Babes and boobs? Analysis of JAMA cover art
Abstract
Objective To determine the representation of the sexes in JAMA cover art.
Design Review of 50 consecutive issues.
Setting JAMA, March 1997-March 1998.
Main outcome measures Numbers and nature of covers portraying men and women.
Results Of the 50 covers, 34 depicted humans. 15 depicted women, 13 men, and 6 were of mixed or indeterminate sex. 11 pictures of women included a child and five included nudity. One cover showed a man with a child (not as a father) and none depicted nudity. Men were depicted exclusively in authoritative roles.
Conclusions Much of the cover art gives strong messages about sexual stereotypes that are inappropriate in modern society. JAMA should consider reviewing its policy for choosing cover art.
Introduction
Since the 1960s JAMA, the journal of the American Medical Association, has featured various pieces of art rather than the conventional table of contents on its front page. "Cover art" distinguishes JAMA from the leading international general medical journals with which it strategically competes for market share. Medical journals have been urged to "preserve the basic elements that make them credible, even as many of the specific practices and the external appearance of these journals change"[1] and the use of fine art provides an interesting example of how JAMA attempts to draw attention to itself and to "emphasize the humanities in medicine."[2] But are there other messages conveyed by cover art? Given that fine art is not just aesthetically moving but--like literature, music, the media, and other cultural products--makes statements that are often social, cultural, and political in nature, cover art demands a critical gaze.
Methods and results
I reviewed 50 consecutive JAMA issues (one year), starting with 19 March 1997. Of these 50 issues, 34 (68%) covers depicted human images; 15 presented female subjects, 13 presented male subjects, and six presented subjects of mixed or unknown sex. Of the 34 covers depicting humans, 25 (74%) presented stereotyped sex images--that is, women were predominantly positioned as "objects" (of desire) and men as (powerful, strong) "subjects." Five covers portrayed women working in traditional roles such as carers or cleaners and eight presented women with soft or white imagery as virginal, angelic, or sexualised figures. Women were depicted as submissive, with their eyes averted or gazing down, in 13 covers. Men, on the other hand, were depicted almost exclusively in authoritative roles, as religious,[4] scholarly[5], or military[3] figures, with their eyes directly facing the viewer.
Of the 15 covers depicting women, 12 included babies and six showed nudity. In contrast, only one male image included a child and none contained nudity. In the cover depicting a man with a child, the man is not the child's father but its doctor. Babes and boobs were featured in 12 of the 50 covers.
Conclusions
Visual imagery associated with medical journals shapes our understanding of health and the human body. Images of babes and boobs in cover art emphasise women's sexual and domestic roles, representing women in traditional and stereotypical ways that undermine contemporary beliefs in the equality, autonomy, and status of women.[3 4] These representations do not reflect women's contributions to the domains of science, medicine, and academia, which are frequently the focus of scientific reporting in the leading medical journals. Although O'Kelly's review of Western art history books showed sexual stereotypes in fine art throughout the Gothic, Renaissance, Baroque, and Modern art periods, 70% of fine art depicted male subjects.[5]
JAMA's traditional representation of women in cover art is in sharp contrast to its coverage of issues relating to women's health, which in this sample of 50 issues amounted to 29 original contributions, five editorials, and seven letters. Furthermore, seven items in these issues discussed domestic violence and its implications for health and medical care. The proportion of women graduates from medical schools is approaching 50%,[6] and the profile of sex and inequity issues in medicine is increasing.[7 8] Critical discussion of the physician-patient relationship is also burgeoning,[9 10] and medical journals have broadened their mandates and scientific and editorial content to include social and political dimensions of health."[11-13]
The stereotypical representations of the sexes in this one year sample of JAMA covers seems to detract from the stated social responsibility of medical journals. Although it is said that you cannot "judge a book by its cover," cover art seems to provide provocative visual imagery each week for JAMA's diverse and international readership. JAMA is widely circulated to a diverse readership and its promotion of scientific excellence implies a critical review of all material published in its pages. It would be of benefit to see a more thoughtful and balanced representation of women on the front page, reflecting growing scientific coverage of and concern with women's health and social issues.
What is already known on this topic
JAMA has used art on its covers since the 1960s
Much art depicts men and women in stereotypical roles
What this paper adds
Two thirds of JAMA covers over one year depicted humans
Women were mostly shown in traditional caring roles or in sexualised images
Men were portrayed in authoritative roles
Use of art which shows sexual stereotypes on covers seems incompatible with the heightened sensitivity to social issues in medicine
This report was originally submitted to JAMA as a letter to the editor. After nine months of evaluation and peer review it was rejected.
I thank Professor Patricia McKeever for valuable discussion and insight.
Contributors: JPC initiated the project, collected data, conducted the data analysis, wrote the manuscript, and is the guarantor of the paper.
Funding: JPC is a doctoral fellow of the National Health Research and Development Program, Health Canada.
Competing interests: None declared.
[1] Fletcher RH, Fletcher SW. The future of medical journals in the western world. Lancet 1998;352:SII30-3.
[2] Lundberg GD. The art of JAMA is now available. Science News Update 1996 October 30:1.
[3] Gamman, L, Marshment M. The female gaze: women as viewers of popular culture. Seattle: Real Comet Press, 1989.
[4] Itzin C. Media images of women: the social construction of ageism and sexism. In Wilkinson S, ed. Feminist social psychology. Philadelphia: Open University Press, 1986.
[5] O'Kelly C. Gender role stereotypes in fine art: a content analysis of art history books. Qual Soc 1983;6:136-48.
[6] Waalen J. Women in medicine: bringing gender issues to the fore. JAMA 1997;277:1404.
[7] Bickel J. Gender stereotypes and misconceptions: unresolved issues in physicians' professional development. JAMA 1997;277:1405-7.
[8] Fried LP, Francomano CA, MacDonald SM, Wagner EM, Stokes EJ, Carbone KM, et al. Career development for women in academic medicine: multiple interventions in a department of medicine. JAMA 1996;276:898-905.
[9] Meryn S. Improving doctor-patient communication--not an option, but a necessity. BMJ 1998;316:1922.
[10] Smith R. Renegotiating medicine's contract with patients--the GMC is leading the way. BMJ 1998;316:1622-3.
[11] Kassirer JP. Should medical journals try to influence political debates? N Engl J Med 1999;340:466-7.
[12] Kandela P. Medical journals and human rights. Lancet 1998;352:SII7-11.
[13] Haines A, Smith R. Working together to reduce poverty's damage. BMJ 1997;314:529-30.
*** We invited,lAMA to comment, but Dr Therese Southgate, who is responsible for JAMA's covers, declined to respond.
Department of Public Health Sciences, University of Toronto, Toronto, Canada M5S 1A8 doctoral candidate
Correspondence to: J P Clark, Centre for Research in Women's Health, Toronto, Canada M5G 1N8
j.clark@utoronto.ca
BMJ 1999;319:1603-5
COPYRIGHT 1999 British Medical Association
COPYRIGHT 2000 Gale Group
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