"I was the Woman, he was the Man": dementia, recognition, recognisability and gendered subjectivity

The research question centers on how gender influences the recognition of subjectivity in individuals with dementia. The article builds upon existing scholarship challenging the notion of "loss of self" in dementia, advocating instead for continued recognition of the person's subjectivity. However, it notes the absence of discussion regarding the role of gender in this recognition process. The study's importance lies in its exploration of how being recognized as a subject is intrinsically linked to being recognized as a gendered subject, particularly within the context of dementia where cognitive changes profoundly affect identity. The introduction uses the example of Anna, a participant in an interview study, whose sense of self as a woman changed significantly following her husband's Alzheimer's diagnosis, illustrating the central research question's relevance and impact. This sets the stage for exploring how dementia impacts gender performativity and how cultural narratives influence the recognizability and recognition of gendered subjectivity in those with dementia.

The literature review examines existing research on dementia and subjectivity, highlighting the dominant discourse of "loss of self" and contrasting it with more recent work emphasizing the persistence of subjectivity in dementia. It critiques the biomedical model's tendency to reduce subjectivity to cognitive capacity. Key figures like Tom Kitwood and Lucy Burke are referenced for their emphasis on the crucial role of intersubjective recognition in sustaining personhood in dementia. The review points out a significant gap in the existing literature: the lack of attention to the role of gender and other social positionings (race, class, sexuality) in shaping experiences of recognition and subjectivity in dementia. Existing studies acknowledging gender are discussed, but their limitations are highlighted due to their implicit assumption of stable pre-existing gendered subjects.

The study employs a "scavenger methodology" combining qualitative interview data with analysis of a literary narrative. The qualitative interview study involved 19 participants in Sweden – individuals diagnosed with Alzheimer's disease and their spouses. The interviews focused on their experiences of sexual relationships and intimacy after an Alzheimer's diagnosis, exploring the impact on subjectivity. Thematic analysis identified the significant theme of recognition (or loss thereof) and its connection to gender. Four interview narratives (Henning, Ellinor, Anna, and Christina) are selected for detailed analysis due to their illustrative portrayal of this theme. The novel *Minns du?* [Do you remember?], by Alice Staffan Beckman, is incorporated as a counterpoint to the interview data; it provides an alternative perspective on intersubjective recognition in dementia that transcends binary gender. The interviews are semi-structured to allow for broader narrative accounts. Participants were recruited from memory clinics, support groups, and day centers. The author acknowledges the ethical complexities involved in representing the perspectives of both individuals with dementia and their partners, especially when experiences are incongruent. The use of pseudonyms protects participant anonymity. The author explicitly discusses the intersectionality of age and class, acknowledging their influence on recognition in the context of dementia.

The analysis of interview narratives reveals how recognition of subjectivity in dementia is closely tied to gendered recognition. In the cases of Henning and Ellinor, maintaining a sense of masculine subjectivity was crucial for sustaining overall selfhood. Henning emphasized his intellect and sexual activity, while Ellinor actively tried to maintain her husband's image as a strong, capable man, even adjusting sexual intimacy to preserve his sense of masculinity. These findings align with other studies that show how families and spouses try to actively counter the challenges of dementia to maintain their loved one's masculine status. However, Anna and Christina's narratives present a contrasting perspective. Anna describes how her husband's cognitive decline diminished her sense of self as a woman; his changing intellect and gaze altered her perception of him as 'The Man', consequently affecting her own sense of self as 'The Woman.' This highlights how dementia disrupts the heterosexual matrix, rendering both partners unrecognizable within their former gendered roles. Christina's narrative illustrates the reduction of her husband to a child-like figure, stripping him of his masculine identity. The 'child' metaphor, and the later metaphor of the 'dog', highlight how dementia narratives can position those with the condition as outside the realm of intelligible human subjectivity, impacting sexual desires and relationships. The analysis of *Minns du?* offers a counterpoint to these narratives of loss and unrecognizability. The novel depicts an enduring intersubjective recognition that transcends both cognitive function and binary gender. The non-binary narrator, Alice, and their partner AnnaBelle's relationship emphasizes touch and mutual care, demonstrating that recognition can persist even in the face of memory loss. Their relationship, described as 'disoriented,' challenges the heterosexual matrix and shows the possibility of recognition beyond conventional gendered norms.

The findings highlight the significant interplay between gender, recognition, and subjectivity in dementia. The persistent recognition of masculine subjectivity within the narratives of Henning and Ellinor underlines its importance in maintaining overall selfhood. The contrasting narratives of Anna and Christina demonstrate how cultural perceptions of dementia can lead to unrecognizability and disrupt gender performativity, affecting both the person with dementia and their partner. The novel *Minns du?* offers a counter-narrative, showing that recognition can exist independently of cognitive function and conventional gender roles. This challenges the dominance of neuroculture, suggesting that affective touch and mutual care can form alternative bases for recognition. The study’s findings have implications for both research and practice in dementia care. Recognizing the significance of gender in maintaining subjectivity in dementia is crucial for providing person-centered care that validates individuals' identities. Future research should explore how dementia interacts with diverse gender identities and sexual orientations and should explore how dementia affects people who live with non-normative gender identities.

This study significantly advances the understanding of subjectivity and gender in dementia. It reveals the importance of gendered recognition in maintaining a sense of self in individuals with dementia while also highlighting the disruptive impact of cultural narratives that render them unintelligible. The study underscores the need for person-centered care approaches that value and affirm diverse identities. Future research should investigate the experiences of individuals with dementia who identify outside the gender binary and explore alternative modes of recognition based on affect and tactility.

The study's reliance on a limited number of narratives, predominantly from a specific cultural context, may limit the generalizability of the findings. The inclusion of a literary text introduces potential biases associated with fictional narratives. Future research should involve a larger, more diverse sample to enhance the robustness of the findings.