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Open Access Publications from the University of California

It's Not Taboo, It's Just Not Relevant : The Absent Presence of Sexuality in Medical Education

  • Author(s): Murphy, Marie Heather
  • et al.

This dissertation ethnographically examines the processes by which teaching and learning about human sexuality were accomplished at "Buena Vista" Medical School, a top-twenty medical school in the United States. Despite indications that sexuality is broadly relevant to medical practice, little sociological inquiry has considered the contemporary production of medical understandings about sexuality, particularly as they are constructed within medical education. Through participant observation and in- depth, semi-structured interviews with Buena Vista students and faculty, I examine the understandings about sexuality that were present at Buena Vista and the curricular processes through which they were produced. The sexuality education that took place at Buena Vista was characterized by haphazard input and fragmented output. A set of teachings about sexuality were provided within the formal curriculum, or the planned, officially-offered, required classes, that were not insubstantial in the aggregate. But this content was not developed through collective planning and did not contain a consistent, cohesive set of messages about what sexuality fundamentally means or is, or how it matters to medicine. These offerings within the formal curriculum were complicated by other simultaneously-occurring curricular processes. The informal curriculum sent a powerful, but highly variable set of messages about the presence and relevance of sexual diversity. A hidden curriculum of heteronormativity rendered a certain set of sexual possibilities familiar, obvious, and unremarkable, while keeping broad swaths of sexual diversity unfamiliar, invisible, or unintelligible. Although faculty and students recognized that anything associated with sexuality is potentially "sensitive" or capable of provoking discomfort, there was a null curriculum, or a lack of discussion of how to negotiate or mitigate this discomfort, thus reifying rather than challenging "sex negativity," or the notion that anything associated with sexuality is taboo. Bridging medical sociology, sociology of sexuality, and sociology of education, this research shows the particular utility of ethnographic methods for revealing how sexuality-related stigma may be produced even within settings in which participants are motivated to help others and have been exposed to norms that discourage overt homophobia and sexuality-related discrimination. It also underscores the importance of studying sexuality education in contexts other than secondary schools

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