臺灣博碩士論文加值系統

雖然同性戀等性少數群體在醫療領域已不再視為異常，但並不代表性少數在醫療場域中的汙名與不平等已經消失。為探究臺灣的醫師養成過程中，是如何看待性少數並從而影響臨床的實作，而醫師與醫學生對此對此又有何回應，本研究針對醫學教育與臨床的性別議題，製作相關問卷並蒐集了 326 份醫師與醫學生有效回覆；且以立意取樣訪談了三十一位性少數或對性別議題感興趣之醫師與醫學生，詢問他們與此議題有關的經歷與看法。本研究發現，在臺灣的醫學院教育、醫院見實習與畢業後臨床工作時的潛在課程等醫學教育場域中，性少數群體仍被當作是不符合異性戀常規性的異常，從而造成許多的汙名與刻板印象，並因此影響臨床實作的運行。如男同志仍被當作是 HIV 的高風險族群，女同志皆為陽剛形象等。而身處保守且階層嚴密的醫療體系下，具性少數身分與其盟友的醫師與醫學生，雖較難直接發聲反抗，但仍以戰略與戰術等行動策略，在日常生活中實踐多元性別友善的態度，並以此作為推廣與增進性別意識的作法。

Although sexual and gender minorities, such as homosexual, are no longer regarded as abnormal in the medical field, it does not mean that the stigma and inequality of sexual and gender minorities have disappeared in the medical field. This study explores how medical knowledge and physician training regard sexual and gender minorities, its effects in clinical practice, and the physicians and medical students respond to it in Taiwan. In this study, I prepared a questionnaire on gender issues in medical education and clinical practice and collected 326 valid responses from physicians and medical students. Also, I interviewed 31 physicians and medical students who are sexual and gender minorities or interested in gender issues with a deliberate sample, asking them about their experiences and views about it. This study found that in Taiwan's medical education fields such as medical school, hospital internships, and hidden curriculum for post-graduation clinical work, sexual and gender minorities are still regarded as anomalies that do not conform to heteronormativity, resulting in many stigmas and stereotypes, and thus affect the clinical practice. For example, gay men are still regarded as a high-risk group for HIV, and lesbians are all masculine Tomboy. Under the conservative and strict medical system, physicians and medical students who are LGBTQ and allies are more difficult to directly protest, but they still use strategies and tactics to practice diversity and gender-friendly as a way of promoting and promoting gender awareness in their daily life.

第一章：研究背景與問題意識 1
第一節、序言與問題意識 1
第二節、研究問題 6
第二章：文獻回顧 8
第一節、科學知識的生成與類型 8
第二節、醫療場域中的異性戀常規性 10
第三節、刻板印象、汙名與不平等 12
第四節、如何行動 14
第三章：研究方法 18
第一節、量化問卷分析 18
一、研究對象 18
二、問卷設計、調查與分析 20
第二節、參與觀察 25
第三節、質性訪談與研究者位置之反省 26
第四章：白色巨塔中的難以撼動的性別不平等與權力結構 30
第一節、本質化、刻板化與權力支配的性別圖像 30
一、忽略社會因素、宣稱中立的醫學知識與研究 32
二、對於男女醫師的刻板印象：能力、科別與家務勞動 33
三、難以消除的醫界性騷擾 38
第二節、持續不斷的師生關係與職級階序 47
第三節、小結 51
第五章：醫師養成過程中如何看待同志 52
第一節、大學前的同志印象 52
第二節、醫學院中如何談同志：正式課程中的性別與同志議題 57
一、醫學院教育中的性別圖像 57
二、可憐、可惡與可怕的同性戀與性病 60
第三節、繼續教育中的性別學分：非正式課程中的同志議題 70
第四節、醫療場域潛在課程中的同志議題 76
一、專業化歷程下的外貌管控：以傳統男性想像為基準穿著規範 78
二、異性戀常規：女同志的刻板印象 81
三、性疾病的道德標籤：HIV汙名與須辨識出的陰柔男同性戀 84
第五節、科別間的差異 96
一、同志友善的精神科 101
二、父權掌握下的外科（系） 102
第六節、小結 107
第六章：醫療場域的行動空間 109
第一節、發聲反抗、隱忍與偷渡：不友善環境下的反應策略 109
一、勇於或不敢發聲？使用申訴機制的經驗與困難 112
二、直接對話與碰撞的效果與侷限 118
第二節、面對的不友善環境的戰略 123
一、以出櫃作為主動出擊的戰略 123
二、群體的抵抗戰略：以團體與講課為戰場 127
第三節、融入日常生活中的迂迴戰術 135
第四節、以生活與生命為行動的跨性別 139
第五節、小結 146
第七章：結論 147
一、研究發現 147
二、研究限制 149
三、研究展望 150
參考文獻 153
附錄一、人體研究審查結案通過書 167
附錄二、某校中醫學系專業必修科目表 168
附錄三、問卷題目 169
附錄四、問卷專家效度原始分數 178
附錄五、問卷專家效度修改意見及回應 179
附錄六、訪談大綱 184
附錄七、臺灣各專科醫師女性醫師比例 185

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