Chapter 4 94 Meanwhile, some gender theorists argue that the way forward in gender theory entails exploring not only when and how gender is socially constructed and performed, but also considers the biological grounding of some patterns of behaviour. In this interactionist perspective, social and biological processes are intertwined in producing the phenomena of gender/sex.50,51 This interaction is perhaps particularly relevant in the context of medicine, in which surgical, pharmacological and psychosocial interventions can influence both social and biological processes. We have yet to develop more precise and personalized methodologies that can capture more nuanced insights into when and how these biopsychosocial interactions and interventions for people with PD become “gendered”, “sexed”, or “gendered/sexed”.51–53 Furthermore, the sample in this study was limited in diversity with regards to social demographics such as age, education level and ethnicity, despite, or perhaps due to, our convenience sampling strategy. Homogeneous sampling in qualitative research is used when the goal is to understand and describe a particular group experience in depth by limiting group variations and could therefore be considered a strength for this particular study. However, there have been calls to action to promote more diversity, equity and inclusion in Parkinson’s research in general.28 The current knowledge base around PD is generally a poor representation of the diversity of people with the disease and data remains scarce on many traditionally underrepresented groups such as Black, Latino, Asian and Indigenous groups, LGBTQAI+ and people with lower socioeconomic status. We encourage future investigations that seek to describe health and illness experiences of people with PD within multiple social categories such as ethnicity and gender, rather than by ethnicity or gender, and which utilize an intersectional gender approach in both participant selection and data analysis.54,55 Prioritizing gender identity as an entry point into more complex analysis that includes intersecting social characteristics of people with PD would allow for a more nuanced understanding into how gender dimensions are informed by other social characteristics and when, how and for whom they become relevant in illness experiences. Future directions Our findings emphasize the individual and contextual character of gender-related aspects in the illness experiences and care preferences of people with PD. These findings highlight the need for more precise and personalized methodologies to create more nuanced insights into the impact of gender on PD and to cultivate competence in healthcare professionals to notice contextual factors related to gendered norms or behaviours that could complicate care. Preferences in providers’ gender identity, particularly in the performance of sensitive physical examinations or care, appeared multifactorial and warrant further research to better understand potential drivers behind these gendered provider preferences among people with PD.
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