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  • 1.
    Brüggemann, Jelmer
    et al.
    Linköping University, Department of Thematic Studies, Technology and Social Change. Linköping University, Faculty of Arts and Sciences.
    Guntram, Lisa
    Linköping University, Department of Thematic Studies, Technology and Social Change. Linköping University, Faculty of Arts and Sciences.
    Nedlund, Ann-Charlotte
    Linköping University, Department of Health, Medicine and Caring Sciences, Division of Society and Health. Linköping University, Faculty of Medicine and Health Sciences.
    On difficult patients and informal complaints2023Other (Other (popular science, discussion, etc.))
    Abstract [en]

    Thinking critically about the role of complaint in patient care, Jelmer Brüggemann, Lisa Guntram and Ann-Charlotte Nedlund explore the ’difficult patient’ as a medical humanities concept.

  • 2.
    Brüggemann, Jelmer
    et al.
    Linköping University, Department of Thematic Studies, Technology and Social Change. Linköping University, Faculty of Arts and Sciences.
    Guntram, Lisa
    Linköping University, Department of Thematic Studies, Technology and Social Change. Linköping University, Faculty of Arts and Sciences.
    Nedlund, Ann-Charlotte
    Linköping University, Department of Health, Medicine and Caring Sciences, Division of Society and Health. Linköping University, Faculty of Medicine and Health Sciences.
    The “Difficult Patient”: Dominant Logics and Misfits in Medicine2023In: Handbook of Social Sciences and Global Public Health / [ed] Pranee Liamputtong, Cham: Springer, 2023, p. 1-14Chapter in book (Other academic)
    Abstract [en]

    Medicine is organized around specific kinds of patients. In the cross-section of overarching biomedical narratives, international and national regulations and guidelines, and local practices, a particular kind of “ideal” patient is produced. The ideal patient embraces the larger biomedical paradigm, fits standardized diagnostic or treatment protocols, and behaves in expected and respectful ways. At the same time, its downside is created. Modern medicine’s narrow pathways create all sorts of “difficult patients.” Rather than focusing on the “difficult patient” as a psychological or relational struggle for individual care professionals or patients – a common focus in medical literature and debate – this chapter approaches the “difficult patient” as a phenomenon inherent in the ways in which medicine is organized. It shows how the difficult patient can provide an analytic lens through which individuals can see health care norms and logics in play. In particular, the chapter discusses how the difficult patient comes into being in “misfits” between dominant logics in medicine and individual patient lives and needs.

    The full text will be freely available from 2024-12-29 17:49
  • 3.
    Ericson, Jenny
    et al.
    Dalarna Univ, Sweden; Uppsala Univ, Sweden; Falun Cent Hosp, Sweden.
    Anagrius, Cecilia
    Falun Cent Hosp, Sweden.
    Rygaard, Agnes
    Falun Cent Hosp, Sweden.
    Guntram, Lisa
    Linköping University, Department of Thematic Studies, Technology and Social Change. Linköping University, Faculty of Arts and Sciences.
    Wendel, Sophia Brismar
    Danderyd Hosp, Sweden.
    Hesselman, Susanne
    Uppsala Univ, Sweden; Falun Cent Hosp, Sweden; Uppsala Univ, Sweden.
    Womens experiences of receiving information about and consenting or declining to participate in a randomized controlled trial involving episiotomy in vacuum-assisted delivery: a qualitative study2021In: Trials, E-ISSN 1745-6215, Vol. 22, no 1, article id 658Article in journal (Refereed)
    Abstract [en]

    Background: Information about and invitation to participate in a clinical trial involving an intervention during childbirth may cause fear or worry in pregnant women. The aim of this study was to describe nulliparous womens experiences of receiving an invitation to participate in a randomized controlled trial (RCT) of lateral episiotomy versus no episiotomy in vacuum-assisted delivery (EVA trial). Methods: This qualitative study was nested in the ongoing EVA trial. Data were collected through semistructured telephone interviews with 23 women regarding their experiences of the information and invitation to participate in the EVA trial. Interviews were audio-recorded and transcribed verbatim. A qualitative content analysis was used to analyse the interview contents. Results: Three main experience categories were identified among the participants. "Timing of trial information and understanding" revealed that women preferred to obtain information about the trial early on during pregnancy. "Reasons to consent to or decline participation in the trial" encompassed a variety of reasons for women to consent, such as goodwill for science or personal benefits, or to decline, such as not wanting to be randomized or fear of increased risk of having a vacuum-assisted delivery. "Thoughts evoked regarding childbirth" were diverse, ranging from not being affected at all to having increased anxiety. Conclusions: The womens experience of receiving an invitation to participate in an RCT of episiotomy in vacuum-assisted delivery varied widely, from immediately giving consent without further worries to increased anxiety or declining participation. Early and personal information with time for reflection was considered most satisfactory.

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  • 4. Order onlineBuy this publication >>
    Guntram, Lisa
    Linköping University, Department of Thematic Studies, Technology and Social Change. Linköping University, Faculty of Arts and Sciences.
    Ambivalent Ambiguity?: A study of how women with 'atypical' sex development make sense of female embodiment2014Doctoral thesis, comprehensive summary (Other academic)
    Abstract [en]

    Against a backdrop of feminist and social scientific research on sex, female embodiment, and normality this thesis aims to discern how young women, who in adolescence have learned that their bodies are developing in ways considered ‘atypical’ for the female sex, make sense of their bodies and their situation. In focus are the ways in which the women make sense of and negotiate female embodiment; how they, particularly in stories about their interactions with others, position their embodied selves; and how norms and beliefs about sexed embodiment, heterosexual practice, and in/fertility are strengthened and challenged in the interviewees’ sense-making. The data comprise 23 in-depth interviews with women who in adolescence have learned that they do not have a uterus and a vagina, or who have learned that they do not have two X chromosomes and have no, or non-functioning, ovaries. Through narrative and thematic analysis the thesis shows how the women’s sense-making can be obstructed by norms about female embodiment, heterosexual practice, and in/fertility, expressed through medical terminology and practice and in interaction with family, friends, and peers, as described by the interviewees. Concomitantly, as the thesis demonstrates, medical terminology can be experienced and function as a resource in the women’s sense-making. Diagnostic categories enable them to put the specificities of sex development into words and raise awareness about bodily variation. Furthermore, in their stories about others’ reactions to their bodies and about their experience and management of certain medical treatments, the women question norms about female embodiment, heterosexual practice, and in/fertility that were previously taken for granted. The complexity of the women’s sense-making is demonstrated through the ways in which the interviewees, on the one hand, align with norms about female embodiment, heterosexual practice, and in/fertility, and in which they, on the other hand, succeed in challenging the same. In this ‘juggling’ of reinforcement and resistance, the thesis argues, the women are found to expand rather than dismiss beliefs about female embodiment.  Thus, the thesis contributes with deepened knowledge about what it can be like to live with these specific conditions and with problematizations of how norms about female embodiment can be enacted and questioned.

    List of papers
    1. Creating, maintaining and questioning (hetero)relational normality in narratives about vaginal reconstruction
    Open this publication in new window or tab >>Creating, maintaining and questioning (hetero)relational normality in narratives about vaginal reconstruction
    2013 (English)In: Feminist Theory, ISSN 1464-7001, E-ISSN 1741-2773, Vol. 14, no 1, p. 105-121Article in journal (Refereed) Published
    Abstract [en]

    Analysing ten interviews with women diagnosed with and treated for congenital absence of the vagina, this article theorises the notion of ideal (hetero) relational normality. It explores how women in my case study negotiate, relate to and challenge this notion and examines the normative and bodily work for which it calls. The article specifically underscores the corporeal dimension of (hetero) relational normality. I argue that this notion of normality shapes the bodies of the women through medical interventions, while concurrently being reinforced through the corporeal shapings that the women undergo. These corporeal shapings consolidate enacted norms concerning heterosexuality and form understandings of female and male bodies. The analysis also reveals how these women nevertheless find ways to re-negotiate and question the notion of ideal (hetero) relational normality and its intertwinement with medical practice. The article contributes both to the critical examination of genital surgery and to feminist discussions of how to critically examine heterosexuality without rejecting it. Furthermore, it provides a deeper understanding of how medical interventions designed to create a vagina, or dilate a vagina considered too small, are made meaningful by the women affected.

    Place, publisher, year, edition, pages
    SAGE Publications (UK and US), 2013
    Keywords
    Disordered sex development; heterosexuality; narrative; normality; vaginal agenesis; vaginal reconstruction; young women
    National Category
    Social Sciences
    Identifiers
    urn:nbn:se:liu:diva-104853 (URN)10.1177/1464700112468573 (DOI)000330303900007 ()
    Available from: 2014-02-28 Created: 2014-02-28 Last updated: 2019-11-26
    2. ‘You have all those emotions inside that you cannot show because of what they will cause’: Disclosing the absence of one’s uterus and vagina
    Open this publication in new window or tab >>‘You have all those emotions inside that you cannot show because of what they will cause’: Disclosing the absence of one’s uterus and vagina
    2016 (English)In: Social Science and Medicine, ISSN 0277-9536, E-ISSN 1873-5347, Vol. 167, p. 63-70Article in journal (Refereed) Published
    Abstract [en]

    This article examines young women's experiences of telling others that they have no uterus and no, or a so-called small, vagina – a condition labelled ‘congenital absence of uterus and vagina’, which falls within the larger category of ‘atypical’ sex development. Our aim is to investigate how affective dissonances such as fear and frustration are expressed in young women's narratives about letting others know about their ‘atypical’ sex development, and how these women narrate desired steps to recognition. By drawing on feminist writings on the performativity of affects or emotions, we examine what affective dissonances accomplish within three identified narratives: how affective dissonances may contribute to the women's positioning of themselves vis-à-vis other individuals and how affective dissonances can imply a strengthening and/or questioning of norms about female embodiment and heterosexuality. This allows us to tease out how routes for questioning of these norms become available through the three narratives that together form a storyline of coming out about a congenital absence of a uterus and vagina in the Swedish context. Furthermore, by demonstrating how others' responses shape the women – their understandings of their own bodies, their envisaged future disclosures and their relations – our analysis highlights the multifaceted intersubjective and in other ways relational, affective and temporal dimensions of coming out about one's 'atypical' sex development.

    Place, publisher, year, edition, pages
    Elsevier, 2016
    Keywords
    Emotions, intersex, Disorder of sex development (DSD), vagina, uterus, coming out, Sweden, Affective dissonance
    National Category
    Social Sciences Interdisciplinary Gender Studies
    Identifiers
    urn:nbn:se:liu:diva-111097 (URN)10.1016/j.socscimed.2016.08.028 (DOI)000384871300008 ()27598551 (PubMedID)
    Note

    At the time for thesis presentation publication was in status: Manuscript

    Funding agencies: Pro Futura Scientia Fellowship; Swedish Collegium for Advanced Study; Uppsala University; Riksbankens Jubileumsfond; Department of Thematic Studies, Linkoping University

    Available from: 2014-10-07 Created: 2014-10-07 Last updated: 2021-12-29Bibliographically approved
    3. "Differently normal" and "normally different": Negotiations of female embodiment in women's accounts of 'atypical sex' development
    Open this publication in new window or tab >>"Differently normal" and "normally different": Negotiations of female embodiment in women's accounts of 'atypical sex' development
    2013 (English)In: Social Science and Medicine, ISSN 0277-9536, E-ISSN 1873-5347, Vol. 98, p. 232-238Article in journal (Refereed) Published
    Abstract [en]

    During recent decades numerous feminist scholars have scrutinized the two-sex model and questioned its status in Western societies and medicine. Along the same line, increased attention has been paid to individuals experiences of atypical sex development, also known as intersex or disorders of sex development (DSD). Yet research on individuals experiences of finding out about their atypical sex development in adolescence has been scarce. Against this backdrop, the present article analyses 23 in-depth interviews with women who in their teens found out about their atypical sex development. The interviews were conducted during 2009-2012 and the interviewees were all Swedish. Drawing on feminist research on female embodiment and social scientific studies on diagnosis, I examine how the women make sense of their bodies and situations. First, I aim to explore how the women construe normality as they negotiate female embodiment. Second, I aim to investigate how the divergent manners in which these negotiations are expressed can be further understood via the womens different access to a diagnosis. Through a thematic and interpretative analysis, I outline two negotiation strategies: the "differently normal" and the "normally different" strategy. In the former, the women present themselves as just slightly different from normal women. In the latter, they stress that everyone is different in some manner and thereby claim normalcy. The analysis shows that access to diagnosis corresponds to the ways in which the women present themselves as "differently normal" and "normally different", thus shedding light on the complex role of diagnosis in their negotiations of female embodiment. It also reveals that the women make use of what they do have and how alignments with and work on norms interplay as normality is construed.

    Place, publisher, year, edition, pages
    Elsevier, 2013
    Keywords
    Sweden; Normality; Negotiation; Diagnosis; Female embodiment; Atypical sex development; Qualitative analysis; Young women
    National Category
    Social Sciences
    Identifiers
    urn:nbn:se:liu:diva-104132 (URN)10.1016/j.socscimed.2013.09.018 (DOI)000329273600029 ()
    Available from: 2014-02-07 Created: 2014-02-07 Last updated: 2019-11-26
    4. Hooked on a feeling?: Corporeal connectedness and relationality in infertility accounts
    Open this publication in new window or tab >>Hooked on a feeling?: Corporeal connectedness and relationality in infertility accounts
    2018 (English)In: Health, ISSN 1363-4593, E-ISSN 1461-7196, Vol. 22, no 3, p. 259-276Article in journal (Refereed) Published
    Abstract [en]

    Sociocultural meanings accorded to infertility, and rapid developments in assisted reproductive technologies, have long been central concerns in feminist and social scientific research. However, knowledge is scarce concerning how individuals make sense of infertility when it is disclosed in adolescence, for example as the result of an ‘atypical’ sex development, rather than as a result of failed conception. This article examines how understandings of desires, kinship and ‘solutions’ take shape and are negotiated in the accounts women give of infertility resulting from ‘atypical’ sex development. Through a thematic analysis it demonstrates how the interviewees described their desire for relationships and connectedness, which they considered to be made possible through pregnant embodiment, and details how these desires connected to a preference for medical ‘solutions’. Specifically, the article discusses how the interviewees’ accounts exemplifies how biological kinship can be ‘done’ without giving precedence to genetics. By addressing the specificities of finding out about infertility as a result of ‘atypical’ sex development, it furthermore highlights gaps in the common medical definition of infertility. These findings underscore the urgency of examining how definitions of infertility obscure certain experiences and consequently limit affected individuals’ access to support and treatment. In conclusion, it is suggested that the article contributes to a more positive discourse on infertility in feminist scholarship by teasing out the temporal dimensions of how affected individuals ‘make active use’ of assisted reproductive technologies to mitigate uncertainty and maintain hope, while at the same time renegotiating dominant norms of kinship.

    Place, publisher, year, edition, pages
    Sage Publications, 2018
    Keywords
    chronic illness and disability, experiencing illness and narratives, gender and health
    National Category
    Social Sciences Interdisciplinary Gender Studies
    Identifiers
    urn:nbn:se:liu:diva-111099 (URN)10.1177/1363459317693403 (DOI)000429809800004 ()28401811 (PubMedID)
    Available from: 2014-10-07 Created: 2014-10-07 Last updated: 2019-11-26Bibliographically approved
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    Ambivalent Ambiguity?: A study of how women with 'atypical' sex development make sense of female embodiment
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  • 5.
    Guntram, Lisa
    Linköping University, Department of Medical and Health Sciences, Division of Health and Society. Linköping University, Faculty of Arts and Sciences.
    Creating, maintaining and questioning (hetero)relational normality in narratives about vaginal reconstruction2013In: Feminist Theory, ISSN 1464-7001, E-ISSN 1741-2773, Vol. 14, no 1, p. 105-121Article in journal (Refereed)
    Abstract [en]

    Analysing ten interviews with women diagnosed with and treated for congenital absence of the vagina, this article theorises the notion of ideal (hetero) relational normality. It explores how women in my case study negotiate, relate to and challenge this notion and examines the normative and bodily work for which it calls. The article specifically underscores the corporeal dimension of (hetero) relational normality. I argue that this notion of normality shapes the bodies of the women through medical interventions, while concurrently being reinforced through the corporeal shapings that the women undergo. These corporeal shapings consolidate enacted norms concerning heterosexuality and form understandings of female and male bodies. The analysis also reveals how these women nevertheless find ways to re-negotiate and question the notion of ideal (hetero) relational normality and its intertwinement with medical practice. The article contributes both to the critical examination of genital surgery and to feminist discussions of how to critically examine heterosexuality without rejecting it. Furthermore, it provides a deeper understanding of how medical interventions designed to create a vagina, or dilate a vagina considered too small, are made meaningful by the women affected.

    Download full text (pdf)
    fulltext
  • 6.
    Guntram, Lisa
    Linköping University, Department of Medical and Health Sciences, Division of Health and Society. Linköping University, Faculty of Arts and Sciences.
    "Differently normal" and "normally different": Negotiations of female embodiment in women's accounts of 'atypical sex' development2013In: Social Science and Medicine, ISSN 0277-9536, E-ISSN 1873-5347, Vol. 98, p. 232-238Article in journal (Refereed)
    Abstract [en]

    During recent decades numerous feminist scholars have scrutinized the two-sex model and questioned its status in Western societies and medicine. Along the same line, increased attention has been paid to individuals experiences of atypical sex development, also known as intersex or disorders of sex development (DSD). Yet research on individuals experiences of finding out about their atypical sex development in adolescence has been scarce. Against this backdrop, the present article analyses 23 in-depth interviews with women who in their teens found out about their atypical sex development. The interviews were conducted during 2009-2012 and the interviewees were all Swedish. Drawing on feminist research on female embodiment and social scientific studies on diagnosis, I examine how the women make sense of their bodies and situations. First, I aim to explore how the women construe normality as they negotiate female embodiment. Second, I aim to investigate how the divergent manners in which these negotiations are expressed can be further understood via the womens different access to a diagnosis. Through a thematic and interpretative analysis, I outline two negotiation strategies: the "differently normal" and the "normally different" strategy. In the former, the women present themselves as just slightly different from normal women. In the latter, they stress that everyone is different in some manner and thereby claim normalcy. The analysis shows that access to diagnosis corresponds to the ways in which the women present themselves as "differently normal" and "normally different", thus shedding light on the complex role of diagnosis in their negotiations of female embodiment. It also reveals that the women make use of what they do have and how alignments with and work on norms interplay as normality is construed.

    Download full text (pdf)
    fulltext
  • 7.
    Guntram, Lisa
    Linköping University, Department of Thematic Studies, Technology and Social Change. Linköping University, Faculty of Arts and Sciences.
    Hooked on a feeling?: Corporeal connectedness and relationality in infertility accounts2018In: Health, ISSN 1363-4593, E-ISSN 1461-7196, Vol. 22, no 3, p. 259-276Article in journal (Refereed)
    Abstract [en]

    Sociocultural meanings accorded to infertility, and rapid developments in assisted reproductive technologies, have long been central concerns in feminist and social scientific research. However, knowledge is scarce concerning how individuals make sense of infertility when it is disclosed in adolescence, for example as the result of an ‘atypical’ sex development, rather than as a result of failed conception. This article examines how understandings of desires, kinship and ‘solutions’ take shape and are negotiated in the accounts women give of infertility resulting from ‘atypical’ sex development. Through a thematic analysis it demonstrates how the interviewees described their desire for relationships and connectedness, which they considered to be made possible through pregnant embodiment, and details how these desires connected to a preference for medical ‘solutions’. Specifically, the article discusses how the interviewees’ accounts exemplifies how biological kinship can be ‘done’ without giving precedence to genetics. By addressing the specificities of finding out about infertility as a result of ‘atypical’ sex development, it furthermore highlights gaps in the common medical definition of infertility. These findings underscore the urgency of examining how definitions of infertility obscure certain experiences and consequently limit affected individuals’ access to support and treatment. In conclusion, it is suggested that the article contributes to a more positive discourse on infertility in feminist scholarship by teasing out the temporal dimensions of how affected individuals ‘make active use’ of assisted reproductive technologies to mitigate uncertainty and maintain hope, while at the same time renegotiating dominant norms of kinship.

  • 8.
    Guntram, Lisa
    Linköping University, Department of Thematic Studies, Technology and Social Change. Linköping University, Faculty of Arts and Sciences.
    May I have your uterus?: The contribution of considering complexities preceding live uterus transplantation.2021In: Medical Humanities, ISSN 1468-215X, E-ISSN 1473-4265, Vol. 47, no 7, p. 425-437Article in journal (Refereed)
    Abstract [en]

    Uterus transplantation combined with in vitro fertilisation (IVF) (henceforth called UTx-IVF) as a treatment for infertility caused by an absence or malfunction of the uterus is advancing. About 50 transplantations have been conducted worldwide and at least 14 children have been born-9 of them by women taking part in a Swedish research project on UTx-IVF. The Swedish research protocol initially stated that the potential recipient must 'have her own donor' who is preferably related to the recipient. But what does it mean to ask someone for a uterus? What challenges does this question instigate? And what norms may it enact? In this article, I explore how 10 women-who have considered, and sometimes pursued, UTx-IVF-describe their experiences of searching for a donor. I aim to show how an analysis of such accounts can help us unpack some of the specific relational and gendered dimensions of UTx-IVF and by doing so enrich discussions of risks, benefits, care and support in UTx-IVF. Drawing on research in social sciences and medical humanities that has demonstrated how assisted reproductive technologies and organ donation can provoke social and familial conundrums, with respect to such topics as embodiment and identity, I present three patterns that describe different dimensions of the interviewees' quest for a uterus donor. I discuss the negotiations that took place, how expectations unfolded and how entanglements were managed as the interviewees considered asking someone for a donation. Such an examination, I suggest, contributes to make care and support more attuned to the experiences and entanglements that UTx-IVF entails for those pursuing it. This will become increasingly important if (or when) UTx-IVF becomes part of general healthcare. To conclude, I problematise responsibilities and relational challenges in medical innovation, and in this way provide insights into how the ethical debate over UTx-IVF can broaden its scope.

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  • 9.
    Guntram, Lisa
    Linköping University, Department of Thematic Studies, Technology and Social Change. Linköping University, Faculty of Arts and Sciences.
    Reproduction and Beyond: Imaginaries of Uterus Transplantation in the Light of Embodied Histories of Living Life Without a Uterus2022In: Reproductive Citizenship: Health, Technologies, Rights and Relationships / [ed] Rhonda Shaw, Singapore: Palgrave Macmillan, 2022, p. 127-152Chapter in book (Refereed)
    Abstract [en]

    In the medical literature, uterus transplantation has often been described as aiming to remedy the last untreatable form of female infertility. It also delivers what alternatives, such as surrogacy and adoption, cannot, namely genetic and gestational parenthood. However, as many social scientists and feminist scholars have shown, medically assisted human reproduction (AHR) does much more than produce babies and parents. 

    This chapter focuses imaginaries – collectively formed meanings and affects that shape how we experience our bodies and the social world – of uterus transplantation. Through an analysis of in-depth interviews with women who have pursued, or have considered pursuing, uterus transplantation it aims to show how certain social imaginaries materially shape bodies, life trajectories, and desires, and, consequently, women’s approaches to uterus transplantation. 

    Specifically, the chapter discusses the significance of the histories of those involved, and of shared social imaginaries of reproductive liberty, medical prospects, and female embodiment, when seeking to understand women’s motivations for pursuing medically assisted human reproduction (AHR). In conclusion, it argues that such considerations must be taken into account in policy discussions about the development of UTx-IVF.

    The full text will be freely available from 2024-06-24 10:38
  • 10.
    Guntram, Lisa
    et al.
    Linköping University, Department of Thematic Studies, Technology and Social Change. Linköping University, Faculty of Arts and Sciences.
    Johnson, Ericka
    Linköping University, Department of Thematic Studies, The Department of Gender Studies. Linköping University, Faculty of Arts and Sciences.
    Feminist Approaches to Using Other People’s Words: Two Examples2018In: SAGE Research Methods Cases Part 2, Sage Publications, 2018Chapter in book (Refereed)
    Abstract [en]

    This research methods case discusses how we use other people’s words—often collected through interviews—when informed by feminist methodology and theory. It presents different approaches to interview material (narrative analysis, discourse analysis, and conversation analysis) and considers how these epistemological approaches create “facts” (often called ontology) from “data.” We end by discussing how our use of interview material created different knowledge through the concept of onto-epistemology. We hope students will be left with an understanding of how one’s own positionality always affects what one sees in material. Using feminist methods and theories (and hoping students see the difficulties in drawing a strong distinction between methods and theories), we problematize a positivist understanding of qualitative research.

  • 11.
    Guntram, Lisa
    et al.
    Linköping University, Department of Thematic Studies, Technology and Social Change. Linköping University, Faculty of Arts and Sciences.
    Williams, Nicola Jane
    Univ Lancaster, England.
    Positioning uterus transplantation as a more ethical alternative to surrogacy: Exploring symmetries between uterus transplantation and surrogacy through analysis of a Swedish government white paper2018In: Bioethics, ISSN 0269-9702, E-ISSN 1467-8519, Vol. 32, no 8, p. 509-518Article in journal (Refereed)
    Abstract [en]

    Within the ethics and science literature surrounding uterus transplantation (UTx), emphasis is often placed on the extent to which UTx might improve upon, or offer additional benefits when compared to, existing treatment options for women with absolute uterine factor infertility, such as adoption and gestational surrogacy. Within this literature UTx is often positioned as superior to surrogacy because it can deliver things that surrogacy cannot (such as the experience of gestation). Yet, in addition to claims that UTx is superior in the aforementioned sense it is also often assumed (either implicitly or explicitly) that UTx is less fraught with ethical difficulties and thus should be considered a less morally problematic option. This article seeks to examine this assumption. Given that much UTx research has been performed in Sweden, a country where surrogacy is effectively although not currently explicitly forbidden, we do this through an analysis of the arguments underpinning a 2016 Swedish white paper which considered amending existing policy such that altruistic surrogacy arrangements would be permitted. By applying the white papers arguments for a restrictive position on altruistic surrogacy to the case of UTx using living altruistic donors we find that such arguments, if they hold in the case of surrogacy, apply similarly to UTx. We thus suggest that, for reasons of consistency, a similar stance should be taken towards the moral and legal permissibility of these two practices.

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  • 12.
    Guntram, Lisa
    et al.
    Linköping University, Department of Thematic Studies, Technology and Social Change. Linköping University, Faculty of Arts and Sciences.
    Zeiler, Kristin
    Linköping University, Department of Thematic Studies, Technology and Social Change. Linköping University, Faculty of Arts and Sciences.
    The Ethics of the Societal Entrenchment-approach and the case of live uterus transplantation-IVF2019In: Medicine, Health care and Philosophy, ISSN 1386-7423, E-ISSN 1572-8633, Vol. 22, no 4, p. 557-571Article in journal (Refereed)
    Abstract [en]

    In 2014, the first child in the world was born after live uterus transplantation and IVF (UTx-IVF). Before and after this event, ethical aspects of UTx-IVF have been discussed in the medical and bioethical debate as well as, with varying intensity, in Swedish media and political fora. This article examines what comes to be identified as important ethical problems and solu-tions in the media debate of UTx-IVF in Sweden, showing specifically how problems, target groups, goals, benefits, risks and stakes are delineated and positioned. It also demonstrates how specific assumptions, norms and values are expressed and used to underpin specific positions within this debate, and how certain subjects, desires and risks become shrouded or simply omitted from it. This approach—which we label the Ethics of the Societal Entrenchment-approach, inspired by Koch and Stemerding (1994)—allows us to discuss how the identification of something as the problem helps to shape what gets to be described as a solution, and how specific solutions provide frameworks within which problems can be stated and emphasised. We also offer a critical discussion of whether some of these articulations and formations should be seen as ethically troubling, and if so, why.

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  • 13.
    Guntram, Lisa
    et al.
    Linköping University, Department of Thematic Studies, Technology and Social Change. Linköping University, Faculty of Arts and Sciences.
    Zeiler, Kristin
    Linköping University, Department of Thematic Studies, Technology and Social Change. Linköping University, Faculty of Arts and Sciences.
    ‘You have all those emotions inside that you cannot show because of what they will cause’: Disclosing the absence of one’s uterus and vagina2016In: Social Science and Medicine, ISSN 0277-9536, E-ISSN 1873-5347, Vol. 167, p. 63-70Article in journal (Refereed)
    Abstract [en]

    This article examines young women's experiences of telling others that they have no uterus and no, or a so-called small, vagina – a condition labelled ‘congenital absence of uterus and vagina’, which falls within the larger category of ‘atypical’ sex development. Our aim is to investigate how affective dissonances such as fear and frustration are expressed in young women's narratives about letting others know about their ‘atypical’ sex development, and how these women narrate desired steps to recognition. By drawing on feminist writings on the performativity of affects or emotions, we examine what affective dissonances accomplish within three identified narratives: how affective dissonances may contribute to the women's positioning of themselves vis-à-vis other individuals and how affective dissonances can imply a strengthening and/or questioning of norms about female embodiment and heterosexuality. This allows us to tease out how routes for questioning of these norms become available through the three narratives that together form a storyline of coming out about a congenital absence of a uterus and vagina in the Swedish context. Furthermore, by demonstrating how others' responses shape the women – their understandings of their own bodies, their envisaged future disclosures and their relations – our analysis highlights the multifaceted intersubjective and in other ways relational, affective and temporal dimensions of coming out about one's 'atypical' sex development.

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  • 14.
    Zeiler, Kristin
    et al.
    Linköping University, Department of Thematic Studies, Technology and Social Change. Linköping University, Faculty of Arts and Sciences.
    Guntram, Lisa
    Linköping University, Department of Thematic Studies, Technology and Social Change. Linköping University, Faculty of Arts and Sciences.
    Sexed embodiment in atypical pubertal development: intersubjectivity, excorporation and the importance of making space for difference2014In: Feminist phenomenology and medicine / [ed] Kristin Zeiler, Lisa Folkmarson Käll, New York: State University of New York, 2014, p. 141-159Chapter in book (Refereed)
  • 15.
    Zeiler, Kristin
    et al.
    Linköping University, Department of Medical and Health Sciences, Health and Society. Linköping University, Faculty of Health Sciences.
    Guntram, Lisa
    Linköping University, Department of Medical and Health Sciences, Health and Society. Linköping University, Faculty of Health Sciences.
    Lennerling, Anette
    Sahlgrenska sjukhuset, Göteborg.
    Moral tales of parental living kidney donation: a parenthood moral imperative and its relevance for decision making2010In: Medicine, Health care and Philosophy, ISSN 1386-7423, E-ISSN 1572-8633, Vol. 13, no 3, p. 225-236Article in journal (Refereed)
    Abstract [en]

    Free and informed choice is an oft-acknowledged ethical basis for living kidney donation, including parental living kidney donation. The extent to which choice is present in parental living kidney donation has, however, been questioned. Since parents can be expected to have strong emotional bonds to their children, it has been asked whether these bonds make parents unable to say no to this donation. This article combines a narrative analysis of parents' stories of living kidney donation with a philosophical discussion of conditions for parental decision-making. Previous research has shown that parents often conclude that it is "natural" to donate. Our study shows that this naturalness needs to be understood as part of a story where parental living kidney donation is regarded as natural and as a matter of non-choice. Our study also highlights the presence of a parenthood moral imperative of always putting one's child's needs before one's own. On the basis of these results, we discuss conditions for decision-making in the context of parental LKD. We argue that the presence of a parenthood moral imperative can matter with regard to the decision-making process when parents consider whether to volunteer as living kidney donors, but that it need not hamper choice. We emphasise the need for exploring relational and situational factors in order to understand parental decision-making in the context of parental LKD.

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