From "career woman's" disease to "an epidemic ignored": Endometriosis in United States culture since 1948.

다국어 초록 (Multilingual Abstract)

From a “career woman's disease” of lifestyle to an “environmental consequence” of dioxin exposure, endometriosis has undergone a dramatic transformation since its initial classification as a “uterine disorder” in 1921. Fewer than 20 reports of endometrial tissue outside the uterus (the defining characteristic of endometriosis) appeared in medical journals prior to the 1920s. Today, however, endometriosis is estimated to affect 5 to 15 percent of women of childbearing age, or as many as 200 million women worldwide. The seemingly dramatic growth in endometriosis cases has led some commentators to describe the disease as “an epidemic ignored” in the 1990s. How did endometriosis, a disease that was once all but absent in medical (and popular) literature, come to assume a prominent role in reproductive science and the lives of millions of women? How and why has endometriosis become a contemporary “epidemic”?.
In my dissertation, I argue that changes in the incidence and cultural significance of endometriosis must be understood historically in relation to a complex web of interests, practices, and policies that have shaped knowledge about the disease. Endometriosis has been formed and re-formed in and through struggles over meaning involving diverse constituencies, including scientists, physicians, corporations, advocates, and/or women with the disease. Focusing on representations of endometriosis in biomedical, mass media, and advocacy texts since 1948 (the year in which the disease first appeared in popular literature), I trace social, cultural, and historical developments that have contributed to current ways of defining, representing, and understanding the disease. To explore the rise of the endometriosis “epidemic,” I offer a genealogical analysis of disease discourses that combines a close reading of a range of cultural texts with an analysis of cultural practices and institutions. I embrace a multi-theoretical perspective in my work, basing my analysis in feminist poststructuralist, feminist cultural studies, and social constructionist approaches to gender, the body, technology, and disease. My dissertation illuminates the vast array of meanings and definitions that have been attached to endometriosis in the last 50 years, emphasizing ways in which linguistic constructions have influenced the diagnosis, treatment, and/or lived experience of the disease.