The health, social care and housing needs of lesbian, gay, bisexual and transgender older people: a review of the literature

This paper reports the findings of a literature review of the health, social care and housing needs of older lesbian, gay, bisexual and transgender (LGBT) adults undertaken in 2006 for the Welsh Assembly Government. Peer-reviewed literature was identified through database searches of BNI, PubMed, CINAHL, DARE, ASSIA and PsychInfo. Follow-up searches were conducted using references to key papers and journals as well as specific authors who had published key papers. A total of 187 papers or chapters were retrieved, of which 66 were included in the study; major themes were identified and the findings synthesised using a meta-narrative approach. The main themes that emerged from the review were isolation, health behaviours, mental health and sexual health behaviours. The literature indicates that the health, social care and housing needs of LGBT older people is influenced by a number of forms of discrimination which may impact upon the provision of, access to and take up of health, social care and housing services. Understanding of the health, social care and housing needs of older LGBT people is limited and research in this area is scarce. The research which exists has been criticised for using small samples and for tending to exclude participants from less affluent backgrounds. The focus of research tends to be on gay men and lesbians; consequently, the needs of bisexual and transgender people remain largely unknown. Additionally, research which does exist tends to focus on a narrow range of health issues, often related to the health needs of younger LGBT people. Discrimination in various forms has a major impact on needs and experiences, leading to marginalisation of LGBT people both in the provision of health and social care services and neglect of these groups in public health research

The effort to control time in the 'new' general practice

Since the 1980s and 1990s doctors in the UK have reported a lack of time; this has been reproduced in the reorganisation of work through various contracts and regulatory mechanisms. I draw on interviews with 32 General Practitioners (GPs) in Wales about their everyday work, focusing on accounts about the limited nature of their time. I use Adams’ analysis of the rationalisation of work time through the processes of commodification, compression, and colonisation, to explore tensions between traditional and new ways of doctoring. While it was possible to find evidence of traditional ways of managing time that shaped the activities of doctors and controlled those activities, the doctors were not passive participants in the rationalisation of work time. Rather they actively modified its processes using notions of professionalism that are aligned to traditional doctoring, and which offer new ways of doing and being a professional

The relationship between affect, subjectivity and care in the context of medicine

This paper addresses transformations in doctor's subjectivities in the context of debates about the increasingly complicated multidirectional, multisided processes of modernisation, technical innovation and other political and social changes in modern medicine (Clarke at al, 2003; Rose 2006). Data was drawn from interviews with 26 general practitioners (GPs) across Wales. Notably, diverse discourses of 'care' (ie those that drew on feminisation, medico-legal contexts, medical tradition, and governance) were used to produce an account of doctoring that was ambivalent, embodied yet which resonated with, and reframed traditional medical sociological ideas about the relationship between doctors and their patients. I further interrogate the question of 'what kind of modern medical health care professionals doctors expected to be' by suggesting that as general practice becomes separated from familiar sociological representations of 'caring', we need to consider the effect of multiple notions of 'care' on affective subjectivities of doctors in modern medicine. Pape

Cochlear implants: Intersubjective and uncanny medical technologies

Clarke et al (2005) argue that technoscientific innovations have produced a transformation in medicine producing ‘new bodies’ and ‘new ways of being’. This paper reviews the current academic research into adult and child cochlear implants; an area of rudimentary study into embodiment and lived experience. I assess how sociological research into cochlear implants engages with the body-world transformation of bodies and selves, and with the production of new hearing subjectivities that emerge from the manipulation of medical hearing. The context for this discussion is to rethink embodied (inter)subjectivity along the lines of the debate against cochlear implants and emerging work into the uncanny and disruptive nature of ‘medically restored hearing’ (Finlay & Molano-Fisher, 2007