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Navigating the Medicalization of Gender Identity: A Qualitative Study of Transgender People’s Experiences of Healthcare in the American Midwest

Murawsky, Stef
http://orcid.org/0000-0002-6983-0251
http://rave.ohiolink.edu/etdc/view?acc_num=ucin1668637185302536

Abstract Details

2022, PhD, University of Cincinnati, Arts and Sciences: Sociology.
Transgender Americans experience high rates of medical discrimination. As a result, they frequently avoid getting medical care, even when needed, for fear of mistreatment. While most trans people want to leverage medicalization to embody their gender identities, finding gender-affirming healthcare is challenging because competent providers are rare, care is geographically inaccessible, and insurers commonly refuse to cover medical interventions. This dissertation describes how trans people access and navigate medicine given the multitude of healthcare constraints and barriers they face. I investigate how trans Americans decide whether and how to medicalize their gender identities. Specifically, people considering or engaged in medicalized body projects described healthcare experiences related to their information-seeking behaviors and practices, receipt of diagnoses, and navigation of provider interactions, medical institutions, and insurance policies. I analyzed 70 hours of indepth interviews with 34 transgender people who live in the greater Cincinnati, Ohio area, using a grounded theory methodology. Interviews were transcribed and thematically coded using NVivo. Emergent analytic categories center on themes related to experiences of medicalization, how trans individuals operationalize community networks to prepare for medicalization, and experiences of gender delegitimation in medicine. This research reveals that: 1) binary-oriented and non-binary trans people experience medicalization differently, particularly when trying to make sense of the diagnosis of gender dysphoria; 2) transgender people cultivate subcultural health capital via community networks, which allows them to gather informational and navigational capital to anticipate and mitigate medical discrimination, mistreatment, and gatekeeping; and 3) trans people experience institutional, interpersonal, and internalized gender delegitimation in medical settings. I present my findings in three journal-length papers. Cumulatively, these articles advance core medical sociology theories of medicalization, diagnosis, patienthood, cultural health capital, and embodiment. My research also suggests the urgency of healthcare and insurance reform, particularly regarding clinical and administrative reliance on the medical model oftrans identity, which uses corrective “wrong body” narratives as its foundation.
Danielle Bessett, Ph.D. (Committee Member)
Ashley Currier, Ph.D. (Committee Member)
Erynn Casanova, Ph.D. (Committee Member)
165 p.
Sociology
transgender; healthcare; transgender healthcare; medicalization; non-binary; non-binary healthcare

Recommended Citations

Citations

  • Murawsky, S. (2022). Navigating the Medicalization of Gender Identity: A Qualitative Study of Transgender People’s Experiences of Healthcare in the American Midwest [Doctoral dissertation, University of Cincinnati]. OhioLINK Electronic Theses and Dissertations Center. http://rave.ohiolink.edu/etdc/view?acc_num=ucin1668637185302536

    APA Style (7th edition)

  • Murawsky, Stef. Navigating the Medicalization of Gender Identity: A Qualitative Study of Transgender People’s Experiences of Healthcare in the American Midwest. 2022. University of Cincinnati, Doctoral dissertation. OhioLINK Electronic Theses and Dissertations Center, http://rave.ohiolink.edu/etdc/view?acc_num=ucin1668637185302536.

    MLA Style (8th edition)

  • Murawsky, Stef. "Navigating the Medicalization of Gender Identity: A Qualitative Study of Transgender People’s Experiences of Healthcare in the American Midwest." Doctoral dissertation, University of Cincinnati, 2022. http://rave.ohiolink.edu/etdc/view?acc_num=ucin1668637185302536

    Chicago Manual of Style (17th edition)

ucin1668637185302536
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This open access ETD is published by University of Cincinnati and OhioLINK.