Attending to gender identities and new add-on treatments: a discursive investigation of heterosexual couples' infertility treatment

This thesis employs discursive psychology to investigate heterosexual gender identities within infertility treatment, discursive practices of clinicians within infertility treatment consultations, and discursive management of infertility treatment add-ons during consultations. The data corpus consists of audio-recordings of interviews with ten heterosexual couples at the end of their first treatment cycle and audio-recordings of twenty-two consultations between clinicians and treated couples. I explore in detail how the couples account for their route to parenthood and argue that the couples employed the narrative of a selfless, good parent to justify the timing. This was to avoid the blame for delaying parenthood and for infertility problems, which are associated with a higher maternal age. Additionally, the way the woman presented herself during the treatment determined position of her man, implying complex interplay between femininity and masculinity. The traditional gender identity of a helpless weak woman created the need for the man to support his partner. I therefore argue that an alliance to the romantic traditional gender roles of a knight on a white horse rescuing his damsel in distress created the legitimated position of men within the treatment and allowed for their inclusion while preserving their masculinity. An investigation of infertility consultations revealed recipientsensitive devices to flexibly reflect the discursive needs of patients. The clinicians firstly employed the gender neutral term "people" to include men within consultations and to alleviate women's responsibility for the treatment results. Secondly, the clinicians employed metaphors and similes to simplify complex medical procedures and to alleviate fear from the treatment. To deal with the lack of evidence-based research supporting the employment of additional treatments, the clinicians employed metaphor, hypophora and rhetorical questions. I argue that clinicians discursively placed the decision to employ the add-ons into the arena of patients, while working on preserving their own authority. I conclude with theoretical and practical implications of my findings for infertility care, specifically for accommodating men within the treatment, for reflecting the patients' discursive needs and dealing with add-ons during consultations. I suggest directions for future research. I also critically reflect on my research position throughout the conduct of my thesis