Contestations of Transgender Rights and/in the Strasbourg Court

Transgender rights are a highly contested issue, upsetting the ‘normal’ ordering of society. In Europe, transgender persons continue to suffer discrimination and harassment, and their rights are contested time and again. Eventually they can turn to the European Court of Human Rights (the Court) in Strasbourg. In such politically sensitive matters, how do judges in Strasbourg decide? Do they set European norms bolstering transgender rights, or do they refrain from interference in state affairs? Testing expectations based on rational and sociological institutionalism, this article analyses all 33 Court cases on transgender issues since 1980. As a judge’s low score on trans rights in their home country does not mean that they vote against trans rights, and as judges do no defend their home country but vote with the ‘pro-state’ or ‘pro-trans’ majority, rationalist expectations were not confirmed. Sociological institutionalist processes of widening and narrowing tell us more about the hesitant and uneven strengthening of transgender rights, if within the limits of binary thinking as regards the transgender body, marriage and family

Identifying context factors explaining physician's low performance in communication assessment: an explorative study in general practice

BACKGROUND Communication is a key competence for health care professionals. Analysis of registrar and GP communication performance in daily practice, however, suggests a suboptimal application of communication skills. The influence of context factors could reveal why communication performance levels, on average, do not appear adequate. The context of daily practice may require different skills or specific ways of handling these skills, whereas communication skills are mostly treated as generic. So far no empirical analysis of the context has been made. Our aim was to identify context factors that could be related to GP communication. METHODS A purposive sample of real-life videotaped GP consultations was analyzed (N = 17). As a frame of reference we chose the MAAS-Global, a widely used assessment instrument for medical communication. By inductive reasoning, we analyzed the GP behaviour in the consultation leading to poor item scores on the MAAS-Global. In these cases we looked for the presence of an intervening context factor, and how this might explain the actual GP communication behaviour. RESULTS We reached saturation after having viewed 17 consultations. We identified 19 context factors that could potentially explain the deviation from generic recommendations on communication skills. These context factors can be categorized into doctor-related, patient-related, and consultation-related factors. CONCLUSIONS Several context factors seem to influence doctor-patient communication, requiring the GP to apply communication skills differently from recommendations on communication. From this study we conclude that there is a need to explicitly account for context factors in the assessment of GP (and GP registrar) communication performance. The next step is to validate our findings.We also thank the Dutch Ministry of Health for funding the collection and videotaping of routine GP consultations

Understanding network societies : two decades of large technical system studies

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In search of the networked nation. Transforming technology, society and nature in the Netherlands in the 20th century

In the Netherlands, the simultaneous construction of society and network technologies has a long history, yet it is only in the twentieth century that the Netherlands has become a veritable Network Society. Drawing on the vocabulary of the research field of 'large technical systems' and the empirical results of the Dutch national history of technology programme, this article argues that during this century technological, social and even natural landscapes were reshaped in processes of material network building. An investigation of selected cases (the development of the electricity supply, the food chain, the petrochemical industry, and nature conservation) shows a variety of development patterns, motives, interests, conflicts, and negotiations behind the seemingly universal human obsession regarding circulation and network building