Women's Experiences of Health-Related Communicative Disenfranchisement

Women's inequitable healthcare experiences are epistemic injustices by which women are discredited and harmed in their position as knowers of their health and their bodies. Drawing on the theory of communicative disenfranchisement (TCD), we sought to amplify voices of women experiencing communicative disenfranchisement (CD) and to unify their stories according to theoretical premises, namely, attention to power, material conditions, discourse, identities and relationships, and process. We interviewed 36 women living in the United States whose health issues have not been taken seriously by health care providers, friends, and family - pervasive sources of disenfranchising talk surrounding health. Mapping onto the TCD framework, our findings explicate the process of CD, including the material and immaterial consequences of disenfranchising talk and women's responses to such talk. CD unfolded as a protracted and often circular process of women seeking care but encountering health dismissals and minimalizations, blaming and shaming, normalizing of their pain, and psychologizing. We unpack how disenfranchising talk rendered women crazy and dehumanized them and inflicted shame and loss. Women responded to disenfranchising talk with silence, and they (re)claimed their voice by resisting psychogenic explanations for their problems, critiquing women's healthcare, asserting their needs, and advocating for others. We discuss the implications of this research for theory and praxis.