Article ID: CBB804149903

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


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.
Baumohl, Jim
Engel, Jonathan
Flemming, Rebecca
Gorsky, Martin
Hess, Volker
Canadian Bulletin of Medical History/Bulletin Canadienne d'Histoire de la Medecine
Social History of Medicine
Centaurus: International Magazine of the History of Mathematics, Science, and Technology
Historical Studies in the Natural Sciences
History of Psychiatry
Medical History
Duke University Press
Boydell & Brewer
McGill-Queen's University Press
Oxford University Press
Wallstein Verlag
Health care
Public health
Social welfare
Hospitals and clinics
Medicine and government
Medicine and gender
Celsus, Aulus Cornelius
Clinton, Bill
Time Periods
20th century, late
21st century
20th century
19th century
18th century
20th century, early
United States
Great Britain
Rome (Italy)
American Medical Association
National Health Service (Great Britain)
University of Miami
University of Oslo

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