I study the interplay among medicine, commerce, and culture in the United States in the 20th-21st centuries. I am especially interested in relationships among biomedical researchers, health care providers, lay people, drug makers, government regulators, and the media and how information flows between these groups. My research has focused on four main areas of inquiry:
1. Birth control
My first book, On the Pill: A Social History of Oral Contraceptives, 1950-1970 (Johns Hopkins, 1998), analyzed the development and subsequent impact of oral contraception on American society and culture during the 1950s and 1960s. It explored 1) the evolving role of science and medicine in attempting to solve what were previously considered social problems within a gendered framework of sexual roles and reproductive responsibilities; 2) the changing role of the popular media in conveying information about health and medicine; and 3) the enduring power and authority of the medical and pharmaceutical establishments, in spite of widespread challenges from feminist critics, consumer groups, governmental regulators, and the press. This work was supported by an NSF Graduate Fellowship and a Charlotte W. Newcombe Doctoral Dissertation Fellowship. I have recently returned to the subject of oral contraception with a project that considers the pill as a lifestyle drug.
I have also recently published two journal articles on the history of Norplant, the contraceptive implant. The first examined Norplant from its development in the 1960s, to its approval by the FDA in 1990, through its tumultuous reception in American society, to its removal from the market in 2000. I argued that the rejection of Norplant by women was influenced by the social and political climate of the 1990s, in which a feminist health agenda, a consumerist ideology in health care, a growing tendency toward class action litigation, and increasing distrust of the pharmaceutical industry worked together to empower women to take charge of their reproductive decision making. The second looked at Norplant qua technology and employed analytic frameworks from the social construction of technology to explain the trajectory of its brief history.
2. Hormones, gender, and aging
My second book, The Estrogen Elixir: A History of Hormone Replacement Therapy in America (Johns Hopkins, 2007), told the story of the rise and fall, and rise again and fall again of estrogen and its promise to forestall the diseases of aging and to maintain youthfulness in women. Three themes guided my explanation of the development, spread, and shifting fortunes of hormone replacement therapy in America: 1) the authority of medical science in American life and how the relationship between science and society shaped the dissemination and reception of HRT, 2) the significance of the medicalization of menopause and aging as estrogen fell in and out of favor, and 3) the cultural context of changing expectations and roles for older women in American society. This work was supported by an NEH Summer Stipend, an ACOG/Ortho-McNeil Fellowship in the History of American Obstetrics and Gynecology, a National Academy of Education/Spencer Foundation Postdoctoral Fellowship, and a three-year G13 Publication Grant from NIH/NLM.
I am currently working on a medical and cultural history of male menopause. This study fits into contemporary efforts to expand gender studies to include men's experiences along with those of women. By exploring the differential reductionism of hormones and aging bodies according to gender, I hope to contribute to a more nuanced understanding of the role of gender in the history of medicine. I have published two journal articles on this topic so far, with a third under review. The first described how the topic of male menopause occupied space on the medical radar screen from the late 1930s through the mid-1950s, then virtually disappeared for the next four decades, but was covered in the popular press from the mid-1950s through the mid-1990s in spite of its contemporary absence from the medical literature. I argued that male menopause became medicalized not by the driving forces of academic researchers and influential clinicians, but instead by a model perpetuated by laypeople and medical popularizers. The second addressed the question of why male menopause vanished from medical discourse in the 1950s and looked to both medical fashion and cultural conceptions of masculinity and aging to explain changes in the framing of this condition. The third looks at the reframing of the concept of male menopause in the 1990s and 2000s as andropause, then androgen deficiency in the aging male, then late-onset hypogonadism, and most recently low T. This shift is discussed in the context of two evolving trends: a changing conception of masculinity, particularly with respect to health and aging, and a reductionism in medicine that based the diagnosis of disease on quantitative measures. This project has been supported by a UC President's Research Fellowship in the Humanities in 2007-08 and an NEH Faculty Fellowship in 2010-11.
3. Information about pharmaceuticals
I co-edited a volume, Medicating Modern America: Prescription Drugs In History (NYU, 2007), that examined the rich and multifaceted history of pharmaceutical medicines in modern America since World War II through the discrete but interconnected histories of eight important drugs. The chapters of the book were linked by three themes: 1) the co-construction of diseases and treatments and the ways in which the definition of pathological states has been closely associated with the development and marketing of new drugs, 2) the drug-mediated process of medicalization, and 3) the communication of medical information about drugs and diseases.
I am currently engaged in co-editing another volume, titled Prescribed: Writing, Filling, Using, and Abusing the Prescription in Modern America (Johns Hopkins, forthcoming 2012). This book will push the history of late 20th century pharmaceuticals and therapeutics beyond the drugs themselves, to shine a spotlight on various actors and their interactions over how these medications are used. It uses the prescription as a shorthand reference for a set of complex relations among the producers, providers, and consumers of medicine, and shifts focus from the biographies, life cycles, and trajectories of individual drugs and specific classes of drugs to explore the processes by which these medications have moved through the social geography of health care. My chapter in this volume builds on my previous work on the history of the patient package insert (PPI) for prescription drugs; it investigates pharmacists' reactions to the patient package insert and uses the debates over the PPI as a focal point to examine pharmacists' perceptions of and constructions of their roles as purveyors of medicines and providers of health care. This work expands the relationship between doctors and patients from a two-party line into a three-party triangle, to include the central role played by pharmacists in mediating communication about prescriptions.
4. Stress and disease
Another manuscript-in-progress explores popular understandings of and references to stress as a cause of disease, looking at how and when stress made its way into common parlance in America. Here, stress serves as a case study of how a medical idea makes its way from professional discourse into everyday vernacular, as I continue my research into the transmission and translation of scientific and medical ideas from experts to the lay public.
“The Social Construction of a Contraceptive Technology: An Investigation of the Meanings of Norplant” Science, Technology & Human Values. January 2011; vol. 36, 1: pp. 33-54.
“Technophilia and the Pharmaceutical Fix” The Lancet. Volume 376, Issue 9753, (November 2010)1638–1639.
“From Breakthrough to Bust: The Brief Life of Norplant, the Contraceptive Implant” Journal of Women’s History. Volume 22, Number 3, (Fall 2010) E-ISSN: 1527-2036 Print ISSN: 1042-7961.
“Medicine, Masculinity, and the Disappearance of Male Menopause in the 1950s” Social History of Medicine 21: 2 (2008): 329-344.
“The Medicalization of Male Menopause in America” Social History of Medicine 20:2 (2007): 369-388.
“Parsing the Postmenopausal Pregnancy: A Case Study in the New Eugenics” New Formations 60 (Spring 2007): 27-34.