Geographies of the secret: Navigating medical, activist, and intimate spaces in intersex research in Chile.

ABSTRACT We introduce the empirical papers in this special issue, each of which presents a different mode of speculation in the context of living with, and caring for, chronic conditions: “educated guesswork” about covid reinfection, “ambivalent speculations” in learning to live “at risk” with Barrett’s Esophagus and “retrospective speculation” in pressure ulcer prevention. We reflect on how they together contribute to current thinking on the politics of time in health and medicine, and wider conversations in medical anthropology and beyond, about chronic illness as both a lived everyday reality and part of an unfolding, unpredictable collective future.

Sickle cell hemoglobinopathy is not merely a genetic disorder but a deeply embedded socio-cultural phenomenon in the remote regions of Odisha. Drawing on long-term ethnographic fieldwork in Koraput and surrounding districts, this study explores the lived experiences of individuals with sickle cell trait (SCT) and sickle cell disease (SCD), focusing on social discrimination, medical uncertainty, and healthcare accessibility. The findings reveal reluctance toward screening, particularly among unmarried women, due to fears of marital exclusion and family stigma. Misconceptions about SCT, including beliefs that it can appear or disappear over time, further reinforce social anxiety and misinformation. Inconsistencies in diagnosis, limited genetic counselling, geographic isolation, and economic insecurity exacerbate these challenges. The study also examines women's caregiving roles, therapeutic pluralism involving traditional healers, and youth perspectives on reproductive futures. By foregrounding the social consequences of carrier status alongside disease, the article challenges assumptions that SCT is negligible. These findings highlight the need for culturally sensitive genetic education, decentralized health services, and community-based interventions, contributing to a holistic understanding of sickle cell hemoglobinopathy within medical anthropology.

Violence against women is most often understood, and addressed, through the lens of direct, physical harm. This Note argues that such a framework is inadequate. Drawing on the theory of structural violence, first articulated by sociologist Johan Galtung and later refined by medical anthropologist Dr. Paul Farmer, this Note contends that women globally are disproportionately harmed not only by individual actors but by the economic, legal, and political systems that constrain their agency, limit their access to resources, and prevent them from attaining the highest standard of physical and mental health. These forms of indirect, institutional violence sit at the base of the iceberg—pervasive, normalized, and largely overlooked in both legal scholarship and U.S. foreign policy. This Note examines the current U.S. human rights sanctions regime, in particular the Global Magnitsky sanctions program, and identifies a significant gap: sanctions designations related to gender-based violence have been limited almost entirely to direct, conflict-related sexual violence, leaving structural forms of violence against women and girls largely unaddressed. It argues that the U.S. government must expand its practical interpretation of what constitutes a “serious human rights abuse” under the Global Magnitsky Human Rights Accountability Act and Executive Order 13818 to encompass gender-based structural violence, particularly where state actors, legal institutions, and government officials are identifiable conduits of harm. It further advocates for gender-sensitive implementation of any sanctions designations to mitigate the risk of disproportionate harm to the very populations such measures seek to protect. Lastly, the Note considers the viability of this proposed framework in light of the second Trump Administration’s significant departure from prior U.S. gender and human rights policy.

Digital mindfulness and the laboring self: A discourse analysis of burnout in Headspace.

Honduran Oncology Nurses Share Inequities in Cancer Treatment and Their Advocacy to Mitigate Challenges.

Background:Black women have a long history of engaging in activism and community advocacy as both a political imperative and a survival strategy (Hill Collins, 2000; Ransby, 2003). Activism may confer psychological benefits such as increased meaning in life, identity affirmation, and social connection (Hope et al., 2019; Klar and Kasser, 2009); simultaneously, activism can involve sustained stress exposure, burnout, and heightened vulnerability to surveillance and (re)traumatization (Gorski, 2019). Biological indicators offer one avenue for examining how social conditions are embodied particularly when psychosocial experiences involve chronic threat, vigilance, and cumulative stress exposure. Given growing attention to activism as a health-relevant practice, this study is framed though an intersectional and critical medical anthropology lens to explore how activism may relate to both psychosocial and biological stress processes among Black women.Methods:Using an embedded mixed-methods pilot design, this study evaluated the feasibility of assessing psychosocial indicators and the Conserved Transcriptional Response to Adversity (CTRA) at baseline (T1) and ~2-month follow-up (T2) during a self-selected intentional activism period among Black women, with baseline semi-structured interviews contextualizing interpretation of T1→T2 patterns. Participants (N = 29; M age = 39.4 years, SD = 11.7; range = 21–63) completed online surveys, a baseline interview, and coached dried blood spot (DBS) collection at T1, then completed follow-up surveys and DBS collection at T2. Analyses followed a three-part workflow: (1) feasibility metrics (enrollment/retention and useable DBS returns), (2) within-person quantitative change (paired-samples t tests for psychosocial measures; mixed-effects linear models of a 53-gene CTRA set), and (3) thematic analysis of baseline interviews with integration via joint display (convergence/complementarity/divergence).Results:Procedures supported remote biobehavioral assessment; useable DBS/CTRA data were available for most participants (T1 n = 28; T2 n = 27). Psychosocial scores decreased from T1 to T2 for psychological distress, activist orientation, and meaning in life (presence and search), with activist identity/commitment also decreasing but not reaching conventional thresholds. At the sample level, mean CTRA showed no net change from T1 to T2; however, within-person increases in activist identity/commitment and increases in search for meaning were associated with more favorable CTRA change. Baseline qualitative themes (Activism’s Paradox; Identity Dialectics; Resistance and Restoration; Community-Rooted Well-being) highlighted co-occurring strain, meaning, identity negotiation under misogynoir, and relational coping infrastructure.Conclusion:Findings support feasibility and provide hypothesis-generating evidence that biobehavioral responses may be contingent on identity and meaning processes rather than uniform mean shifts in a heterogeneous activism window.

Indigenous communities in Canada (First Nations, Inuit, and Métis peoples) have distinct traditional knowledge and practices for pregnancy and birth, and these have sustained healthy and thriving Indigenous communities for millennia. Indigenous midwives historically held a leading role as primary providers of sexual and reproductive healthcare. However, colonial practices severely disrupted the role of Indigenous midwives and the transfer of their knowledge from generation to generation. The obstetric evacuation policy in Canada requires people who live in rural and remote locations to leave their community to have a hospital delivery. Evidence suggests this policy negatively impacts Indigenous people who desire to give birth in their communities. To implement optimal perinatal care for Indigenous people, Indigenous midwives in Canada seek evidence to answer the following questions: (1) What is the cost of obstetric evacuation, compared to Indigenous midwifery? And (2) What are the health outcomes for obstetric evacuation versus Indigenous midwifery? We present our framework for Reclaiming Indigenous Birth, a study using multiple methods. Our framework brought together researchers, midwives (National Council of Indigenous Midwives, Association of Ontario Midwives, and Juniper Midwives), community organizations (Native Women's Association of Canada and Pauktuutit Inuit Women of Canada) and knowledge users (Indigenous Services Canada). We used Gwayakgooshgawin (balance) to bring four disciplines together in a theoretical framework: Indigenous methodologies, gender-based analysis, critical medical anthropology, and population and public health. We then created a relational framework with guidance of the Seven Grandparent Teachings, which taught us to nurture relations with research team members, partner organizations, and individuals whose data was included in this study. We upheld standards for Indigenous research ethics. The specific objectives of this study were to: (1) examine economic costs and outcomes of obstetric evacuation and Indigenous midwifery; (2) understand experiences of Indigenous midwifery; and (3) conduct knowledge translation activities to inform policy and programming for perinatal health in Indigenous communities. This research framework will contribute evidence to support calls to action to reclaim Indigenous ways of birth and address disparities between Indigenous and non-Indigenous people in birth outcomes.

ABSTRACT This paper examines the challenge of designing for issue-driven groups, which participatory design (PD) has approached through the concept of publics. It identifies two methodological gaps: understanding how publics form and how to design with digitally mediated, distributed publics. To address these, this paper proposes a ‘hotspot’ method adapted from medical anthropology and refined through a year-long digital ethnography of the COVID-conscious public. The case study illustrates how this public forms via contested material practices at three hotspots: medical sites, schools, and indoor public spaces. The study demonstrates that the hotspot method can identify how publics are constituted and pinpoint specific sites for design intervention. This advances PD methodologies by offering an empirical framework for analysing large, distributed publics that moves beyond the limitations of localised, face-to-face workshops. Such a shift allows designers to pinpoint material entry points for addressing global issues without relying on institutional stakeholders to provide scale.

From research method to community resource: Co-developing a body mapping toolkit for peer support with Long Covid patients.

Abstract In this commentary, I approach ‘kinship trouble’ as a cultural and medical anthropologist with two decades of ethnographic and collaborative engagement with genetics, and as someone deeply committed to and interested in interdisciplinary collaboration. From this perspective, the collection’s significance is its focus on the emergent encounter between two very different fields—new kinship studies and palaeogenetics—both of which intersect with archaeology. Combining the intellectual explosion of new kinship studies with the data explosion of palaeogenetics is an enticing premise. What can happen, kinship trouble asks us, if the creativity that characterizes the new kinship studies could be married with the rich new layers of genomic information that have sedimented archaeological scholarship? And what could be lost if this opportunity is squandered? The contributions to this collection read archaeological and palaeogenetic evidence against the grain to reveal active kin-making practices that often disrupt presentist, ethnocentric and heterosexist assumptions. These vibrant interpretations of relatedness provide many ‘carrots’ to entice anthropologists, archaeologists and palaeogeneticists to become ‘oddkin’ and to ‘lean in’ to kinship trouble.

Male body dysmorphic disorder (BDD) focused on genital concerns remains significantly under-recognized despite affecting 2.5% of adults and up to 15% in appearance-focused medical settings. Contemporary therapeutic approaches often fail to address the cultural construction of masculine body ideals, potentially leading to frequent misdiagnosis and inappropriate treatment. To develop an evidence-informed clinical framework integrating historical morphometric data from Western sculpture with contemporary body image counseling approaches for men with genital size anxiety. We synthesized historical morphometric evidence from 24 museum-quality sculptures (600BCE-1822CE), contemporary prevalence data on male BDD and genital size anxiety, current treatment guidelines, and theoretical frameworks from medical anthropology and cultural psychology. Digital morphometric measurements were conducted using ImageJ software following established clinical protocols. Historical sculptures demonstrate mean phallus-to-height ratios of 0.0285 ± 0.0061, significantly smaller than contemporary measurements (0.0403-0.0567). This 29%-50% proportional difference provides quantitative evidence consistent with the cultural relativity of masculine ideals. We present preliminary considerations for integrating historical psychoeducation within established cognitive-behavioral therapy frameworks. Historical contextualization offers a pragmatic perspective requiring empirical validation through controlled trials before clinical implementation. The morphometric findings document substantial variation in masculine representation across historical periods, which may be relevant for understanding contemporary body image concerns.

The Making of Vulnerability. An ethnographic study exploring vulnerability in specialized outpatient care for pregnant persons with diabetes in Denmark.

To explore the impact, barriers, and facilitators of routinely sharing clinic visit recordings with patients in diverse clinical settings. We conducted a multiple-case study of three early-adopter clinics in the U.S.: a primary care clinic in Michigan and an oncology clinic in Texas that shared audio recordings, and a neurology clinic in Arizona that shared video recordings. From March 2016 to January 2017, we conducted semi-structured interviews with clinicians, patients, care partners, and administrators (≥18 years, English-speaking), and direct observation of patients using their recordings. Transcripts were analyzed using framework analysis to identify cross-cutting themes. Three coders independently reviewed all transcripts, and a medical anthropologist audited key analytic stages. We interviewed 67 stakeholders (32 patients, 10 care partners, 15 clinicians, and 10 administrators). Across sites, stakeholders reported that recordings improved patients' recall, understanding, and communication. Patients also used recordings for reflection on their performance in visits and planning, while care partners described reduced anxiety and enhanced involvement. Clinicians reported improved visit interactions, and some used recordings for self-assessment. Key factors influencing implementation included clinic culture, institutional support, workflow logistics, data security, and patient characteristics. Concerns were limited and focused primarily on data privacy. A conceptual framework summarizing themes related to barriers, facilitators, use, and impact of routine recording in healthcare was developed. Routinely sharing visit recordings can enhance patient-centered communication and care partner engagement while supporting clinician performance. Successful implementation depends on aligning institutional culture, privacy safeguards, and workflow integration. Sharing visit recordings was acceptable and beneficial across stakeholders. The practice of sharing recordings revealed that clinic visit interventions are more than just transactions of medical information-they promote emotional support, self-reflection, and family engagement.

This article examines the contemporary meaning of social medicine, a field marked by its porous boundaries, plurality, and contestation. Rather than offering a fixed definition, we trace its shifting forms across time, geography, and politics, positioning it as a "boundary object" that adapts to diverse contexts while retaining a minimal common identity. Comparative discussion with medical anthropology, social studies of medicine, global health, underscores social medicine's distinct focus on structural determinants, inequities, and justice. We propose three elements that could be the basic common elements of social medicine, drawing on foundational tenets of Latin American Social Medicine for this classification: 1) political commitment to social justice, 2) the central role of social sciences, and 3) participatory methodologies rooted in community participation. We highlight how these elements informed transformative reforms while also noting how institutionalization sometimes diluted revolutionary impulses into bureaucratic logics. Finally, we analyze how these basic common elements of social medicine identified through the Latin American case are manifested in other historical currents within the field and in contemporary expressions of "protest medicine". In these contexts, health professionals and volunteers provide care, document state violence, and transform medical testimony into political action. By situating these practices at the intersection of grassroots militancy and institutional incorporation, the article reflects on the enduring tensions and possibilities of social medicine as a global, evolving project oriented toward health equity and social justice.

The increasing cultural and linguistic diversity of contemporary societies poses critical reflection on language as a culturally embedded framework that shapes and interprets the world. In the context of migration to Italy, this perspective highlights the intertwined nature of linguistic and cultural mediation, challenging health communication, particularly in multilingual medical interactions. This study integrates medical anthropology and linguistics, and focuses on the intersection between professional roles, cultural mediation, and the fluid identities of healthcare providers. Drawing on ethnographic fieldwork conducted in three clinics of the third sector, two in Cosenza and one in Florence (Italy), the research combines participant observation with discourse analysis (Gee 2014) to investigate the interactional asymmetries between non-Italian-speaking patients and healthcare professionals. In these specific contexts, data collection involved recorded medical consultations and ethnographic fieldnotes. The latter became one of the primary methods of documentation, and shaped the content of the analysis, thus based on practitioners’ medical consultations given in two of the clinics, and psychological/psychiatric consultations given in the third. Active involvement with the care team provided additional insights into how cultural and linguistic mediation shapes patient access to healthcare services. The study also highlights the complexities of the interpreter’s dual role as both a cultural mediator and an observer, revealing tensions and challenges that might arise in these kinds of multilingual interactions. The preliminary findings underscore the need for a context-sensitive approach that adapts medical anthropology and linguistic analysis to the challenges of multilingual healthcare. Using a mixed-methods approach, this contribution examines qualitative data and critical reflections from the field, seeking innovative strategies for improving healthcare communication. The research reflects on professional identity’s fluidity and its implications for fostering more culturally sensitive healthcare practices. It aims to contribute to the development of integrated methodologies enhancing the quality of care for patients from diverse backgrounds.

In Embodied Progress, Sarah Franklin examines assisted reproductive technologies (ARTs), particularly in vitro fertilization (IVF), in the United Kingdom. She discusses these technologies not only as biomedical innovations but also as cultural phenomena that reshape ideas of kinship, gender, and nature. The first edition (1997) is foundational to feminist and anthropologic scholarship on reproduction. In her recent second edition (2022), Franklin adds a modernized forward and afterward, situating ARTs within contemporary social, economic, and political contexts. This book review highlights the new perspectives introduced in the second edition. The first edition draws from anthropology, feminist theory, and biological science to trace how ARTs are constructed, contested, and lived. Franklin moves fluidly between national policy debates, media portrayals, intimate clinical encounters, and the lived experiences of her interlocutors. While not a traditional ethnography with extended observational histories, the work uses brief participant accounts to anchor a rich cultural analysis of ART in the moral and political debates of the late 20th century UK. Nearly thirty years later, Franklin uses the second edition to document both continuity and change in the assisted fertility landscape. She revisits themes from the original text, including the sense among patients as “having to try” IVF, framing it as a social obligation and a last resort, one's interlocutors may feel guilty of not pursuing. IVF, she argues, remains a “hope technology,” simultaneously offering the possibility of alleviating infertility-related pain while intensifying the anguish of reproductive failure. She contends that the drive to “never stop trying” is rooted in social values, relationships, and norms, not biology. Central to this second edition is Franklin's concept of “iFertility,” a term capturing how fertility aspirations have shifted from private matters to conditional, externally mediated projects. Franklin defines iFertility as a product of careful planning and investment and one dependent on supply chains, products, and markets. She describes how iFertility is embedded, now, in the global service economy and describes those undergoing IVF as consumers. This concept, she asserts, has evolved within a shifting societal understanding that fertility cannot be assumed and often requires technological intervention. Franklin also expands the scope of discussion in her second edition to address omissions from the first edition, namely regarding LGBTQ+ individuals pursing IVF. Franklin examines how IVF has enabled “rainbow families” to access new paths to parenthood while also noting that these technologies simultaneously reinforce heteronormative scripts in which biologically related children confer social legitimacy. Franklin further broadens her lens to the global scale, exploring the commercialization and commodification of reproduction. She traces how the corporate consolidation of fertility services intersects with, and often exacerbates, existing economic, racial, and gender inequalities, raising pressing questions about equity and access within the global “repro-commerce” market. Pedagogically, Embodied Progress remains highly adaptable. Its interdisciplinary reach makes it well-suited for both undergraduate and graduate courses, particularly when paired with more recent ethnographies of ART. The second edition's juxtaposition of early sociocultural understandings of ART with their current pervasiveness offers fertile ground for discussion on the ethics of medical intervention, governmental regulation, commercialization, global access, and evolving definitions of hope. As Franklin aptly notes, “The way society organizes and perceives reproduction tells you how it organizes and perceives everything else.” As IVF approaches its 50th anniversary in 2028, the updated Embodied Progress is a timely reminder that ARTs are simultaneously scientific and cultural projects. Franklin's ability to weave interlocutors’ voices into critical theory ensures the work remains a vital contribution to medical anthropology, feminist scholarship, and contemporary debates on reproduction.

Primary Care and Cross-Cultural Care.

Nancy Scheper-Hughes's and Margaret Lock's (1987) article on the "the mindful body," in which they introduce their framework of three interconnected bodies (individual, social, and the body politic), has shaped debates in medical anthropology over the last three decades and, as Yates-Doerr (2017: 142) puts it, represented "a zeitgeist for the field" (italics in original). Scheper-Hughes's related, but more politicized idea of the "rebel body," however-which she sketches in the following reprint-has not yet entered mainstream debates.Originally published only in print in the Traditional Acupuncture Society Journal (Scheper-Hughes, 1991), the article conceptualizes the rebel body as one that "refuse[s] the demand to suffer quietly" and thereby reveals and challenges political etiologies of illness. We discovered the article in our preparation of the special issue (see Führer and Vorhölter, 2025) and found it to be extremely valuable for our reflections on liberation medicine-and surprisingly timely. The article offers a compelling analysis of the political causes and potentials of illness, of pain and its demand for recognition, and of the power of refusal. While some of these themes have since been prominently discussed in more recent scholarship (see e.g., Buchbinder, 2015; Hamdy, 2008; Rose Hunt, 2016; McGranahan, 2016; Simpson, 2014), the conceptualization of the rebel body remains provocative and relevant to contemporary debates in and on medicine. By republishing this article here, we hope to make it accessible to a new generation of scholars, practitioners, patients, and activists and hereby further their aspirations toward an understanding of medicine as a form of everyday resistance.The article begins with a survey of anthropological understandings of and debates on the body, embodiment, and somatization. Based on her own fieldwork in North-Western Brazil, and using the framework of the "three bodies," Scheper-Hughes reflects on the interrelations between the individual body, the social body, and the body politic. Through a reworking of established notions of illness, suffering, and healing, she proposes to understand illness as a form of bodily praxis that can be read as an expression of protest and rebellion to unequal and unjust social and political orders. Thus read, the moment of illness carries the potential for radical reflection and subsequent action, which medicine as well as society can either mute through biomedical cooptation or respond to with engagement in political therapy.We are republishing the article with the kind permission of the British Acupuncture Council. The text has been lightly edited and this introductory note/abstract has been added by Amand-Gabriel Führer and Julia Vorhölter. We have added references that were missing in the original article and have removed those that were not mentioned in the text. Furthermore, we have included the works that we cite in this introductory note/abstract in the reference section. The article in the present form is reprinted with the permission of the author.

What can be learned about pandemic preparedness from greater attention to perspectives of people who live in regions labelled as 'hotspots' for disease outbreaks? And how might such attention require us to reconfigure science, policy, and practice - as part of a broader shifting of power in pandemics? These are the questions that motivate and are explored through the papers in this special issue on pandemic preparedness, for which this paper serves as Introduction. All the contributions to this special issue present perspectives, experiences, and reflections from African settings, drawing on research co-designed and conducted in close engagement with local communities or in dialogue with African scientists and public health actors. They approach biosocial questions from the concerns of the disciplinary fields of social, medical, and political anthropology, of engaged interdisciplinary social science, and, crucially, of embedded, 'grassroots' fieldwork by researchers who have grown up with the communities they are studying. The team bringing these complementary areas of expertise came together for a collaborative programme on 'Pandemic preparedness: local and global concepts and practices in tackling disease threats in Africa' supported by a collaborative award from the Wellcome Trust during 2018-2023. This special issue thus forms part of wider advocacy for rethinking pandemic preparedness and for the value of anthropology in informing its meanings and practices, now more than ever.