UC San Diego

Gender scholars argue that in Western culture hegemonic gender beliefs are widespread and stable, and individuals' access to resources and power are contingent upon their ability to conform to these ideals (Ridgeway and Correll 2004 ; West and Zimmerman 2002). However, they also argue that gender is a fluid and dynamic aspect of identity, as demonstrated by individuals' ability to revise personal notions of gender based on other salient features of identity, including, race, class, age, sexual orientation or physical (dis)abilities (Connell 1995 ; Fenstermaker and West 2002 ; Kimmel 2006 ; Ridgeway and Correll 2004 ; West and Zimmerman 2002). This dissertation uses male infertility as a case study for exploring what happens when the perceived foundations of masculinity are destabilized in the lives of heterosexual married men. Male factor infertility is a clinical condition that affects nearly half of the more than seven million infertile couples in the United States. For this original research study, I employed mixed qualitative research methods, including ethnographic observation in male infertility clinics, in-depth interviews with male infertility specialists, clinic staff, infertile men and their wives, and content analysis of medical texts and conference addresses, in order to examine how medical institutions and individuals socially construct male infertility. I argue that the social processes of constructing gender and negotiating masculinity are tightly intertwined with the process of constructing disease. Early in this dissertation I show that preconceived notions regarding women's responsibility for all aspects of reproduction have historically shaped popular understandings of male infertility and hindered the development and organization of male infertility as a medical specialty. I describe how medical practices are designed around preconceived notions of men as sexually knowledgeable and experienced, yet all the while strive to protect presumably fragile masculine identities. I detail the various ways infertile men work to redefine their condition in terms that downplay infertility's threat to masculinity. Throughout this dissertation I argue that gender-constructing and disease-constructing processes are inextricable, because notions of gender inform understandings of disease. When disease presents a threat to gender identities, individuals create new understandings of disease in order to negotiate and stabilize their personal gender identities