Abstract：
Previous research shows that men who experience erectile or sexual dysfunction may feel uncomfortable discussing their sexual experiences in face-to-face clinical encounters. Part of the reason is the stigma and embarrassment associated with discussing private sexual matters. This study examines how e-patients, or more precisely advice-seekers, and doctors communicate about sexual dysfunction in online medical consultations (OMCs). We conducted a Theme-Oriented Discourse Analysis of relevant OMCs on CH Doctor, a Chinese medical consultation website, to understand how individuals with perceived sexual dysfunction articulate their conditions and how doctors on the platform respond and provide recommendations to these individuals. Our analysis reveals that OMCs afford advice-seekers a place to openly discuss their sexual health issues and gain empowerment from doctors who assist in mitigating the associated social stigma. Upon detailed discourse analysis, however, we find that individuals seeking advice often interpret their sexual experiences as symptoms of illness that requires medical intervention. In response, doctors tend to validate these advice-seekers\' preliminary self-diagnoses by treating their conditions as medical issues and characterizing them as psychosocial problems caused by stress and anxiety. Aligning with a critical sociological perspective that views sexual dysfunction as socially constructed problems referenced against dominant norms of sexual functioning, we argue that the medicalization and psychologization of certain sexual behaviors by doctors and advice-seekers discursively reinforce and legitimize essentialist views of hetero-coital sexual interaction. Such views reify penile-vaginal intercourse and ejaculation as the only standard, successful, and desirable form of sexual activity. This may further induce fear and anxiety among adult men whose sexual behaviors do not realistically align with these norms.
摘要：
先前的研究表明，经历勃起或性功能障碍的男性在面对面的临床接触中讨论他们的性经历可能会感到不舒服。部分原因是与讨论私人性行为相关的污名和尴尬。这项研究调查了电子病人，或者更确切地说，寻求建议的人，和医生在在线医疗咨询（OMC）中交流性功能障碍。我们对CHDoctor的相关OMC进行了主题导向的语篇分析，一个中国医疗咨询网站，了解感知性功能障碍的个体如何表达他们的病情，以及平台上的医生如何回应并向这些个体提供建议。我们的分析显示，OMC为寻求建议者提供了一个公开讨论其性健康问题的地方，并从协助减轻相关社会污名的医生那里获得授权。经过详细的语篇分析，然而,我们发现，寻求建议的人经常将他们的性经历解释为需要医疗干预的疾病症状。作为回应,医生倾向于通过将他们的状况视为医疗问题，并将其描述为由压力和焦虑引起的心理社会问题，来验证这些寻求建议的人的初步自我诊断。与批判的社会学观点保持一致，该观点将性功能障碍视为社会建构的问题，而这些问题是针对性功能的主导规范的，我们认为，医生和寻求建议者对某些性行为的医学化和心理化，在话语上强化了异性性交的本质主义观点并使之合法化。这些观点将阴茎阴道性交和射精作为唯一标准，成功,和可取的性活动形式。这可能会进一步引起成年男性的恐惧和焦虑，他们的性行为实际上与这些规范不符。
