"What Do You Do if They Say 'No'?": Agency, Materiality, and Justice in Pelvic Exams.

In this defining moments essay, I take up feminist new materialist and reproductive justice theories to explore communication, autonomy, consent, and in/justice in the context of pelvic exams. I use feminist new materialism and reproductive justice to illustrate the ways in which traditional medical education practices, histories of misogynoir, speculums, patient gowns, and more communicate and matter in pelvic exam teaching and practice. In so doing, I move between academic prose and short narratives drawn from my lived experiences as both a patient and a Gynecological Teaching Associate (a role in which I instruct medical students learning to perform pelvic exams). Ultimately, I argue that attending to influence of other-than-humans and adopting relational conceptions of agency can help health communication scholars and practitioners advance equity and justice in pelvic exams.

"I'm Worth Saving": Making Sense of Medication Taking in a Care Coordination Organization.

Patients and healthcare providers (HCPs) may communicatively make sense of medication taking in divergent ways. Often, HCPs prioritize medication adherence, the extent to which patients consume medications as prescribed. In contrast, patients may focus on how medications fit in with their everyday lives. Care coordination organizations (CCOs) provide cohesive, interdisciplinary, health services to chronically ill patients and may help bridge the gap between patient and HCP sensemaking. Our qualitative study asked: How do patients and HCPs involved in a CCO communicatively make sense of medication taking? Through thematic analysis, we found three themes related to patients' sensemaking. Patients (N = 9) made sense of medication taking (1) as necessary and important through embodied experiences, social discourses, and interpersonal interactions; (2) as easy when supported; and (3) through building bonds. We also found three themes related to HCPs' sensemaking: HCP participants (N = 5) made sense of medication taking (1) through dialogue with patients; (2) by interacting in patients' home spaces; and (3) through building relationships with patients. Our final theme explores how communicative sensemaking became more complicated for participants in the context of psychotropic medications. Using Mishler's Voice of the Lifeworld (VoL) and Weick's sensemaking, we advance a constitutive perspective on medication taking. We suggest that researchers and HCPs should focus on constructing shared meanings about medication taking through dialogue, rather than on increasing adherence. Our study provides evidence that, by promoting engagement with the VoL, CCOs may facilitate such dialogs.

Localocentricity, mental health and medical poverty in communication about sex work, HIV and AIDS among trans women engaged in sex work.

Trans women engaged in sex work live at the intersections of discrimination against sex workers, women and transgender people. Dominant public health approaches have constructed trans women in sex work as a group at high risk of HIV infection. This study employed localocentricity, situated within a cultured-centred approach, as a theoretical framework to document health narratives among 29 trans women who had knowledge of or experience in sex work. This theoretical framing draws attention to the articulations between health and illness expressed by trans women in sex work in USA. Research participants emphasised how their health was affected by extreme socio-political-cultural marginalisation as well as medical poverty and mental health issues.