Article ID: CBB804149903

Bureaucratizing Medicine: Creating a Gender Identity Clinic in the Welfare State (2022)

unapi

This essay considers the creation of a gender identity clinic at Rikshospitalet, the National Hospital of Norway, in the early 2000s and its implications for the production of medical knowledge during that era. In the preceding decades, medical transition was overseen by an informal, self-organized, multidisciplinary team of medical experts, but this situation changed when a centralized gender identity clinic was established under psychiatric control. The essay argues that shifting institutional, societal, economic, legal, and bureaucratic circumstances redistributed expertise and authority on trans medicine. Economic framing, institutional frictions, patient activism, and media attention restricted the doctors’ room for maneuver and created a scientific crisis of legitimacy in trans medicine. These processes changed medical knowledge regarding medical transition; eventually, “sex change” and, therefore, all that is denoted by “sex” became intertwined with and inseparable from the politico-bureaucratic processes of reforming a modern public health-care system and welfare state. By anchoring the analysis in the history of science and expertise, this inquiry offers a new focus on the role of bureaucratic practices in the production, structuring, and circulation of medical knowledge in the welfare state.

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Authors & Contributors
Marchildon, Gregory P.
Bramanti, Barbara
Stenseth, Nils Christian
Sarah F. Liebschutz
Sampsa Saikkonen
Michael Pfeiffer
Concepts
Health care
Social welfare
Public health
Medicine and government
Hospitals and clinics
Authority of medicine
Time Periods
20th century, late
21st century
20th century
18th century
Modern
Medieval
Places
United States
Europe
Canada
Oslo (Norway)
Levant and Near East
Miami (Florida)
Institutions
University of Oslo
University of Miami
National Health Service (Great Britain)
American Medical Association
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