“I feel like most people seem to just go with the flow”: Menopause, stigma and Chinese culture

This study investigates the lived experiences of menopause among Chinese women residing in Greater China (Hong Kong and mainland China). Specifically, it focuses on menopausal stigma, a focal theme identified by previous research on menopause. Existing public outreach and health campaigns in Western and Chinese contexts to date assume universality of menopausal stigma and focus on de-stigmatizing this life stage. In this paper, we draw on theme-oriented discourse analysis and 46 interviews with Chinese women to examine their actual experiences of menopausal stigma in relation to their self-perceptions (self-stigma) and their social environment (public stigma). Based on the analysis of our data, we demonstrate that menopausal stigma is less pervasive and more implicit in the analysed Chinese contexts, with a general societal shift towards a greater acceptance and normalization of menopause. Women also express a preference for traditional Chinese medicine and cultural practices of care. Residual stigma, however, still exists, and manifests discursively through contextual factors (topic focus, preference of informal settings) and interactional features (vague language, hedging, pauses). Overall, our analysis challenges the universality of the phenomenon of menopausal stigma and foregrounds the importance of culturally- and context-specific frameworks of menopause for public outreach and health campaigns. Our study lends support to observational methodologies being most suitable to investigating the intra- and inter-personal dimensions of stigma. In particular, a discourse analytic enquiry provides a nuanced understanding of women’s lived experiences and reveals the subtleties of underlying societal attitudes and ideologies. • Menopausal stigma is less pervasive and more implicit in Greater China • There is a societal shift towards a greater acceptance of menopause in China • The shift towards acceptance of menopause is related to increased knowledge • Sociocultural contexts shape women’s experiences and societal attitudes • Discourse analysis is useful for investigating intra- and inter-personal stigma