To alleviate uncertainty in the specialized field of transgender medicine, mental and physical healthcare providers have introduced the rhetoric of evidence-based medicine (EBM) in clinical guidelines to help inform medical decision making. However there are no diagnostic tests to assess the effectiveness of transgender medical interventions and no scientific evidence to support the guidelines. Using in-depth interviews with a purposive sample of 23 healthcare providers, I found that providers invoked two strategies for negotiating the guidelines. Some used the rhetoric of EBM and closely followed clinical guidelines to contain uncertainty. Others flexibly interpreted the guidelines to embrace uncertainty. These findings raise questions about the effectiveness of EBM and guidelines in medical decision making. While trans medicine involves an identity and not a biomedical illness, providers use the same strategies to respond to uncertainty as they may in other medical arenas.

Using in-depth interviews with forty transgender people, I explore “discursive aggression,” a term for the communicative acts used in social interaction to hold people accountable to social- and cultural-based expectations, and subsequently to reinforce inequality in everyday life. I show how these interactional affronts restore social order, are based in dominant language systems, and reflect expectations for how interactions should unfold. Gendered expectations—such as the assumption that gender is identifiable based on visual cues alone—come to life through language, are delivered through discursive aggression, and become routinized micro-inequalities that people negotiate in interaction. I present five vignettes to exemplify how discursive aggression typically unfolds in interaction. In so doing, this research demonstrates the value of discursive aggression as a concept to capture a pervasive, yet under-examined, feature of everyday life and a mechanism for how power is reified in interaction.

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Research on the social dimensions of health and health care among sexual and gender minorities (SGMs) has grown rapidly in the last two decades. However, a comprehensive review of the extant interdisciplinary scholarship on SGM health has yet to be written. In response, we offer a synthesis of recent scholarship. We discuss major empirical findings and theoretical implications of health care utilization, barriers to care, health behaviors, and health outcomes, which demonstrate how SGMs continue to experience structural- and interactional-level inequalities across health and medicine. Within this synthesis, we also consider the conceptual and methodological limitations that continue to beleaguer the field and offer suggestions for several promising directions for future research and theory building. SGM health bridges the scholarly interests in social and health sciences and contributes to broader sociological concerns regarding the persistence of sexuality- and gender-based inequalities.

Joy is a crucial element of people’s everyday lives that has been understudied by sociologists. This is particularly true for scholarship about transgender people. To address what we term a joy deficit in sociology, we analyze 40 in-depth interviews with trans people in which they were asked what they find joyful about being trans. Their responses demonstrate the methodological and theoretical importance of asking about joy. Four main themes emerged from the interviews. First, interviewees easily answered the question about joy. Second, contrary to common assumptions, we found that transgender people expressed joy in being members of a marginalized group and said that they preferred being transgender. Third, embracing a marginalized identity caused the quality of their lives to improve, increasing self-confidence, body positivity, and sense of peace. Finally, being from a marginalized group facilitated meaningful connections with other people. Our findings demonstrate a vital need to address the joy deficit that exists in the sociological scholarship on transgender people specifically, and marginalized groups more generally. Bridging the sociology of knowledge and narratives, we show how accentuating joy offers nuance to understandings of the lived experiences of marginalized people that has been absent from much of sociological scholarship.