Does Self-Identifying as Having a Health Problem Precede Medical Contact? The Case of Infertility

Abstract

Studies of medical help-seeking presume that self-identifying as having a health problem precedes medical contact, but this ordering of the identity-behavior relationship has not been systematically examined. We used longitudinal data from the National Survey of Fertility Barriers (2004Barriers ( to 2010 on 412 women with infertility to document the temporal relationship between self-identifying as having a fertility problem and making medical contact. The symbolic interactionist perspective suggests that infertility will be perceived as identity disruption and that in response women will align self-identity and medical behavior over time. Cross-tabulation analysis indicated that more women do self-identify as having a fertility problem first (24 percent) as opposed to making medical contact first (5.5 percent). There was also a tendency toward aligning self-identification and behavior over time. Latent class analyses revealed six patterns: 1) consistently involved, 2) early consulters, 3) consistently uninvolved, 4) consistent perceivers, 5) medical dropouts, and 6) early perceivers. Strong fertility intent and primary infertility, two identity-relevant characteristics, had the strongest associations with latent class membership. The relationship between selfidentification and medical help-seeking is thus dynamic and complex.Studies of medical help-seeking often presume that self-identifying as having a health problem precedes medical contact (Andersen 1968;Pescosolido 1992;Thoits 1985;White et al. 2006;Zola 1973), but such temporal ordering of the identity-behavior relationship has not been systematically addressed. Furthermore, there are examples of people seeking *

Self-Perceived Infertility is Not Always Associated with Having Fewer Children: Evidence from German Panel Data

“…If they become pregnant relatively soon after perceiving a fertility problem, they are likely to cease to perceive a problem, but—if they continue to attempt to have a child without success—they will continue to perceive themselves to be infertile. People may sooner or later seek medical treatment, at which time doctors will define them as infertile, and this will likely help to solidify their self-perceptions (Greil et al, 2020 ).…”