The Medicalization of Society: On the Transformation of Human Conditions into Treatable Disorders

by Peter Conrad

Over the past half-century, the social terrain of health and illness has been transformed. What were once considered normal human events and common human problems—birth, aging, menopause, alcoholism, and obesity—are now viewed as medical conditions. For better or worse, medicine increasingly permeates aspects of daily life. Building on more than three decades of research, Peter Conrad explores the changing forces behind this trend with case studies of short stature, social anxiety, "male menopause," erectile dysfunction, adult ADHD, and sexual orientation. He examines the emergence of and changes in medicalization, the consequences of the expanding medical domain, and the implications for health and society. He finds in recent developments—such as the growing number of possible diagnoses and biomedical enhancements—the future direction of medicalization. Conrad contends that the impact of medical professionals on medicalization has diminished. Instead, the pharmaceutical and biotechnical industries, insurance companies and HMOs, and the patient as consumer have become the major forces promoting medicalization. This thought-provoking study offers valuable insight into not only how medicalization got to this point but also how it may continue to evolve.

Genres: Nonfiction, Sociology, Medicine, Science, Health, Philosophy, Psychology

224 pages, Paperback

First published April 20, 2007

About the author

Librarian Note: There is more than one author in the GoodReads database with this name. See this thread for more information.

Reviews

[Thomas · Rating 4 out of 5]

Just as we now do with aging and ADHD, we once medicalized homosexuality and masturbation. In The Medicalization of Society, Peter Conrad argues that society pathologizes diversity and reduces people's acceptance of behaviors that fall outside of predetermined norms. While medicalization - or viewing issues from a medical perspective - brings benefits to the sick, it also creates illnesses so that pharmaceutical companies and others can profit. Take male baldness or female breast augmentation: both emerge as ways for individuals to alter their bodies to meet a stupid and harmful and shallow societal conception of beauty.

As an aspiring clinical psychologist, I loved Conrad's critical approach to medicalization and how he questioned many concepts several people take for granted. Medicalization both heals many and harms many, and by accepting it as neither good nor bad, we can work to enhance its benefits and minimize its negatives. For example, many psychiatrists and others in the medical field encourage antidepressants or other drugs to cope with mental illness, even when several studies support the efficacy of therapy over drug treatments alone. Medicalization intersects with money and with politics; the amazing work of gay rights activists and how they decreased public perception of homosexuality as disease shows how we can work to change the status quo for the better. Conrad includes many more relevant examples as he writes about the expansion of medicalization and its consequences.

Overall, a well-written book I would recommend to anyone interested in health, sociology, or psychology. One main takeaway: you do not have to take medicine to make your problem(s) real. From my studies and personal experiences I perceive that, with the rise of the biomedical model, people feel biased toward medicine to legitimize their issues and to work as a quick fix for their struggles. But many more holistic and effective therapies exist, even if they involve more effort than swallowing a pill.

[Ahmad · Rating 5 out of 5]

Really a great book. Argues the term 'medicalization' and how it affected us very simple and in detail. Loved it.

[Regina · Rating 5 out of 5]

My review of this book will appear in the next issue of Culture, published by the Institute for Advanced Studies in Culture.

[Nastaran Masoomi · Rating 3 out of 5]

کتاب کتاب خوبی بود ولی ترجمه ی فارسی عالی از اون نشر نشده پس اگه می تونید قطعا خوندن زبان اصلی کتاب پیشنهاد می شه.
پادکست بی پلاس خلاصه ی خیلی خوبی از کتاب را ارائه داده.

[Courtney · Rating 3 out of 5]

This book truly could've used an editor! Parts of Conrad's analysis of medicalization were interesting, but they often felt out-of-order or jumbled. This also feels like a book that became outdated from the moment it was published, so the most interesting insights involve the general definitions and trends of medicalization more than the specific case studies. And though Conrad tries to claim he's more interested in the process of medicalization than medical validity, his descriptions did often carry a subjective dismissal of contested diagnoses' validity, which frustrated me.

[Farshad Shahkarami · Rating 4 out of 5]

کتابی خوب،
با ترجمه‌ی فارسی بد،
و خلاصه‌ای عالی در بی‌پلاس

[Shima Ghaheri · Rating 3 out of 5]

از پادکست بی پلاس:
“شرایط و پدیده‌هایی در زندگی ما هست که امروز به عنوان مشکلات پزشکی معرفی میشه، مثل تمرکز نداشتن یا چاقی. ۵۰ سال پیش این‌ها اختلال یا مسئله‌ی پزشکی نبودن. برای همین هم نسخه‌ی درمانی و دارویی براشون وجود نداشت. جزو وضعیت و شرایط طبیعی بشر فرض می‌شدن. اما طی یک فرآیندی این پدیده‌ها به عنوان اختلال تعریف شدن. پیتر کنراد نویسنده کتاب پزشکی شدن جامعه حرفش اینه که توی این فرایند پزشک‌ها و متخصص‌ها نقش کمرنگی داشتن. جای متخصص‌هارو صنعت دارو و شرکت‌های بیمه پر کردن.“

[Michael Burnam-Fink · Rating 3 out of 5]

You ever fought a war for so long that you can't even imagine what the end would look like? This book is something like that. Peter Conrad was one of the first scholars to study medicalization, starting in the 1970s with ADHD. This book builds on his more than three decades of research in the field, and the detailed sources are by far its strongest accomplishment. However, Conrad has lost the distance necessary to take a neutral look at the complex phenomena he describes.

Medicalization is the process by which something becomes defined as a medical problem, rather than a social, criminal, or moral failure, or simply a delusion. As such, it is entirely about the definition and boundaries of illness, and the responsibilities for health allocated to doctors, patients, insurance companies, and pharmaceutical researchers. From Conrad's perspective, medicalization has advanced on all fronts, claiming new territory. The problem with medicalization is that it reduces the diversity of human existence to "normal" and a series of pathologies, and that it is being carried out by pharmaceutical companies which stand to benefit from new diseases and drugs.

I don't disagree with these complaints, but if medicalization is really a question about definitions, responsibility, and values, then we need to step back and examine the ways in which diseases are defined, the consequences of holding various stakeholders responsible, and what our values truly are. Medicalization is a symptom of our desire to control our own destines--medical interventions are widely believed to be effective--not a problem to be fixed.

[Kristina · Rating 4 out of 5]

A good foray into the history of and predictions about the future of medicalization. By exploring men's health, ADHD, human growth hormone and homosexuality, this book explores many facets of medicalization (and demedicalization). The intro is dense reading, but the rest of the book flows more easily. There are a few times it seems like Conrad is repeating himself (eg., didn't I read that same sentence in chapter 2?), but still the content was insightful. I'm looking forward to reading his earlier work, Deviance and Medicalization.

[Kelly · Rating 2 out of 5]

Okay intro to the study of medicalization. Not much on physical disorders popping up recently....mostly psychological. Would like more on the drug industry's financial backing of grass roots campaigns to get diseases recognized mainstream. Will look elsewhere for something more comprehensive. Would also like more on identity and illness, particularly something that explores illness and American identity.

[♥ Sarah · Rating 4 out of 5]

Normal v. deviant behavior is transformed by medicalization/ pathologization of psychological disorders, whereby deviant behavior is labeled, stigmatized but at the same time justified, and used as a form of social control. Research focuses on various aspects of medicalization: ADHD, biotechnology, reproductive technologies, pharmaceutical companies and the medical field are critically examined. Great insight.

[Anna · Rating 2 out of 5]

Might have been interesting were the writing not so DRY. Also, there's a lack of nuance here that I find immensely troubling--of the "medicalization is ALWAYS bad" sort. The author does not seem to consider that medicalization can have a few advantages, particularly for "controversial" illnesses (CFS, fibromyalgia) and those who have those illnesses. Overall, a disappointing read.

[Aaron · Rating 5 out of 5]

Peter Conrad explores medicalization, the process of something becoming a subject of medicine. Considering how modern medicine is such a huge and complex industry, it may seem obvious what's a medical issue and what isn't, especially with all the professionals, the schooling, the literature, the technology, and so on. Yes, there are so many formalities and technicalities in the world of medicine, but everything in medicine is fundamentally a human issue, which means there will always be gray areas, areas of dispute, and areas of commercial opportunity. (A related concept is demedicalization, where things formerly considered to belong under the expertise of physicians are no longer so; two common examples for this are childbirth and sexuality, as in the last several decades people generally feel that their doctor isn't the final authority on either how they choose to deliver or on their sex lives.) Conrad highlights several areas that have, contentiously, becomes medicalized over time. That's not to say that the medicalization for each has been universally accepted, but to demonstrate how medicalization happens through case study and to illustrate some of the factors involved.

For example, it's sometimes assumed that something may fall under the realm of medicine when enough doctors decide that they should be considered the sole authority for a given topic. True that has happened. But another factor may be desire from affected groups to frame something as a medical condition to lessen stigma, or diminish personal responsibility. Another factor may be economic demand, where conditions classified as medical may qualify for medical treatment covered by insurance companies. Another factor may be desire for access to things that would not be available otherwise if not classified as medical treatment.

The four areas covered are:
- Extension: extending the condition of menopause in women to the proposed "andropause" in men, to classify baldness and erectile dysfunction as conditions that require medical treatment. The question is to what extent the concept fits, should these conditions be classified as medical per se, and who decides that. There is a market for commercial products, and classifying this as a medical condition lessens the stigma of from considering it a measure of masculinity.
- Expansion: in the early days of the DSM, there were conditions that applied to restlessness, disruptiveness, and hyperactivity in children. Over time, studies showed that some children with these symptoms tended to retain them through adolescence or even adulthood. Later, controversially, there arose greater consciousness of these symptoms in adults, framed under the names ADD/ADHD, largely facilitated by marketing from drug companies and adults eager to seek a pill for their problems or to frame their behavior as a medical condition. This led to widespread self-diagnosis, and a huge demand for providers to fill. That's not to say that there aren't real conditions or that these conditions should not be classified as medical, but it shows that the condition itself largely arose to fill a public need and a consumer need.
- Enhancement: the human growth hormone (hGH) was once in extremely limited supply, and could only be obtain by extracting hormone from a cadaver after death; to me, it sounds like "hormone donation" was a practice along the lines of organ donation. By necessity, it could only be provided to people greatest need, that is, young children with severe hormone deficiencies. In the 1980s, a synthetic form of hGH was developed, and finally supply was no longer a problem. However, hGH has huge benefits for "normal," healthy people, with potential for increasing height to improving athletic performance. Obviously, there's market demand for anyone who wants to be bigger, stronger, faster, and accordingly there was a huge incentive for drug companies to find "off-brand" uses. One consequence is that it creates an arms race among athletes (and everyone else), where the average changes so everyone needs to take hGH to keep up; this is one of so many social and ethical issues raised as a consequence of medicalizing a condition.
- Continuity: the one case of demedicalization discussed here is homosexuality, which was classified as a mental illness is the DSM-II (1968), but de-classified in the DSM-III (1980). This reclassification was in response to changes in social attitudes, not a change in scientific literature or research. Gender Identity Disorder was included in the DSM-IV (1994), which Conrad discusses as an area of contention: some were concerned this was a reversal to try to re-medicalize sexuality, while others supported it for opening the door for insurance payers to cover sex change procedures.

Overall, this book was an excellent introduction into a topic I was aware of but knew little about. The case studies were relevant and clear, and he maintains an even and objective tone throughout. The style can be a little dry at times, but I think it's fitting for the subject matter, and considering that I don't read medical journals, I would presume that it fits well there. Definitely recommend this if you're interested in medicalization or in any of the specific topics covered.

[TJ]

Philosophy 473 Social Health Care Ethics

[Katie Reece · Rating 5 out of 5]

Great introduction to the theory of the medicalization of society. A good follow up to this is Medicating Modern America by Andrea Tone and Elizabeth Watkins.

[Dean Luce · Rating 5 out of 5]

Another excellent book by Peter Conrad.

[Brandon Lee · Rating 4 out of 5]

Reaction: What a read, highly recommend to anyone interested in the most interesting and stigmatized medicalized conditions in our clinical practice
Writing Style: academic sociologist, but easy to understand jargon that will be engaging
Argumentation: Society is capable of creating a disease out of a condition, but is it for the benefit of patient’s well being or the ease for the physician to treat? Draws upon important discussions in ADHD, homosexuality, aging, hormonal therapies, and gendered behavior
Commendation: even took the time to explicate the economic role of medicalization, bringing it even closer to how important it is to be aware of this phenomenon
Critique: devote a longer chapter into the role of biotech rather than just pointing out new treatments and regulations, but tracing a similar path as with the other conditions

[Julia · Rating 5 out of 5]

From the psychotropic prescriptions that proliferate psychiatry to the maligning of masculinity for medical purposes, Conrad's critical takes are unfiltered,unabated and uninsipid. Using a social constructionist lens, his book delves into the historical context of the different diagnostic expansions. Conrad's conscious criticism of the Medicalization of Society definitely gives a unique reflection on the etiology of a spate of different "disorders."

(self notes: Read up to halfway the first time then I reread the whole book for the second time).

[Sadjad Esfeden · Rating 4 out of 5]

Notes:
- Pharma companies have become more aggressive to feed people with no/little problems the pills and medicine that is for specific diseases!
- doctors and patients need to control the consumption of the medicine and not rely on FDA!
- some differences in behavior (which in some cases are caused by the society and now individualized) are now considered as disorders and pharma companies are after solutions and medicine to fix them (as they’re problems) and make profit out of them!

[Shrimpy · Rating 4 out of 5]

While some of the information and terminology is outdated, that's a given considering the age of the book. A really human perspective to healthcare that I feel we're often lacking. Overall an informative and interesting read :]

[Ibid.]

Read for class. Pop-y, digestible, fairly well researched and collected, though a little dated. But that doesn't really matter—being dated simply implies that he hadn't been able to witness some of the failures of today

"Layman's Foucault"

[Maysam Ebadi · Rating 3 out of 5]

خلاصه این کتاب رو در پادکست بی‌پلاس گوش کردم. کتاب حرف‌های جالبی برای گفتن داره.


لینک پادکست:
https://bpls.me/z5ysex

[Violeta · Rating 4 out of 5]

very interesting account on the sociological, seemingly ‘natural’ components of medicine and what gets to be defined as health

[Fen · Rating 4 out of 5]

I had no idea there was a name for this phenomenon until recently, let alone that it had been studied. It turns out Peter Conrad has similar misgivings to my own--and, even better, has been researching the subject--since the '70s. This book, while limited in scope, really helps put things in perspective. What's considered a "disease" depends on a lot of things; diseases are defined by social norms, for one. And increasingly, they are also defined by pharmaceutical companies looking to create new markets.

The Medicalization of Society is inevitably dated, 15 years after its publication, but medicalization has become more common now than ever, in my estimation. I'm not the only one who's noticed every individual human difference increasingly slotted into the category of "mental illness." In the book, Conrad discusses a history of consumer and activist groups advocating for increased diagnoses--a phenomenon he believes to be on a downward trend. I'd argue that trend reversed itself sometime in the last decade, with the birth of social movements that embrace labels to an extreme degree. The labels often, though not always, have corresponding diagnoses (autism and gender dysphoria are two big examples).

His discussion of generalization, where a diagnosis becomes increasingly vague to the point of meaninglessness, so it can "help" as many people as possible, is also enlightening. While it usually starts out well-meaning, this issue both underscores the impracticality of labeling people as "diseased" based on subjective difference, and it also allows it to be misused. (While reading the part about ADHD, I couldn't help but remember how the "rich" high school in my area was revealed to have a mysteriously high amount of students with ADHD diagnoses... Many not diagnosed until the months leading up to college entrance exams. They weren't that much smarter than us middle class kids; they just got extra time on the test!)

The chapter on gender, too, is interesting. He chooses to focus on medicalization of male bodies, due to the abundance of literature on women and medicalization. The trends he identifies have only increased since the book was published. In the U.S. I think there had particularly been an uptick in the medicalization of "unmasculine" men (a reaction to feminism and LGBT rights?). The products are infamously associated with certain right-wing media figures now, who make money by instilling in their listeners insecurity in their masculinity...

Conrad is definitely biased against medicalization, and to his credit, he admits it. I didn't mind since I share his opinions, most of the time. Since Western culture is so unabashedly pro-medicalization, to the point where people almost unanimously assume others will find it "helpful" if their problems are medicalized, for me it is a welcome perspective and breath of fresh air.

The book is a good intro on the subject, though it betrays its origins as a collection of previously published essays at times, due to repetition of some of the basic facts. It's a small nuisance that does not impact the strength of individual pieces.