Visible body, invisible care: Family, gender politics, and the female caregiver in living donor liver transplantation in Taiwan

Abstract

This study contributes to existing research on gender inequities in living donor liver transplantation (LDLT) by employing a feminist and sociocultural theoretical perspective. Through participant observation and in-depth interviews with 36 participants from 13 families, including 13 donors, 10 recipients, and 13 caregivers, at the Chang Gung Memorial Hospital, this study provides a nuanced understanding of the complexities of family dynamics and gender relations throughout the decision-making and meaning-making processes for LDLT in Taiwan. The interviews were transcribed verbatim, translated from Mandarin to English, and analysed using grounded theory and thematic analysis. The findings reveal that LDLT is a gendered experience embodied through four aspects: 1) the impact of family dynamics and gender politics on decision-making, 2) societal and cultural perceptions of women's bodies and families, 3) the multiple roles and multifaceted care work of female caregivers, and 4) gender differences in the discourse on the meaning-making of LDLT. The study illuminates the complex interplay of family, gender, and care within the sociocultural landscape of Taiwan. It underscores the gendered and hierarchical division of care work within households and the vulnerability experienced by female caregivers and donors, as well as other disadvantaged family members. Furthermore, the study offers insights for healthcare professionals and policymakers to recognise the value of caregiving and the need for more support and resources for caregivers. Future research could adopt a multifaceted approach and inform interventions and policies aimed at reducing gender inequities in LDLT, moving beyond the narrow focus on numerical gender imbalance.