GENDER'S ROLE IN RESPONSES TO INFERTILITY

Infertility is a major life stressor that affects approximately 10% of U.S. married couples. Infertile women and men have reported experiencing depression, helplessness, and marital strain. Given U.S. society's emphasis on women's role as mothers, it has been suggested that women's lives are more disrupted by infertility than those of men. This hypothesis was supported in a survey of 185 infertile couples and 90 presumed fertile couples. Infertile wives, as compared to their husbands, perceived their fertility problem as more stressful, felt more responsible for and in control of their infertility, and engaged in more problem-focused coping. Infertile husbands experienced more home life stress and lower home life performance than did their wives. These differences were not found for presumed fertile couples. Both infertile and presumed fertile wives experienced more depression, more sexual dissatisfaction, and lower self-esteem than did their husbands. Theoretical and counseling implications of these findings are discussed.     

Downward Comparison in Infertile Couples

The tendency of infertile individuals to compare themselves favorably to others with regard to coping efficacy was examined among 61 women and 52 men, including 52 husband-wife pairs. Comparison targets were same-sex infertile others and the spouse. Eighty-three percent of men, but only 45% of women, believed that they were coping better than same-sex others (i.e.,downward comparison). Both men (51%) and women (47%) tended to see no difference between their own and their spouses' coping efficacy. However, comparing themselves to their spouses, men in general compared downward, whereas women compared upward. For both same-sex and spouse comparisons, husbands were significantly more likely to engage in downward comparison than their partners. Analyses testing the correlates of downward comparison revealed that (a) infertile participants who were more likely to engage in downward comparison felt less threatened by infertility, (b) no association emerged between comparison indices and self-esteem, and (c) downward same-sex comparison was more likely for men who had been attempting conception for a longer period.     

Traditional vs. nontraditional women and men's perceptions of the personalities and physiques of ideal women and men

Traditional and nontraditional women and men's perceptions of ideal people, in terms of both traits and physiques, were assessed using 80 male and 80 female Caucasian undergraduates as study participants. The data indicated that traditional women and men perceived the ideal male as mesomorphic and as having more instrumental than expressive traits. Nontraditional women and men also favored a mesomorphic physique for the ideal male, but they differed from traditionals in that they saw this mesomorphic male as being androgynous in regard to traits. Concerning the ideal female, traditional and nontraditional women and men preferred an androgynous physique, but they differed in their perceptions of the ideal personality for a woman. Traditional women and men perceived their ideal women as having more expressive than instrumental traits, whereas nontraditional women and men saw their ideal women as being androgynous in regard to traits. The results are discussed within the framework of Bem's gender schema and enculturated lens theories.     

Childless in the Land of Imperative Motherhood: Stigma and Coping Among Infertile Israeli Women

Drawing on Goffman's stigma framework, this in-depth study explored the experiences of 26 infertile Jewish women in Israel, the country with a strong pronatalist ideology, both institutional and popular. The findings are in line with the key postulates of the stigma concept: women's coping strategies included selective disclosure, avoidance of exposure of their “hidden disability,” and other information management techniques. Infertility became a “master status” for these women, undermining any other merits and achievements they might have. Most women fully internalized and endorsed the pronatalist discourse by way of pursuing long-term and burdensome infertility treatments, at any personal cost. The paper argues that resistance to stigma of infertility is only possible where women dare question the motherhood imperative, which is clearly not the case with most Israelis. Material and mental resources needed for resisting the stigma of infertility are found among few educated professional women. The paper suggests three theoretical inferences: (a) stigma as a psychological response is graded by the extent of individual's conformity with the dominant norms; (b) the stigma of childlessness is most devastating for the less educated women without career or other nonfamilial aspirations; and (c) in pronatalist societies, the coping and management approach to the study of infertility is more relevant than the resistance approach suggested by some authors.     

Perceived control over the medical procedure and its association with adjustment to a low-control situation: the case of infertility

Illness perceptions were shown to be related to emotional and physical outcomes, as proposed by Leventhal’s self-regulation model. These perceptions include the illness identity, its timeline, consequences, causes, and controllability, which later research found to include self-control and treatment control. The current study aimed to examine the role of a third type of perceived control: Control over the treatment procedures. We hypothesized that this type of control would be important for women undergoing infertility treatments, which are characterized by high uncertainty and low personal control. The sample included 194 Israeli women who were undergoing infertility treatments, 70% recruited in hospitals and the remainder in a fertility counseling center and website. All participants were married religious Jewish women, which added to the stress inherent in infertility. Study measures included the Illness Perception Questionnaire-Revised (IPQ-R), adapted to infertility, with an additional subscale assessing control over the procedure, and infertility-specific distress and well-being scales. Exploratory and confirmatory factor analyses supported the factor structure, including the distinct new subscale. A structural equations model showed that perceived consequences were most strongly related to distress and well-being. The three types of control were positively intercorrelated but differed in their associations with distress and well-being: Self-control over the problem and treatment control were unrelated to either measure while self-control over the procedure was related to greater well-being. These findings suggest that when control over the condition or the treatment outcomes is impossible, individuals may still benefit from control over external factors such as their health care. Healthcare providers can support them by seeking ways to increase their control over their treatment procedures, which may contribute to better psychological adjustment. Future studies should examine the role of perceived control over the procedures in other low-control situations (e.g., newly diagnosed cancer; aging-related declines).     

Gender and Infertility: A Relational Approach to Counseling Women

Much of the research on infertility reinforces differing effects for women and men, with women reporting more serious repercussions medically, psychologically, and socially. However, the unique counseling needs of infertile women have not been addressed through traditional counseling theory. The Relational Model (J. V. Jordan, 1995) of women's development is a theory that explains women's development in a context of relationships, specifically relationships that promote growth for self and others. This model is applied to counseling women who are experiencing infertility, and a case presentation is provided to illustrate the approach.     

Traditional and Nontraditional Women's Attributions of Responsibility to Physically Resistive and Nonresistive Rape Victims1

This research examined the interactive effect of women observers' sex-role attitudes and a victim's use of physical resistance on perceptions of victim responsibility for a sexual assault. Women read one of two rape scenarios in which a victim either did or did not physically resist a rapist's attack and made judgments concerning victim responsibility. The observers were categorized as being either traditionally conservative or nontraditionally profeminist in their attitudes toward women and their roles in society. An analysis of responsibility judgments indicated that traditional women perceived a victim who resisted the attack as being more responsible for her own victimization than did nontraditional women, whereas nontraditional women assigned more responsibility to a victim who did not resist than did traditional women. These results are considered from a sex-role socialization perspective; the implications of these findings for legal and health care professionals are discussed.     

The Role of Dyadic Coping on the Marital and Emotional Adjustment of Couples With Infertility

Infertility is a challenging experience, affecting individual and couples’ adjustment. However, the way the members of the couple support each other may affect the experience of infertility and their adjustment. This study aimed to investigate the role of dyadic coping by oneself and by the partner in the association between the impact of infertility and dyadic and emotional adjustment (anxiety and depression) to infertility. In this cross‐sectional study, a total of 134 participants (67 couples with infertility) completed self‐report questionnaires assessing infertility‐related stress, dyadic coping, dyadic adjustment, and depression and anxiety symptoms. A path analysis examined the direct and indirect effects between the impact of infertility in one's life and dyadic and emotional adjustment. There is an indirect effect of the impact of infertility in one's life on dyadic adjustment through men's perceived dyadic coping efforts employed by the self (dyadic coping by oneself) and women's perceived dyadic coping efforts of the partner (dyadic coping by the partner). Regarding the emotional adjustment of infertile couples, infertility stress impact had an indirect effect only on depressive symptoms through men's dyadic coping by oneself. The results highlight the importance of men's dyadic coping strategies for the marital adjustment of couples as well as for men's emotional adjustment. Findings emphasize the importance of involving men in the fertility treatment process, reinforcing the dyadic nature of infertility processes.     

How Gendered Attitudes Relate to Women’s and Men’s Sexual Behaviors and Beliefs

This study examines associations between endorsement of a sexual double standard, gender role attitudes, and sexual behaviors and beliefs. First year university students in the northeastern United States (N = 434; 52 % female; 33 % Black, 29 % Latino, 39 % White; ages 17–19) participated during their first year of college. Endorsement of a sexual double standard was associated with more conventionally gender-stereotyped sexual behaviors and beliefs, specifically, more sexual partners and fewer perceived barriers to condom use for young men, and more perceived barriers to condom use for young women. Women who were more conventional about men’s roles in society tended to use condoms less, whereas women who were more conventional about women’s roles tended to use condoms more. Men who were more conventional about men’s roles tended to have fewer sexual partners. Findings suggest the importance of examining gender’s role in sexual behaviors and beliefs by assessing multiple gendered attitudes, rather than simply considering biological sex.     

Childbirth pain,attachment orientations,and romantic partner support during labor and delivery

Attachment anxiety is associated with greater perceived physical pain, whereas social support is associated with lower pain perceptions. Few studies, however, have examined the joint effects of attachment and support on acute physical pain in a dyadic context. In this study, first‐time expectant mothers (N = 140) and their male partners completed romantic attachment measures (prenatally) and postnatal assessments of women's pain and men's emotional support during labor and delivery. More securely attached women benefited from emotional support in terms of reduced pain, more avoidantly attached women reported greater pain when given more support, and more anxiously attached women reported greater pain, regardless of their partners' support. These results advance our understanding of which women are most vulnerable to painful childbirth.     

Television Viewing and Self-Perceived Health,Weight, and Physical Fitness: Evidence for the Cultivation Hypothesis1

Television (TV) often depicts a version of the world that differs from social reality in several ways. The present study examined the relationship between the amount of TV people watch, how important TV is for their entertainment and information-gathering purposes, and their perceptions of their health, weight, and physical fitness. Regression analyses showed that, after controlling for their actual level of obesity, health perceptions were negatively related to both the amount of time spent watching TV and TV's perceived importance as an entertainment medium, but for women only. In addition, those who watched a lot of TV tended to see themselves as more overweight than did those who watched less TV. The implications of these findings for the cultivation hypothesis, as well as issues of replication, were discussed.     

Racial and Ethnic Differences in the Utilization of Prayer and Clergy Counseling by Infertile US Women Desiring Pregnancy

Religion can have a significant influence on the experience of infertility. However, it is unclear how many US women turn to religion when facing infertility. Here, we examine the utilization of prayer and clergy counsel among a nationally representative sample of 1062 infertile US women. Prayer was used by 74.8% of the participants, and clergy counsel was the most common formal support system utilized. Both prayer and clergy counsel were significantly more common among black and Hispanic women. Healthcare providers should acknowledge the spiritual needs of their infertile patients and ally with clergy when possible to provide maximally effective care.     

The psychological reactions to infertility: Sex roles and coping styles

The purpose of this study was to determine if sex roles would predict the extent to which people experience problems in coping with infertility. Based on questionnaire responses of 164 medical patients, it was found that patients scoring higher in masculinity or androgyny reported fewer problems in coping with infertility, as measured by self-esteem and body image. It was also found that groups of infertile, formerly infertile, and fertile patients were no different in levels of coping. It was suggested that physicians might be able to identify patients at risk for poorer coping with infertility by screening new referrals for self-esteem and historical-background variables.     

Examining congruence between partners' perceived infertility-related stress and its relationship to marital adjustment and depression in infertile couples

Because studies examining the emotional impact of infertility-related stress generally focus on individuals, there has been little research examining how relationship and individual variables are linked. The purpose of this study was to explore the impact of congruence (e.g., agreement) between partner's perceived infertility-related stress and its effects on depression and marital adjustment in infertile men and women. Couples referred for infertility treatments at a University-affiliated teaching hospital completed the Fertility Problem Inventory (FPI), the Beck Depression Inventory (BDI), and the Dyadic Adjustment Scale (DAS) 3 months prior to their first treatment cycle. Study findings show that men and women in couples who perceived equal levels of social infertility stress reported higher levels of marital adjustment when compared to men and women in couples who perceived the stress differently. In addition, women in couples who felt a similar need for parenthood reported significantly higher levels of marital satisfaction when compared to women in couples where the males reported a greater need for parenthood. While couple incongruence was unrelated to depression in males, incongruence over relationship concerns and the need for parenthood was related to female depression. These findings provide initial support for the theory that high levels of agreement between partners related to the stresses they experience help them successfully manage the impact of these stressful life events. Possibilities for future research examining the construct of couple congruence are discussed.     

Psychosocial responses associated with perceived risk of cancer in an African-American community

This epidemiologic health survey study examined the association between health risk perceptions and psychosocial factors in 145 African Americans in East Montgomery, Alabama. The survey gathered information on demographics, population dynamics, health risk perceptions, and coping behaviors. Psychosocial variables measured were worries, concern, stress, and trauma associated with perceived risk of cancer. Results indicated that women were more concerned about the environmental health risks in their community than men. Compared to men, women were highly concerned about the economic effect of perceived environmental health risk. The findings indicate that an individual's health status and educational level were significant predictors of psychosocial responses.     

Political Ideology Outdoes Personal Experience in Predicting Support for Gender Equality

Indices of gender equality provide an inconsistent picture of current gender inequality in countries with relatively high equality. We examined women's and men's subjectively perceived gender inequality and their support for gender equality in the general population and in politicians, respectively, in three countries with relatively high gender equality: the United States, the United Kingdom, and Germany (total N = 1,612). In both women's and men's perceptions, women were treated more unequally than men. However, the inequality that women perceived was larger than the inequality men perceived. Additionally, women reported they personally experience less inequality than women as a group (person-group discrepancy). Finally, women's and men's left/liberal (vs. right/conservative) political ideology turned out to be a relatively more powerful predictor of support for gender equality than perceived personal and societal inequality. We discuss reasons for why political ideology emerged as the strongest predictor of equality support and sketch out implications for policy efforts toward promoting gender equality.     

Individual differences in women's perceptions of other women's dominance

Recent research on men's dominance perception suggests that the extent to which men perceive masculine men to be more dominant than relatively feminine men is negatively correlated with measures of their own dominance. In the current studies, we investigated the relationship between indices of women's own dominance and their perceptions of other women's facial dominance. Women's own height and scores on a dominance questionnaire were negatively correlated with the extent to which they perceived masculine women to be more dominant than relatively feminine women. In follow‐up studies, we observed similar individual differences when (i) women separately judged other women's social and physical dominance, suggesting that individual differences in women's dominance perceptions generalize across two different types of dominance judgment and (ii) we assessed the perceivers' dominance indirectly by using a questionnaire that measures the extent to which women view interactions with other women in competitive terms. These findings present new evidence that the extent to which people perceive masculine individuals to be more dominant than relatively feminine individuals is negatively correlated with measures of their own dominance and suggest that competition and conflict among women may have shaped individual differences in women's dominance perception. Copyright © 2011 John Wiley & Sons, Ltd.     

Perceptions of informal sanctioning and the stigma of involuntary childlessness

This study systematically examines the role of informal social response in the emergence of involuntary childlessness or infertility as a stigmatizing attribute. Seventy‐one involuntarily childless women provide detailed instances of perceived informal social sanctions related to their infertility. Subjects perceive that normals consider infertility to be caused by psychological or sexual malfunctioning, or by the woman in the dyad. Infertility is also seen by some to act as a master status. Subjects categorize other infertile individuals in terms of stigma and consider male infertility to be more stigmatizing than female infertility. Social sanctions and social control are shown to be relevant to an understanding of the experience of involuntary childlessness.     

Comparison of dysfunctional attitudes and social adjustment among infertile employed and unemployed women in Iran

This study aims to compare dysfunctional attitudes and social adjustment in infertile employed and unemployed females. Due to the stresses of infertility, infertile females are faced with a variety of sexual and psychological problems, as well as dysfunctional attitudes that can lead to depression. Moreover, infertility problems provoke women into maladjustment and inadvertent corruption of relationships. In this regard, our goal is to consider the effects of employment in conjunction with education on dysfunctional attitudes and social adjustment among infertile women in Iran. In this work, we employed the survey method. We recruited 240 infertile women, utilizing the cluster random sampling method. These women filled out the Dysfunctional Attitudes Scale and the social adjustment part of the California Test of Personality. Next, multivariate analysis of variance was performed to test the relationship of employment status and education with dysfunctional attitudes and social adjustment. Our results indicated that dysfunctional attitudes were far more prevalent in infertile unemployed women than in infertile employed women. Also, social adjustment was better in infertile employed women than in infertile unemployed women. It was shown that education level alone does not have significant effect on dysfunctional attitudes and social adjustment. However, we demonstrated that the employment status of infertile women in conjunction with their education level significantly affects the two dimensions of dysfunctional attitudes (relationships, entitlements) and has insignificant effects on social adjustment. It was revealed that in employed infertile women in Iran, the higher education level, the less dysfunctional were attitudes in relationships and entitlements, whereas in unemployed infertile women, those with a college degree had the least and those with master's or higher degrees had the most dysfunctional attitudes in terms of relationships and entitlements.     

Menstrual-related perceptual changes in women with premenstrual syndrome: Factors to consider in treatment

The state-dependent model of premenstrual syndrome (PMS) suggests that women's perceptions of daily stressors are affected by menstrual cycle phase. Our objective was to further examine the applicability of this model to perceptions of specific kinds of daily stressors and to explore its generalizability to perceptions involving significant others. Thirty-two undergraduate women, 10 PMS and 22 asymptomatic controls, completed the Daily Stress Inventory (DSI) and the Daily Rating Form (DRF) for 35 days. Questionnaires measuring perceived social support and self-esteem were completed premenstrually and postmenstrually. Results indicated that all women perceived a greater number of stressors as being severe premenstrually as compared to postmenstrually. Furthermore, all women perceived a lesser number of signifcant others as being present in their social support network premenstrually. However, only the PMS women were less satisfied with their social support and had more negative self-esteem premenstrually as compared to postmenstrually. Results are discussed within the context of designing treatment intermentions for women with PMS.