Explanations as to the origins of the difference between males and females have existed since antiquity, but substantiated evidence for these is highly contested and controversial. Aristotle suggested that their source lay in the fact that women were biologically ‘defective’, amongst other reasons because they lacked bodily heat, something, which rendered them less perfect than men. In other ways, male and female bodies were considered structurally similar and ‘what could be seen of men’s bodies was assumed as the pattern for what could not be seen of women’s’ (Martin, P30).
Many gender scholars are currently modifying feminist theory to accommodate analyses of differences in power and privilege amongst the inter-male dominance
81
hierarchies described by Dominelli and Gollins (1997), which constitute the larger gender order. Busfield (1996) claims that an adequate theory of gender must be based on feminist foundations. However, if feminist theory itself is to develop, it needs to evolve and be ’mature' enough to recognise, as did Enlightenment intellectuals such as Hume (Essays, 560) and Choderlos de Laclos, that women should not be assumed by either other women or men to never themselves jockey for places in dominance hierarchies and achieve power simply because they have frequently been “victims” . Baier (1991), says that having been subject to deceit, exploitation and betrayal
’cannot be expected to make (women) less ready themselves to lie. cheat and betray’
(p234). This view severely undermines Wolf’s, (1996) and Noddings’ description of almost all typical women as self-abnegating, altruistic carers.
Gender relations are also subject to on-going negotiation within the workplace.
Whilst everyone is now aware of them, there has been little research into their implications for gender inequalities in mental health practice, in spite of the fact that male health care workers, whilst greatly outnumbered by their female colleagues, occupy a disproportionate number of senior positions in professional hierarchies' and.
somewhat ironically, are also far more likely to be subject to disciplinary hearings for professional misconduct2 * 1
1 The incidence of men amongst policy makers in nursing, for example, is quite disproportionate to their numbers in the profession as a whole. Two new professional officers were appointed to the UKCC (now N&MC) in 2001, both were male.
1 'The UKCC (now N&MC) id currently commissioning research into this area of concern. Whereas male members of the nursing professions comprise only 9% of the Register, almost 50% of the respondents on PCC (Professional Conduct Committee) hearings are men. More information needs to be gathered as to the types of allegations of misconduct that are made against male practitioners and
82
In view of this, Annandale and Hunt’s (2000) assertion that: ‘The closer we move towards embracing complexity, inevitably the closer we simultaneously move towards undermining the primacy of gender as difference, that is male/female as a binary division of power’ (p25) is intriguing. Recently, it has been suggested that gender should not be perceived as a set of fixed attributes and behaviour, but more as a process - ‘doing gender' - in which gender is continually ‘re-established, sustained or modified’, depending on the extent to which actions, and the rationales for these, conform to particular gender ideologies (Dunscombe & Marsden, 1998, Berk, 1985;
West and Zimmerman, 1987). Others claim that it is necessary to retain gender and sex as dichotomies in order to facilitate recognition of the means by which women are oppressed as ‘others’ and the implications of this for health care (Doyal, 1998, Scambler, 1998).
On this theme of 'selves' and ‘others’, Anthony Giddens (1991), referring to men and women, suggests that self-identity can be continuously rellexively rewritten. This is the result of a continuous dialogue with the self, in the face of new social experiences and dilemmas. This view is endorsed by Butler (1990) and Hood-Williams (1996) who stress the relative fluidity of gender as it is currently enacted in everyday life.
Dunscombe and Marsden (1998), on the other hand, suggest that the processes involved in becoming an ‘emotionally warm and sensitive new man’ or a ‘ruthless career woman' arc not simply those of re-inventing self-identity to make it
further scrutiny of the available data is necessary’ (UKCC, 1996, Issues arising from professional conduct complaints. p6)
83
correspond to a chosen gender ideal. ‘Doing gender’ involves ‘the more complex task of displaying the emotional skills, capacities and propensities to do emotional labour3 in a manner appropriate to the chosen gender ideology’ (p218). They believe that in this process individuals may experience a tension between the strain of the emotion work involved in reconciling the feeling ‘rules’ of the gender ideology to which they aspire and how they ‘really’ feel as a consequence of the 'core self’ or ‘core identity’
developed in childhood (ibid).
From the analysis of how male practitioners in mental health perceive themselves as carers and are perceived by users, it should be possible to ascertain whether this tension exists in the therapeutic use of the self in caring and emotional labour.
Gender structures appear to be changing in a manner likely to affect different social groups in diverse ways. Inevitably some similarities may emerge between men and women but the overall picture remains generally obscure. Hence the need to re
examine the gender inequalities inherent to health care from user and carer perspectives.