抄録
「性役割」をどのように捉えるかは諸家の意見の分かれるところであるが, 「自分は自分であることの自覚」とも表現される, 自我同一性の面からみると, これは単一ではなく多様である。こうした男性・女性が共同生活を営む時, それは「結婚」として表現される。そこで「性役割からみた中高年の心身医学」を筆者の経験した4症例をあげて検討した。その結果, 夫婦それぞれの性役割の混乱, 婦人科手術後における女性としての性役割の混乱, 夫婦それぞれの性役割の分離, 分散と統合への欠如, さらに男性・女性それぞれの性役割を抱えすぎ, 「どのような自分」として生きていこうとするのかの同一性選択の危機などがみられた。ことに, 産婦人科領域の心身症を扱う場合には, 「性」および「性役割」は看過できない問題である。
The concept of "gender" gives us a vague impression. The term"gender role" rs usually deflned as the role people are expected to play in the community based on their sex, but how to interpret the phrase is disputable. When gender role is considered from the standpoint of ego identity, as expressed by the term "I am myself", it is not simple. Female identity should be studied with a view to the position of a daughter, wife, mother and woman who experiences ovulation and menstruation. The same approach may be applied to male identity. Marriage is the union of man and woman who have such ego identity, as well as background differences. This study describes 4 cases entitled "Psychosomatic Medicine applied to Middle-aged and Elderly People from the Viewpoint of Gender Role" : 1) a couple who have problems in the bond between husband and wife : 2) a woman who has lost confidence regarding her sexuality after a gynecological operation : 3) husband and wife in climacterium, and 4) a woman with psychosomatic pruritus vulvae. As a result, in 1), the couple was confused about their gender roles. In 2), the woman lost her sexual identity after an operation, causing inner confusion about her gender role. In 3), they had different ideas about their gender roles and little willingness to compromise. Finally, in 4), the woman had too strong a role both as a man and a woman as she defined her identity, and faced a crisis in identity choice. Such anxieties were thought to have been expressed in various symptoms. It is suggested that in the three cases above, reading a full understanding between husband and wife by exchanging their views, which I summarize as 6 points, is essential to remission and resolution of these symptoms. In any patient with psychosomatic disease, especially when it is related to gynecological issues, gender and gender role should not be overlooked.
