Microaggressions and the reproduction of social inequalities in medical encounters in Mexico.

This article examines the role of microaggressions in the interactions between biomedical personnel and marginalized patients to addresses the constitutive property of medical interactions and their contribution to a class-differentiated and discriminatory local social world. Based on ethnographic fieldwork over the course of three months (2008-2011) the study examined the clinical relationships between obstetric patients and clinicians in a public hospital in the city of Puebla, Mexico. It reveals four factors present in the social hierarchies in Mexico that predispose clinicians to callous interactions toward "problematic others" in society, resulting in microaggressions within clinical encounters: (a) perceptions of suitability for good motherhood; (b) moralized versions of modern motherhood inscribed on patient bodies; (c) a priori assumptions about the hypersexuality of low-income women; and (d) clinician frustration exacerbated by overwork resulting in corporeal violence. This work concludes by questioning the efforts for universal health rights that do not address underlying social and economic inequities.