COMMENTARY
Commentary on Cook C (2012) ‘Nice girls don’t’: women and the condom conundrum. Journal of Clinical Nursing 21, 535–43 Clare Whitfield
Cook (2012) explores how women manage the sexual health messages they receive once diagnosed with a sexually transmitted viral infection and how clinicians provide support and advice. She suggests that feminine identity is threatened by assertiveness in relation to sex and condom use. Sexual health goals become ‘subsumed by ideals of femininity’ (Cook 2012, p. 538), which are to be ‘innocent’ and ‘responsive’. Therefore, women need support to develop the negotiation skills necessary to instigate safer sex discussions with their partner, and clinicians need to recognise the complex contexts within which these decisions must be negotiated. Cook’s (2012) analysis raises a number of pertinent points. First, she adopts a methodology that seeks to ensure that the concerns of women are given a voice. This allows her to develop an understanding of the barriers to discussing safer sex that women experience in their daily lives. In addition, the use of a feminist poststructuralist methodology highlights fundamental gender issues, which are evident in the power dynamics within heterosexual relationships (see e.g. Glick & Fiske 1999, Spencer et al. 2008). Second, rather than looking at provision of sexual health advice as information dissemination, a matter of rational decision-making, with a focus on the problem of noncompliance, Cook (2012) explores the real tensions that form the context within which these decisions are made and suggests that support must include a recognition of the barriers to initiating safer sex and developing the skills needed to overcome these.
At the same time, men must also be supported to develop skills to negotiate safer sex, as this is not solely a ‘woman’s problem’. Approaches to sexual health education that originate in response to the lived experience are more likely to produce valid, workable and pragmatic solutions. This also reflects the necessity of working with people who are seeking advice rather than ministering to them, a position fundamental to patient-centred care and considered best practice. Third, and most importantly, Cook (2012) provides an insight into the significance of power dynamics within the sociocultural context, relationships and between people when sexual decisions are being made. This analysis can be applied elsewhere, for example to understanding the sexual health behaviours of adolescents or teenage pregnancy, particularly with teenagers with more than one child. Cook’s (2012) analysis suggests a move away from measuring and evaluating interventions, which are largely technically focused, towards considering the genuine dilemmas and decision-making contexts within which women live. Healthcare professionals need to be mindful of these issues when planning and delivering sexual health advice, which must be developed through collaboration between healthcare professionals and the people they support. Cook (2012) calls for recognition of the problems faced by women negotiating condom use and reminds us that ‘sex education must be relevant to the specific contexts of women’s lives’ (Cook 2012, p. 541).
References Cook C (2012) ‘Nice girls don’t’: women and the condom conundrum. Journal of Clinical Nursing 21, 535–543. Glick P & Fiske S (1999) Gender, power dynamics and social interaction. In Revi-
sioning Gender (Ferree M, Lorber J & Hess B eds). AltaMira Press, Oxford, pp. 365–398. Spencer G, Maxwell C & Aggleton P (2008) What does ‘empowerment’
Author: Clare Whitfield, BA, PhD, RGN, Lecturer, Health Professional Studies, Faculty of Health and Social Care, University of Hull, Hull, UK
© 2014 John Wiley & Sons Ltd Journal of Clinical Nursing, 23, 2691, doi: 10.1111/jocn.12480
mean in school-based sex and relationships education? Sex Education 8, 345–356.
Correspondence: Clare Whitfield, Lecturer, Health Professional Studies, Faculty of Health and Social Care, University of Hull, Hull HU6 7RX, UK. Telephone: +44 (0)1482 463222. E-mail: [email protected]
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Commentary on Cook C (2012) ‘Nice girls don’t’: women and the condom conundrum. Journal of Clinical Nursing 21, 535–43 Clare Whitfield
Cook (2012) explores how women manage the sexual health messages they receive once diagnosed with a sexually transmitted viral infection and how clinicians provide support and advice. She suggests that feminine identity is threatened by assertiveness in relation to sex and condom use. Sexual health goals become ‘subsumed by ideals of femininity’ (Cook 2012, p. 538), which are to be ‘innocent’ and ‘responsive’. Therefore, women need support to develop the negotiation skills necessary to instigate safer sex discussions with their partner, and clinicians need to recognise the complex contexts within which these decisions must be negotiated. Cook’s (2012) analysis raises a number of pertinent points. First, she adopts a methodology that seeks to ensure that the concerns of women are given a voice. This allows her to develop an understanding of the barriers to discussing safer sex that women experience in their daily lives. In addition, the use of a feminist poststructuralist methodology highlights fundamental gender issues, which are evident in the power dynamics within heterosexual relationships (see e.g. Glick & Fiske 1999, Spencer et al. 2008). Second, rather than looking at provision of sexual health advice as information dissemination, a matter of rational decision-making, with a focus on the problem of noncompliance, Cook (2012) explores the real tensions that form the context within which these decisions are made and suggests that support must include a recognition of the barriers to initiating safer sex and developing the skills needed to overcome these.
At the same time, men must also be supported to develop skills to negotiate safer sex, as this is not solely a ‘woman’s problem’. Approaches to sexual health education that originate in response to the lived experience are more likely to produce valid, workable and pragmatic solutions. This also reflects the necessity of working with people who are seeking advice rather than ministering to them, a position fundamental to patient-centred care and considered best practice. Third, and most importantly, Cook (2012) provides an insight into the significance of power dynamics within the sociocultural context, relationships and between people when sexual decisions are being made. This analysis can be applied elsewhere, for example to understanding the sexual health behaviours of adolescents or teenage pregnancy, particularly with teenagers with more than one child. Cook’s (2012) analysis suggests a move away from measuring and evaluating interventions, which are largely technically focused, towards considering the genuine dilemmas and decision-making contexts within which women live. Healthcare professionals need to be mindful of these issues when planning and delivering sexual health advice, which must be developed through collaboration between healthcare professionals and the people they support. Cook (2012) calls for recognition of the problems faced by women negotiating condom use and reminds us that ‘sex education must be relevant to the specific contexts of women’s lives’ (Cook 2012, p. 541).
References Cook C (2012) ‘Nice girls don’t’: women and the condom conundrum. Journal of Clinical Nursing 21, 535–543. Glick P & Fiske S (1999) Gender, power dynamics and social interaction. In Revi-
sioning Gender (Ferree M, Lorber J & Hess B eds). AltaMira Press, Oxford, pp. 365–398. Spencer G, Maxwell C & Aggleton P (2008) What does ‘empowerment’
Author: Clare Whitfield, BA, PhD, RGN, Lecturer, Health Professional Studies, Faculty of Health and Social Care, University of Hull, Hull, UK
© 2014 John Wiley & Sons Ltd Journal of Clinical Nursing, 23, 2691, doi: 10.1111/jocn.12480
mean in school-based sex and relationships education? Sex Education 8, 345–356.
Correspondence: Clare Whitfield, Lecturer, Health Professional Studies, Faculty of Health and Social Care, University of Hull, Hull HU6 7RX, UK. Telephone: +44 (0)1482 463222. E-mail: [email protected]
2691
