Abstract
This article studies the depiction of psychosexual health in literary accounts through a critical analysis of three seminal texts: Jane Eyre, The Yellow Wallpaper and The Treatment of Bibi Haldar from Interpreter of Maladies. It traces the thematic development of feminine “madness” in these works and examines how madness is historically ingrained in unacknowledged sexual dissatisfaction and universal medicinal negligence. Rooted in historical accounts of 18th to 19th-century gynecological practices, predominantly the practice of genital massage by physicians as an ostensible cure for “hysteria.” This article aims to highlight how psychosexual anguish was both misinterpreted and altered through a gendered medical purview. The study further questions the structure of a patriarchal chronicle that pathologized female sexuality, associating emotional countenance and carnal desires with cerebral volatility. In contrast, masculine emotional restraint was valorized as rationality, emphasizing on the binary oppositions in emotive and sensual comportment. By aligning these texts within the broader psychosexual discourse of sexual medicine, psychiatry, and gendered storytelling, this article accentuates the necessity to revisit historical attitudes toward women’s sexual well-being and redefine the limits of psychosexual wellness in modern medical practice. Such analysis aligns with the study of psychosexual health to integrate medical, psychological, and cultural viewpoints on sexuality, offering a critical reflection on the historical reinforcements that continue to shape modern understandings of gendered sexual health.
Keywords
Introduction
Psychosexual health refers to the general welfare of an individual regarding their sexual development. It includes identity, sexual orientation, behavior, relationships, and mental experiences of sexuality. 1 It is a holistic notion that integrates the biological, emotional, and cognitive aspects, which affect the social scopes of sexuality and mental health. Essentially, it includes healthy sexual performance, including the ability to feel desire, arousal, intimacy, and satisfaction without distress or dysfunction. 2 It also comprises a stable and cohesive sense of sexual identity and orientation. It makes individuals feel comfortable with their gender, body, and desires. Emotional and psychological well-being is essential in an individual for the absence of shame, fear, or anxiety related to one’s sexuality and the poise to express and navigate carnal desires. Psychosexual health also depends on the capability to establish and sustain consensual, respectful, and emotionally fulfilling relationships, where communication and mutual satisfaction are prioritized. 3 This study bridges that gap by showing in what way feminine insanity is rooted in sexual subjugation. It has been both criticized and disseminated through literary accounts informed by therapeutic experts. The World Health Organization (WHO) defines sexual health accordingly, which includes psychosexual health, as: “A state of physical, emotional, mental, and social well-being in relation to sexuality; it is not merely the absence of disease, dysfunction, or infirmity.” 4 Psychosexual health specifically emphasizes the interaction between the emotional and erotic. The selection of Jane Eyre, The Yellow Wallpaper and Jhumpa Lahiri’s The Treatment of Bibi Haldar is intentional in order to construct a cross-historical and cultural psychosexual repression with gendered medicalization of female distress. These texts emerge from different literary traditions: Victorian British fiction, American feminist short fiction and contemporary postcolonial South Asian literature; collectively reveal the persistence of a shared narrative pattern and the pathologization of women’s emotional and sexual expression within patriarchal societal structures. By situating these texts across different historical moments, the study demonstrates how the discourse of feminine “madness” evolves yet continues to function as a mechanism for regulating women’s sexuality, autonomy and psychological agency. Despite increasing scholarly attention to women’s mental health in literature, the relationship between psychosexual repression and the literary construction of feminine madness remains insufficiently addressed across cross-historical literary traditions. While previous studies have examined hysteria within individual texts, fewer studies investigate how emotional repression and denial of sexual autonomy collectively function as mechanisms that produce the narrative trope of female madness. This study, therefore, aims to examine how literary representations of hysteria in Jane Eyre, The Yellow Wallpaper and The Treatment of Bibi Haldar reveal the intersection of psychosexual repression, patriarchal medical discourse and social construction of female insanity.
Historical Medical Discourse on Hysteria
Historically, disturbances in women’s emotional and sexual well-being were frequently interpreted through the medical category of hysteria, a diagnosis rooted in patriarchal assumptions about female biology and morality. 19th-century medical discourse frequently portrayed hysteria as a natural outcome of female physiology rather than as a response to social and psychological repression. Contemporary scholarship, however, suggests that hysteria functioned less as a medical condition and more as a cultural mechanism used to regulate women’s sexuality, emotional expression and social roles. 5 Literary texts from this period provide an important archive through which these assumptions can be examined, revealing how psychosexual repression, restrictive gender norms and medical authority collectively contributed to the stigmatization of female psychological distress. Emotional repression and sexual deprivation form a central thematic axis in these texts, in which female psychological suffering has historically been expounded through moral and medical structures rather than a complete understanding of psychosexual well-being.
Madness, Women and Literature: Overview
Across the complete Western literary history, women’s insanity has often been punished, not only as a narrative trope but also utilized to reflect broader societal mechanisms aimed at regulating female behavior, sexuality, and agency. One of the most iconic portrayals of female madness appears in William Shakespeare’s Hamlet through the character of Ophelia, whose descent into madness is often read as the consequence of emotional repression, patriarchal control, and the denial of self-expression.
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Polonius, her father, silences her and Hamlet, her partner, abandons her. Finally, Ophelia’s lost sanity unfolds through her song, fragmented speech and symbolic gestures. She sings,
Young men will have sex if they have the chance; By God, they are to blame. She said, Before you slept with me, You promised to marry me.
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Her insanity is poetically visible and mournfully aesthetic, making her a tragic figure. She reflects the wider cultural tendency to equate female suffering with beauty and fragility, rather than with political resistance or psychological realism. Literary critics such as Sandra Gilbert and Susan Gubar, using the lens of feminism in The Madwoman in the Attic, argue that characters like Ophelia presage a lineage of “madwomen” in literature. 8 They serve as surrogates for feminine rage and resistance. Getting repressed under the weight of patriarchal expectations. Elaine Showalter, in Representing Ophelia, states that Ophelia’s insanity has been repeatedly interpreted through shifting historical lenses. From a psychosexual perspective, Ophelia’s collapse can also be interpreted as the consequence of emotional suppression and the denial of sexual and personal agency, conditions that feminist scholars identify as central to the historical pathologization of women’s psychological distress. These lenses often strip it of context and reduce it to a male-authored display of feminine vulnerability. 9 In the 18th and 19th centuries, feminine insanity was often diagnosed as “hysteria,” a term derived from the Greek “hystera,” which literally means “uterus.” 10 The literary tradition maintains its critical pedigree by portraying a female protagonist’s mental instability as a response to isolation, a lack of sex, and actual neglect, as opposed to a predisposition stemming from internal causes that actually manifest from psychosexual impulses that are denied a high degree of autonomy. The treatment meted out to these individuals can be a function of the control maintained over the psychosexual impulses of females.11,12 Influenced by the theories of Michel Foucault on medical surveillance and the institutional construction of “truths” and work on the medicalization of female sexuality, particularly The Birth of the Clinic and The History of Sexuality, it would seem that female madness is often a socially constructed reaction against confinement, repression, and erasure.13,14 More contemporary critical frameworks of Mad Studies and Disability Studies further critique this by rejecting madness as an exclusively medical category and instead viewing it as cultural dissidence and an embodied protest.15,16 Within literary narratives, hysteria frequently emerges as a symbolic expression of repressed emotional and sexual subjectivity. When female characters are denied autonomy over their bodies, desires and intellectual lives, psychological distress is often translated into the narrative language of madness. Feminist critics argue that such portrayals reflect not biological instability but the psychological consequences of social repression, where emotional silencing and sexual regulation produce forms of psychological fragmentation that literature represents as hysteria.
Theoretical Framework
The research undertaken incorporates an interdisciplinary approach to theory that brings together feminist literary theory, the history of medicine, and critical disability/mad studies as a way of critically analyzing the concept of women’s psychosexual health and madness as portrayed within literature. The literature that has been cited primarily includes the works of authors such as Elaine Showalter, Michel Foucault, Rachel Maines, Lennard J. Davis, Rosemarie Garland-Thomson, and Margaret Price to trace the medicalization of women’s psychosexual health as a concept that has been culturally constructed. Within her book The Female Malady, Showalter highlights the role of women’s mental illness within literature as linked to their psychosexual repression through the medically constructed concept of hysteria as a way to promote patriarchal values. 17 Characters, like the protagonist in The Yellow Wallpaper, represent a defiance against restrictive social expectations of domestic femininity and intellectual conformity. Foucault, in The Birth of the Clinic and The History of Sexuality, showed how the medical gaze turned the sexual and emotional experiences of women into subjects of institutional observation.18,19 Based on Discipline and Punish ideas, Foucault formulated his idea of disciplinary power, where the psychiatric establishments produced “truths” regarding the regulation of “psychosexuality” through classification and control. 20 In The Technology of Orgasm, Maines studied the use of genital massages for “hysteria” in the 18th and 19th centuries, describing how the sexual pleasure of women became a professional concern, resulting in the institutional appropriation of women’s bodily autonomy. 21
Taken together, these theoretical perspectives reveal that hysteria cannot be understood merely as a medical diagnosis but must be interpreted as a discursive construct shaped by institutional power, gender ideology and and sexual regulation. Feminist literary criticism exposes how patriarchal narratives encode female rebellion as madness, while Foucauldian analysis demonstrates how medical discourse transforms sexuality into an object of surveillance. Mad Studies further complicates this structure by reframing madness as a form of cultural dissent rather than pathology. This interdisciplinary framework enables the present study to examine literary madness as a manifestation of psychosexual repression within patriarchal structures.
Mad Studies and the Social Construction of Madness
This scholarship also draws on insights from Mad Studies and Disability Studies, notably the work of Lennard J. Davis, Rosemarie Garland-Thomson, and Margaret Price. Margaret Price’s Mad at School makes an invaluable contribution by pointing out that cognitive and psychological differences are pushed to the margins of dominant epistemologies, particularly in gendered contexts. 22 Rosemarie Garland-Thomson’s work in Extraordinary Bodies develops the narrative framing of deviance, while Davis’s Enforcing Normalcy critically looks at the construction of the “norm.” These views further the analysis that women’s non-normative behaviors, especially sexual or emotional expressions, are medicalized as insane.23,24 These perspectives reveal how literature reflects and challenges the intersections between sexuality, mental health and institutional power, problematizing the binary of sanity-madness while recasting psychosexual distress as an artifact of social surveillance and gendered expectation. Theoretical perspectives are summarized in Table 1.
Psychosexual Health and Power.
Literature Review
Recent scholarship in the medical humanities and feminist literary studies has increasingly revisited historical narratives of hysteria in order to interrogate the gendered assumptions implanted within psychiatric discourse. It is argued that hysteria functioned not merely as a medical diagnosis but also as a cultural tool used to discipline women whose emotional or sexual behavior deviated from patriarchal norms. Literary texts, therefore, provide an important site for examining how these medical narratives shaped cultural understandings of women’s psychosexual health. Similarly, feminist medical humanities highlights how literary narratives serve as important cultural documents that reveal the intersection between psychological distress, sexual repression and patriarchal structures. These studies highlight the relevance of literary analysis for understanding how historical narratives continue to influence modern interpretations of women’s psychosexual health. The portrayal of women’s madness, particularly as it is allied with psychosexual repression, has been a significant theme that has recurred over the years as a subject for literature. The debate that has developed between scholars over three significant works within literature, The Yellow Wallpaper and The Treatment of Bibi Haldar, shall be explored to better understand the role of madness within literature as a construct that is both gender-specific and psychosexual. Sandra Gilbert and Susan Gubar’s The Madwoman in the Attic remains an influential feminist literary critique that explores the dynamics of female characters and female writers in the patriarchal literary canon. 25 Their core argument rests on the point that the figure of the madwoman in literature, as seen in the character of Bertha Mason in Jane Eyre, represents the literary double of the silent, marginalized, and powerless female writer herself. 26 Gilbert and Gubar introduce the notion that the Victorian literary canon, and mainstream literary canon by extension, tends to consign the female figure to the role of the “angel” or the “monster”: the “mad” or the “deviant.” This complementarity reflects the societal perceptions of female sexuality, for which the ideal remains the repression and the pathological the expression. 27 Contemporary feminist health research further demonstrates that women’s mental health remains deeply intertwined with social control over sexuality and reproduction.
The Yellow Wallpaper: Hysteria, Repression and Medical Authority
Charlotte Perkins Gilman’s The Yellow Wallpaper is perhaps the most iconic literary exploration of hysteria and its relationship to patriarchal medical authority. Written as a first-person narrative by a woman undergoing a “rest cure” for what is implied to be postpartum depression or neurasthenia, the story critiques the 19th-century practice of treating women’s mental and emotional distress by confining them to inactivity and denying their intellectual and sexual agency. The “yellow wallpaper” becomes a symbol of entrapment visually and psychologically as the narrator projects her disintegrating sense of self onto the imagined figure behind the wallpaper. Gilman describes it as, “Sometimes I think there are a great many women behind, and sometimes one, and she crawls around fast, and her crawling shakes it all over.” 29 Rachel Maines’ research contextualizes this within the era’s broader medical practices, where female pleasure was ignored, feared, or controlled, and where even orgasm was pathologized or medicalized under the guise of hysteria treatment. 28 Repeated visits to doctors yield vague and unhelpful diagnoses, culminating in a recommendation that “marriage and a regular sex life” might be the cure. 29
Madness and Surveillance in The Yellow Wallpaper
Charlotte Perkins Gilman’s The Yellow Wallpaper stands as a seminal literary exploration of the intersection between madness, gender, and institutional control. 30 At the heart of the narrative lies a critique of patriarchal medical authority and its treatment of women’s psychological distress, particularly through the 19th-century practice of the “rest cure.” This dynamic can be critically unpacked through the frameworks of Michel Foucault’s theories of power and the medical gaze, and Elaine Showalter’s feminist critique of hysteria and the gendering of mental illness. Foucault’s concept of the medical gaze, as articulated in The Birth of the Clinic, is particularly relevant to understanding the narrator’s predicament. In the story, the narrator’s husband, John, who is also her physician, exercises total control over her treatment, bodily autonomy, and mental evaluation. He dictates her rest, reading, writing and even her thoughts, under the pretense of benevolent care. Her diagnosis of “temporary nervous depression” (now understood as postpartum depression) becomes a social script that silences and pathologizes her emotional and creative life. 31 This process of surveillance and normalization mirrors Foucault’s broader theory of biopower and discipline, where institutions produce “truths” that regulate bodies and enforce conformity. 32 Elaine Showalter, in The Female Malady, offers a complementary lens, emphasizing that women’s madness in the 19th century was not merely a clinical diagnosis but a cultural response to patriarchal repression and sexual frustration. Showalter argues that the figure of the “madwoman” became a repository for everything society found threatening or deviant in female behavior particularly autonomy, creativity, and erotic expression. 33 In Gilman’s story, the narrator’s urge to write, express, and engage with her environment is constantly shut down. Her madness is not rooted in disorder but in disempowerment. It is a psychological rebellion against a system that denies her subjectivity and reduces her to a medical case. Together, Foucault and Showalter provide a powerful framework for understanding The Yellow Wallpaper as a critique of the ways in which female madness was produced, regulated, and aestheticized within patriarchal society. The story transforms the private domestic sphere into a site of surveillance and control, revealing how medical discourse functioned as a tool of gendered discipline. Rather than depicting madness as a personal failing, Gilman reclaims it as a symptom of systemic violence, and, ultimately, a means of confronting the suffocating norms imposed on women’s minds and bodies.
Psychosexual Neglect and Social Control
Jhumpa Lahiri’s The Treatment of Bibi Haldar presents one of the most heartbreaking stories of a conservative Indian community, portraying gendered exile, sexual privation, and socially constructed insanity against the backdrop of cultural values. Bibi Haldar is a young woman afflicted with seizures and emotional instability due to an illness that no medical professional can diagnose. Bibi has been banished, rendered infantile, and deprived of any prospects for growing up and of the conventional social and sexual life. Her “treatment” becomes a diagnostic joke, a list of absurd remedies ranging from tonics and prayers to the final prescription: marriage and sexual activity. Through Bibi’s story, Lahiri critiques the systemic neglect of women’s psychosexual health, drawing attention to how madness is constructed not through pathology but through social deprivation and institutional apathy. 34 Rachel Maines’ The Technology of Orgasm offers a relevant historical backdrop to this narrative. 35 The recommendation to “cure” Bibi of marriage and sex has the same paternalistic impulse: that women’s bodies are not to be trusted on their own but need to be controlled by men. In doing so, Lahiri illustrates how the commercialization of sexual health occurs while ignoring the psychological aspects of sex and satisfaction. Under Foucauldian analysis, Bibi’s condition then becomes an object of community surveillance and regulation; this is how psychosexual neglect operates not only through medical institutions but also through community structures that regulate female sexuality and autonomy. Yet despite being uncaged within a medical facility, Bibi’s body becomes regulated by family, community, and medical officials. Her symptoms are diagnosed according to a set of morality and cultural narratives rather than scientific medical records. Once again, as in The Yellow Wallpaper, the reality of Jane’s condition is constructed, meaning that it reflects the cultural narratives and concerns about femininity, marriageable female bodies, and female deviance. Here, Foucault’s theory on biopower becomes very productive as it becomes apparent that Jane’s body becomes a regulatable body, with Jane’s identity being reduced to a problem that can ideally be solved by being incorporated into the heteronormative narrative that is marriage. Mad Studies would take that analysis and augment it by dismissing the premise that there’s something “abnormal” about Jane’s behavior that warrants medical attention. Lennard J. Davis argues that mental difference and neurodivergence are often social constructs, shaped by dominant norms of ability, emotion, and productivity. 36 Whereas in Bibi’s case, her “madness” is less a personal disorder and more a reflection of the community’s inability to accommodate difference. Her exclusion is not driven by her condition, but by her failure to conform to socially prescribed roles, especially those of wife, mother, and economically productive woman. Notably, Lahiri does not disappoint totally as she allows Bibi to find her agency outside of prescribed femininity. After a rape, an act of profound violence and violation that the story leaves deliberately vague, Bibi becomes pregnant, gives birth, and starts to experience a new sense of physical and emotional stability. Upsetting as this transformation is, it problematizes any simple interpretation of madness as resolved or cured. Instead, Lahiri has used Bibi’s trajectory to question narrow definitions of health, sexuality, and womanhood. Motherhood, which had previously been denied to her, is not a moral reward that she gets; instead, it offers legitimacy and social presence, one that is still framed within conventional norms. In short, The Treatment of Bibi Haldar looks at how female psychosexual health is sculpted and more often denied by a network of social expectations, gendered norms, and cultural taboos. Through Bibi, Lahiri challenges both Western and South Asian medical discourses that pathologize or repudiate women’s sexual and emotional needs. On the basis of Maines, Foucault, and Mad Studies, the story reinscribes madness as something that is not an individual illness but rather a symptom of its neglect and violence. Bibi’s struggles are not toward curing but toward survival and definition in a world that does not recognize her as fully human.
Literary Archetypes and the Gendering of Madness in the Madwoman in the Attic
Gilbert and Gubar’s the Madwoman in the Attic remains a foundational text in feminist literary criticism for its analysis of how patriarchal literary traditions construct female identity through restrictive archetypes. In the reading of Brontë’s Jane Eyre, the character of Bertha Mason embodies the “madwoman” trope; a symbolic figure representing suppressed female anger, sexuality and creative agency. Gilbert and Gubar opine that Victorian literature often positioned women within a binary opposition: the submissive “angel” or the deviant “monster.” 37 This dichotomy reflects broader social anxieties surrounding female sexuality and autonomy. When read alongside Michel Foucault’s theory of disciplinary power, the madwoman figure can be interpreted not simply as a narrative device but as a cultural mechanism through which patriarchal societies regulate women’s behavior, bodies, and psychosexual expression. Foucault’s concept of disciplinary systems that produce normalized subjects has been quite explanatory in understanding the role of the madwoman in literature as something that appears in literature not solely as an aesthetic or narrative construct but also as subject to regulation by society. 38 The attic or room that imprisons the madwoman in literature is merely symbolic of the larger restraints of female freedom that exist in society. Gilbert and Gubar pick up Gilman’s lead in tracing the “madwoman” trope in various literary texts from Emily Dickinson and Mary Shelley to George Eliot and Emily Brontë to discover that women writers of that era were employing double narratives in literature in their own lives to represent their dual selves in literature; that of the temperate and controlled woman and of her other self that was her passionate and rebellious self. These literary constructions reflect a split consciousness imposed by patriarchal culture, 39 in which such literary devices are a product of split consciousness, which is enforced upon women in patriarchal culture. Such women had two options—to comply or to be deemed mentally unwell. 40 Thus, when analyzed from this aspect, madness in literature is nothing but an encoded message in which women manifest themselves beyond the realms of domesticity and subservience. Such is the importance of the “madwoman” figure that it now symbolizes neither weakness nor indecisiveness. Her “insanity” is a political and psychic result of the denial of agency, authorship, and voice. Linking Gilbert and Gubar’s analysis to Jane Eyre, The Yellow Wallpaper and The Treatment of Bibi Haldar, we realize a further development in our archetype from Victorian gothic horror through feminist allegory to postcolonial realism. Though specific contexts differ, the mechanism at work is singular: female insanity as a response to systemic erasure and psychosexual neglect. What the madwoman reveals is not just the interior state of one character but the failures of the world around her. Psychosexual & socio-cultural dimensions of these texts are outlined in Table 2.
Pathologization of the Feminine Psyche.
Patterns of Resistance, Shared Silences, and Intertextual Psychosexual Narratives
In The Yellow Wallpaper, Jane Eyre, and The Treatment of Bibi Haldar, the need for decoding the motives behind the plot tends not to apply. Rather than finding themselves drawn through a compelling or alluring tale in which the motivations of the characters can easily be explained or interpreted through a surface-level exposition of the plot, the reader is set upon a quest for the reception and construction of meaning. In other words, the justification for reading these texts demands a decoded plot. In Gilman’s The Yellow Wallpaper, resistance assumes the form of creative defiance; the protagonist’s descent into madness is paradoxically a reclaiming of narrative and space, a refusal to remain passive under the male medical gaze. During the process, talking about Jane Eyre, Gilbert and Gubar expose how literary tradition itself has encoded the figure of the madwoman as both warning and whisper-a rebellious voice, echoing through the margins of male-authored texts, screaming from attics, prisons, and locked rooms. And in Lahiri’s The Treatment of Bibi Haldar, silence is both a condition imposed on the protagonist and a site of unexpected transformation. Bibi’s lack of sexual and emotional fulfillment, interpreted as illness by her community, becomes, at last, the very point of rupture which allows her to assert agency in ways that are not normative. Not for a single moment are these intertextual echoes thematic; they are, in fact, political. The silences around women’s bodies and sexual needs in these texts reflect real-world medical, legal, and cultural silencing of female psychosexual health across centuries. However, by actively engaging with such silences through a reading of the repressed, metaphorized, and unsaid, this reader becomes a participant in a feminist project of recovery, recuperating subjectivity for those who had been categorized as mad, hysterical, and pathological. Through these texts, it is not so much the theme of madness that corresponds, but rather madness as a signifying system, a form of non-verbal communication and resistance to oppressive systems of gender, medicine, and culture. 41 By stripping away the layers of wallpaper, transgressing the borderline of community, and reinscribing certain narratives within canonical texts, each of these texts subverts the dominant narrative of madness and sexuality.
Conclusion
This article has examined how psychosexual health and female madness are constructed and problematized in The Yellow Wallpaper, The Treatment of Bibi Haldar and The Madwoman in the Attic, with an interdisciplinary approach that engages the framework of feminist literary studies, medical humanities, Foucauldian studies, and Mad Studies. Madness, in these three narratives, appears not as a pathology or a biological reality, but rather as a social construction and a gendered category inextricably linked with women’s refusal of their psychosexual empowerment, expressiveness, and narrativity. In a historical account of women’s medically constructed sexuality, it is clear how patriarchy has long medically and psychiatrically constructed women’s needs and desires as “mad.” Implications of this analysis extend beyond literary criticism with contemporary discussions in psychosexual health. Contemporary scholarship increasingly recognizes that women’s mental health concerns should not be separated from the social regulation of sexuality, body autonomy and reproductive rights. Beyond literary analysis, this study contributes to broader interdisciplinary conversations in psychosexual health by demonstrating how historical medical narratives continue to influence contemporary understandings of female psychological distress. Recognizing the cultural and historical roots of these narratives allows scholars and clinicians alike to reconsider how gendered assumptions shape the diagnosis and treatment of women’s mental health. By establishing literary madness within the context of psychosexual repression, this research highlights the importance of integrating literary humanities, feminist theory and clinical discourse in order to develop more nuanced approaches to gender and mental health.
Footnotes
Declaration of Conflicting Interests
The authors declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.
Ethical Approval
Not applicable.
Funding
The authors received no financial support for the research, authorship, and/or publication of this article.
Informed Consent
Not applicable.