Biomedikalisering (BIO)

There seems to be a broad shift in the way the rights of trans-people are addressed and the way gender identities are perceived.  This new state of affairs calls for a closer look at the historical events that brought us here.

Awareness of transgender issues has increased rapidly during the last decade and exploded in Norway. Still, the history of medical interventions in transgender is understudied internationally. 

In this project we will explore the history of "transsexuality" and transgender during the last fifty years through the lens of biomedicalization. Different medical terms have been used to characterize, define, distinguish and pathologize biological, psychological and social sex. Biomedicin has challenged, changed and rejected disease categories and understandings of gender.

We will explore how biomedicine has both created new and stabilized former body and gender identities, and how it has opened up a new field of technoscience – techniques like hormone therapy, puberty blockers and sex reassignment surgery. We will further explore how patient involvement and activism shaped this development

We intend to explore treatment practices and conceptualization of illicit drug use since the 1960. From being understood as a “choice”, drug use and abuse became to be understood as a disease inflicted on the person dependent on drugs (Conrad and Schneider 1980, Keane 2002).

Norwegian drug policy has been directed towards the prevention of drug use, consequently punishing drug use hard, although there is a call to soften policies.

The literature on addiction are consistent with the standard “medicalization” framework. We will look at the medical terms used to characterize, define, distinguish and pathologize illicit drug use, and further how the process of demedicalization  (1960s) and  biomedicalization (1980s and 1990s) changed treatment practice. In the latter decade (largely as a result of the hiv-epedemic) there has been an introduction of harm reduction programs as well as the introduction of the substance treatment reform in 2004. We ask to what extent biomedical treatment practice changed bodies and identities and how such interventions competed with other forms of rehabilitation and with the penalty system. Further it is relevant to study how patient involvement and activism shaped the development, and to what extent medical terms used still have an effect in our current understanding of drug use.   

We will look at how biomedicalization has been used by political reformers from different ideological positions in their objectives for criminal justice reform, and to what extent this process has depended on other social processes within a given context, for instance criminalization.

Existing accounts of the growing role of psychiatry in the courtroom as part of a “medicalization of deviance”, tend to focus on a monolithic, infallible expertise of the psychiatrist in wielding a growing set of diagnostic tools which serve to displace forms of deviance from criminal law to psychiatric treatment. Yet the use of biomedical categories to treat mental illness in the courtroom has far more layers and actors than this simple narrative of ‘medicalization’ suggests. Psychiatrists and lawyers have participated together in movements to reform the US criminal justice system, and these efforts have connected with much broader political struggles over the ideal form and function of the American state.

The goal of this subproject is to explore the complex and often antagonistic ways in which different medicolegal experts sought to align scientific and legal expertise in the use of psychiatric diagnosis in the courtroom. In particular, we will explore the plurality of medical views on mental illness and culpability by engaging with figures like the forensic psychiatrist Hervey Cleckley and his political opponent Manfred Guttmacher. The center of their debate was a category of the psychopath, the medicolegal negative of the ‘insanity defense’: that is, a diagnosis which, when rendered, tended to make a courtoom more likely rather than less likely to hold a defendant culpable for a crime. We will also examine the co-production of standard legal categories of crimes in the context of standardizing, biomedicalizing categories of mental disorders in the Diagnostic and Statistical Manual of Mental Disorders (DSM, US handbook for health professionals). The project will further meditate on how these various movements disillusioned reformers with the potential applications of psychiatry to criminal justice in Norway compared with the United States.