The stigmatization of female oukup and kusuk therapists in the health and wellness tourism industry: a critical study of Gramscian hegemony

This study explores the stigmatization of female oukup and kusuk therapists through the perspective of Gramsci’s hegemony in the health and wellness tourism industry in North Sumatra, Indonesia. Six therapists participated in in-depth interviews, supported by field observations. Data were analyzed phenomenologically and thematically. The study reveals that most therapists enter the profession due to limited educational and economic opportunities. Working conditions are marked by long hours, informal labor structures and blurred boundaries between domestic and professional spaces. Despite widespread public stigma (including accusations of immoral conduct) the therapists deploy subtle forms of resistance. These include performing professionalism, negotiating with family prejudice, and reclaiming dignity through everyday acts of care and ethical labor. Results can inform policies for legal protection, professional training, and certification to strengthen legitimacy, reduce stigma and improve working conditions, contributing to sustainable wellness tourism. Challenging stigma requires public education, community engagement and policy reform to protect vulnerable female workers. Recognizing their agency and cultural contributions can promote gender equity and preserve traditional health practices. The findings suggest that oukup and kusuk function as a contested site where gender and cultural politics intersect. This profession reflects subaltern tensions and female therapists’ micro-level resistance to dominant narratives.