisexual, ‘other sexual orientation’ or preferring not to say. Heteronormative environments extend to health care settings, which may put increased stress on MSO individuals attending a GP practice. The introduction of environmental signs/symbols to show that a practice is inclusive of MSOs could reduce the potential stress experienced by patients.

Lesbian, Gay, Bisexual, and Transgender Issues

People identifying as lesbian, gay, bisexual, or transgender (LGBT) often experience unique issues and needs in the context of cancer care. These include experiences and fear of discrimination within heteronormative healthcare environments, assumptions of cisgender/heterosexual identity, exclusion of same-sex partners from care, and a lack of relevant supportive care and information resources. There are also unique impacts of cancer and treatment on LGBT sexuality and fertility. To provide the best possible care for LGBT people living with and after cancer, providers must understand the specific needs of LGBT people and be aware of strategies to deliver inclusive healthcare services. This chapter presents key background information to contextualize the needs of LGBT people with cancer before discussing specific challenges that LGBT people may face when accessing cancer care. We provide guidance for general cancer care, as well as specific concerns regarding the sexual health and fertility needs of LGBT patients. Finally, we outline issues for consideration by healthcare services seeking to advance LGBT awareness and improve care for this patient group.

Sex During Menstruation: Race, Sexual Identity, and Women’s Accounts of Pleasure and Disgust

This study analyzes qualitative interviews with 40 women across a range of age, race, and sexual orientation to examine experiences with sex during menstruation. Results show that 25 women describe negative reactions, two describe neutral reactions, and 13 describe positive reactions. Negative responses involve four themes: discomfort and labor to clean ‘messes,’ overt partner discomfort, negative self-perception, and managing partner’s disgust. Positive responses cohere around physical and emotional pleasure from sex while menstruating and rebellion against anti-menstrual attitudes. Race and sexual identity differences appear: White women and bisexual or lesbian-identified women describe more positive feelings than women of color or heterosexual women. Bisexual women with male partners describe more positive reactions than heterosexual women with male partners, implying that heterosexual identity relates to negative attitudes more than heterosexual behavior. Those with positive attitudes also enjoy masturbation more than others. Additionally, interviews address sexual and racial identities’ informing body practices, partner choice affecting body affirmation, and resistance against ideas about women’s bodies as ‘disgusting.’

The “Gay Voice” and “Brospeak”: Toward a Systematic Model of Stance

Taking Elinor Ochs’s (1992) notion of indirect indexicality as a starting point, this chapter explores the significance of stance for studies of sexuality. Stance helps organize identity registers and is thus central in the creation and display of sexuality. After defining stance and reviewing ways in which it has been used in studies of language and sexuality, the chapter analyzes representations of two sexual identity registers: a “gay voice” homosexual identity and a “brospeak” heterosexual identity. The analysis reveals how these representations are based on different configurations of stances that in turn constitute the differential enregisterment of personae or characterological figures. The chapter concludes with an outline of the ways that the concept of stance may be used in further research, especially with respect to the analysis of sexuality in interaction.