Changing bodies, changing discourses : women's experiences of early menopause

Early menopause has been constructed by discourses of biological determinism as an untimely, but natural, failure of the female body. Medical discourses in particular have interpreted early menopause as a congenital irregularity and a rare anomaly of menopause at midlife. In this thesis I challenge the notion that early menopause is an innate imperfection related only to women’s age. I propose that early menopause is dependent upon the cultural interpretations of individual women and is constituted through the mercurial and multiple discourses of women who have this embodied experience. Moreover, I reveal that early menopause is a contemporary condition and that its location in history is inextricably bound to discourses of risk, naturalism and the self. Further I make the assumption that having an early menopause both affects and is an effect of women’s fertility, sexuality and subjectivity. I have drawn upon a broad range of sources to provide a sociological analysis of early menopause. Literature on early menopause is dominated by positivist discourses, yet many alternate discourses negotiate these influential constructions. I suggest here that the perception of early menopause as a natural fault is merely a construction by medical discourses and does not incorporate the dynamic discourses of early-menopausal women. Moreover, the restriction of early menopause to a genetic female failure excludes the majority of women who have an early menopause through iatrogenisis. This omission occurs through the failure of positivist discourses to accommodate diversity in discourses. Recent sociological and feminist studies have vindicated menopausal women. They have reconstructed menopause through notions of embodiment and have removed the veil of negativity used by the medical sciences to contain menopausal women (Komesaroff, Rothfield and Daly 1997). The visibility of menopausal women, however, remains connected to age. Menopause has been created as a predictable consequence of aging and as such has come to be synonymous with middle age. Nowadays, even men are said to experience menopause at midlife (Carruthers 1996). But early menopause is constituted within the discourses of women who have this experience. Medico-scientific discourses, based upon theories of genetic inevitability, disregard this perspective. Consequently early menopause is subsumed by naturalistic discourses that relate menopause to midlife. Such restraint reflects the unease created by menopause that does not coincide with prescribed life stages. Women's experiences of their changing bodies are largely unheard. Thus, women who have an early menopause are faced with a chasm of ‘cultural non-recognition’ (Fraser 1997). Conjointly with this discursive repression early-menopausal women face social imbalances that are transacted as both cause and consequence of early menopause. In particular the contemporary creation of early menopause is bound to the social and historical location of women as a group. Women are exploited by the institution of medicine, ‘exposure to environmental toxicity’ (Fraser 1997: 11) and commercialization as causes of early menopause. Yet the corporeal effects of practices of risk avoidance (Beck 1993), social practices (Shilling 1993) and Western consumerism (Lupton 1994) fail to be recognized. I address these problematics through a poststructural and feminist critique that assumes moments of commonality among women, while at the same time recognizes shifting and multiple differences (Nicholson 1999). I suggest here that early menopause falls into cultural misrecognition in Fraser's (1997) terms and argue that it is united concurrently with the gender injustice of androcentrism (Fraser 1997: 21). Fraser (1997: 16) suggests that it is only by relating these dual problematics that we are able to make sense of current dilemmas. Thus I have critiqued early menopause through a connection between individual embodied experiences of early menopause and early menopause as a modern phenomenon that is specific to women. I have attempted to unravel these arguments that simultaneously call to ‘... abolish gender differentiation and to valorize gender specificity’ (Fraser 1997: 21) while at the same time acknowledging their interconnectedness. An approach of merely combining women’s discourses with overarching social issues would be inadequate as not only do these problematics intersect but they also can be opposed. As Fraser (1997: 25) notes with her theory, redressing one aspect of cultural or social analysis can further imbalance another. For instance making visible the diversity and uniqueness of individual experiences of early menopause could detract from acknowledging the contemporary construction of early menopause through social inequality. Crucial to this understanding is a destabilizing of the binary construction of differences between the sexes that makes way for a reconstruction of early menopause through ‘sexual slippage’ (Matus 1995). In this thesis I look for a subtlety between the particular and the collective that views early menopause as concurrently a singular and changeable experience as well as imbedded in social practice. I suggest that these concepts are entwined as interactive effects of early menopause. Thus I have analyzed the bivalent problematics of the embodiment and social location of early menopause as imbricated, dynamic and unending discourses. From this perspective I reviewed the literature that was available on early menopause. In Chapter One I look to descriptions of early menopause and note that it has disappeared into a conglomeration of disparate, mostly medical, discourses that are contradictory. Nevertheless medical discourses offer ‘conclusive’ definitions of early menopause that are based on naturalistic views of the body (Shilling 1994). The determinants used are inconsistent and do not include women's discourses of early menopause. Thus, dominant medical discourses obscure women’s embodied experiences of early menopause and ignore the contemporary causes of early menopause. In Chapter Two I examine the causes of early menopause as a way of explaining the disparity between medical discourses and my anecdotal observations of early menopause as a fairly common contemporary occurrence. The relatively recent escalation in gynaecological surgery, especially hysterectomy, appears to account almost single-handedly for early menopause as a current phenomenon. Moreover, the extraordinary number of women who have their uterus removed at hysterectomy can be interpreted as a modern implementation of ancient anxieties. Women's sexuality has been constructed throughout history as problematic and this unease has been translated through women's bodies as dangerous and in need of control (Greer 1992). Thus social concerns which have evolved historically have emerged through the representation of a woman's uterus as an unseen, dark and mysterious risk (Beck 1993). Medical discourses define this risk and are able to negate the so-called dangers of women's sexuality through the surgical removal of their organs. Widespread negotiation of medical discourses is apparent, as hysterectomy in the modern Western world is the most common of all surgical operations (Hufnagel 1989). It is overwhelmingly the most common cause of early menopause as well. I examine also the historical condemnation of infertile women and how this anxiety has been transposed to the modern world through the commercialization of reproduction. Transactions of this social unease can cause early menopause. For instance the medical technology of in-vitro fertilization (I.V.F.) has been offered as a panacea for the infertility of early menopause but, paradoxically, can cause early menopause as well. Conception through technology has been normalized as a viable option for women who are unable to conceive and understandings of I.V.F. have moved into everyday discourse. Medical discourses have constructed fertility as a saleable item and infertile women expect that they can purchase this merchandise. Human eggs have become lucrative commodities that now are available in the market place. Egg ‘donation’ for I.V.F. programs can hasten the attrition rate of eggs and can cause early menopause in some pre-menopausal women (Rowland 1992: 24). Even the recycling of a woman’s uterus supposedly has become a possibility through the transferring of this ‘used’ organ at hysterectomy to a recipient woman who can use the other woman’s uterus as a ‘gestational garage’ (Rogers 1998). In this way women have been disembodied as mechanical systems with inter-changeable body parts and the potentially detrimental consequences of these commercial transactions are ignored. In addition I show how early menopause can be caused by the connection between the self and the social structure. Women's subjectivity is constituted through the cultural discourses available to them and these discourses affect social behaviour (Lupton 1995). For instance smoking and dieting have been identified as causes of early menopause. These activities have been related to the creation of women’s bodies as hetero-sexually desirable and are endemic to young women (Evans-Young 1995). This suggests that cultural causes of early menopause are transactions of sexual politics. Yet there is a paucity of literature that acknowledges the relationship between women’s subjectivity and early menopause. Thus the second chapter exposes a link between sexual politics and causes of early menopause through women's relationships with risk, naturalism and the self. In Chapter Three I deconstruct early menopause through theoretical considerations. I rely on an overarching poststructuralism that embraces the concept of fragmented plural discourses and the subjectivity of menopausal women as a continuous process (Komesaroff 1997: 61). I have woven these variables through broad feminist critiques (Leonard 1997). Through this eclectic approach I hoped to find some loose alignment between the corporeal, ontological and embodied dimensions of early menopause. The recurring themes of sexuality, fertility and subjectivity emerge through deconstructing discourses of sexual difference as immutable and non-negotiable; exposing ‘premature ovarian failure’ as a discursive construction that censures early-menopausal women; and acknowledging the discourses of individual women as unique, diverse and dynamic. I looked to a method of exposing some of these individual discourses and in Chapter Four I describe a critical research process aimed at understanding early menopause as a lived experience. In the remaining chapters I align these ontological arguments with an analysis of the discourses of women who had experienced or were experiencing an early menopause. This section partly relieves the ‘cultural non-recognition’ of the discourses of early-menopausal women. I recorded the narratives of fifty early-menopausal women through in-depth interviews and used this empirical data to direct the study. This data provides the opportunity to understand early menopause as an assortment of embodied experiences. For instance women’s experiences of age at commencement of menopause spanned over three and half decades. They did not reflect the age specifications prescribed by medical discourses. Rather women interpreted their experiences within their own discourses and determined their menopause as early based upon the expectations of their cultural context. Many of the women experienced changes attributed to menopause at midlife. It was not these changes that were significant to early-menopausal women it was how each woman translated these changes that provided meanings of early menopause. In Chapter Five I introduce the women through a table that connects the varying experiences of each woman. This profile shows that, in the main, the women’s experiences of early menopause were unexpected. I suggest that this is due to the disparity between early-menopausal women’s experiences and the current age and social norms of menopause. By bracketing the women into cohorts patterns emerged displaying differences between women who had menopause in their teens, twenties, thirties and forties. Adolescent women had intense feelings of abnormality and despair. Women who were in their twenties were less devastated by menopause than the younger women but described their sexuality and self-identity as changing. And although some women in their thirties were shocked or dismayed to have an early menopause others were ambivalent or happy. These women also described their sexuality and self-identity through changing discourses. A number of the women who were in their forties said that they were ‘too young for the menopause’ but were far less despondent than the younger women. It seemed that the greater the distance between age norms and social norms the more negatively women responded. Age norms that determine the social norms of women's lives through a ‘biological clock’ are constructed to reflect social values. But age is a social construction that changes over time. Thus it would appear that women’s changing bodies and changing discourses of early menopause are in the process of recreating age and social norms around menopause. In Chapter Six I draw upon women’s narratives that describe a connection between early menopause and sexuality. Yet the respondents were not unified in their constructions of sexuality. For instance a number of the women rejected the containment of their sexuality as absolute and defined in terms of bi-lateral hetero-sexual opposition. The discourses of these women constructed their sexuality as continuously flexible. Some early-menopausal women described this sexual mobility as an equivocal relationship between their sexuality, reproductive capacity and female organs. Other women articulated their sexuality as vacillating, ambiguous and unrepresentative of the so-called ‘true woman’. Several felt that they were not meant to have female reproductive organs at all. Nearly one third of the women had had their uterus removed at hysterectomy and the reproductive organs of two women were rudimentary. Women’s narratives showed that the social value of fertility influences constructions of early menopause. In Chapter Seven I record the contrast between the poignant responses of women who wished to have a baby of their own and other women who resisted discourses that entwine reproductivity with being a woman. For instance some women negotiated fertility through economic discourses of consumerism with the expectation that they could purchase conception as a commodity. Other women welcomed their early menopause as freedom from contraceptive concerns and others had no interest in reproduction at all. Thus discord arose through discourses that problematize early-menopausal women as non-reproductive and discourses that value variability. In addition many of the women’s accounts constructed their subjectivity as mobile, challenging the notion that discourses of the self are immutable. Chapter Eight presents narratives which suggest that the subjectivity of many women was altered continuously by early menopause. Yet some of the women rejected the construction of their subjectivity as unfluctuating. These contradictions reflect the uncertainties of the contemporary world. Nevertheless most respondents found that the tethering of menopause to constructions of midlife was incongruous with their own experiences. Many women refused to accept the label of social redundancy attached to middle-aged women. They moved their subjectivity beyond the reproductive body to a shifting and tractable identity of the self. This thesis demonstrates that the medical construction of early menopause as a rare and natural female flaw varies from women's experiences which suggest that early menopause is common and discursively constructed. This disparity has occurred through the privilege placed upon the construction of bodies as immutable and sexually static. This privileging has obscured the multi-dimensional causes of early menopause and given preference to a mono-causal theory. By exposing the variety of causes of early menopause the medical construction of women through a universal and unalterable body of reproduction is challenged. Moreover, women's discourses of early menopause demonstrate that the medical reduction of early menopause to a spontaneous bio-chemical malfunction has ignored the volatility of women’s embodied experiences. Women experience early menopause variously and through mercurial discourses. I suggest here that women's discourses of their experiences of early menopause reflect recurring and restructuring philosophical quandaries of fertility, sexuality and subjectivity. While there can be no representative claims made from this thesis it contributes to an understanding of the embodied experiences of early menopause. It provides an understanding of the creation of early menopause through social practices and goes part way to redressing the problematics of what Fraser terms ‘cultural non-recognition’. But, more importantly, it acknowledges early menopause as a variety of experiences where women interpret their changing bodies through changing discourses.

Community attitudes to fertility and infertility

Assesses by survey some of the current community attitudes to fertility and infertility with reference to artificial insemination. Indicates that a pronatalist norm is dominant with some reservation in acceptance of artificial insemination by donor.

Understanding the tensions in place – conflict and conservation in Kashmir

The ongoing evolution of the global heritage movement has been marked by a move away from fabric-centred understandings of heritage, towards a language of ‘place’, ‘values’ and ‘stakeholders’. Recent initiatives like the ‘Vienna Memorandum on Historic Urban Landscapes’ and the ‘Seoul Declaration on Heritage and the Metropolis in Asia and the Pacific’ represent important steps in such directions for managing the heritage of urban environments. This paper examines these developments in the context of Srinagar, the capital city of Indian administered Kashmir. With the conflict in the region enduring for more than fifteen years, the city - regarded as one of the most important pre-modern urban landscapes in South Asia - has suffered extensive physical damage. Nonetheless, the city remains the cultural and political heart of a wider collective identity rooted in the Kashmir Valley. As such, Srinagar presents a rich example of a city that would strongly benefit from the insights gained from Seoul and Vienna; an approach that recognises how a sense of ‘place’ arises through an intimate dialogue between the built environment and the socio-cultural context within which it sits. However, as we shall see, a framework oriented around ‘values’ and ‘context’ opens up unfamiliar and difficult questions and challenges. If a city like Srinagar is to be discussed in more holistic, less fabric-based terms, the interfaces between heritage and its wider social values, such as cultural sovereignty, multi-culturalism or democracy require far greater attention than they have received to date.

The experience of old age in West Sumatra, Indonesia: Culture shift and cultural consonance in the modern era

The past four decades have seen enormous social change in Indonesia as the nation continues to experience rapid urbanization and social pressures in the globalized economy that have led to tensions between traditional cultures and the modern mainstream around the nation. This cultural shift has been felt strongly in West Sumatra, a region of Indonesia inhabited almost entirely by members of the matrilineal Minangkabau ethnic group. While the traditional social values of the area remain strong, they are eroding, and the Minang are becoming more like other Indonesians in terms of their family structure, occupations, and lifestyle. This has had a significant impact on the experience of old age as social and culture change has affected the traditional matrilineal structures that supported and ensured care for the elderly in past generations. This paper will describe the ways in which traditional institutions accommodated older individuals and describe how these systems have changed in the present day. Case studies across generations will be presented to illustrate the ways in which traditional matrilineal social structures are, and have been, perceived in the context of aging. Further, the paper will describe what this means for the elderly and their families in terms of cultural consonance in today’s society, and discussion will focus on the changing experience of old age in a society in transition against a backdrop of rapid urbanization and modernization.

CmyView: Walking together apart

Networked learning practices are impacting the field of cultural heritage, both tangible and intangible, with implications for the way in which places of cultural significance are understood, managed, documented, engaged with and studied. Our research explores the intersection between walking, photography, technology and learning, investigating how mobile devices can be used to foster community participation and assess social value within a networked framework for digital heritage. The paper introduces CmyView, a mobile phone application and social media platform in development, with a design concept grounded on both digital heritage and networked learning perspectives. CmyView encourages people to collect and share their views by making images and audio recordings of personally meaningful sites they see, while walking outdoors. Each person’s walking trajectory (along with their associated images and audio files) then becomes a trace-able artefact, something potentially shareable with a community of fellow walkers. The aim of CmyView is to encourage networked heritage practices and community participation, as people learn to assess their own and experience others social values of the built environment. Drawing on a framework for the analysis and design of productive learning networks, we explore the educational design of CmyView arguing that the platform offers a space for democratic heritage education and interpretation, where participatory urban curatorship practices are nurtured. CmyView reframes social value as dynamic, fluid and located within communities, rather than fixed in a place. The paper presents preliminary findings of the activity of a group of four undergraduate students at an Australian university, who used CmyView to explore the immediate surroundings of their campus. Participants interacted with the platform, mapping, capturing, audio recording their impressions and sites of interest in their walks. In so doing, they created shareable trajectories, which were subsequently experienced by the same group of participants on a second walk. The paper concludes with a discussion about the impact of our research for the design of mobile technologies that embrace participation and sharing, through a networked learning perspective. The paper brings together concepts that sit at the intersection of previously separate fields, namely digital heritage and networked learning, to find their synergies.

The significance of social influences and established housing values

Investment in housing represents the largest single source of wealth for individuals and has an important role in the macro economy. Traditional economic indicators cannot always observe the degree of purchaser and vendor willingness and therefore consideration should also be given to characteristics of buyers and sellers in the marketplace. This study draws the disciplines of housing research and demography closer and looks to social indicators for an insight into residential housing markets.

The research analysed changes in the value of established residential house prices in Brisbane and the influence of variations in social structure on a longitudinal time series basis. Results confirmed the existence of strong linkages between social constructs and established house prices. While it is acknowledged that established house values are significantly influenced by external! economic and political factors, this research confirmed that serious consideration must also be given to social factors and demographic variables.

Making modern lives: subjectivity, schooling and social change

Making Modern Lives looks at how young people shape their lives as they move through their secondary school years and into the world beyond. It explores how they develop dispositions, attitudes, identities, and orientations in modern society. Based on an eight-year study consisting of more the 350 in-depth interviews with young Australians from diverse backgrounds, the book reveals the effects of schooling and of local school cultures on young people's choices, future plans, political values, friendships, and attitudes toward school, work, and sense of self. Making Modern Lives uncovers who young people are today, what type of identities and inequalities are being formed and reformed, and what processes and politics are at work in relation to gender, class, race, and the framing of vocational futures.

Corners, squares and urban identities: perceptions, attitudes and values

In February 2000, the new Victorian Labor Government announced that they were removing the western shard from Lab Architecture Studio's winning Melbourne Federation Square design. then under construction. The specific 'contested terrain' at the intersection of Flinders Street and Swanston Street Walk. Melbourne, allows the exploration of the politics of place construction over time, through an examination of Young and Jackson's Hotel [1861]. St Paul's Cathedral [1886). Flinders Street Station [1912]. the Westin Hotel [1999) and Federation Square. This site brings together architectural and social history, questions public space and identity, and looks at Melburnian's perceptions, attitudes and values. It further demonstrates that the fragmentation of the professions, and fragmentary histories. lead to the preservation of 'bits' of architecture and the destruction of the urban/landscape context, jeopardizing the Identity of place.

'Publics' or 'stakeholders'? Performing social responsibility through stakeholder software

Government and corporate organizations increasingly seek the support of the communities where they operate and represent themselves as good corporate citizens with a sense of Corporate Social Responsibility (CSR). These organizations seek to create and sustain dialogue with their many and varied ‘stakeholders’ and reject traditional ‘PR’ approaches that regard communication as a way to manipulate ‘target publics’. Some of these organizations use a form of ‘stakeholder software’ to guide and support their efforts to embrace CSR in their operations and this article examines two such software packages. It sets their use and the broader drive for CSR in the context of a diminishing trust in traditional institutions and a rise in new, extra-parliamentary forms of activism (new activism); and it examines stakeholder software’s potential contribution to a values-based approach to PR training in universities and colleges.

Bringing shared values out of the shadows

As part of its wider promotion of a world that is peaceful and tolerant, the United Nations declared 2005 the International Year of Sport and Physical Education. At the fore of the UN's proclamation was recognition of the important role sport and PE play in nurturing the health and harmony of society. Sport and PE, the UN declared, provide important nodes for social connection around which shared values and understandings can be formed. In the wake of the UN's endorsement of the role that sport and PE can play in fostering social and emotional development, it is more important that ever that we reflect on and refine our practices towards this end. This paper draws on two research narratives to illustrate how easily this potential can be undermined. Indeed, behind some of the wonderful opportunities for connection that exist through a participation in PE and sport exists a dark shadow of alienation and oppression. The challenge raised through this paper centres on the need for PE teachers and coaches to work deliberately and strategically towards the cultivation of inclusive, tolerant and responsible forms of participation, and not leave their development to chance.

Social intervention or market intervention? A problem for governments in promoting the value of the Arts

The research design for this paper is based on the critical need for greater emphasis by Australian arts organizations on relationship marketing as a means of achieving sustainability. Recent injections of government funds into the performing arts in Australia, to meet a "crisis" in financial viability and audience development, highlighted the dependence of arts organizations on government funds in building audiences. A hypothesis was developed through an analysis of the literature on relationship marketing, cultural economics and value measurement, and an analysis of the long-term outcomes of government strategies for the funding of arts marketing. The hypothesis is that while social intervention is acceptable (even desirable and necessary), and achieves the social goals of governments, market intervention reduces the benefits of relationship-building and the exchange of values between arts organizations and their audiences.

Analysis of government documents and primary research in audience development proved the hypothesis. Empirical research resulted in the development of a theory and model that describe the limits of market intervention and in the development of a definition of values in the continuum of government activity from social to market intervention. The model could be useful for governments in developing arts policy with regard to audiencebuilding. It could also be useful in demonstrating to arts managers that sustainability results not from government funding but rather from relationship-marketing strategies.