Joking about sex was based on the assumption of

joking about sex was based on the assumption of heterosexuality of the docto
patient, and it might be used more often in heterosocial encounters in the intim
context of the physical exam.
Joking reaffirms the legitimacy and normalcy of some sexual behaviors, and
taboo nature of others. But it does this by inverting the normal and the taboo. O
what makes a joke funny is the absurdity and impossibility of the situatio
describes. Thus, some of the health care workers who were interviewed felt
fortable joking about sex with opposite-sex patients and elderly patients. By p
ing out what is absurd, it affirms what is normal and expected. Sexual joking is
a means through which men establish intimacy, although typically this inv
challenging each other's masculinity and sexual prowess. Male joking of this
requires that participants appear invulnerable to these attacks (Lyman 198
situation impossible to maintain in the context of a medical examination. Co
quently, this type ofjoking is absent from the accounts of our respondents, exce
the case of the male nurse who uses joking to demonstrate his heterosexuality t
male patients. Finally, joking can decrease the social distance between patient
their health care providers, and hence it can be used to help comfort and empat
with patients. Even so, it is used selectively, often only with elderly patie
reflecting the ageist assumption that old people are asexual. Several health
providers did acknowledge that sexual joking is potentially dangerous in het
social encounters in the examining room because of its sexualized overtone
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Giuffre, Williams / DESEXUALIZING PHYSICAL EXAMS 475
Consequently, most of the doctors and nurses interviewed said they assiduously
avoid any such joking because they fear it will be misconstrued as a sexual interest.
Threatening the Patient
Four female physicians and nurses encountered problems desexualizing the
physical examination of their patients because they experienced unwanted sexual
advances from male patients. To control such patients, they threatened to physically
or verbally punish them. Some men also reported sexual harassment from patients,
but they never threatened them to control their behaviors. Seven physicians (5 of
them were women) and 11 nurses (9 of them women) said they experienced sexual
harassment from patients, ranging from male patients who attempted to fondle or
grab them, to engage in sexual innuendo, and/or to expose themselves. Some of
these behaviors were experienced as threatening; others were seen as "nothing to
get upset about" and "a part of the job."
Recent studies indicate that sexual harassment affects many women in the health
care industry. Phillips and Schneider (1993) found that 75 percent of female doctors
surveyed reported sexual harassment from patients, most of whom were male. (See
also Schneider and Phillips 1997.) Grieco (1987) found that 76 percent of nurses
surveyed experienced sexual harassment from both physicians and patients. Foner's