Common Patterns of Cisgender Use in Public Health Articles and Their Implications for Gender Inclusivity Efforts, 2013‒2020.

Objectives. To identify how "cisgender" has been used in public health articles in recent years relative to the historical origins of the term to mark normative gender and describe systems of social power. Methods. I analyzed 352 US-focused public health articles (2013-2020) using a summative content analysis approach. I traced cisgender use by year and compared it by sample population (cisgender-only, mixed, not cisgender). Results. I identified 4 interlocking and mutually reinforcing patterns of cisgender use: limited and narrow use, undertheorized use, use as the default gender, and reinforcing binary categorization. These patterns largely result from the narrowing of cisgender to a demographic label. Conclusions. Cisgender is primarily used to categorize individual research participants as not transgender rather than to reflect participants' actual identity and experiences within gendered systems of power, which undermines cisgender's potential to support gender-inclusivity efforts and deepen understandings of gender-based health disparities. Public Health Implications. Two paths for creating more robust use of cisgender are (1) supporting gender inclusivity by clarifying and standardizing how and when the demographic category is used and (2) expanding the analytic potential of cisgender by returning to its historical origins as a framework for exposing and explaining patterns of power. (Am J Public Health. 2024;114(2):202-208. https://doi.org/10.2105/AJPH.2023.307441).

Good sex/bad sex: the individualised focus of US HIV prevention policy in sub-Saharan Africa, 1995-2005.

The expanding reliance on the health sciences to address social problems is well documented, as are the effects of the social construction of public (health) problems on 'target' populations, intervention design and broader social systems. Less attention has been given in the literature to the cultural meanings that configure public health efforts themselves. This study demonstrates how the cultural understandings of sex and sexuality that inform US human immunodeficiency virus (HIV) prevention policy in sub-Saharan Africa shape policy recommendations. Based on an analysis of 119 US policy documents, a relatively stable and highly gendered narrative of sexual risk was found across the Clinton and (G.W.) Bush administrations. This narrative locates HIV risk in (what is constructed to be) the inevitable clash between women's sexuality and men's sexuality, and delineates HIV risk by the form of relationship in which sex occurs. The two narratives diverge at this point, offering different definitions of 'bad' sex and 'good' sex. This divergence helps to explain the different prevention foci of the administrations - condoms during the Clinton era and abstinence-outside-of-marriage during the Bush administration. In both cases, the sexual risk narrative points to individual targeted prevention strategies, even as the policy identifies structural factors as driving global HIV epidemics.

The process of preventing pregnancy: women's experiences and emergency contraception use.

The model of "unintended" pregnancy has dominated reproductive health research and policy since the early 1970s. The concept reflects the prevailing highly rational model of behavior in public health and the assumption that the only acceptable points of preventing pregnancy are before or during intercourse. This model is simplistic, overly utilitarian, and does not reflect the experiences of the more than 1 million women who use emergency contraception (EC) and have abortions each year in the United States. Based on stories gathered through open-ended interviews of32 women seeking EC, the authors proposea dynamic process of pregnancy prevention, spanning the act of intercourse and situated in a complex cultural context. Such a model reconceptualizes efforts to control one's fertility, normalizes the experiences of women who do not fit the existing models, and generates new ideas for supporting women and their male partners in their efforts to control their reproduction.

Making sense of sex: rethinking intentionality.

After 30 years of public health policy based on a rational-choice model of behaviour, women in the USA continue to have sex, get pregnant and give birth to children in ways that do not conform to the behavioural prescriptions of family planning programmes. Traditionally, USA social science research has attempted to explain why women deviate from public health behavioural models. In this paper, narrative theory is employed to reorient the study of women's sexual behaviour. Specifically, reproductive life histories are analysed to illuminate how women interpret their reproductive experiences and how culturally available interpretative materials, in particular prescriptive ideals and explanatory narratives, may prospectively influence women's reproductive experiences.