Receiving a positive test result for a BRCA mutation is a life-altering event. Thrust into a biomedical category of “high-risk” for developing breast and ovarian cancer, unaffected BRCA -positive women confront decisions about how to manage their risk. The knowledge provided through the use of genetic testing burdens women with having to make crucial decisions in a context of great uncertainty. Using 25 semi-structured interviews, this paper examines how women make decisions about how to manage their health after learning about a BRCA mutation. We situate the biographies of these women in the context of neoliberal expectations about personal responsibility for health and gender norms, and argue that the intersection of these imperatives plays out in unique ways depending on an individual’s life-stage, resulting in stratified decision-making. For older women who are married and have children, gender and health expectations neatly align. However, for younger, single women without children, the normative expectations about gender and health management often conflict, resulting in the prioritization of gender imperatives over health expectations, albeit temporarily. The analysis concludes with a discussion of the implications of BRCA testing for women and their experiences of choice and decision-making as well as their resistance to preventative surgeries.

中文翻译：

---

健康和性别要求的交叉点：BRCA 突变女性的分层决策

收到 BRCA 突变的阳性检测结果是改变生活的事件。被推入患乳腺癌和卵巢癌的“高风险”生物医学类别，未受影响的 BRCA 阳性女性面临如何管理风险的决定。通过使用基因检测提供的知识使女性不得不在非常不确定的情况下做出关键决定。本文使用 25 次半结构化访谈，研究了女性在了解 BRCA 突变后如何就如何管理自己的健康做出决定。我们将这些女性的传记置于新自由主义对健康和性别规范的个人责任的期望的背景下，并认为这些要求的交集会根据个人的生命阶段以独特的方式发挥作用，从而导致分层决策。对于已婚并有孩子的老年妇女，性别和健康期望完全一致。然而，对于没有孩子的年轻单身女性，关于性别和健康管理的规范期望经常发生冲突，导致性别要求优先于健康期望，尽管是暂时的。分析最后讨论了 BRCA 检测对女性的影响、她们的选择和决策经历以及她们对预防性手术的抵抗力。