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This thesis is a discursive and conversation analytic study of how people talk about gender in the context of discussions about leisure. The data comprise a corpus of over 600 pages of transcribed talk-in-interaction from a variety of sources, including dinner discussions, focus groups, informal interviews, newspaper and magazine articles, television talk shows and documentaries. In contrast to most feminist leisure research, I take participants' talk as my starting point. I explore how gender is made relevant by participants and constituted in the course of their discussions, and what these constructions are used to do interactionally. The thesis works on two levels. First, it provides a distinctive contribution to leisure research, sport sociology and psychology. It explores what leisure theorists have themselves constructed as 'the problem' in leisure theory, and demonstrates how a discursive, conversation analytic approach can help transcend some of these theoretical and methodological 'problems' - including the way that the concept of leisure itself might be conceived and studied. It identifies three structuring concerns in feminist leisure theory, and provides a discursive and conversation analytic reworking of each of them: (i) Justifications for the Non-Participation of Women in 'Male-Identified' Activities; (ii) Hegemonic Masculinity; and (iii) Heterosexism. Second, it provides a distinctive contribution to discursive and conversation analytic approaches to gender, by problematizing and developing our understanding of the way femininity, sexism, masculinity and heterosexism 'get done' in talk. It concludes with a discussion of the implications of this approach for feminist leisure theory, discursive psychology and conversation analysis, and challenges researchers with an interest in 'ideology' and 'power' to take this approach seriously. It finishes with some questions for future analysis.

Objectives: Kinship care is an arrangement that provides permanency for children who would otherwise be in care or adopted, in which they live with members of their own families. This policy is widely promoted on the basis of continuity of family identity for the child. However, the reverse is experienced by carers, who are observed in kinship care studies encountering a range of challenges to their parental identities from people both in- and outside the family. This study aims to investigate how carers manage their 'alternative' parental identities, and how they establish and defend their good character in the process. It also aims to extend the application of Conversation Analysis (CA), both to analysing the construction of non-standard family identities, and the co- construction of peer identities. Methods: The dataset comprises video recordings and verbatim transcriptions of ten unfacilitated community-based peer support group meetings across England (total number of participants n=92), in which kinship carers engaged in conversation with each other in response to the question 'What's it like being a kinship carer? Following data trawl of detailed transcriptions, using CA theory relevant to the interactional co- construction of identity, sets of discursive features were identified, which were analysed to show how carers were achieving parental identities in the group interactions. Results: The study identifies 105 complaint sequences containing discourse features which confirm prior studies' findings about the identity challenges endemic in the role but show how carers actively manage those challenges and affirm their own 'good parent' identity. Novel processes of parental identity construction are shown, relevant to the everyday experiences of carers, in complaints of third party microaggressions, and birth parents' use of social media and time. In the process of sharing these complaints, carers establish their own membership of the 'good parent' category. Conclusions: The study has produced new insights concerning kinship carer's family identities. It also develops and extends CA theory on identity construction relating to parental identities, non-standard family roles, and the interactive construction of 'peer' identities. The implications of these findings are discussed, together with avenues for future research on the co-construction of identity, particularly in hidden, stigmatised or non-traditional roles.

Background: Thousands of patients and general practitioners (GPs) talk about medicines every day during their consultations. Due to the confidential setting in which these conversations take place, little is known about the ways in which they play out between participants. Alongside the benefits provided by medicines doctors prescribe, there is a worrying degree of avoidable harm and expenditure introduced by errors and misunderstandings about these treatments. This thesis sets out to explore talk about medicines in GP consultations and enhance our understanding of the ways in which medicines are requested, reviewed and included in the fabric of talk-in-interaction. Methods: GPs working at five practices were approached. Eight GPs agreed to take part. Surgery lists were assigned to the research and adult patients from each surgery were contacted. Information about the research was provided to all patients recruited to take part in the study. Video recordings of their consultations were made with the participants' consent. These were collected at eleven surgeries. Talk from the recordings of these consultations were analysed using a conversation analytic approach. The analysis of conversation was made alongside review of non-verbal communication and body position of participants captured in the video recordings. Results: Seventy-nine patients were recruited and 78 consultations were recorded. Patients and GPs used a spectrum of practices during their talk about medicines. Features of patient talk included expression of their lifeworld experiences, concerns and considerations in relation to medicines. Doctors varied in their responses to these biopsychosocial contexts, with a range of practices. Some took a biomedical perspective and excluded these contexts; others embraced the lifeworld as part of the fabric of their consultation. Requests for medicines were made during a variety of consultation activities. Doctors and patients were both seen to orient to contingencies around the supply of prescription medicines as part of this talk. In the review of medicines, the electronic record played a powerful part in the consultation. Doctors used a range of conversational and non-verbal practices in relation to this resource. Some practices inhibited and constrained patient slots in conversation, and some opened out possibilities for patients to participate in talk. Conclusions: The analysis of talk that takes place between GPs and patients as they discuss medicines has revealed a rich and informative insight into the ways in which participants conduct these conversations. The findings from this research can help guide future design of education and practice, focused on the creation of slots for talk about medicines during medical consultation.

The thesis sought to gain an in-depth understanding of the psychosexual impact of prostate cancer treatment and associated clinical communication needs. It is comprised of three standalone papers. Papers one and two are prepared for submission to the journal Social Science and Medicine and in accordance with the journal guidelines. Paper one is a systematic review and meta-synthesis of qualitative findings related to men's perspectives of the impact of localised prostate cancer treatment on sexual intimacy. A systematic search of four key databases was conducted. Twelve studies met the inclusion criteria for the review. Findings are organised within four inter-related themes: i) Loss and grief: Destroyed intimacy; ii) Going through the motions: Artificial intimacy; iii) Fear of failure: Avoiding intimacy; iv) Breaking barriers: Alternative intimacy. The themes form a conceptual model describing how men can experience sexual intimacy in the context of localised prostate cancer. The implications of this model for health care professionals and researchers are discussed. The meta-synthesis established that psychosexual wellbeing is a salient concern of men who have undergone prostate cancer treatment providing a strong rationale for empirical study into men's clinical communication needs in this area. Hence, paper two is a qualitative study illuminating men's clinical communication needs in relation to the psychosexual aspects of prostate cancer treatment. Twenty one men were interviewed and transcripts were analysed using thematic analysis. Three themes were identified which describe the psychosexual clinical communication challenges men encountered: i) "Sex is kind of the last thing on my mind": It can be too soon to talk about sex; ii) The importance of "recognising nuance": Clinician's assumptions can lead to not treating as an individual; iii) "It's just so mechanical": The psychology of sex is missing. Theoretical and substantive implications of the findings are discussed. Paper three provides a critical review of papers one and two and offers reflexive commentary on the qualitative research process. This paper offers personal and professional reflections, a critique of epistemological and methodological issues raised by the two studies and an extended discussion of the implications of the findings in relation to both research and clinical practice.

Working at the intersection of medical sociology and the psychology of health, language and communication, in this PhD I use thematic analysis (TA) and conversation analysis (CA) to provide an insight into various aspects of doctor-patient communication that may be considered, or are constructed as, challenging and/or delicate for either the patient, doctor or both at a Gender Identity Clinic (GIC) in the UK. This project involves the secondary analysis of two existing data-sets: (i) 21 recorded telephone interviews between my PhD supervisor and transsexual patients who attended the GIC; (ii) 156 transcribed audio-recordings and 38 video-recordings (total = 194) of psychiatrist-patient consultations in the GIC. The first original research paper uses TA to investigate the views and experiences of transsexual patients regarding their communication with psychiatrists at the GIC. An important finding was that patients actually appreciated being challenged in this setting, subsequently the implications of this are considered with regards to the achievability and desirability of patient centred communication. The second research paper uses CA to consider how patients overtly challenge psychiatrists in the GIC in ways that have not been shown in conversation analytic research on medical interactions to date. Analysis of the data corpus revealed that there were three common ways in which patients challenged psychiatrists at the GIC, which are (1) by problematising their questions; (2) by disagreeing with statements that are made regarding their treatment; (3) and by initiating complaints. The findings of this study are considered in relation to the implications that they have for clinicians and for the persistence and desirability of asymmetry in clinical interaction in light of the current debates surrounding the concept of patient-centeredness. The final research paper also uses CA, in this instance to study how the topic of weight, which is often constructed and orientated towards as delicate in talk-in-interaction, is occasioned and discussed by psychiatrists and patients at the GIC. Whereas previous CA research on this topic has focused on how this is constructed by speakers as a moral issue, this paper is concerned with focusing on how psychiatrists (1) establish with patients that their weight is an issue, (2) encourage patients to lose weight by informing them that this is their responsibility and (3) offer advice on the behavior changes associated with weight loss. The results of this paper are discussed with regards to the implications that they have for clinicians who discuss the potentially delicate topic of weight with patients in a number of different settings. This project contributes towards the growing debates regarding the achievability and desirability of patient centred communication and the persistence of asymmetry in clinical interaction. It also contributes to medical conversation analytic literature to date on asymmetry and talk about weight in clinical interactions.