{"paper_id":"dbc10c55-1710-4b79-9b4e-d2d0ce25f3b2","body_text":"The  control  of  pain  \nA  critical  discourse  analysis  of  Socialstyrelsens  \nguidelines\n \nfor\n \nEndometriosis\n \n     Author:  Rebecka  Lidberg  Rosenlind  GNVM03  VT25  Division  of  Gender  Studies  Lund  University  Supervisor:  Riya  Raphael  \n \n\n \nAcknowledgements   This  thesis  would  not  have  been  possible  without  the  unwavering  support  of  my  supervisor,  \nRiya.\n \nAlthough\n \nthis\n \nproject\n \nstems\n \nfrom\n \ngenuine\n \ninterest\n \nand\n \npassion,\n \nit\n \nis\n \neasy\n \nto\n \nlose\n \nyour\n  \nfooting\n \nand\n \nfeel\n \nas\n \nif\n \none’s\n \nproject\n \nis\n \ndirectionless.\n \nWhen\n \nI\n \nhave\n \nturned\n \nto\n \nRiya\n \nwith\n \nthese\n \nfeelings\n \nof\n \ndoubt,\n \nshe\n \nhas\n \nnot\n \nonly\n \ngiven\n \nme\n \nbrilliant\n \nadvice,\n \nbut\n \nhas\n \nbeen\n \nan\n \nanchor,\n \nreminding\n \nme\n \nthat\n \nwriting\n \nis\n \na\n \nprocess\n \nof\n \nups\n \nand\n \ndowns,\n \nwhilst\n \nensuring\n \nme\n \nof\n \nmy\n \nabilities.\n \nI\n \nam\n \nso\n \ngrateful\n \nfor\n \nyour\n \npatience\n \nand\n \nkindness\n \nRiya,\n \nthank\n \nyou\n \nfor\n \neverything.\n  To  my  classmates,  I  am  so  proud  of  us!  Spending  these  last  two  years  with  you  has  been  such  \na\n \ngenuine\n \npleasure.\n \nOur\n \nconversations\n \nhave\n \ntaught\n \nme\n \nso\n \nmuch\n \nand\n \nhave\n \nchanged\n \nme\n \nfor\n \nthe\n \nbetter.\n \nAlthough\n \nI\n \ngrieve\n \nthe\n \nfact\n \nthat\n \nwe\n \nare\n \nthe\n \nlast\n \nclass\n \nto\n \ngraduate\n \nfrom\n \nthe\n \nMasters\n \nprogram\n \nin\n \nGender,\n \nMigration\n \nand\n \nSocial\n \nJustice,\n \nI\n \nam\n \nassured\n \nby\n \nthe\n \nfact\n \nthat\n \nyou\n \nwill\n \nall\n \nharbour\n \nits\n \nlegacy\n \nin\n \nyour\n \nfuture\n \nprojects.\n \nTo\n \nMaja,\n \nand\n \nall\n \nthose\n \nwho\n \ncontribute\n \nto\n \nthe\n \nDivision\n \nof\n \nGender\n \nStudies,\n \nthank\n \nyou\n \nfor\n \nremaining\n \na\n \ncritical\n \nfeminist\n \nvoice\n \nin\n \nacademia\n \nand\n \nfor\n \nall\n \nyour\n \nbrilliant\n \nresearch.\n \n  And  to  my  partner,  Benjamin,  thank  you  for  always  comforting  me  and  making  me  laugh.  \nThank\n \nyou\n \nfor\n \nthe\n \nhugs\n \nand\n \ngentle\n \nwords.\n \nThank\n \nyou\n \nfor\n \nall\n \nthe\n \ndiscussions\n \nand\n \nadvice.\n \nI\n \nam\n \nconstantly\n \nin\n \nawe\n \nof\n \nyour\n \nkindness,\n \nintelligence,\n \nwit\n \nand\n \nbeauty.\n \nOur\n \nlove\n \ninspires\n \neverything\n \nI\n \ndo.\n \n            \n1  \n\n \nAbstract  and  keywords   This  thesis  analyzes  Socialstyrelsens  (Swedish  Social  Services)  guidelines  for  endometriosis  \nhealthcare,\n \nwith\n \nthe\n \naim\n \nof\n \nunderstanding\n \nthe\n \nsocial\n \naspects\n \nof\n \nthe\n \nmedicalized\n \nfield\n \nof\n \nendometriosis.\n \nFormer\n \nresearch\n \non\n \ntransnational\n \nand\n \nSwedish\n \nendometriosis\n \nexperience,\n \nstudies\n \non\n \nendometriosis\n \nguidelines\n \nand\n \nSocialstyrelsens’\n \nguidelines\n \nfor\n \nhealthcare,\n \nis\n \npresented\n \nto\n \ncontextualize\n \nthe\n \nproject.\n \nThe\n \nthesis’\n \nmethodological\n \nframework\n \nconsists\n \nof\n \nfeminist\n \ncritical\n \ndiscourse\n \nanalysis,\n \nbased\n \non\n \nthe\n \nwritings\n \nof\n \nFairclough\n \nand\n \nfeminist\n \nreflections\n \non\n \ndiscourse,\n \npower\n \nand\n \nreflexivity.\n \nThe\n \ntheoretical\n \nframework\n \ndraws\n \nupon\n  \ntheories\n \non\n \ndiscourse\n \nand\n \nbiopower,\n \nworkfare,\n \ngender\n \nand\n \nthe\n \nbody,\n \nfeminist\n \nbioethics\n \nas\n \nwell\n \nas\n \ntheories\n \non\n \nthe\n \nsociology\n \nof\n \npain.\n  The  critical  discourse  analysis  of  the  Socialstyrelsens  guidelines  highlights  four  main  \nfindings.\n \nThe\n \nfirst\n \nis\n \nthe\n \ncentrality\n \nof\n \nfertility\n \nin\n \nthe\n \ndocument\n \nwhile\n \nlacking\n \ndiscussions\n \non\n \nthe\n \nsocial\n \naspects\n \nof\n \nreproduction.\n \nThe\n \nsecond\n \nsection\n \nhighlights\n \nthat\n \nthe\n \nsocial\n \nperspectives\n \nin\n \nrelation\n \nto\n \npain\n \nare\n \nnot\n \naccounted\n \nfor.\n \nThe\n \nthird\n \nfinding\n \nreveals\n \nhow\n \nthe\n \nguidelines\n \nemphasise\n \nthe\n \nimportance\n \nof\n \nendometriosis\n \ntreatment\n \nwith\n \nthe\n \noverall\n \ngoal\n \nof\n \nbeing\n \nable\n \nto\n \nlead\n \n'normal'\n \nworking\n \nlife\n \nand\n \nenforces\n \nable\n \nbodied\n \nas\n \nthe\n \nnorm.\n \nThe\n \nlast\n \ntheme\n \naddresses\n \nthe\n \nambivalences\n \nin\n \nthe\n \nrepresentation\n \nof\n \ngender\n \nin\n \nthe\n \ndocument,\n \nand\n \ncritically\n \nanalyzes\n \nfeminizing\n \npractices.\n  Keywords:  Endometriosis,  Socialstyrelsen  guidelines,  pain,  queer  theory.   Nyckelord:  Endometrios,  Socialstyrelsens  riktlinjer,  smärta,  queerteori.           \n2  \n\n \nTable  of  contents  \n 1.  Introduction .................................................................................................................... 4 2.  Aim  and  research  questions ........................................................................................... 6 2.1  Aim ........................................................................................................................... 6 2.2  Research  questions ................................................................................................... 6 2.3  Following  the  research  problem ............................................................................... 6 3.  Research  field .................................................................................................................. 7 3.1  Transnational  experiences  of  endometriosis  and  related  healthcare ........................ 8 3.2  Swedish  experiences  of  endometriosis  and  related  healthcare ............................... 11 3.3  Government  guidelines  for  endometriosis  healthcare ............................................ 13 3.4  Socialstyrelsen’s  guidelines  for  healthcare ............................................................. 13 4.  Theory ........................................................................................................................... 15 4.1  Discourse  and  Biopower ........................................................................................ 15 4.2  Workfare ................................................................................................................. 16 4.3  Sex,  gender  and  the  body ....................................................................................... 17 4.4  Feminist  Bioethics .................................................................................................. 18 4.6  Sociology  of  chronic  pain ...................................................................................... 19 4.7  Operationalisation .................................................................................................. 20 5.  Methodology,  methods  and  material .......................................................................... 20 5.1  Material .................................................................................................................. 20 5.2  Methodology .......................................................................................................... 21 5.3  Method ................................................................................................................... 22 5.4  Ethical  considerations ............................................................................................ 24 6.  Analysis:  tracing  the  social  in  the  medical ................................................................. 26 6.1  The  centrality  of  fertility ........................................................................................ 27 6.2  Access  to  care  and  pain  -  Whose  pain  is  taken  seriously? ..................................... 30 6.3  Cost  efficiency  and  workfare  -  Patients  in  the  realm  of  the  neoliberal  order ......... 35 6.4  Gendered  ambivalence  -  Who  is  the  patient  group  for  endometriosis? ................. 37 6.5  Suggestions  for  future  endometriosis  guidelines ................................................... 43 7.  Concluding  discussion .................................................................................................. 45 7.1  Summary  and  conclusions ...................................................................................... 45 7.2  My  thesis’  contributions ......................................................................................... 48 7.3  Reflections  and  future  research .............................................................................. 48 8.  References ..................................................................................................................... 51     \n3  \n\n \n1.  Introduction   \nWhose  pain  is  taken  seriously?  This  question  has  been  at  the  center  of  recent  testimonies  of  \nexperience\n \nregarding\n \nhealthcare\n \nfor\n \nendometriosis,\n \na\n \nreproductive\n \nchronic\n \ndisease\n \nwhere\n tissue  similar  to  that  inside  the  uterus  grows  outside  the  organ  (1177.se).  The  condition  is  chronic,  and  symptoms  consist  of  fatigue  and  intense  pelvic  pain,  usually  worsening  during  \nperiods\n \nand\n \novulation.\n \nStudies\n \nalso\n \nshow\n \ncorrelation\n \nbetween\n \nendometriosis\n \nand\n \nirritable\n \nbowel\n \nsyndrome\n \n(IBS),\n \nimmunological\n \ndiseases\n \nand\n \ncardiovascular\n \ndisease\n \n(Kirk\n \net\n \nal,\n \n2024,\n \np.1).\n \nEndometriosis\n \nwas\n \ndiscovered\n \nas\n \nearly\n \nas\n \nthe\n \n19th\n \ncentury\n \n(Benagiano\n \net\n \nal,\n \n2014),\n \nbut\n \nis\n \nstill\n \na\n \ncritically\n \nunderfunded\n \nmedical\n \nissue,\n \nwhich\n \nhas\n \nimplications\n \non\n \nhealthcare,\n \nresearch\n \nand\n \npatient\n \nexperience\n \n(Kirk\n \net\n \nal,\n \n2024,\n \np.1).\n \nOne\n \nof\n \nthese\n \nimplications\n \nis\n \nthe\n \nomnipresent\n \nlack\n \nof\n \nrecognition\n \nregarding\n \nendometriosis,\n \nboth\n \nin\n \nthe\n \ngeneral\n \npopulation\n \nand\n \namongst\n \nhealthcare\n \nprofessionals\n \n(Kirk\n \net\n \nal,\n \n2024,\n \npp.1-2)\n \n  Swedish  media  accounts  endometriosis  experience  display  the  material  effects  of  lacking  \nrecognition\n \nwithin\n \nhealthcare\n \nsettings.\n \nOne\n \nwoman\n \nshare\n \nhow\n \nshe\n \nhad\n \nto\n \nwait\n \n11\n \nyears\n \nto\n \nreceive\n \ndiagnosis,\n \ndespite\n \nher\n \nsymptoms\n \nclearly\n \ncorrelating\n \nwith\n \nendometriosis\n \ndiagnosis\n \ncriteria\n \n(Lind,\n \n2024).\n \nAnother\n \nwoman\n \nexperienced\n \ndismissal\n \nfrom\n \nhealthcare\n \nservices,\n \nwho\n \ntold\n \nher\n \ncramps\n \nwere\n \npart\n \nof\n \na\n \nregular\n \nmenstrual\n \ncycle,\n \ndespite\n \nher\n \ncollapsing\n \nand\n \nscreaming\n \nin\n \nagony\n \nfrom\n \nher\n \npain\n \n(Monzon,\n \n2024).\n \nShe\n \ndid\n \nnot\n \nreceive\n \nher\n \nendometriosis\n \ndiagnosis\n \nuntil\n \n8\n \nyears\n \nafter\n \nfirst\n \nexperiencing\n \nsymptoms.\n \n  These  articles  give  examples  of  how  intense  menstrual  pain  is  dismissed  by  Swedish  \nhealthcare\n \nprofessionals\n \nas\n \nunproblematic\n \nparts\n \nof\n \npatients’\n \nmenstrual\n \ncycles,\n \nwhich\n \ncontributes\n \nto\n \nextensive\n \ndiagnostic\n \ndelays\n \n(Lind,\n \n2024)\n \n(Monzón,\n \n2024).\n \nOn\n \naverage,\n \nit\n \ntakes\n \n8\n \nyears\n \nto\n \nreceive\n \ndiagnosis\n \nand\n \nrelated\n \ntreatment\n \nfor\n \nendometriosis\n \nin\n \nSweden\n \n(Monzón,\n \n2024).\n \nRFSU\n \nstates\n \nthat\n \nthe\n \ndisease\n \naffects\n \n10\n \npercent\n \nof\n \nSwedish\n \npeople\n \nwith\n \na\n \nmenstrual\n \ncycle\n \n(RFSU,\n \n2022),\n \nwith\n \nan\n \nestimated\n \nhigh\n \nnumber\n \nof\n \nunreported\n \ncases\n \n(Monzón,\n \n2024).\n \n\"Endometriosföreningen\",\n \nan\n \nassociation\n \nwhich\n \nworks\n \nwith\n \npatient\n \nsupport\n \nand\n \npolitical\n \nchange\n \nin\n \nSweden,\n \nmention\n \nthat\n \none\n \nof\n \nthe\n \nmost\n \ncommon\n \nmisconceptions\n \nof\n \nthe\n \ndisease,\n \nwhich\n \nprevent\n \npatients\n \nfrom\n \nreceiving\n \nhealthcare\n \nand\n \nworking\n \ncoping-strategies,\n \nis\n \nthe\n \nnormalisation\n \nof\n \nexcessive\n \nmenstrual\n \npain\n \n(Endometriosföreningen,\n \n2021).\n \nWhen\n \nI\n \napproached\n \nthe\n \ntopic\n \nof\n \nendometriosis,\n \nI\n \nwas\n \nhugely\n \ninspired\n \nby\n \nthese\n \ndiscussions\n \non\n \nthe\n \nnormalisation\n \nof\n \npain.\n \n \n4  \n\n \nIn  an  article  by  Aftonbladet,  a  Swedish  trans-man  shares  how  he  was  told  by  endometriosis  \nhealthcare\n \nthat\n \nsince\n \nhe\n \nwas\n \nnot\n \na\n \nwoman,\n \nhe\n \nhad\n \n“nothing\n \nto\n \nthere”,\n \ndismissing\n \nhim\n \neven\n \nthough\n \nit\n \nwas\n \nlater\n \nshown\n \nthat\n \nhe\n \nhad\n \nsevere\n \nendometriosis,\n \nwhich\n \nhad\n \nspread\n \nto\n \nthe\n \nbowels\n \n(Melin,\n \n2025).\n \nThis\n \ndisplays\n \nhow\n \ncisnormativity\n \nand\n \nfeminization\n \nof\n \nendometriosis\n \nas\n \na\n \ndisease,\n \ncontributes\n \nto\n \nhealthcare\n \nprofessionals\n \ndismissing\n \ntrans\n \nand\n \nqueer\n \npatients\n \nfrom\n \nnecessary\n \nhealthcare,\n \nleading\n \nto\n \nsymbolically\n \nand\n \nmaterially\n \nviolent\n \nconsequences.\n \nConsidering\n \nthese\n \nexamples\n \nof\n \nexclusionary\n \npractices\n \nin\n \nswedish\n \nendometriosis\n \nhealthcare,\n \ntogether\n \nwith\n \nrecent\n \nyears\n \nregression\n \nregarding\n \ntrans\n \ninclusivity,\n \nillustrated\n \nby\n \nthe\n \nviolent\n \ndecision\n \nto\n \nexclude\n \ntrans\n \nwomen\n \nfrom\n \nthe\n \nlegal\n \ndefinition\n \nof\n \na\n \nwoman\n \nin\n \nthe\n \nUK\n \n(Haq,\n \n2025),\n \nI\n \nalso\n \ntook\n \nan\n \ninterest\n \nin\n \nthe\n \nquestion\n \nof\n \ntrans\n \ninclusivity\n \nand\n \nfeminization\n \nin\n \nrelation\n \nto\n \nendometriosis.\n \n  These  combined  interests  motivate  my  choice  of  material:  Socialstyrelsens  guidelines  on  \nendometriosis\n \nhealthcare.\n \nIn\n \nSweden,\n \nSocialstyrelsen\n \n(The\n \nNational\n \nBoard\n \nof\n \nHealth\n \nand\n \nWelfare\n \nin\n \nSweden)\n \nprovides\n \nguidelines\n \nfor\n \nspecific\n \nhealthcare\n \nconcerns,\n \nwhich\n \nare\n \nused\n \nby\n \nmedical\n \nexecutives\n \nand\n \npractitioners\n \nin\n \nthe\n \nwhole\n \ncountry\n \n(Socialstyresen,\n \n2023).\n \nThese\n \nguidelines\n \nare\n \nwritten\n \nin\n \ncorrespondence\n \nwith\n \ncurrent\n \nresearch,\n \nand\n \nare\n \ndone\n \nto\n \nassess\n \nthe\n \ncurrent\n \nfunctionality\n \nof\n \nmedical\n \nservices\n \nas\n \nwell\n \nas\n \nto\n \ngive\n \ntreatment\n \nrecommendations,\n \nwith\n \nthe\n \noverarching\n \ngoal\n \nto\n \ncreate\n \ngood\n \nand\n \nequal\n \nhealthcare\n \nfor\n \nall\n \n(Socialstyrelsen,\n \n2023).\n \nMy\n \nmaterial\n \nis\n \na\n \nroughly\n \n100\n \npage\n \nlong\n \ndocument\n \nwhich\n \nwas\n \npublished\n \nin\n \n2018,\n \nand\n \nare\n \nthe\n \nfirst\n \nguidelines\n \nfor\n \nendometriosis\n \nproduced\n \nby\n \nSocialstyrelsen.\n \nSince\n \nSocialstyrelsen\n \nis\n \nthe\n \nmost\n \nprominent\n \npublic\n \nhealth\n \nawareness\n \noriented\n \nnational\n \nboard\n \nin\n \nSweden,\n \ntheir\n \ndefinitions\n \nand\n \ndiscussions\n \non\n \nendometriosis\n \nare\n \ndiscursively\n \ninfluential,\n \nmotivating\n \nme\n \nto\n \nanalyze\n \nthe\n \nguidelines\n \nusing\n \ncritical\n \ndiscourse\n \nanalysis.\n \nGiven\n \nmy\n \ngender\n \nstudies\n \nbackground,\n \nmy\n \ntheoretical\n \nfocus\n \nlies\n \non\n \nfeminist\n \nperspectives\n \non\n \nhealthcare,\n \nmaking\n \nme\n \ninterested\n \nin\n \nthe\n \nsocial\n \nfactors\n \nwhich\n \ninform\n \nendometriosis\n \nexperience,\n \nand\n \nthe\n \nways\n \nthese\n \nare\n \nmore\n \nor\n \nless\n \nevident\n \nin\n \nmy\n \nmaterial.\n \nThus,\n \nthe\n \nmain\n \naim\n \nof\n \nthis\n \nthesis\n \nis\n \nto\n \napply\n \na\n \nsocial\n \nlens\n \nto\n \nthe\n \nguidelines.\n \n  \n5  \n\n \n2.  Aim  and  research  questions  \n2.1  Aim  \nThis  thesis  explores  how  endometriosis  and  its  target  patients  are  defined  and  framed  by  The  \nNational\n \nBoard\n \nof\n \nHealth\n \nand\n \nWelfare\n \nin\n \nSweden\n \n(Socialstyrelsen).\n \nThe\n \nmain\n \naim\n \nis\n \nto\n \nexamine\n \nthe\n \nmedical\n \ndiagnosis\n \nof\n \nendometriosis\n \nthrough\n \na\n \nsocial\n \nlens,\n \nand\n \nto\n \nhighlight\n \nthe\n \nimportance\n \nof\n \nutilising\n \ninclusive\n \nand\n \ninformed\n \nlanguage\n \nin\n \nstate\n \nhealthcare\n \npolicy,\n \nto\n \nensure\n \nequal\n \npractice\n \nand\n \naccess\n \nfor\n \nall.\n \nA\n \nfeminist\n \ncritical\n \ndiscourse\n \nanalysis\n \nenables\n \nthis\n \nthesis\n \nto\n \nanalyse\n \nthe\n \nsocial\n \naspects\n \nthat\n \nare\n \nembedded\n \nwithin\n \npublic\n \nhealthcare\n \nawareness\n \ndocuments.\n \n \n2.2  Research  questions  \n1.  How  is  endometriosis  defined  in  Swedish  public  healthcare?   2.  How  can  we  explore  the  social  aspects  of  endometriosis  by  examining  \nSocialstyrelsens\n \nguidelines?\n  3.  How  can  feminist  theories  help  in  conducting  a  critical  discourse  analysis  of  \nSocialstyrelsens’\n \nguidelines?\n \n \n2.3  Following  the  research  problem  \nNormalisation  of  pain,  dismissal  of  symptoms  and  diagnostic  delay  are  not  just  experienced  \nin\n \nSweden,\n \nbut\n \nglobally.\n \nIn\n \nan\n \narticle\n \nfor\n \nthe\n \nBBC,\n \na\n \nwoman\n \nwith\n \nendometriosis\n \nspeaks\n \nof\n \nlacking\n \nworkplace\n \nsupport,\n \nrecalling\n \nthat\n \nher\n \npast\n \nemployers\n \nhave\n \nnot\n \nunderstood\n \nthe\n \nseverity\n \nof\n \nher\n \ncondition\n \n(Baines,\n \n2025).\n \nThis\n \ntestimony\n \nreflects\n \na\n \nlarger\n \nissue,\n \nbeing\n \nthat\n \none\n \nin\n \nsix\n \npeople\n \nwith\n \nendometriosis\n \nin\n \nthe\n \nUK\n \nhas\n \nto\n \nleave\n \ntheir\n \nmain\n \nsource\n \nof\n \nincome\n \ndue\n \nto\n \ntheir\n \ndiagnosis,\n \naccording\n \nto\n \nEndometriosis\n \nUK.\n \nFurther,\n \nThe\n \nScotsman\n \nreports\n \nhow\n \nmany\n \nendometriosis\n \npatients\n \nexperience\n \ntheir\n \nsymptoms\n \nbeing\n \ndownplayed\n \nby\n \nhealthcare\n \nprofessionals,\n \nsome\n \nbeing\n \ntold\n \nthat\n \nthe\n \n“only\n \nway\n \nto\n \nfix\n \nit\n \nis\n \nthrough\n \npregnancy”\n \n(McCann,\n \n2025).\n \nThe\n \nBetter\n \nIndia\n \nwrites\n \non\n \ntwo\n \nwomen’s\n \nexperiences\n \nof\n \nendometriosis,\n \nand\n \ntheir\n \nexcessive\n \nperiod\n \npain\n \nnot\n \nbeing\n \ntaken\n \nseriously\n \n(Mani,\n \n2024).\n \nThe\n \nsystematic\n \ndismissal\n \nof\n \none\n \nof\n \nthe\n \nwomen’s\n \nsymptoms\n \nas\n \n“just\n \nperiod\n \npain”\n \nled\n \nto\n \na\n \ndiagnostic\n \ndelay\n \nof\n \n14\n \nyears.\n \n(Mani,\n \n2024).\n \nIn\n \nAustralia,\n \na\n \nwoman\n \nhad\n \nto\n \nwait\n \n6\n \nyears\n \nto\n \nreceive\n \nher\n \ndiagnosis\n \nafter\n \n6  \n\n \nrepeatedly  begging  doctors  to  help  her  (Leach,  2024).  The  same  article  reports  how  2  out  of  3  \nAustralian\n \nwomen\n \nexperience\n \nhealthcare\n \ndiscrimination\n \n(Leach,\n \n2024).\n \n  Transnational  media  accounts  of  trans,  intersex  and  queer  experience  of  the  disease  gives  \ninsight\n \ninto\n \nhow\n \nfeminizing\n \nthe\n \nissue\n \ncan\n \nworsen\n \ndysphoria\n \nand\n \nhealthcare\n \nexperience\n \nfor\n \npatients.\n \nOne\n \nAustralian\n \npatient\n \nrecalls\n \nthe\n \nincreased\n \nfeeling\n \nof\n \ndysphoria\n \nstemming\n \nfrom\n \nendometriosis\n \nbeing\n \nconsidered\n \na\n \n“women’s\n \nissue”,\n \nconsidering\n \nthat\n \nthey\n \ndo\n \nnot\n \nidentify\n \nas\n \na\n \nwoman\n \n(Withers,\n \n2023).\n \nThey\n \nalso\n \nfelt\n \nas\n \nif\n \nthey\n \nhad\n \nto\n \nconstantly\n \njustify\n \nand\n \nexplain\n \ntheir\n \ntrans-identity\n \nin\n \nhealthcare\n \nencounters\n \nrelated\n \nto\n \nendometriosis,\n \nwhich\n \nthey\n \nfelt\n \nwas\n \nexhausting.\n \nThe\n \nEndometriosis\n \nFoundation\n \nof\n \nAmerica\n \nwrites\n \non\n \nthe\n \nexperiences\n \nof\n \na\n \ntrans\n \nman\n \nwith\n \nendometriosis,\n \nwho\n \nrecalls\n \nhim\n \nand\n \nhis\n \ntrans\n \npeers\n \nfeeling\n \nuncomfortable\n \nin\n \nreproductive\n \nhealthcare\n \nsettings,\n \nconsidering\n \nthat\n \nthey\n \nare\n \ntraditionally\n \nseen\n \nas\n \nwomen’s\n \nonly\n \nspaces\n \n(Stovicek,\n \n2018).\n \nAnother\n \ntrans\n \nperson\n \nwith\n \nendometriosis\n \nfrom\n \nCanada,\n \nfelt\n \nas\n \nif\n \nthey\n \nexperienced\n \na\n \ndouble\n \nbattle\n \nwith\n \nthe\n \ndisease:\n \none\n \nagainst\n \nthe\n \nexcruciating\n \npain\n \nof\n \nendometriosis\n \nand\n \nthe\n \nother\n \nagainst\n \nmisgendering\n \nand\n \ndehumanizing\n \npractices\n \nin\n \nhealthcare\n \nsettings\n \n(Landry,\n \n2021).\n \n  In  this  section,  I  have  aimed  to  provide  background  for  my  topic  as  well  as  to  summarize  the  \noverall\n \naim\n \nof\n \nthe\n \nproject.\n \nThe\n \nfollowing\n \nsection,\n \nchapter\n \n3,\n \nintroduces\n \nfindings\n \nfrom\n \nrelevant\n \nfields,\n \nincluding\n \nresearch\n \non\n \nendometriosis\n \nexperience\n \nas\n \nwell\n \nas\n \nprojects\n \non\n \nhealthcare\n \nguidelines.\n \nIn\n \nchapter\n \n4,\n \nthe\n \ntheoretical\n \nframework\n \nof\n \nthe\n \nthesis,\n \nconsisting\n \nof\n \ntheories\n \non\n \nbiopower,\n \nworkfare,\n \nqueer\n \nunderstandings\n \nof\n \ngender\n \nand\n \nsex,\n \nfeminist\n \nbioethics\n \nand\n \nsociology\n \nof\n \npain,\n \nis\n \ndescribed\n \nand\n \ndiscussed.\n \nThe\n \nmethodological\n \nframework,\n \nconsisting\n \nof\n \nfeminist\n \ninterpretations\n \nof\n \nFairclough's\n \ncritical\n \ndiscourse\n \nanalysis,\n \nis\n \nlater\n \nintroduced\n \nin\n \nchapter\n \n5,\n \nas\n \nwell\n \nas\n \nfeminist\n \nreflexivity\n \nand\n \nhow\n \nit\n \ninforms\n \nmy\n \nwork.\n \nIn\n \nchapter\n \n6,\n \nI\n \nutilize\n \nthese\n \nmethodological\n \nand\n \ntheoretical\n \ntools\n \nto\n \nthematically\n \nanalyze\n \nmy\n \nmaterial.\n \nI\n \nconclude\n \nthe\n \nanalysis\n \nby\n \ngiving\n \nsuggestions\n \nfor\n \nSocialstyrelsens\n \nfuture\n \nrenditions\n \nof\n \nendometriosis\n \nguidelines.\n \nFinally,\n \nchapter\n \n7\n \nincludes\n \na\n \nconcluding\n \ndiscussion\n \nwhich\n \nsummarizes\n \nmy\n \nfindings,\n \nhighlights\n \ntheir\n \nunique\n \ncontributions\n \nas\n \nwell\n \nas\n \nsuggestions\n \nfor\n \nfuture\n \nresearch.\n \n3.  Research  field  \nTo  contextualize  the  thesis,  this  section  consists  of  an  overview  of  relevant  research.  This  \nprovides\n \na\n \nbackground\n \nto\n \nthe\n \nthesis\n \nand\n \nshows\n \nhow\n \nthis\n \nstudy\n \nis\n \nlocated\n \nwithin\n \nbroader\n \nfields\n \n7  \n\n \nof  research.  Previous  research  is  structured  thematically,  based  on  prominent  foci  within  \ncontemporary\n \nresearch\n \ndone\n \non\n \nendometriosis\n \nexperience\n \nand\n \nhealthcare.\n \nThe\n \nfield\n \nof\n \nstudies\n \nconducted\n \non\n \nthe\n \ntopic\n \nof\n \nendometriosis\n \nexperience\n \nwas\n \nmuch\n \nwider\n \nthan\n \nthat\n \nof\n \nguideline\n \nanalysis,\n \nmaking\n \nthe\n \nlatter\n \nsection\n \nmuch\n \nless\n \ncomprehensive.\n \nThis\n \nmotivated\n \nme\n \nto\n \ninclude\n \nmedically\n \nsituated\n \narticles\n \nregarding\n \nendometriosis\n \nguidelines,\n \ndespite\n \ntheir\n \nepistemological\n \ndistance\n \nfrom\n \nthis\n \nproject.\n \n  In  addition  to  published  research,  I  also  include  two  recently  available  student  thesis  projects  \nin\n \nthe\n \nsection\n \non\n \nSocialstyrelsens\n \nguidelines.\n \nThey\n \nwere\n \nincluded\n \nsince\n \nthey\n \ndirectly\n \naddress\n \nmy\n \ntopic\n \nand\n \nindicate\n \nthe\n \nnovelty\n \nof\n \nsocial\n \nstudies\n \non\n \nendometriosis.\n \nThese\n \nsources\n \nare\n \ntreated\n \ndifferently\n \nthan\n \npeer-reviewed\n \nacademic\n \narticles,\n \nand\n \nare\n \nnot\n \ncited\n \nin\n \nthe\n \nanalysis.\n \nThe\n \nfour\n \nthematic\n \nsections\n \nof\n \nthe\n \nliterature\n \nreview\n \nare:\n \nTransnational\n \n(non-Swedish)\n \nexperiences\n \nof\n \nendometriosis\n \nand\n \nrelated\n \nhealthcare,\n \nSwedish\n \nexperiences\n \nof\n \nendometriosis\n \nand\n \nrelated\n \nhealthcare,\n \nGovernment\n \nguidelines\n \nfor\n \nendometriosis\n \nhealthcare\n \nand\n \nSoialstyrelsens\n \nguidelines\n \nfor\n \nhealthcare.\n \n \n3.1  Transnational  experiences  of  endometriosis  and  related  healthcare   \nThe  transnational  research  field  on  the  experiences  of  endometriosis  and  related  healthcare  is  \nextensive,\n \nconsisting\n \nof\n \nstudies\n \nfocused\n \non\n \nwomen's\n \nexperiences,\n \ntrans\n \nand\n \nintersex\n \npeople’s\n \nexperiences,\n \nand\n \nclinicians\n \nperspectives.\n \nFor\n \nexample,\n \nLightbourne\n \net\n \nal\n \n(2024),\n \nanalyzes\n \nIrish\n \nwomen’s\n \nexperiences\n \nof\n \nthe\n \ndisease\n \nand\n \nmedical\n \nservices,\n \nwhereas\n \nKaltsas\n \net\n \nal\n \n(2024)\n \nreviews\n \nresearch\n \non\n \ntrans-men's\n \nexperiences\n \nof\n \nthe\n \ndisease\n \nand\n \nYoung\n \net\n \nal\n \n(2018)\n \nexplores\n \nthe\n \nperceptions\n \nof\n \nclinicians\n \nin\n \nendometriosis\n \nhealthcare\n \nin\n \nAustralia.\n  Research  done  on  the  topic  also  utilizes  a  range  of  methodologies.  For  instance,  Pina-Romero  \n(2023)\n \nuses\n \nethnographic\n \ninterviews\n \nto\n \nexplore\n \nexperiences\n \nrelated\n \nto\n \nthe\n \nproduction\n \nof\n \nignorance\n \nfrom\n \nthe\n \nwomen\n \nof\n \n“Endometriosis\n \nMexico”,\n \na\n \nMexican\n \nbased\n \nendometriosis\n \nassociation\n.\n \nOther\n \nresearch\n \nutilizes\n \na\n \nreview-based\n \nor\n \ncontent\n \nanalytical\n \napproach,\n \nsuch\n \nas\n \nGiacomozzi\n \net\n \nal\n \n(2024)\n \nwhich\n \napplied\n \na\n \nsystematic-review\n \napproach\n \nto\n \nformer\n \nresearch\n \nexploring\n \nthe\n \nexperiences\n \nof\n \nendometriosis\n \nwithin\n \ntrans\n \nand\n \nintersex\n \ndemographics.\n \nA\n \nsurvey\n \nbased\n \napproach\n \nwas\n \nused\n \nby\n \nCarvalho\n \net\n \nal\n \n(2024),\n \nto\n \nexplore\n \nthe\n \nexperiences\n \nof\n \npain,\n \nsexual\n \ndistress\n \nand\n \nmental\n \nhealth\n \nin\n \ntrans\n \nand\n \nintersex\n \npatient\n \ngroups\n \nof\n \nthe\n \ndisease,\n \nwhereas\n \nBergen\n \net\n \nal.\n \n(2023)\n \nused\n \na\n \nnarrative\n \nmethodology\n \nto\n \ncapture\n \nthe\n \nlived\n \nexperience\n \nof\n \nKenyan\n \nwomen\n \nwith\n \nendometriosis.\n \n \n8  \n\n \nResearch  on  endometriosis  represents  studies  conducted  across  numerous  contexts,  including  \nIreleand,\n \nAustralia,\n \nMexico\n \nand\n \nKenya.\n \nOther\n \nexamples\n \nof\n \nresearch\n \ncontexts\n \ncan\n \nbe\n \nfound\n \nin\n \nAbraham\n \n&\n \nRajasekaran\n \n(2023),\n \nwhich\n \nanalyzed\n \ntwo\n \nAmerican\n \nmemoirs\n \non\n \nendometriosis\n \nexperience,\n \nas\n \nwell\n \nas\n \nsome\n \nstudies\n \nwhich\n \nwere\n \nsituated\n \ninternationally,\n \nsuch\n \nas\n \nEder\n \n&\n \nRoomaney\n \n(2024)\n \nwho\n \ninterviewed\n \ntrans\n \nand\n \nnon-binary\n \nparticipants\n \nwith\n \nendometriosis,\n \nwhich\n \nwere\n \nrecruited\n \nthrough\n \nsocial\n \nmedia\n \ninternationally.\n \nBelow\n \nI\n \norganise\n \nthe\n \nrelevant\n \nresearch\n \non\n \nthe\n \ntopic,\n \nin\n \nthematic\n \ncategories.\n \n  A  prominent  theme  in  the  articles  was  the  prevalence  of  medical  delegitimization  of  \nendometriosis\n \nrelated\n \nsymptoms\n \n(such\n \nas\n \nintense\n \npain\n \nworsening\n \nduring\n \nmenstruation).\n \nOne\n \narticle\n \ndescribes\n \nhow\n \na\n \nwoman\n \nwith\n \nendometriosis,\n \nwho\n \nexperienced\n \nsevere\n \nabdominal\n \nand\n \nvaginal\n \npain\n \nwhich\n \nworsened\n \nduring\n \nher\n \nperiods,\n \nwas\n \ntold\n \nthat\n \n“periods\n \nare\n \nsupposed\n \nto\n \nhurt”\n \nby\n \na\n \ndoctor\n \nwhen\n \nseeking\n \nmedical\n \nhelp\n \n(Abraham\n \n&\n \nRajasekaran,\n \n2023,\n \npp.\n \n577-579).\n \nAnother\n \nsource\n \ndescribes\n \nthat\n \na\n \nreason\n \nfor\n \ndiagnostic\n \ndelay\n \nwithin\n \ntrans\n \ndemographics\n \nof\n \nendometriosis,\n \nis\n \nthe\n \ndismissal\n \nof\n \nsymptoms\n \nas\n \nmerely\n \nmanifestations\n \nof\n \ngender\n \ndysphoria,\n \nrather\n \nthan\n \nrelated\n \nto\n \na\n \nphysiological\n \ncondition\n \n(Carvalho\n \net\n \nal.,\n \n2024,\n \np.\n \n6).\n \nA\n \nrelated\n \nissue\n \nmentioned\n \nin\n \nsome\n \nof\n \nthe\n \narticles\n \nis\n \nthat\n \nof\n \nmedical\n \ngaslightning,\n \nreferring\n \nto\n \nwhen\n \nmedical\n \nprofessionals\n \nuse\n \ntheir\n \npowerful\n \nposition\n \nto\n \ndeny\n \nthe\n \nvalidity\n \nof\n \npatients'\n \nreality\n \nand\n \nlived\n \nexperience.\n \nFor\n \ninstance,\n \nEder\n \n&\n \nRoomaney\n \n(2024)\n \nreport\n \nhow\n \nmedical\n \ngaslighting\n \nmade\n \ntheir\n \ntrans\n \nparticipants\n \nfeel\n \ninvalidated\n \nand\n \nblamed\n \nfor\n \ntheir\n \nissues,\n \nwhich\n \nwas\n \naccompanied\n \nby\n \na\n \ndisproportionate\n \nfocus\n \non\n \nfertility\n \ninstead\n \nof\n \npatient\n \nneeds\n \n(Ibid,\n \npp.\n \n914-916).\n \nEvans\n \net\n \nal.\n \n(2022)\n \npresents\n \nthe\n \nissue\n \nof\n \nmedical\n \ngaslighting\n \nas\n \ngendered,\n \ndescribing\n \nhow\n \none\n \nof\n \ntheir\n \nparticipants\n \nfelt\n \nas\n \nif\n \nmedical\n \nprofessionals\n \nfound\n \nher\n \nhusband\n \nmore\n \ncredible\n \nthan\n \nherself\n \n(ibid,\n \np.\n \n2099)\n  A  significant  delay  for  diagnosis  is  reported  in  former  research  on  the  topic  of  endometriosis  \nexperience,\n \nmost\n \naccounting\n \nfor\n \nseveral\n \nyear\n \nlong\n \ndiagnostic\n \ndelays\n \nfor\n \nthe\n \naverage\n \npatient.\n \nDelegitimization\n \nand\n \ndelay\n \nfor\n \ndiagnosis\n \nis\n \npartially\n \nexplained\n \nby\n \nignorance\n \nregarding\n \nendometriosis\n \nfrom\n \nmedical\n \nprofessionals.\n \nPiña-Romero\n \n(2023)\n \nexplains\n \nhow\n \nignorance\n \nregarding\n \nthe\n \ndisease\n \nis\n \na\n \ncentral\n \npart\n \nof\n \nthe\n \nexperiences\n \nof\n \ntheir\n \ninformants\n \n(Ibid,\n \np.\n \n3,\n  \npp.\n \n9-10).\n \nAnother\n \narticle\n \ndescribes\n \nhow\n \npatients\n \nfelt\n \nthe\n \nneed\n \nto\n \neducate\n \nthemselves\n \non\n \nendometriosis\n \nbecause\n \nthe\n \nexpert\n \ncompetence\n \nin\n \nhealthcare\n \nservices\n \nfor\n \nthe\n \ndisease\n \nwas\n \nso\n \nlow\n \n(Lightbourne\n \net\n \nal.,\n \n2024,\n \npp.\n \n319).\n \nFurther,\n \nsome\n \nsources\n \nreport\n \nhow\n \nlack\n \nof\n \nresources\n \nfor\n \nhealthcare\n \nservices\n \nrelated\n \nto\n \nendometriosis\n \ncontribute\n \nto\n \ndiagnostic\n \ndelay\n \n(Bergen\n \net\n \nal.,\n \n9  \n\n \n2023,  p.  6).  Research  done  with  trans  and  intersex  people  as  its  main  demographic  point  to  \nhow\n \ntrans\n \nand\n \nintersex\n \nidentities\n \nseems\n \nto\n \nbe\n \nrelated\n \nto\n \nan\n \nexacerbation\n \nof\n \nalready\n \nexisting\n \ndelays\n \nand\n \ndifficulty\n \nto\n \npertain\n \nendometriosis\n \ndiagnosis,\n \nmaking\n \nthe\n \nissue\n \nof\n \nunderdiagnosis\n \neven\n \nmore\n \npressing\n \nwithin\n \nthis\n \ndemographic\n \n(Jeffrey\n \net\n \nal.,\n \n2024,\n \np.\n \n3;\n \nKaltsas\n \net\n \nal.,\n \n2024,\n \np.\n \n4;\n \nEder\n \n&\n \nRoomaney,\n \n2024,\n \np.\n \n912;\n \nCarvalho\n \net\n \nal.,\n \n2024,\n \np.\n \n6).\n \n  Former  research  report  a  prevalence  of  discrimination  within  endometriosis  healthcare.  In  \nwomen’s\n \nexperiences,\n \nthe\n \ndiscrimination\n \nmostly\n \nconsists\n \nof\n \nnormalisation\n \nof\n \npain,\n \nan\n \nandrocentric\n \noutlook\n \non\n \nhealthcare\n \nand\n \ngeneral\n \ndisrespect,\n \nstigmatization\n \nand\n \ngeneralizations\n \nof\n \ntheir\n \nbodies\n \nand\n \nneeds\n \n(Abraham\n \n&\n \nRajasekaran,\n \n2023,\n \np.\n \n577;\n \nPiña-Romero,\n \n2023,\n \np.\n \n9;Lightbourne\n \net\n \nal.,\n \n2024,\n \np.\n \n318).\n \nOne\n \nof\n \nthe\n \narticles\n \ndescribes\n \nthe\n \nhistorical\n \nheritage\n \nof\n \nmisogyny\n \nin\n \nendometriosis\n \nhealthcare,\n \nstigmatizing\n \nwomen\n \nwith\n \nexcessive\n \nmenstrual\n \npain\n \nas\n \ncrazy\n \nand\n \nhysterical,\n \nwhich\n \nis\n \ndescribed\n \nas\n \nhaving\n \nconsequences\n \nfor\n \ncurrent\n \nhealthcare\n \nexperience\n \n(Piña-Romero,\n \n2023,\n \np.\n \n9).\n \nTrans\n \nand\n \nintersex\n \nexperience\n \nof\n \ndiscrimination\n \nwithin\n \nhealthcare\n \nis\n \ndescribed\n \nas\n \nrelated\n \nto\n \nthe\n \noverall\n \ncisnormativity\n \nof\n \nendometriosis\n \nhealthcare,\n \nlabelling\n \nit\n \na\n \n“women’s\n \nissue”,\n \nas\n \nwell\n \nas\n \nthrough\n \nmisgendering\n \nand\n \nreluctance\n \nto\n \nuse\n \ncorrect\n \npronouns\n \nin\n \nspecific\n \nmedical\n \nencounters\n \n(Giacomozzi\n \net\n \nal.,\n \n2024,\n \np.\n \n16;\n \nEder\n \n&\n \nRoomaney,\n \n2024,\n \np.\n \n916-920;\n \nKaltsas\n \net\n \nal.,\n \n2024,\n \np.\n \n4;\n \nCarvalho\n \net\n \nal.,\n \n2024,\n \np.\n \n7;\n \nJeffrey\n \net\n \nal.,\n \n2024,\n \np.2-3).\n \nJeffrey\n \net\n \nal\n \n(2024)\n \nreport\n \nhow\n \none\n \nof\n \ntheir\n \ntrans\n \nparticipants\n \nremoved\n \ntheir\n \nown\n \nIUD,\n \ndue\n \nto\n \nfear\n \nof\n \nreturning\n \nto\n \nreproductive\n \nhealthcare\n \nproviders\n \nbecause\n \nof\n \nprevious\n \nexperiences\n \nof\n \ndiscrimination\n \n(2024,\n \np.\n \n2)\n  Recounts  of  positive  experiences  of  endometriosis  healthcare  were  not  as  prevalent  in  former  \nresearch,\n \nbut\n \nwas\n \ndescribed\n \nin\n \none\n \narticle\n \nas\n \ncharacterized\n \nby\n \ninstances\n \nwere\n \nthere\n \nwas\n \na\n \nswift\n \ntransferral\n \nto\n \nspecialist\n \ncare\n \n(Lightbourne\n \net\n \nal.,\n \n2023,\n \np.\n \n313),\n \nand\n \nanother\n \nas\n \nlinked\n \nto\n \ninclusive\n \nlanguage\n \nin\n \ndescriptions\n \nof\n \nbody,\n \nreproduction\n \nand\n \nsexual\n \nthemes\n \n(Eder\n \n&\n \nRoomaney,\n \n2024,\n \np.\n \n920-921).\n \nIn\n \nregards\n \nto\n \nexperiences\n \nof\n \nendometriosis\n \noutside\n \nof\n \nmedical\n \nencounters,\n \nthe\n \nresearch\n \nfield\n \nshows\n \nhow\n \nendometriosis\n \n(especially\n \nwhen\n \nuntreated)\n \nhas\n \nnegative\n \neffects\n \non\n \nquality\n \nof\n \nlife,\n \nmental\n \nhealth,\n \nidentity\n \nand\n \nsocial\n \nrelationships.\n \nSome\n \narticles\n \nalso\n \nindicate\n \na\n \ncorrelation\n \nbetween\n \nuntreated\n \nendometriosis\n \nand\n \nincreased\n \nwork\n \nabsence\n \n(Lightbourne\n \net\n \nal.,\n \n2024,\n \np.\n \n311;\n \nKaltsas\n \net\n \nal.,\n \n2024,\n \np.\n \n8;\n \nJeffrey\n \net\n \nal.,\n \n2024,\n \np.\n \n3;\n \nBergen\n \net\n \nal.,\n \n2023,\n \np.\n \n8).\n  \n10  \n\n \nYoung  et  al.  suggest  that  there  is  a  tendency  amongst  their  informants  (who  worked  as  \nclinicians\n \nin\n \nAustralia)\n \nto\n \nportray\n \nwomen\n \nwith\n \nendometriosis\n \nas\n \nhysterical\n \n(Young\n \net\n \nal.,\n \n2018,\n \npp.\n \n349-350),\n \nas\n \nwell\n \nas\n \nequating\n \nthem\n \nwith\n \ntheir\n \nreproductive\n \nfunctions.\n \nThis\n \nfurther\n \nestablished\n \nthe\n \nfield\n \nof\n \nmedicine\n \nas\n \nthe\n \nauthoritative\n \nknowledge\n \nproducers\n \nof\n \ntheir\n \nbodies\n \n(Young\n \net\n \nal.,\n \n2018,\n \np.\n \n345).\n \nAlthough\n \nthese\n \nresults\n \nare\n \nbased\n \non\n \nclinicians'\n \nopinions\n \non\n \nwomen\n \nwith\n \nendometriosis,\n \nit\n \nis\n \nlikely\n \nthat\n \nclinicians\n \nnormative\n \nassumptions\n \ntowards\n \nwomen\n \nwill\n \nalso\n \naffect\n \ntrans\n \nand\n \nintersex\n \npeople\n \nwithin\n \nthe\n \nhighly\n \nfeminized\n \nmedical\n \nfield\n \nof\n \nendometriosis,\n \nas\n \ndescribed\n \nby\n \nJeffrey\n \net\n \nal.\n \n(2024,\n \np.\n \n3).\n \nThis\n \nis\n \nnot\n \nto\n \nsuggest\n \nthat\n \nthese\n \nexperiences\n \nare\n \nentirely\n \nsimilar,\n \non\n \nthe\n \ncontrary\n \nI\n \nam\n \nof\n \nthe\n \nbelief\n \nthat\n \ndifferent\n \nembodiments,\n \nindividual\n \nand\n \ngroup-related,\n \nwill\n \nalways\n \nproduce\n \nunique\n \nexperiences.\n \nRather,\n \nthis\n \nliterature\n \nreview\n \nshows\n \nthat\n \nwomens\n \nand\n \ntrans/intersex\n \npeople's\n \nexperiences\n \nof\n \nendometriosis\n \nmight\n \nhave\n \noverlapping\n \nqualities.\n \n \n3.2  Swedish  experiences  of  endometriosis  and  related  healthcare   \n \nThe  research  field  regarding  Swedish  experience  of  endometriosis  and  related  healthcare  is  \nless\n \nextensive\n \nthan\n \nits\n \ntransnational\n \ncounterparts,\n \nconsisting\n \nmostly\n \nof\n \nprojects\n \nfocused\n \non\n \nwomen’s\n \nexperiences,\n \nwith\n \nresearch\n \non\n \nendo-experience\n \nwithin\n \ntrans\n \nand\n \nintersex\n \ndemographics\n \n(found\n \nin\n \nthe\n \nscope\n \nof\n \nthis\n \nliterature\n \nreview)\n \nbeing\n \nmarginal.\n \nHowever,\n \nstudies\n \non\n \nendometriosis\n \nfrom\n \nvarious\n \ncontexts\n \nare\n \nstarting\n \nto\n \naddress\n \nthe\n \nurgent\n \nneed\n \nfor\n \nmore\n \ninclusive\n \nresearch\n \non\n \nqueer\n \nperspectives\n \non\n \nthe\n \ndisease\n \n(Giacomozzi,\n \n2024,\n \np.\n \n18),\n \nmotivating\n \nthe\n \nsignificance\n \nof\n \nthe\n \nqueer\n \nperspective\n \nin\n \nthis\n \nthesis.\n \n  Methodological  choices  in  the  field  varied  from  surveys,  qualitative  content  analysis  and  \ninterviews.\n \nFor\n \nexample,\n \nBodén,\n \nWendel\n \n&\n \nAdolfsson\n \n(2013)\n \nutilized\n \nquestionnaires\n \nto\n \ngather\n \nthe\n \nexperiences\n \nof\n \nschool\n \nmedical\n \nservices\n \nfrom\n \nadolescents\n \nwith\n \nendometriosis.\n \nGrundström\n \net\n \nal.,\n \n(2023)\n \nalso\n \nutilized\n \nquantitative\n \nmethodology,\n \nthrough\n \nsurveys\n \ndirected\n \nat\n \nwomen\n \nwith\n \nself-reported\n \nendometriosis\n \nregarding\n \nvalidating/invalidating\n \ncommunication\n \nin\n \nrelation\n \nto\n \ntheir\n \ndiagnosis.\n \nExamples\n \nof\n \nqualitative\n \nmethodology\n \ncan\n \nbe\n \nfound\n \nin\n \nHållstam\n \net\n \nal\n \n(2018),\n \nwho\n \nused\n \ninterviews\n \nwith\n \nwomen\n \nin\n \ntheir\n \nmid\n \ntwenties\n \nand\n \nthirties\n \nregarding\n \ntheir\n \nexperiences\n \nof\n \nliving\n \nwith\n \npainful\n \nendometriosis.\n \n  Healthcare  experience  in  Sweden  closely  resembles  those  from  transnational  studies,  \ndisplaying\n \nthe\n \nissue\n \nof\n \nsignificant\n \ndelay\n \nto\n \nreceive\n \ndiagnosis.\n \nAnother\n \ntheme\n \nprevalent\n \nin\n \nthe\n \n11  \n\n \nfield  was  professionals  excusing  patients  excessive  menstrual  pain  as  normal  parts  of  their  \nmenstrual\n \ncycle,\n \nagain\n \ntying\n \ninto\n \ntransnational\n \nfindings.\n \nGrundström\n \net\n \nal.,\n \n(2020)\n \nwrite\n \nhow\n \ntheir\n \ninformants\n \nreported\n \nnormalisation\n \nand\n \ntrivialisation\n \nof\n \ntheir\n \nexcessive\n \nmenstrual\n \npain\n \nas\n \nmain\n \nderivatives\n \nof\n \ntheir\n \nnegative\n \nexperiences\n \nof\n \nendometriosis\n \nhealthcare\n \n(Ibid,\n \np.\n \n21).\n \n Another  article  points  to  how  knowledge  regarding  pain  is  gained,  lost  and  negotiated  in  \nhealthcare\n \ncontexts\n \ntreating\n \nendometriosis,\n \nsometimes\n \ncontributing\n \nto\n \nepistemologies\n \nof\n \nignorance\n \n(Hallström,\n \n2024,\n \np.1).\n \n  Another  aspect  brought  up  in  former  research  is  the  double-edged  experience  of  \nendometriosis\n \nhealthcare.\n \nGrundström\n \net\n \nal.\n \n(2018),\n \ndescribes\n \nhow\n \nsome\n \npatients\n \nexperience\n \nendo-healthcare\n \nas\n \nnot\n \nentirely\n \nnegative\n \nbut\n \nalso\n \nconsisting\n \nof\n \npositive\n \nexperience\n \nof\n \nsympathy\n \nand\n \nunderstanding\n \nfrom\n \nhealth\n \ncare\n \nprofessionals\n \n(Ibid,\n \np.\n \n207).\n \nFurther,\n \nHallström\n \n(2024)\n \nidentified\n \npatients'\n \nfeelings\n \nof\n \nrelief\n \nwhen\n \nreceiving\n \nrecognition\n \nand\n \ndiagnosis\n \nfrom\n \nmedical\n \nprofessionals,\n \nproviding\n \npositive\n \neffects\n \non\n \ntheir\n \nself-relation\n \nand\n \nmarking\n \na\n \ncritical\n \nturning\n \npoint\n \nin\n \ntheir\n \nlives,\n \nwhile\n \nstill\n \nnot\n \nsolving\n \nthe\n \nproblem\n \nof\n \nnot\n \nbeing\n \ntaken\n \nseriously\n \nin\n \nhealthcare\n \nsettings\n \ncomprehensively\n \n(Ibid,\n \np.\n \n14).\n \n  In  regards  to  endometriosis'  effect  on  patient  wellbeing,  the  Swedish  research  field  also  points  \nto\n \nthe\n \nfact\n \nthat\n \nendometriosis\n \n(especially\n \nwhen\n \nundiagnosed\n \nand\n \nuntreated)\n \nhas\n \na\n \nnegative\n \neffect\n \non\n \nquality\n \nof\n \nlife\n \nand\n \nsocial\n \nrelationships.\n \nOne\n \narticle\n \npoints\n \nto\n \nthe\n \nimportance\n \nof\n \nunderstanding\n \nand\n \nmediating\n \nepistemic\n \nobstacles\n \nwithin\n \nendometriosis\n \nhealthcare,\n \nas\n \ncentral\n \nto\n \nimproving\n \nthe\n \nquality\n \nof\n \nlife\n \nof\n \npatients\n \nthrough\n \nrecognition\n \n(Hallström,\n \n2024,\n \np.2).\n \nTwo\n \nother\n \narticles\n \npoint\n \nto\n \nthe\n \ndependence\n \npeople\n \nwith\n \nendometriosis\n \nhave\n \non\n \ntheir\n \nclose\n \nsocial\n \nrelationships,\n \nwhich\n \nboth\n \nproved\n \nto\n \nbe\n \nhelpful\n \nand\n \nharmful\n \nto\n \ntheir\n \nquality\n \nof\n \nlife\n \n(Grundström\n \net\n \nal.,\n \n2023,\n \np.5;Hållstam\n \net\n \nal.,\n \n2018,\n \np.\n \n99).\n \n  Again  my  material  contributes  to  this  field  by  providing  critical  perspectives  on  \nSocialstyrelsens\n \nguidelines,\n \nwhich\n \nshape\n \nSwedish\n \nendometriosis\n \nexperience,\n \nespecially\n \nin\n \nhealthcare\n \nsettings.\n \nIt\n \nalso\n \ncontributes\n \nto\n \nthis\n \nfield\n \nby\n \nproviding\n \nqueer\n \nperspectives\n \non\n \nthe\n \nissue\n \nof\n \nendometriosis,\n \nwhich\n \nis\n \nlacking\n \nin\n \nformer\n \nresearch\n \nof\n \nSwedish\n \nexperiences\n \nof\n \nthe\n \ndisease.\n \nAlthough\n \nhealthcare\n \ndiscrimination\n \nis\n \nforbidden\n \nby\n \nlaw\n \nin\n \nSweden\n \n(DO,\n \n2024),\n \nthere\n \nare\n \na\n \nlarge\n \nnumber\n \nof\n \nunreported\n \ncases\n \n(DO,\n \n2023),\n \nmotivating\n \nthe\n \nneed\n \nfor\n \nfurther\n \nawareness\n \non\n \nthe\n \nissue.\n \n \n12  \n\n \n3.3  Government  guidelines  for  endometriosis  healthcare  \n \nOnto  research  which  is  more  closely  related  to  the  material  of  this  thesis,  namely  research  \ndone\n \non\n \ngovernment\n \nguidelines\n \nfor\n \nendometriosis\n \nhealthcare.\n \nResearch\n \non\n \nthe\n \ntopic\n \nprimarily\n \nused\n \nsystematic\n \nreview-based\n \nmethodologies,\n \nand\n \nfocused\n \non\n \nthe\n \nscientific\n \nbasis\n \nand\n \ntreatment\n \nplans\n \nof\n \nguidelines,\n \nusing\n \ncomparative\n \nanalysis\n \non\n \nnational\n \nas\n \nwell\n \nas\n \ninternational\n \nguidelines.\n \nThis\n \nfield\n \nwas\n \nfound\n \nto\n \nbe\n \nrather\n \nslim,\n \nfurther\n \nmotivating\n \nthe\n \nsignificance\n \nof\n \nthis\n \nthesis.\n  Hirsch  et  al.  (2017)  suggest  that  there  is  a  large  variation  in  their  material  in  regards  to  quality  \nof\n \nhealthcare\n \nand\n \ntreatment\n \nplans.\n \nIt\n \nalso\n \nmentions\n \nthat\n \na\n \nthird\n \nof\n \nthe\n \nrecommendations\n \nmade\n \nin\n \nthe\n \nguidelines\n \nwere\n \nunreferenced,\n \nand\n \nthat\n \nthe\n \ninvolvement\n \nof\n \nwomen\n \nwith\n \nendometriosis\n \nvaried\n \nsubstantially\n \n(Hirsch\n \net\n \nal.,\n \n2017,\n \npp.\n \n560-562).\n \nThis\n \nsupports\n \nformer\n \nresearch\n \non\n \nthe\n \ntopic,\n \npointing\n \nto\n \nthe\n \npoor\n \nquality\n \nof\n \nguidelines\n \nfocused\n \non\n \nendometriosis\n \nrelated\n \npain\n \n(Hirsch\n \net\n \nal.,\n \n2017,\n \np.\n \n562).\n \nKalaitzapoulos\n \net\n \nal.\n \n(2021)\n \nstate\n \nthat\n \npain\n \nmediation\n \nand\n \nfertility\n \npreservation\n \nwere\n \nthe\n \nmost\n \ncommon\n \nreasons\n \nfor\n \nseeking\n \nendometriosis\n \nrelated\n \nhealth\n \ncare\n \nin\n \ntheir\n \nselection\n \nof\n \nmaterials,\n \nand\n \nsuggest\n \nthat\n \nchosen\n \nguidelines\n \ncorrespond\n \nfairly\n \nwell\n \nin\n \nregards\n \nto\n \ntheir\n \ntreatment\n \nrecommendations\n \nfor\n \npain\n \nand\n \ninfertility\n \nissues,\n \nalthough\n \nthey\n \ndiffer\n \nsome\n \nin\n \nregards\n \nto\n \nrecommendations\n \nfor\n \npain\n \nmedication\n \n(Kalaitzapopulus\n \net\n \nal.,\n \n2021,\n \np.\n \n7).\n  \n  Former  research  primarily  analyzes  endometriosis  guidelines  from  a  clinical  perspective,  \nmotivating\n \nthe\n \nneed\n \nfor\n \nmore\n \nsocial\n \nscientific\n \nstudies\n \non\n \nendometriosis\n \nguidelines.\n \nFeminist\n \nperspectives\n \nare\n \nalso\n \nlacking\n \nin\n \nformer\n \nresearch\n \non\n \nguidelines,\n \nmotivating\n \nthe\n \ntheoretical\n \nsignificance\n \nof\n \nthis\n \nthesis.\n \n3.4  Socialstyrelsen’s  guidelines  for  healthcare\n \nOnto  the  research  field  of  analysis  done  on  Socialstyrelsens  guidelines  for  healthcare.  \nResearch\n \nat\n \nhand\n \nconducted\n \ncomparative\n \nanalysis\n \nof\n \nother\n \nadministrative\n \ndocuments\n \nand\n \nSocialstyrelsens\n \nguidelines\n \n(Andersson\n \n&\n \nKindevåg,\n \n2024)\n \nand\n \nanalyzed\n \nguidelines\n \nindependently\n \n(Topor,\n \n2010),\n \nutilizing\n \nqualitative\n \ncontent\n \nanalysis\n \nas\n \ntheir\n \nmethodological\n \nframework\n \nfor\n \nresearch.\n \nThis\n \nfield\n \nwas\n \nalso\n \nfound\n \nto\n \nbe\n \nrather\n \nslim,\n \nagain\n \nmotivating\n \nthe\n \nsignificance\n \nof\n \nmy\n \nproject.\n \n \n13  \n\n \nIn  Andersson  &  Kindevåg  (2024),  differences  between  Socialstyrelsen  and  Skolverkets  \ndocuments\n \nfor\n \nhealthcare\n \nprofessionals\n \nin\n \ngeriatric\n \ncare,\n \nwere\n \nidentified\n \nas\n \nlinked\n \nto\n \ninstitutional\n \npower\n \nhierarchies\n \nin\n \nthe\n \nSwedish\n \nauthoritative\n \nlandscape\n \n(Andersson\n \n&\n \nKindevåg,\n \n2024,\n \npp.\n \n130-131).\n \nBoth\n \nof\n \nthe\n \ndocuments\n \nstrongly\n \nencouraged\n \ntolerant\n \ncommunication\n \nstyles\n \ntowards\n \npatients\n \ncultures\n \nand\n \nintegrity,\n \nand\n \nconsidered\n \nit\n \nvital\n \nto\n \nhave\n \nbe\n \nable\n \nto\n \ndeal\n \nwith\n \nethical\n \ndilemmas\n \nwithin\n \nhealthcare,\n \nto\n \nfurther\n \n”democratic\n \nvalues\n \nand\n \nhuman\n \ndignity”\n \n(Andersson\n \n&\n \nKindevåg,\n \n2024,\n \npp.\n \n120-127).\n \nThe\n \nauthors\n \ncritique\n \nthat\n \nneither\n \nof\n \nthe\n \ndocuments\n \ncontained\n \ndescriptions\n \nof\n \nhow\n \nhealthcare\n \nprofessionals\n \nshould\n \nbe\n \neducated\n \non\n \nnorm\n \ncriticism\n \nand\n \ndemocratic\n \nvalues,\n \nbut\n \ninstead\n \ntake\n \nthis\n \nknowledge\n \nfor\n \ngranted\n \n(Andersson\n \n&\n \nKindevåg,\n \n2024,\n \npp.\n \n130-131).\n \n  In  Topot  (2010),  medicalizing  practices  (such  as  putting  emphasis  on  diagnostic  requirements  \nrather\n \nthan\n \nsocial\n \nexperience)\n \nin\n \nthe\n \nknowledge\n \nbase\n \nfor\n \nSocialstyrelsens\n \nguidelines\n \nfor\n \nbipolar\n \ndisorder\n \nand\n \nschizophrenia,\n \nare\n \nproblematized\n \nas\n \na\n \npractice\n \nthat\n \nultimately\n \nindividualizes\n \nthe\n \nperspectives\n \nof\n \nthe\n \nconditions\n \n(Topot,\n \n2010,\n \npp.\n \n70-74).\n \nMethods\n \nfor\n \nmediating\n \npsychiatric\n \nconditions\n \ndeveloped\n \nthrough\n \nsocial\n \npractices\n \nare\n \nnot\n \nincluded\n \nin\n \nSocialstyrelsens\n \nknowledge\n \nbase,\n \nsince\n \nthey\n \nare\n \nnot\n \nconsidered\n \nas\n \nevidence-based\n \nenough\n \n(compared\n \nto\n \nsources\n \nwithin\n \nmedicine).\n \nThis\n \nexcludes\n \nsocial\n \nperspectives\n \nfrom\n \nthe\n \nfinalized\n \nguidelines,\n \nsomething\n \nconsidered\n \nas\n \na\n \nproblematic\n \nconsequence\n \nof\n \nincreased\n \nmedicalisation\n \nof\n \nthe\n \npsychosocial\n \nfield\n \n(Topot,\n \n2010,\n \npp.\n \n70-74).\n \n \nOnto  the  field  of  student  papers  on  the  topic  of  Socialstyrelsens  guidelines.  As  stated  above,  \nthese\n \nwere\n \nchosen\n \ndespite\n \nnot\n \nbeing\n \npeer-reviewed,\n \nconsidering\n \ntheir\n \nproximity\n \nto\n \nmy\n \nthesis\n \nproject.\n \nTopics\n \nin\n \nthe\n \nstudent\n \nprojects\n \nranged\n \nfrom\n \nguidelines\n \nfor\n \ntrans\n \nand\n \nintersex\n \nindividuals\n \n(Skanung\n \n&\n \nSvensson,\n \n2024),\n \nto\n \nrepresentations\n \nof\n \ndepression\n \n(Ahlbertz\n \n&\n \nForsberg,\n \n2021).\n \nIn\n \nSkanung\n \n&\n \nSvensson\n \n(2024),\n \nthe\n \nwriter’s\n \ndescribe\n \nhow\n \npotentially\n \nregretting\n \ngender\n \naffirming\n \ncare\n \nwas\n \nmore\n \nproblematized\n \nin\n \nguidelines\n \nfor\n \ntransgender\n \nyouth\n \nin\n \ncomparison\n \nto\n \npeople\n \nwith\n \nintersex\n \nvariations\n \n(Skanung\n \n&\n \nSvensson,\n \n2024,\n \npp.\n \n44-46).\n \nThis\n \nis\n \nproposed\n \nas\n \nlinked\n \nto\n \nthe\n \nilligitamizing\n \nof\n \ntrans-people's\n \nneed\n \nfor\n \ngender\n \naffirming\n \ncare\n \nand\n \nthe\n \nstigmatisation\n \nof\n \nintersex\n \nbodies\n \n(Skanung\n \n&\n \nSvensson,\n \n2024,\n \npp.\n \n44-46).\n \nAhlbertz\n \n&\n \nForsberg\n \n(2021)\n \nfound\n \nthat\n \ntheir\n \nmaterial\n \nrepresented\n \npeople\n \ndiagnosed\n \nwith\n \ndepression\n \nas\n \nnon-functioning,\n \ncodependent,\n \nunreliable,\n \npassive\n \nand\n \nsuffering,\n \nwhich\n \ncontrasted\n \nthe\n \nideal\n \n“healthy”\n \nindividual\n \nwho\n \nwas\n \nportrayed\n \nas\n \ndiligent,\n \nhigh-functioning\n \nand\n \n14  \n\n \nindependent,  creating  a  dichotomy  of  health  and  sickness  which  ultimately  simplifies  the  \nhuman\n \nexperience\n \n(Ahlbertz\n \n&\n \nForsberg,\n \n2021,\n \npp.\n \n21-26).\n \n  My  contribution  to  this  field  lies  in  analysing  the  Socialstyrelsens  guidelines  for  \nendometriosis,\n \nwhich\n \nwhen\n \nwriting\n \nthis\n \nremains\n \nan\n \nunder-researched\n \ntopic,\n \nat\n \nthe\n \nsame\n \ntime\n \nas\n \nendometriosis\n \nis\n \nan\n \nemerging\n \nsocial\n \nissue\n \nin\n \nSweden.\n \n4.  Theory  \nThis  chapter  describes  and  discusses  the  theoretical  framework  of  the  thesis,  consisting  of  six  \nsubsections.\n \nThe\n \nfirst\n \nfive\n \ndescribe\n \nthe\n \ndifferent\n \nparts\n \nof\n \nthe\n \ntheoretical\n \nframework,\n \naddressing\n \ndiscourse\n \nand\n \nbiopower,\n \ncontemporary\n \nworkfare\n \ntheory,\n \nqueer\n \ntheories\n \nof\n \nsex\n \nand\n \ngender,\n \nfeminist\n \nbioethical\n \nperspectives\n \nas\n \nwell\n \nas\n \nwritings\n \non\n \nsociology\n \nof\n \nchronic\n \npain.\n \nIn\n \nthe\n \nlast\n \nsubsection,\n \nthe\n \noperationalisation\n \nof\n \nthe\n \ntheoretical\n \nframeworks\n \nfor\n \nanalysis\n \nis\n \ndescribed.\n \n \n4.1  Discourse  and  Biopower   \nBecause  of  this  thesis’  theoretical  and  methodological  basis,  it  might  be  useful  to  give  an  \ninitial\n \ndescription\n \nof\n \nthe\n \nterm\n \ndiscourse,\n \nusing\n \nthe\n \ndefinitions\n \noriginated\n \nby\n \nFoucault.\n \nDiscourse\n \ncan\n \nbe\n \ndefined\n \nas\n \nstructures\n \nof\n \nlanguage,\n \nusually\n \nmaterialized\n \nas\n \ntexts\n \nor\n \nspeech,\n \nwhich\n \ndetermine\n \nassumptions\n \nabout\n \nsubjects\n \nand\n \nthe\n \ncontexts\n \nthey\n \nexist\n \nin\n \n(Foucault,\n \n1972,\n \npp.\n \n37-38).\n \nBecause\n \nlanguage\n \nfunctions\n \nsocially,\n \nmade\n \nand\n \nfurthered\n \nby\n \nparticipants\n \nof\n \ncertain\n \ndiscourses,\n \nthese\n \nnormative\n \nassumptions\n \nbecome\n \nconstitutive\n \nof\n \nsocial\n \nrealities\n \nthrough\n \nvarying\n \nforms\n \nof\n \nhuman\n \ninteraction\n \n(Foucault,\n \n1972,\n \npp.\n \n37-38).\n \nDiscourse\n \ngains\n \npower\n \nin\n \nits\n \nproclamation\n \nof\n \ntruth,\n \nmaking\n \nits\n \nassumptions\n \nappear\n \nas\n \nobjective\n \nand\n \ntherefore\n \nalso\n \nmaking\n \ncontradictions\n \nto\n \nits\n \ndefinitions\n \nappear\n \nas\n \ncategorically\n \nfalse\n \nand/or\n \nintelligible\n \n(Foucault,\n \n1977,\n \np.\n \n27).\n \nFoucault\n \nhighlights\n \nthe\n \nneed\n \nto\n \ncritically\n \nexamine\n \nthese\n \npowerful\n \nstructures\n \nof\n \nlanguage,\n \nin\n \nspite\n \nof\n \nbeing\n \nsubjects\n \ndefined\n \nby\n \nthem\n \n(Foucault,\n \n1972,\n \np.\n \n22),\n \nwhich\n \nmakes\n \ncritical\n \nanalysis\n \nof\n \ndiscourses\n \nappear\n \nboth\n \nas\n \npossible\n \nand\n \nnecessary\n \nto\n \nunderstand\n \nthe\n \nways\n \nin\n \nwhich\n \nlanguage\n \nexplicate,\n \nexclude\n \nand\n \ninvisibilize.\n \n  Foucault’s  theories  on  biopower  deploys  the  logic  of  discourse  theory  to  explain  how  state  \ninstitutions'\n \npower\n \nover\n \nlife,\n \ndeath\n \nand\n \nthe\n \nbody\n \nhave\n \nbeen\n \ncentral\n \nin\n \nthe\n \ndevelopment\n \nof\n \ncapitalism\n \n(Foucault,\n \n2002,\n \npp.\n \n141-142).\n \nHe\n \nexplains\n \nhow\n \nthe\n \nstate’s\n \npower\n \nover\n \nlife\n \nand\n \n15  \n\n \ndeath,  formerly  performed  mostly  through  methods  focused  on  bodily  punishment,  have  been  \nreplaced\n \nby\n \ndisciplinary\n \ndevices\n \nwhich\n \nconditions\n \nthe\n \nbody\n \nto\n \nact\n \naccording\n \nto\n \nstate\n \nideals\n \nand\n \nsubmit\n \nto\n \nits\n \npower\n \n(Foucault,\n \n2002,\n \np.\n \n141).\n \nThrough\n \nschool\n \ncurriculums,\n \nmedical\n \ninstitutions\n \nand\n \nmilitary\n \nservice,\n \nthe\n \nstate\n \nperforms\n \nwhat\n \nFoucault\n \nidentifies\n \nas\n \n“biopower”,\n \nmaking\n \npopulations\n \nbehave,\n \nreproduce\n \nand\n \nappear\n \nin\n \nways\n \nwhich\n \nuphold\n \nthe\n \nstatus\n \nquo\n \nand\n \nreproduce\n \nmodes\n \nof\n \nproductivity\n \n(Foucault,\n \n2002,\n \np.\n \n142).\n \nThese\n \ntheories\n \nexplain\n \nhow\n \ninstitutions\n \nwith\n \npower\n \ncondition\n \npeople\n \nin\n \nways\n \nthat\n \nuphold\n \ncurrent\n \ndiscursive\n \norders,\n \nwhich\n \nbecomes\n \nuseful\n \nin\n \norder\n \nto\n \nunderstand\n \nthe\n \nways\n \nin\n \nwhich\n \nmy\n \nmaterial,\n \nproduced\n \nby\n \na\n \npowerful\n \nSwedish\n \ninstitution\n \nfor\n \npublic\n \nhealth,\n \ndescribes\n \nendometriosis\n \npatients,\n \ntheir\n \nneeds\n \nand\n \ntheir\n \nembodiments.\n \n \n4.2  Workfare  \n \nConnecting  to  Foucault's  discussions  on  biopower  and  state  mechanisms  for  population  \ncontrol,\n \nI\n \nhave\n \nchosen\n \nto\n \ndevelop\n \nthis\n \nthesis’\n \ntheoretical\n \nframework\n \nby\n \ndeploying\n \ntheories\n \non\n \nworkfare.\n \nWorkfare\n \nrefers\n \nto\n \nan\n \noverarching\n \ntrend\n \nin\n \nwelfare\n \npolicy\n \nin\n \nEurope\n \nand\n \nthe\n \nUnited\n \nStates\n \nsince\n \nthe\n \n1990’s,\n \nwhere\n \nactivation\n \nrequirements\n \nas\n \neligibility\n \nrequirements\n \nfor\n \nwelfare\n \nservices\n \nsuch\n \nas\n \nbenefits\n \nare\n \nbecoming\n \nincreasingly\n \npopular\n \n(Lodemel\n \n&\n \nMoreira,\n \n2014,\n \np.\n \n2).\n \nThis\n \ntrend\n \nis\n \nreferred\n \nto\n \nas\n \nan\n \nactivation\n \nparadigm,\n \nwhich\n \nis\n \ninformed\n \nby\n \npolicy\n \nmakers\n \nwillingness\n \nto\n \ncapitalize\n \nof\n \npublic\n \nideas\n \nwhich\n \nview\n \npoor\n \nand\n \nunemployed\n \nindividuals\n \nas\n \na\n \nburden\n \nfor\n \nsociety,\n \nwho’s\n \nobligation\n \nto\n \nseek\n \nemployment\n \nand\n \nbecome\n \neconomically\n \ncontributing\n \ncitizens\n \noverweighs\n \ntheir\n \nrights\n \nto\n \nbasic\n \nincome,\n \nhousing\n \nand\n \nother\n \nwelfare\n \nservices\n \n(Gubrium\n \net\n \nal.,\n \n2014,\n \np.\n \n344).\n \n  Developing  the  term  workfare,  Soldatic  &  Meekosha  (2012)  discuss  the  ways  in  which  \ndisability,\n \nclass\n \nand\n \ngender\n \ninform\n \nspaces\n \nof\n \nworkfare.\n \nThey\n \nwrite\n \nthat\n \nspread\n \nof\n \nneoliberalism\n \nin\n \nthe\n \nWest\n \nhas\n \ncontributed\n \nto\n \nan\n \nincreased\n \nintegration\n \nof\n \nworkfare\n \nlogics\n \nin\n \nwelfare\n \npractices,\n \nwhich\n \nare\n \ntied\n \nto\n \nthe\n \nmoralisation\n \nof\n \nworklessness\n \n(Soldatic\n \n&\n \nMeekosha,\n \n2012,\n \np.\n \n142).\n \nDisgust\n \nis\n \nidentified\n \nas\n \na\n \nmain\n \ncharacteristic\n \nof\n \nthis\n \nneoliberal\n \nmoralisation,\n \ninformed\n \nby\n \nclass\n \nrelations,\n \ngendered\n \ndivisions\n \nand\n \nableist\n \nstructures\n \nof\n \nsociety\n \nwhich\n \nlabels\n \nsome\n \nas\n \nabject\n \nbeings\n \nworthy\n \nof\n \ndisgust.\n \nIn\n \nthe\n \nabjection\n \nof\n \nsome,\n \nwho\n \nbecome\n \nsources\n \nof\n \ndisgust\n \nfrom\n \nthose\n \nwho\n \naim\n \nto\n \nembody\n \nliberal\n \nmiddle-class\n \nnormalcy,\n \nworkfare\n \nbecomes\n \nan\n \nexpression\n \nof\n \noppressive\n \ncultural\n \nimperialism\n \n(Soldatic\n \n&\n \nMeekosha,\n \n2012,\n \npp.\n \n142-143).\n \n  \n16  \n\n \nState  institutions  capitalizing  off  these  public  ideas  of  moralisation  and  disgust,  materialize  \nthrough\n \nemphasis\n \non\n \nthe\n \nactivation\n \nof\n \npopulations\n \nwhen\n \ndealing\n \nwith\n \nwelfare\n \nissues,\n \nlike\n \nhealthcare,\n \nmaking\n \nit\n \nrelevant\n \nfor\n \nmy\n \nthesis.\n \nWorkfare\n \nlogics\n \nare\n \ncommon\n \nin\n \nneoliberal\n \nnations\n \nin\n \nthe\n \nglobal\n \nnorth\n \n(Lodemel\n \n&\n \nMoreira,\n \n2014,\n \np.\n \n2),\n \nincluding\n \nSweden,\n \nmaking\n \nit\n \nrelevant\n \nfor\n \nthe\n \nlocus\n \nof\n \nmy\n \nmaterial.\n \n4.3  Sex,  gender  and  the  body\n \nI  consider  Judith  Butler’s  theories  on  the  sex,  gender  and  the  body  as  a  useful  development  of  \nFoucault’s\n \nframework\n \nof\n \ndiscourse\n \nand\n \nbiopower.\n \nIn\n \ntheir\n \nbook\n \n“Bodies\n \nthat\n \nmatter\n \n-\n \non\n \nthe\n \ndiscursive\n \nlimits\n \nof\n \nsex”\n \n(2011)\n \nButler\n \naims\n \nto\n \nidentify\n \nthe\n \nnormative\n \naspects\n \nof\n \n“sex”\n \nas\n \na\n \ncategory,\n \nto\n \nnuance\n \nthe\n \ndichotomy\n \nof\n \nsex\n \nas\n \nmaterial\n \nand\n \ndefinite,\n \nand\n \ngender\n \nas\n \nsocially\n \nconstructed\n \nand\n \nfluent.\n \nSex\n \nis\n \ninstead\n \nconsidered\n \nas\n \ngreatly\n \ninfluenced\n \nby\n \ndiscursive\n \nnorms,\n \nsince\n \nbodily\n \nfunctions\n \nrelated\n \nto\n \nsex\n \nare\n \noften\n \ninterchangeable\n \nwith\n \ncertain\n \ncategories\n \nof\n \nembodiment\n \n(Butler,\n \n2011,\n \npp.\n \nxi-xii).\n \nBearing\n \nchild,\n \nproducing\n \nsemen,\n \ndeveloping\n \nbreasts\n \nand\n \nhaving\n \ntesticles\n \nare\n \nnot\n \nviewed\n \nas\n \nmerely\n \nmaterial\n \nfunctions\n \nof\n \nthe\n \nbody,\n \nbut\n \nalso\n \nsignals\n \nof\n \nfemininity\n \nand\n \nmasculinity,\n \nsignals\n \nwhich\n \nhave\n \nbeen\n \ndiscursively\n \nprojected\n \nonto\n \nthe\n \nbodies\n \nit\n \nwishes\n \nto\n \ndefine.\n \n  Sex  is  also  referred  to  (in  Foucauldian  terms)  as  a  “regulatory  ideal”,  meaning  that  it  serves  \nthe\n \nfunction\n \nof\n \nassuring\n \nthat\n \ndefinitions\n \nof\n \nthe\n \nbody\n \ncontribute\n \nto\n \nproductive\n \npower,\n \nthrough\n \nthe\n \nreproduction\n \nof\n \nthe\n \nlabour\n \nforce\n \n(Butler,\n \n2011,\n \npp.\n \nxi-xii).\n \nWe\n \ncan\n \ntherefore\n \nidentify\n \na\n \nconnection\n \nbetween\n \ngender,\n \nsex\n \nand\n \nmodes\n \nof\n \nreproduction,\n \nmotivating\n \ninstitutions\n \nof\n \npower\n \nto\n \nuphold\n \nnormative\n \ndefinitions\n \nof\n \nthe\n \nbody\n \nto\n \ninsure\n \nits\n \nproliferation.\n \nThrough\n \ninstitutions\n \npowerful\n \nprocesses\n \nof\n \ndefining,\n \nbodies\n \nwhich\n \ndo\n \nnot\n \nmake\n \nsense\n \naccording\n \nto\n \nthe\n \nheterosexual\n \nmatrix\n \nare\n \nsystematically\n \nexcluded,\n \nmaking\n \nthem\n \n“abject\n \nbeings”\n \n(those\n \nwho\n \nexist\n \noutside\n \nof\n \nthe\n \ndomain\n \nof\n \nintelligible\n \nsubjectivity)\n \n(Butler,\n \n2011,\n \npp.\n \nxi-xii).\n \nButler\n \nmeans\n \nthat\n \nit\n \nis\n \nthis\n \nvery\n \nexclusion\n \nthat\n \nthe\n \nfurthering\n \nof\n \nnormativity\n \nrely\n \non,\n \nwhere\n \nabject\n \nindividuals\n \nbecome\n \nthe\n \ndeviant\n \nwhich\n \ndefines\n \nthe\n \nnatural\n \nand\n \nnormal.\n \nButler’s\n \ntheories\n \nhelp\n \nexplain\n \nthe\n \nsocial\n \naspects\n \nof\n \nsex,\n \nwhich\n \nact\n \nas\n \nmarkers\n \nof\n \nintelligibility.\n \nThis\n \ncan\n \nassist\n \na\n \ncritical\n \nanalysis\n \nof\n \nmy\n \nmaterial,\n \nand\n \ncontribute\n \nto\n \nan\n \nunderstanding\n \nof\n \nhow\n \nit\n \nmight\n \nuphold\n \nor\n \ncontradict\n \ndiscursive\n \nformations\n \nof\n \nsex\n \nand\n \ngender,\n \nwhich\n \nultimately\n \nshape\n \nwho\n \nis\n \nconsidered\n \nas\n \na\n \nvalid\n \ncare\n \nseeking\n \nsubject\n \nfor\n \nendometriosis\n \nhealthcare.\n \n \n17  \n\n \n4.4  Feminist  Bioethics\n \nFeminist  bioethical  theory  relies  on  the  notion  that  the  field  of  medicine  is  interlinked  with  \noppressive\n \nstructures\n \nof\n \nmarginalisation,\n \nmaking\n \nit\n \nrelevant\n \nto\n \nperform\n \nfeminist\n \ncritique\n \nof\n \nhealthcare\n \npractices\n \nand\n \npolicies\n \n(Rogers\n \net\n \nal.,\n \n2022,\n \npp.\n \n18-19).\n \nThis\n \nfeminist\n \ncritique\n \nserves\n \nthe\n \npurpose\n \nof\n \nelucidating\n \nthe\n \nways\n \nin\n \nwhich\n \nutilitarian\n \nideals\n \nof\n \nhealthcare\n \npractice\n \nare\n \ncompromised\n \nby\n \nsocial\n \nrelations\n \nof\n \npower\n \n(Lindemann,\n \n2022,\n \npp.\n \n18-19).\n \nIn\n \n“Handbook\n \nof\n \nFeminist\n \nBioethics”\n \n(Rogers\n \net\n \nal.,\n \n2022)\n \nseveral\n \nthemes\n \nrelevant\n \nfor\n \nthis\n \nthesis\n \nare\n \ndiscussed,\n \nwhich\n \nI\n \nmake\n \nan\n \naccount\n \nfor\n \nbelow.\n \n  In  her  chapter  “Toward  a  Queer  Feminist  Bioethics  of  Sexuality”  Tiia  Sudenkaarne  discusses  \nthe\n \nimportance\n \nof\n \nutilizing\n \nqueer\n \nunderstandings\n \nof\n \nsexuality\n \nand\n \ngender\n \nin\n \ntheories\n \nof\n \nbioethics,\n \nin\n \norder\n \nto\n \navoid\n \nthe\n \nfurthering\n \nof\n \nhetero/cis-normative\n \nnotions\n \nwithin\n \nfeminist\n \ncritique\n \n(Sudenkaarne,\n \n2022,\n \npp.\n \n167-168).\n \nThe\n \nwriter\n \nexplains\n \nhow\n \n“morality\n \ntales”\n \n(understandings\n \nof\n \ngender\n \nand\n \nsexuality\n \nwhich\n \nare\n \nthe\n \nfoundation\n \nof\n \nmoral\n \nbeliefs\n \nregarding\n \nhealth\n \nand\n \nthe\n \nbody)\n \noften\n \ninform\n \nhealth-care\n \npolicy\n \nin\n \nways\n \nthat\n \nexclude\n \nand\n \ncriminalize\n behaviours  and  identities  which  do  not  conform  to  normative  expectations  (Sudenkaarne,  \n2022,\n \np.\n \n167).\n \nShe\n \nuses\n \nexamples\n \nof\n \npolicies\n \nwhich\n \nconnect\n \nhomosexuality\n \nwith\n \nHIV,\n \nadvocate\n \nfor\n \nabstinence\n \ninstead\n \nof\n \nbirth\n \ncontrol\n \netc.,\n \nto\n \nillustrate\n \nhow\n \nideas\n \nof\n \nsexuality\n \nand\n \nidentity\n \ninform\n \nthe\n \nways\n \nhealthcare\n \npolicies\n \nare\n \nformulated.\n \nCritiquing\n \nthe\n \nnormative\n \nassumptions\n \nwhich\n \nshape\n \nthese\n \npolicies\n \nbecomes\n \na\n \nproject\n \nthat\n \ndoes\n \nnot\n \nonly\n \nengage\n \nin\n \nthe\n \ninclusion\n \nqueer\n \npeople\n \n(by\n \ntaking\n \ndiscrimination\n \ntoward\n \nthem\n \nseriously\n \nand\n \naiming\n \nto\n \nchange\n \ndiscriminatory\n \nframeworks),\n \nbut\n \na\n \nproject\n \nthat\n \naims\n \nto\n \nexpand\n \nlimiting\n \ndescriptions\n \nof\n \nhuman\n \nembodiment\n \nand\n \nexperience\n \nwhich\n \nultimately\n \naffects\n \neveryone\n \n(Sudenkaarne,\n \n2022,\n \np.\n \n168).\n \nThis\n \nchapter\n \nprovides\n \na\n \ncritical\n \nqueer\n \nperspective\n \non\n \nhealthcare\n \npolicies,\n \nwhich\n \ncontextualizes\n \ntheoratizarions\n \nof\n \nsex\n \nand\n \ngender\n \nin\n \nthe\n \nfield\n \nof\n \nmedicine.\n \n  Ilke  Turkmendag  addresses  the  role  of  reproduction  in  the  shaping  of  women's  health  issues  \nin\n \nher\n \nchapter\n \n“Exploitation\n \nand\n \ncontrol\n \nof\n \nwomen’s\n \nreproductive\n \nbodies”\n \n(Turkmendag,\n \n2022).\n \nShe\n \nexplains\n \nhow\n \nsocial\n \nassumptions\n \nwhich\n \ncentralize\n \nfertility\n \nand\n \nreproduction\n \nin\n \nwomen’s\n \nhealth\n \nissues\n \ntend\n \nto\n \nreinforce\n \nmaternal\n \nstereotypes\n \nfor\n \nwomen,\n \nfurthering\n \nthe\n \nidea\n \nthat\n \nthe\n \nmain\n \npurpose\n \nof\n \ntheir\n \nbody\n \nis\n \nto\n \ncreate,\n \ngive\n \nbirth\n \nto\n \nand\n \nnurture\n \na\n \nbaby\n \n(Turkmendag,\n \n2022,\n \np.\n \n487).\n \nShe\n \nnotes\n \nhow\n \nfertility\n \nrelated\n \ntreatments\n \nare\n \ninterconnected\n \nwith\n \nthese\n \nlimiting\n \nnorms,\n \nas\n \nmodes\n \nof\n \nbiopower\n \nfocused\n \non\n \nwomen's\n \nreproduction\n \n18  \n\n \n(Turkmendag,  2022,  p.  488).  Turkmendags  framework  is  useful  to  understand  the  role  of  \nfertility\n \nand\n \ngendered\n \nembodiment\n \nin\n \nmy\n \nmaterial.\n \nAlthough\n \nTurkmendag\n \naddresses\n \nwomen\n \nspecifically,\n \nthe\n \nissue\n \nof\n \ncentralizing\n \nfertility\n \nwhen\n \ndealing\n \nwith\n \nthe\n \nhealthcare\n \nof\n \nfeminized\n \nbodies\n \nwill\n \nalso\n \nhave\n \nsocial\n \nand\n \nmedical\n \nconsequences\n \nfor\n \npeople\n \nwho\n \ndo\n \nnot\n \nidentify\n \nwith\n \nthe\n \nlabel\n \nwoman,\n \nsince\n \n(as\n \nnoted\n \nabove\n \nin\n \naccounts\n \nof\n \nprevious\n \nresearch)\n \nendometriosis\n \nhealthcare\n \nis\n \na\n \nhighly\n \nfeminized\n \nmedical\n \nfield.\n \n  Finally,  in  Arienne  Shahvisi’s  chapter  “Toward  an  Anticolonial  Feminist  Bioethics”,  the  issue  \nof\n \ndecolonizing\n \nfeminist\n \nbioethics\n \nis\n \ndiscussed.\n \nThe\n \nwriter\n \ndefines\n \ndecolonizing\n \nas\n \na\n \npractice\n \nwhich\n \naims\n \nto\n \neradicate\n \ncolonialism\n \nand\n \ncolonial\n \nlogics\n \nfrom\n \nall\n \naspects\n \nof\n \nglobal\n \nsociety,\n \ndemanding\n \na\n \npervading\n \ncritique\n \nand\n \nawareness\n \nwithin\n \nacademic\n \ndisciplines\n \n(Shahvisi,\n \n2022,\n \npp.\n \n209-210).\n \nFeminist\n \nbioethics\n \nfocuses\n \non\n \nthe\n \nexperiences\n \nand\n \nrepresentations\n \nof\n \nmarginalized\n \ngroups\n \nwithin\n \nhealthcare,\n \nbut\n \nstill\n \noften\n \nfails\n \nto\n \naccount\n \nfor\n \nnuanced\n \nexperiences\n \naffected\n \nby\n \nother\n \nsubjectivities\n \nthan\n \ngender\n \nand\n \nsexuality\n \n(Shahvisi,\n \n2022,\n \np.\n \n210).\n \nThe\n \ndiscipline\n \ntherefore\n \nneeds\n \nto\n \nemploy\n \nan\n \nanticolonial\n \nperspective,\n \nwhich\n \nallows\n \ncomplicated\n \nand\n \nintersecting\n \nexperiences\n \nand\n \nembodiments\n \nto\n \nexist\n \nand\n \nbe\n \ndescribed,\n \nand\n \nwhich\n \nunderstands\n \nhow\n \nthe\n \noppression\n \nof\n \npeople\n \nof\n \ncolour\n \nand\n \nthe\n \nGlobal\n \nSouth\n \nare\n \ninterconnected\n \nwith\n \nnormative\n \nassumptions\n \nregarding\n \ngender,\n \nsexuality,\n \nclass\n \netc.\n \n(Shahvisi,\n \n2022,\n \npp.\n \n210-211).\n \nIt\n \nis\n \nby\n \nunderstanding\n \nthe\n \nconnections\n \nbetween\n \nissues\n \nsuch\n \nas\n \nforcefully\n \ngendering\n \nbodies\n \nwithin\n \nmedicine\n \nand\n \ncolonial\n \nexpectations\n \nand\n \ndefinitions\n \nof\n \ngender,\n \nthat\n \nwe\n \ncan\n \nutilize\n \nthe\n \nsubversive\n \npotential\n \nof\n \nfeminist\n \nbioethics,\n \nan\n \nunderstanding\n \nwhich\n \ninforms\n \nthis\n \nthesis.\n \n \n4.6  Sociology  of  chronic  pain\n \nEndometriosis  is  a  disease  largely  characterized  by  pain,  motivating  me  to  utilize  a  theoretical  \nframework\n \nwhich\n \nfocuses\n \non\n \nthe\n \nindividual\n \nas\n \nwell\n \nas\n \nsocietal\n \naspects\n \nof\n \npain\n \nexperiences.\n \nThe\n \narticle\n \n“Sociology\n \nof\n \nchronic\n \npain”\n \n(Zajacova,\n \nGrol-Prokopczyk\n \n&\n \nZimmer,\n \n2021)\n \nsummarizes\n \nthe\n \ntheoretical\n \nfield\n \nof\n \nSociology\n \nof\n \nchronic\n \npain,\n \none\n \nwhich\n \nmet\n \nthe\n \nrequirements\n \nof\n \na\n \ntheoretically\n \nnuanced\n \nframework.\n \nIt\n \ndescribes\n \npain\n \nas\n \nnot\n \nonly\n \nan\n \nindividual\n \nexperience\n \nof\n \nsuffering\n \nand\n \ndiscomfort,\n \nbut\n \nan\n \nissue\n \nwhich\n \nis\n \nconnected\n \nto\n \nsocial\n \nissues\n \nof\n \ndiscrimination\n \nand\n \ninequality,\n \nultimately\n \nshaping\n \nwhose\n \npain\n \nis\n \ntaken\n \nseriously,\n \nwhat\n \npain\n \nbecomes\n \nchronic\n \nand\n \nhow\n \npatients\n \nwho\n \nexperience\n \npain\n \nmight\n \nbe\n \ntreated\n \nby\n \nthe\n \nhealthcare\n \nsystem\n \n(Zajacova,\n \nGrol-Prokopczyk\n \n&\n \nZimmer,\n \n2021,\n \np.\n \n303).\n \nBy\n \napplying\n \na\n \nsociological\n \nlens\n \nto\n \nstudies\n \nof\n \npain,\n \nresearchers\n \ncan\n \ncounter\n \nan\n \nindividualizing\n \nview\n \nof\n \npain\n \n19  \n\n \nexperience  with  nuanced  frameworks  of  how  societal  processes  shape  pain  and  vise-versa  \n(Zajacova,\n \nGrol-Prokopczyk\n \n&\n \nZimmer,\n \n2021,\n \np.\n \n303).\n \n \n4.7  Operationalisation  \nIn  this  section  I  briefly  describe  how  the  different  elements  of  theory  will  be  implemented  in  \nanalysis.\n \nFoucault's\n \ntheories\n \non\n \ndiscourse\n \nand\n \nbiopower\n \naid\n \nunderstanding\n \nof\n \nSocialstyrelsens\n \npowerful\n \nposition,\n \nas\n \na\n \nstate\n \ninstitution\n \nwith\n \ngreat\n \npower\n \nover\n \nbodies,\n \nreproduction\n \nand\n \nhealth.\n \nTheories\n \non\n \nworkfare\n \nlocate\n \nbiopower\n \nin\n \ncurrent\n \nactivation\n \nparadigms\n \nin\n \nEurope,\n \nand\n \nButler’s\n \ntheories\n \non\n \nsex\n \nand\n \ngender\n \naid\n \nunderstanding\n \nof\n \nhow\n \nSocialstyrelsens\n \ndescriptions\n \nof\n \nbodies\n \nrelates\n \nto\n \nthe\n \nheterosexual\n \nmatrix.\n \nFeminist\n \nbioethics\n \nprovide\n \na\n \ncritical\n \nview\n \nof\n \nthe\n \nways\n \nSocialstyrelsens\n \nrecommendations\n \nfor\n \nhealthcare\n \naddress\n \nand\n \nrelate\n \nto\n \nissues\n \nof\n \nhealthcare\n \ndiscrimination,\n \nand\n \nhow\n \nthey\n \nmight\n \nreinforce\n \ncolonial\n \nideas\n \nof\n \nwestern\n \nmedical\n \nsuperiority.\n \nFinally,\n \nsociology\n \nof\n \nchronic\n \npain\n \nprovides\n \na\n \ncritical\n \nlens\n \nfor\n \nSocialstyrelsens\n \ndescriptions\n \nof\n \npain,\n \nits\n \ncauses\n \nand\n \nsuggested\n \nmeasures.\n \n5.  Methodology,  methods  and  material  \nOnto  this  thesis  methodological  framework  and  related  discussions.  This  section  includes  \nfour\n \nsections.\n \nThe\n \nfirst\n \nsection\n \nincludes\n \ncontextual\n \ndescriptions\n \nof\n \nSocialstyrelsen\n \nand\n \ntheir\n \nguidelines\n \nfor\n \nendometriosis\n \nhealthcare,\n \nwhereas\n \nthe\n \nsecond\n \none\n \ndescribes\n \nand\n \ndiscusses\n \nFairclough's\n \ndiscourse\n \ntheoretical\n \nmethodology.\n \nFeminist\n \ncritical\n \ndiscourse\n \nanalysis\n \nand\n \nits\n \noperationalisation\n \nin\n \nthis\n \nspecific\n \nthesis\n \nare\n \ndescribed\n \nin\n \nthe\n \nthird\n \nsection,\n \nand\n \nthe\n \nlast\n \nsection\n \nincludes\n \ndiscussions\n \non\n \nethics\n \nand\n \nreflexivity\n \nin\n \nthis\n \nresearch\n \nproject,\n \nrelated\n \nto\n \nfeminist\n \ndiscussions\n \non\n \nthe\n \ntopic.\n \n5.1  Material   \nIn  this  section  I  present  the  material  chosen  for  the  thesis:  Socialstyrelsens  guidelines  for  \nendometriosis.\n \nI\n \nalso\n \ninclude\n \na\n \nbackground\n \nto\n \nSocialstyrelsen\n \nas\n \nan\n \ninstitution,\n \nas\n \nwell\n \nas\n \ntheir\n \nrole\n \nin\n \nSwedish\n \nsociety.\n \nLastly,\n \nI\n \nmotivate\n \nmy\n \nchoice\n \nof\n \nmaterial,\n \nand\n \nwhy\n \nit\n \nis\n \ndeemed\n \nappropriate\n \nfor\n \nfeminist\n \nanalysis.\n  Socialstyrelsen  (The  National  Board  of  Health  and  Welfare  in  Sweden)  has  a  wide  array  of  \nresponsibilities,\n \none\n \nof\n \nthem\n \nbeing\n \nto\n \nprovide\n \nguidelines\n \nfor\n \nspecific\n \nhealthcare\n \nconcerns,\n \nwhich\n \nare\n \nused\n \nin\n \nthe\n \ndecision\n \nmaking\n \nof\n \nmedical\n \nexecutives\n \nand\n \npractitioners\n \nin\n \nthe\n \nwhole\n \n20  \n\n \ncountry  (Socialstyresen,  2023).  National  guidelines  for  healthcare  were  introduced  in  1996,  \nwith\n \nthe\n \nmotivation\n \nto\n \nincrease\n \nthe\n \nquality\n \nand\n \nknowledge\n \nbase\n \nof\n \nhealthcare\n \npractice\n \n(Edhag\n \n&\n \nEriksson,\n \n2018,\n \np.\n \n133).\n \nRecommendations\n \nin\n \nthe\n \nguidelines\n \nare\n \nnot\n \nconclusive\n \nfor\n \npractitioners,\n \nbut\n \nare\n \ninstead\n \nmeant\n \nas\n \nguiding\n \nprinciples\n \nfor\n \nindividual\n \npatient\n \nencounters\n \nand\n \ntreatment\n \nplans\n \n(Edhag\n \n&\n \nEriksson,\n \n2018,\n \np.\n \n133).\n \nThe\n \nguidelines\n \nare\n \nwritten\n \nin\n \ncorrespondence\n \nwith\n \ncurrent\n \nresearch,\n \nand\n \nare\n \ndone\n \nto\n \nassess\n \nthe\n \ncurrent\n \nfunctionality\n \nof\n \nrelevant\n \nhealthcare\n \nservices\n \nas\n \nwell\n \nas\n \nto\n \ngive\n \nrecommendations\n \nfor\n \nhow\n \ntreatments\n \nshould\n \nbe\n \nprovided,\n \nwith\n \nthe\n \noverarching\n \ngoal\n \nto\n \ncreate\n \ngood\n \nand\n \nequal\n \nhealthcare\n \nfor\n \nall\n \n(Socialstyrelsen,\n \n2023).\n \n  The  material  for  this  thesis  is  Socialstyrelsens  guidelines  for  the  reproductive  disorder  \nendometriosis\n \n(Socialstyrelsen,\n \n2018).\n \nThe\n \nguidelines\n \nwere\n \npublished\n \nin\n \n2018,\n \nand\n \nare\n \nthe\n \nfirst\n \nguidelines\n \nfor\n \nendometriosis\n \nproduced\n \nby\n \nSocialstyrelsen.\n \nIt\n \nis\n \na\n \nroughly\n \n100\n \npage\n \nlong\n \ndocument,\n \nconstituted\n \nby\n \nthree\n \nmain\n \nsections.\n \nThe\n \nfirst\n \nsection\n \nintroduces\n \nendometriosis\n \nby\n \ndescribing\n \nsymptoms,\n \npresenting\n \ndata\n \nas\n \nwell\n \nas\n \ncurrent\n \nissues\n \nwithin\n \nthe\n \nhealthcare\n \nsector.\n \nThe\n \nsecond\n \npart\n \ncontains\n \nthe\n \n32\n \nmedical\n \nrecommendations\n \nimplemented\n \nto\n \nimprove\n \ncurrent\n \nendometriosis\n \nhealthcare,\n \nand\n \nthe\n \nthird\n \npart\n \nconsists\n \nof\n \nevaluative\n \ndiscussions\n \nregarding\n \neconomic\n \nperspectives\n \nas\n \nwell\n \nas\n \nethics\n \nand\n \ninclusivity\n \n(Socialstyrelsen,\n \n2018).\n \nIts\n \ndescriptions\n \nand\n \nconclusions\n \nare\n \nbased\n \non\n \n39\n \nkey\n \nsources\n \nlike\n \nscientific\n \nreports,\n \nformer\n \nrelated\n \nguidelines\n \nand\n \nstatistical\n \ndata.\n  I  choose  this  material  because  of  Socialstyrelsens'  powerful  position  in  Swedish  society,  as  a  \nprimary\n \nsource\n \nfor\n \nknowledge\n \nproduction\n \nconcerning\n \nhealthcare\n \nand\n \ndisease.\n \nThis\n \nmakes\n \nthe\n \ninstitutions\n \nguidelines\n \ncorrelated\n \nto\n \nhow\n \nhealthcare\n \nis\n \npracticed,\n \nwhile\n \nsimultaneously\n \nbeing\n \nof\n \nlarge\n \ndiscursive\n \nsignificance\n \nfor\n \nunderstandings\n \nof\n \ndisease\n \nand\n \npatient\n \ndemographics.\n \nAnalysis\n \nof\n \nthe\n \nguideline’s\n \ninnate\n \nlogics\n \nand\n \nconnotations\n \nbecome\n \nrelevant\n \nfor\n \nunderstanding\n \nthe\n \ndiscursive\n \nformations\n \nregarding\n \nendometriosis,\n \nhealthcare\n \nand\n \npatient\n \npriority\n \nwhich\n \nexist\n \nin\n \nSwedish\n \nsociety,\n \nand\n \nhow\n \nthey\n \nmight\n \nbe\n \nreinforced\n \nor\n \ncontradicted\n \nin\n \ninstitutional\n \nmaterial.\n \nBy\n \nanalyzing\n \nthe\n \nsocial\n \naspects\n \nwhich\n \ninform\n \nendometriosis,\n \nand\n \nhow\n \nthese\n \nare\n \ndealt\n \nwith\n \nin\n \nthe\n \nmaterial,\n \nthe\n \nchoice\n \nof\n \nmaterial\n \nis\n \ngiven\n \na\n \nfeminist\n \nfocus.\n \n5.2  Methodology   \nFor  this  thesis  I  have  chosen  a  critical  discourse  theoretical  methodology  consisting  of  \nFairclough's\n \ndevelopment\n \nof\n \nFoucault's\n \nmethodological\n \nframework.\n \nThis\n \nwas\n \ndeemed\n \nas\n \n21  \n\n \nappropriate  considering  my  materials'  powerful  position  as  state  mandated  guidelines,  and  \nconsidering\n \nmy\n \ninterest\n \nin\n \nthe\n \ndiscursive\n \nelements\n \nthat\n \ninstitutional\n \ndescriptions\n \nof\n \nreproductive\n \nfunctions\n \nand\n \nbodies\n \nrely\n \non.\n \nIn\n \nthis\n \nsection\n \nI\n \nexplain\n \nFaircloughs\n \nmethodology.\n \n  Critical  discourse  analysis  was  coined  by  Fairclough  as  a  development  of  the  Foucauldian  \ndiscourse\n \nanalysis,\n \nwith\n \na\n \nlinguistic\n \nfocus\n \nin\n \ncontrast\n \nto\n \nthe\n \nmore\n \nbroad\n \nstroked\n \nand\n \nhistorical\n \nfocus\n \nof\n \nFoucault\n \n(Fairclough,\n \n1995,\n \np.\n \n7).\n \nAlthough\n \nlanguage\n \nis\n \ncentral\n \nin\n \nall\n \npoststructural\n \nmethodology,\n \nCDA\n \nsituates\n \nitself\n \nin\n \nthe\n \ntradition\n \nof\n \nlinguistics\n \nwhich\n \nmakes\n \nits\n \nfocal\n \npoint\n \non\n \nhow\n \nspecific\n \ngrammatical\n \nconstructions\n \nreinforce,\n \ncontradict\n \nand\n \nproduce\n \nformations\n \nof\n \ndiscourse\n \n(Fairclough,\n \n1995,\n \np.\n \n11,\n \np.\n \n19).\n \nThe\n \ngoal\n \nof\n \ncritical\n \ndiscourse\n \nanalysis\n \nis\n \nto\n \n“denaturalize”\n \ndiscursive\n \nassumptions,\n \nreferring\n \nto\n \nthe\n \npractice\n \nof\n \ncritically\n \nviewing\n \ntexts\n \nand\n \ntheir\n \nconnotations,\n \nin\n \norder\n \nto\n \nlocalize\n \nits\n \nlogics\n \nas\n \nreliant\n \non\n \nideological\n \nclaims\n \nrather\n \nthan\n \nbeing\n \nobjectively\n \ntruthful,\n \nnaturalized\n \n“common\n \nsense”\n \n(Fairclough,\n \n1995,\n \npp.\n \n27-28).\n \n  Fairclough  develops  this  by  highlighting  the  boundaries  and  relationships  between  different  \ndiscourses\n \n(Fairclough,\n \n1995,\n \npp.\n \n12-13).\n \nThrough\n \nsociocultural\n \nchange,\n \ndiscourses\n \nevolve\n \nin\n \nvarious\n \ndegrees\n \nand\n \nmight\n \ngrow\n \nto\n \nreinforce\n \neach\n \nother\n \nor\n \nexist\n \nas\n \noppositional\n \n(Fairclough,\n \n1995,\n \npp.\n \n12-13).\n \nThis\n \nshows\n \nthe\n \nmoldable\n \nrelationship\n \nthat\n \ndiscourses\n \nhave\n \non\n \neach\n \nother,\n \nas\n \nwell\n \nas\n \nthe\n \npossibility\n \nof\n \ncontradictions\n \nwithin\n \ndiscourses\n \nmade\n \nthrough\n \nthese\n \nsynergies.\n \nThe\n \nterm\n \nintertextuality\n \nrefers\n \nto\n \nthis\n \nphenomenon\n \n(the\n \ninterlinkage\n \nof\n \ndiscursive\n \nformations),\n \nwhich\n \nhighlights\n \nthe\n \nrelevance\n \nof\n \ncontextualizing\n \nand\n \nhistorizing\n \ntexts\n \nin\n \norder\n \nto\n \nfully\n \nunderstand\n \nthem\n \n(Fairclough,\n \n1995,\n \np.\n \n11,\n \np.\n \n19).\n \n \n5.3  Method   \n5.3.1  Feminist  critical  discourse  analysis  \n \nTo  operationalize  the  above  stated  methodology,  feminist  critical  discourse  analysis  is  applied  \nto\n \nmy\n \nmaterial\n \nusing\n \nthe\n \nthree\n \ndimensions\n \nof\n \ncritical\n \ndiscourse\n \nanalysis,\n \nwhich\n \nstructures\n \nthe\n \nanalysis.\n \nBelow\n \nI\n \ndescribe\n \nthe\n \ndifferent\n \nsteps\n \nof\n \nCDA\n \nanalysis,\n \nas\n \ndescribed\n \nby\n \nBurnett\n \n(2024),\n \nas\n \nwell\n \nas\n \nthe\n \nfeminist\n \noperationalisation\n \nof\n \nmy\n \nmethods.\n \n  Step  1  of  critical  discourse  analysis  focuses  on  the  concrete  language  of  the  text,  where  you  \naim\n \nto\n \ndescribe\n \nits\n \nsemantic\n \nconstructions\n \nas\n \nwell\n \nits\n \nreferences/connotations\n \nin\n \norder\n \nto\n \ndecode\n \nthe\n \nlanguage\n \nuse\n \n(Burnett,\n \n2024,\n \np.\n \n370).\n \nHere\n \nthe\n \nanalysis\n \nis\n \nquite\n \nzoomed\n \nin,\n \nplacing\n \n22  \n\n \nemphasis  on  specific  formulations  in  the  text  (usually  illustrated  through  quotes).  Intertextual  \nconnections\n \nare\n \nmade,\n \nconnecting\n \nquotes\n \nto\n \nlarger\n \ndiscursive\n \nformations\n \nof\n \nlanguage.\n \nIn\n \norder\n \nto\n \nunderstand\n \nthe\n \nsemantic\n \nthemes\n \nand\n \ntheir\n \nconnotations,\n \nthe\n \nreader\n \nis\n \nrequired\n \nto\n \nbe\n \ninformed\n \non\n \nthe\n \ncontext\n \nin\n \nwhich\n \nthey\n \nare\n \nproduced\n \n(Burnett,\n \n2024,\n \np.\n \n370).\n \nBefore\n \nstep\n \n1,\n \nthe\n \nso-called\n \nstep\n \n0\n \nof\n \nanalysis\n \nis\n \ntherefore\n \ndone\n \nthrough\n \nreading\n \nthe\n \nmaterial\n \nthoroughly\n \nand\n \neducating\n \noneself\n \non\n \nthe\n \ncontext\n \nit\n \nwas\n \nwritten\n \nin.\n \n  In  Step  2 ,  you  zoom  out  to  interpret  the  text's  linguistic  structures  as  part  of  discursive  \npractices,\n \nwhere\n \nknowledge\n \nclaims\n \nare\n \ncontextualized\n \nin\n \nrelevant\n \nsocial,\n \nhistorical\n \nand\n \nideological\n \nsettings.\n \nThis\n \nis\n \ndone\n \nin\n \norder\n \nto\n \nunderstand\n \nhow\n \nthe\n \ntext’s\n \nlogics\n \nmight\n \nreinforce\n \ninstitutional\n \narrangements\n \nand\n \nsocial\n \nroles,\n \nor\n \nquestions\n \nthem\n \n(Burnett,\n \n2024,\n \np.\n \n370-371).\n \nIt\n \nalso\n \naddresses\n \nwhat\n \nideologies\n \nare\n \ninvoked\n \nin\n \nthe\n \ntext,\n \nand\n \nwhat\n \nknowledge\n \nclaims\n \nare\n \nmade\n \neither\n \nimplicitly\n \nor\n \nexplicitly\n \nas\n \nwell\n \nas\n \nidentifying\n \nconflicting\n \ndiscourses\n \nand\n \nhow\n \nthey\n \ninteract\n \nwith\n \neach\n \nother\n \n(Burnett,\n \n2024,\n \np.\n \n370-371).\n  In  Step  3  you  aim  to  explain  the  sociocultural  significance  of  the  text,  in  order  to  discuss  what  \nthe\n \ntext\n \nis\n \nwritten\n \nto\n \naccomplish\n \nand\n \nwho\n \nbenefits\n \nfrom\n \nits\n \nclaims\n \n(Burnett,\n \n2024,\n \np.\n \n371).\n \nHere\n \nyou\n \nalso\n \nask\n \nyourself\n \nif\n \nthe\n \ntext\n \naims\n \nto\n \njustify\n \ncurrent\n \nsocial\n \nor\n \npolitical\n \norders,\n \nand\n \nwho\n \nmight\n \nsuffer\n \nnegative\n \nconsequences\n \nfrom\n \nthe\n \nreinforcement\n \nof\n \nthese\n \nsystems\n \n(Burnett,\n \n2024,\n \np.\n \n371).\n  In  this  thesis  I  have  chosen  a  feminist  critical  discourse  analysis,  referring  to  feminist  \nreformulations\n \nof\n \nFairclough's\n \noriginal\n \nmethodology\n \nwhere\n \nemphasis\n \nis\n \nput\n \non\n \ncritically\n \nexamining\n \nlinguistic\n \nstructures\n \nwhich\n \nfurthers\n \nthe\n \noppression\n \nof\n \nmarginalized\n \ngroups\n \nand\n \nindividuals\n \n(Burnett,\n \n2024,\n \np.\n \n363).\n \nElsbeth\n \nTilley\n \nexplains\n \nin\n \nher\n \narticle\n \n“Feminist\n \ndiscourse\n \nanalysis”\n \nhow\n \nthe\n \ngeneral\n \npower\n \ncritical\n \nposition\n \nof\n \ndiscourse\n \nanalysis\n \ngoes\n \nhand\n \nin\n \nhand\n \nwith\n \nfeminist\n \ngoals\n \nof\n \nemancipation,\n \nmaking\n \nit\n \ncompatible\n \nfor\n \nfeminist\n \nmethodologies\n \nwhich\n \naim\n \nto\n \nassist\n \nintersectional\n \nstruggle\n \nfor\n \njustice\n \nin\n \nsociety\n \n(Tilley,\n \n2018,\n \np.1).\n \nThe\n \nmain\n \nobjective\n \nof\n \nfeminist\n \nCDA\n \ntherefore\n \ngoes\n \nhand\n \nin\n \nhand\n \nwith\n \nthe\n \naim\n \nof\n \nthis\n \nthesis:\n \nfurthering\n \nthe\n \ninclusion\n \nof\n \nthe\n \nsocial\n \nperspectives\n \nof\n \nmarginalized\n \ngroups\n \nwithin\n \nhealthcare.\n     \n23  \n\n \n5.3.2  Operationalization  \n \nCDA  is  operationalized  in  this  thesis  through  a  thematic  analysis  of  my  material,  which  is  \nproduced\n \ninductively.\n \nThrough\n \nthorough\n \nreadings\n \nof\n \nthe\n \ntextual\n \nmaterial,\n \nI\n \ninitially\n \ncode\n \nthe\n \ntext\n \nof\n \nits\n \ncentral\n \nthemes,\n \nwhich\n \nis\n \nthen\n \nmap\n \nout\n \nand\n \npresented\n \nin\n \ndifferent\n \nthematic\n \nsections\n \nof\n \nanalysis,\n \ncontaining\n \nmostly\n \nqualitative\n \ndata\n \nbut\n \nalso\n \nsome\n \nquantitative\n \nelements.\n \nIn\n \nthese\n \nthematic\n \nsections\n \nI\n \nthen\n \nconduct\n \nanalysis\n \nusing\n \nthe\n \nthree\n \nsteps\n \nof\n \nCDA:\n \ndescribing\n \nthe\n \nsemantics\n \nof\n \nthe\n \nthemes\n \nthrough\n \ndiscussions\n \nof\n \nspecific\n \nquotes\n \nand/or\n \nquantifications,\n \ninterpreting\n \nand\n \ncontextualizing\n \nthe\n \ntheme’s\n \ndiscursive\n \nlogics\n \nand\n \nexplaining\n \nthe\n \nsociocultural\n \nsignificance\n \nof\n \nthe\n \nthemes.\n \nExcerpts\n \nfrom\n \nmy\n \nmaterial\n \nare\n \ntranslated\n \nfrom\n \nSwedish\n \nto\n \nEnglish,\n \nto\n \nmake\n \nthese\n \nmore\n \naccessible\n \nto\n \nthe\n \nreader\n \nand\n \nto\n \npromote\n \nlanguage\n \nconsistency\n \nin\n \nthe\n \nthesis.\n \n  I  use  some  terminology  in  the  thesis  which  might  be  favourable  to  define.  Endometriosis  is  at  \ntimes\n \nshortened\n \nto\n \nendo-,\n \nmostly\n \nfor\n \nvariation\n \npurposes.\n \nTo\n \nrefer\n \nto\n \npatient\n \ngroups\n \nfor\n \nendometriosis,\n \nI\n \nprimarily\n \nuse\n \nthe\n \ngender-neutral\n \nformulation\n \n‘people\n \nwith\n \nendometriosis’.\n \nI\n \nchoose\n \nnot\n \nto\n \nuse\n \nthe\n \nterm\n \nuterus\n \nbearer\n \nand\n \npeople\n \nwho\n \nmenstruate,\n \ndespite\n \nthe\n \ncentral\n \nrole\n \nof\n \nthe\n \nuterus\n \nand\n \nmenstruation\n \nin\n \nendometriosis.\n \nThis\n \nis\n \nbecause\n \nhysterectomies\n \n(surgical\n \nremoval\n \nof\n \nthe\n \nuterus)\n \nis\n \nperformed\n \nas\n \ntreatment\n \nfor\n \nendometriosis,\n \nas\n \nwell\n \nas\n \npart\n \nof\n \nsome\n \ntrans\n \nand\n \nintersex\n \npatients\n \ngender\n \naffirming\n \ntreatment,\n \nmeaning\n \nthat\n \nnot\n \nall\n \nendometriosis\n \npatients\n \nhave\n \na\n \nuterus.\n \nMenstruation\n \nusually\n \ndisappears\n \nwhen\n \none\n \nhas\n \nhad\n \na\n \nhysterectomy,\n \nand\n \nsome\n \npatients\n \ndo\n \nnot\n \nmenstruate\n \nfor\n \nother\n \nreasons,\n \nsuch\n \nas\n \nbirth\n \ncontrol\n \nor\n \nhormone\n \ntherapy,\n \nmotivating\n \nme\n \nto\n \nnot\n \nuse\n \nthe\n \nterm\n \n‘people\n \nwho\n \nmenstruate’\n \neither.\n \nWhen\n \ndiscussing\n \ngender\n \nand\n \nendometriosis,\n \nI\n \nalso\n \nuse\n \nthe\n \nterm\n \n‘feminized’,\n \nreferring\n \nto\n \nthe\n \npractice\n \nof\n \nlabelling\n \nsubjects\n \nas\n \nwomen\n \nor\n \nfemale-adjacent.\n \nbased\n \non\n \nsocietal\n \nexpectations\n \non\n \ngender\n \n&\n \nsexual\n \ndifference.\n \nFeminization\n \ntherefore\n \nincludes\n \nall\n \nthose\n \nwho\n \nare\n \nassumed\n \nto\n \nhave\n \ncertain\n \nneeds\n \nand\n \ntraits\n \nbecause\n \nof\n \nthe\n \nsocial\n \nroles\n \nprojected\n \nonto\n \nthem.\n \n5.4  Ethical  considerations  \nIn  this  thesis,  my  empirical  data  does  not  concern  research  subjects  and/or  sensitive  personal  \ninformation,\n \nwhich\n \nmakes\n \nethical\n \nconsiderations\n \nin\n \nrelation\n \nto\n \nstorage\n \nof\n \ndata\n \nand\n \nrelationships\n \nto\n \nparticipants\n \nof\n \nlittle\n \nrelevance.\n \nHowever,\n \nin\n \nthe\n \nintroduction\n \nand\n \nliterature\n \nreview\n \nI\n \ndo\n \ninclude\n \ntestimonies\n \nof\n \nexperience,\n \nbut\n \nsince\n \nthese\n \nare\n \neither\n \nmade\n \nanonymous\n \nby\n \nresearchers\n \nor\n \npublished\n \npublicly\n \nby\n \nnews\n \noutlets,\n \nthe\n \ninformation\n \nis\n \nnot\n \nconsidered\n \nas\n \n24  \n\n \nsensitive.  Instead,  this  section  focuses  on  reflexivity  as  a  feminist  approach,  and  how  this  \nshapes\n \nthe\n \nways\n \nI\n \ndeal\n \nwith\n \nthe\n \ntopic\n \nof\n \nendometriosis\n \nin\n \nmy\n \nthesis\n \nin\n \nrelation\n \nto\n \nmy\n \nown\n \npositions\n \nand\n \nexperiences.\n \n  In  feminist  tradition,  reflexivity  is  often  highlighted  as  a  central  practice  for  ethical  research.  \nHarraway\n \nspoke\n \nof\n \navoiding\n \nthe\n \n“god-trick”,\n \nreferring\n \nto\n \na\n \ncritical\n \nawareness\n \nin\n \nfeminist\n \nresearch\n \ntowards\n \nenlightenment\n \nideals\n \nof\n \nan\n \nall-knowing,\n \nunbiased\n \nresearcher\n \nwhose\n \nhuman\n \nqualities\n \nof\n \npartisanship\n \ndo\n \nnot\n \nbleed\n \ninto\n \nthe\n \nresults\n \nof\n \nscientific\n \nwork\n \n(Harraway,\n \n1988).\n \nInstead,\n \nreflexivity\n \nbecomes\n \na\n \npractice\n \nof\n \nrecognizing\n \none’s\n \nown\n \npositions\n \nin\n \nsociety\n \nas\n \nto\n \nremain\n \ntransparent\n \ntowards\n \nthe\n \nbiases,\n \nprivileges\n \nand\n \nexperiences\n \nthat\n \nwill\n \nultimately\n \nshape\n \nthe\n \nknowledge\n \nthat\n \none’s\n \nresearch\n \nprojects\n \nproduce\n \n(Gunaratnam,\n \n2024,\n \npp.\n \n134-136).\n \nAlthough\n \nreflexivity\n \nas\n \nan\n \nidea\n \nproposes\n \na\n \nsystematic\n \nquestioning\n \nof\n \nmethodological\n \nprivilege,\n \nacademic\n \nelitism\n \nand\n \nunequal\n \npower\n \ndynamics,\n \nthe\n \nclaim\n \nof\n \ndoing\n \nreflexive\n \nresearch\n \nis\n \nnot\n \nenough.\n \nSince\n \nreflexivity\n \nis\n \na\n \nbroad\n \nconcept,\n \nit\n \ncan\n \nbe\n \nweaponized\n \nto\n \njustify\n \nlack\n \nof\n \nresponsibility\n \nfor\n \nvoyeuristic,\n \nassumptive\n \nand\n \noutwards\n \nproblematic\n \nways\n \nof\n \nconducting\n \nscience,\n \nin\n \nthe\n \nname\n \nof\n \nself-critique\n \nand\n \nintrospection\n \n(Gunaratnam,\n \n2024,\n \npp.\n \n132-135).\n \n  It  is  therefore  key  to  distinguish  what  reflexivity  should  do  with  research,  to  not  let  it  become  \nan\n \noutlet\n \nfor\n \nbrief\n \negocentric\n \nreflection\n \non\n \none’s\n \nown\n \nprivileges\n \nbut\n \ninstead\n \nan\n \nall\n \nencompassing\n \nresearch\n \napproach\n \n(Gunaratnam,\n \n2024,\n \npp.\n \n132-135).\n \nOne\n \nkey\n \nelement\n \nof\n \nthis\n \nis\n \nto\n \nlet\n \nreflexivity\n \nas\n \nan\n \napproach\n \nbleed\n \ninto\n \nall\n \naspects\n \nof\n \nthe\n \nresearch\n \nproject,\n \nand\n \nto\n \nlet\n \nresponsibility\n \nover\n \none’s\n \npositions\n \nconsequently\n \ninform\n \nthe\n \nscientific\n \nchoices\n \nthat\n \nare\n \nmade\n \nin\n \nthe\n \nprocess\n \nof\n \nwriting,\n \nreading\n \nand\n \ncollecting\n \n(Gunaratnam,\n \n2024,\n \npp.\n \n136-137).\n \nIt\n \nis\n \nalso\n \nimportant\n \nto\n \nallow\n \npositions\n \nto\n \nremain\n \nfluid,\n \nand\n \nto\n \nunderstand\n \nhow\n \none’s\n \nexperiences\n \nboth\n \ndifferentiates\n \nand\n \nrelates\n \nto\n \nthat\n \nof\n \nresearch\n \nparticipants\n \nand\n \nmaterial,\n \nas\n \nto\n \nnot\n \ncontribute\n \nto\n \nrigid\n \nand\n \nlimiting\n \nconstructions\n \nof\n \nidentity\n \nwhich\n \nultimately\n \ndenies\n \nthe\n \nfluidity\n \nand\n \ndiversity\n \nof\n \nembodiments\n \n(Gunaratnam,\n \n2024,\n \np.\n \n131).\n \nFeminist\n \nreflexivity\n \nis\n \ntherefore\n \nequipped\n \nin\n \nthis\n \nproject\n \nas\n \na\n \ntoolbox\n \npresent\n \nin\n \nall\n \naspects\n \nof\n \nthe\n \nthesis,\n \nas\n \nI\n \ntry\n \nto\n \nnavigate\n \nmy\n \nown\n \nambivalent\n \npositions\n \nin\n \nrelation\n \nto\n \nmy\n \nscientific\n \nchoices.\n \n  Endometriosis  is  an  under  researched  topic,  at  the  same  time  as  vast  amounts  of  knowledge  \nregarding\n \nthe\n \ndisease\n \nexists\n \nin\n \nspaces\n \noutside\n \nof\n \nacademia.\n \nIt\n \nis\n \nimportant\n \nto\n \nhighlight\n \nthe\n \nlimits\n \nof\n \nthe\n \nknowledge\n \nthat\n \nmy\n \nmethods\n \ncan\n \nproduce\n \nregarding\n \nendometriosis,\n \ngiven\n \nthe\n \n25  \n\n \nscope  of  this  project  as  a  student  master  thesis.  Conducting  work  on  bodies  also  poses  the  \nethical\n \ndilemma\n \nof\n \ninclusion,\n \nespecially\n \nsince\n \nendometriosis\n \nis\n \na\n \nhighly\n \nfeminized\n \nfield.\n \nI\n \naim\n \nto\n \nuse\n \ngender\n \ninclusive\n \nlanguage,\n \nto\n \ninclude\n \nall\n \npatients\n \nof\n \nendometriosis\n \nhealthcare\n \nand\n \nfurther\n \nthe\n \nimportance\n \nof\n \nintersectional\n \ninclusivity.\n \nThis\n \nsometimes\n \nmeans\n \nusing\n \ngender\n \nneutral\n \nterminology,\n \nand\n \nat\n \nother\n \ntimes\n \ngiving\n \nan\n \naccount\n \nfor\n \nhow\n \ngendered\n \nidentities\n \nshape\n \nendometriosis\n \nexperience.\n \nI\n \nalso\n \ndeal\n \nwith\n \nthis\n \ndilemma\n \nby\n \naiming\n \nto\n \nprovide\n \npostcolonial\n \nperspectives\n \non\n \nthe\n \nissue\n \nof\n \nendometriosis\n \ninequality,\n \nbut\n \nI\n \nacknowledge\n \nthat\n \nthe\n \nprevailing\n \nstruggle\n \nfor\n \ninclusion\n \nof\n \nbodies\n \nis\n \nnot\n \nsomething\n \nwhich\n \nthis\n \nessay\n \nultimately\n \ncan\n \ncompletely\n \ndistance\n \nitself\n \nfrom.\n \n  Writing  on  endometriosis  as  someone  who  does  not  experience  the  disease  myself  is  \nsomething\n \nthat\n \npushes\n \nme\n \nfurther\n \nfrom\n \nthe\n \nexperiences\n \nof\n \nwhich\n \nI\n \nwish\n \nto\n \ncentralize\n \nin\n \nmy\n \ninstitutional\n \ncritique,\n \nat\n \nthe\n \nsame\n \ntime\n \nas\n \nexperiences\n \nof\n \nmenstrual\n \npain,\n \nnot\n \nbeing\n \ntaken\n \nseriously\n \nby\n \nmedical\n \npractitioners\n \nand\n \nexisting\n \nas\n \na\n \nqueer\n \nwoman\n \nwithin\n \nmedicalizing\n \nstructures\n \nis\n \nsomething\n \nI\n \ncan\n \nrelate\n \nto\n \nemotionally\n \nthrough\n \nlived\n \nexperience.\n \nAs\n \nsomeone\n \nwho\n \ndoes\n \nnot\n \nhave\n \nexperience\n \nof\n \nbeing\n \nracialized,\n \nwho\n \nconducts\n \nresearch\n \nfrom\n \nthe\n \nglobal\n \nnorth,\n \nit\n \nis\n \nespecially\n \nimportant\n \nthat\n \nI\n \nremain\n \ncritical\n \ntowards\n \nreproducing\n \ncolonial\n \nideas\n \nof\n \nbodily\n \nstandards,\n \nrigid\n \nidentity\n \nand\n \nwestern\n \nmedical\n \nsuperiority,\n \nat\n \nthe\n \nsame\n \ntime\n \nas\n \nmy\n \nability\n \nto\n \ntransverse\n \nthese\n \nstructures\n \nare\n \nlimited,\n \nwhich\n \ntogether\n \nwith\n \nmy\n \nlack\n \nof\n \nexperiences\n \nof\n \nendometriosis\n \nhighlights\n \nthe\n \nneed\n \nfor\n \nmore\n \ncritical\n \nresearch\n \ndone\n \non\n \nthe\n \ntopic\n \nfrom\n \nother\n \nlived\n \nexperiences\n \nthan\n \nmy\n \nown.\n \n6.  Analysis:  tracing  the  social  in  the  medical  \nIn  this  section  I  analyze  Socialstyrelsens  guidelines  for  endometriosis.  The  guidelines  contain  \nthree\n \nprimary\n \nsections:\n \nfirst,\n \nan\n \nintroduction,\n \nwhich\n \ndescribe\n \nthe\n \noverall\n \ngoals\n \nof\n \nthe\n \nguidelines\n \nand\n \na\n \nsummary\n \nof\n \nthe\n \ncurrent\n \nstate\n \nof\n \nendometriosis\n \nhealthcare,\n \nsecond,\n \nthe\n \nconcrete\n \nhealthcare\n \nrecommendations\n \nmade\n \nto\n \nimprove\n \ncurrent\n \nmedical\n \nservices\n \n(with\n \na\n \ntotal\n \nof\n \n32\n \nrecommendations),\n \nand\n \nthird,\n \na\n \nfinal\n \npart\n \nwhich\n \nincludes\n \neconomic\n \nmodels\n \nas\n \nwell\n \nas\n \ndiscussions\n \non\n \nethical\n \nconsiderations\n \nand\n \ninclusivity.\n \n  The  findings  from  the  material  are  thematically  described,  analyzed  and  discussed  using  \nfeminist\n \ncritical\n \ndiscourse\n \nanalysis\n \nas\n \nwell\n \nas\n \nthe\n \ntheoretical\n \nframework\n \ndescribed\n \nabove.\n \nCritical\n \ndiscourse\n \nanalysis\n \nconsists\n \nof\n \nthree\n \nsteps,\n \nwhich\n \nwill\n \norganize\n \nthe\n \nsections\n \nbelow.\n \n26  \n\n \nStep  1  focuses  on  semantics  and  the  language  used  in  the  guidelines,  whereas  step  2  and  3  \nzooms\n \nout\n \nand\n \ntakes\n \ninto\n \naccount\n \nthe\n \ndiscursive\n \ncontext\n \nand\n \nsociocultural\n \nsignificance\n \nof\n \nthe\n \ntext.\n \nThe\n \nanalysis\n \nprimarily\n \nfocuses\n \non\n \nqualitative\n \ndata,\n \nand\n \nbrings\n \nin\n \nsome\n \nquantitative\n \naspects\n \nrelevant\n \nin\n \nthe\n \nempirical\n \nmaterial.\n \nAll\n \nthe\n \nincluded\n \nquotes\n \nhave\n \nbeen\n \ntranslated\n \nfrom\n \nSwedish\n \nto\n \nEnglish\n \nby\n \nmyself.\n \n  Themes  in  the  analysis  emerged  through  a  close  and  systematic  reading,  drawing  upon  tools  \nfrom\n \ncritical\n \ndiscourse\n \nanalysis,\n \nand\n \nthe\n \nconcepts\n \nand\n \ntheories\n \nfrom\n \nthe\n \ntheoretical\n \nframework.\n \nThe\n \nmain\n \naim\n \nof\n \nthe\n \nthesis\n \nis\n \nto\n \nexamine\n \nthe\n \nsocial\n \naspects\n \nembedded\n \nwithin\n \nmedical\n \ndiscourse\n \naround\n \nendometriosis.\n \nTherefore,\n \nfeminist\n \ncritical\n \ndiscourse\n \nanalysis\n \nenables\n \nthis\n \nthesis\n \nto\n \nexplore\n \nthe\n \nfollowing\n \nthemes:\n \n(a)\n \nThe\n \ncentrality\n \nof\n \nfertility;\n \n(b)\n \nAccess\n \nto\n \ncare\n \n&\n \npain\n \n-\n \nwhose\n \npain\n \nis\n \ntaken\n \nseriously?;\n \n(c)\n \nCost\n \nefficiency\n \nand\n \nworkfare\n \n-\n \npatients\n \nin\n \nthe\n \nrealm\n \nof\n \nthe\n \nneoliberal\n \norder,\n \nand\n \n(d)\n \nGendered\n \nambivalence\n \n-\n \nWho\n \nis\n \nthe\n \npatient\n \ngroup\n \nfor\n \nendometriosis?,\n \nwhich\n \nare\n \ndiscussed\n \nbelow.\n \n \n6.1  The  centrality  of  fertility  \n Although  Socialstyrelsens’  guidelines  for  endometriosis  do  not  include  treatments  for  \ninfertility\n \n(Socialstyrelsen,\n \n2018,\n \np.\n \n10),\n \nfertility\n \nis\n \na\n \nrelevant\n \naspect\n \nof\n \nendometriosis,\n \nconsidering\n \nthat\n \nmany\n \nwho\n \nseek\n \nhealthcare\n \nfor\n \nthe\n \ndisease\n \nalso\n \nseek\n \ncare\n \nfor\n \nfertility\n \npreservation\n \npurposes\n \n(Socialstyrelsen,\n \n2018,\n \np.\n \n12;\n \nKalaitzapopulus\n \net\n \nal.,\n \n2021).\n \nFertility\n \nis\n \nalso\n \ninterlinked\n \nwith\n \nreproductive\n \nroles\n \nand\n \nstereotypes,\n \nespecially\n \nfor\n \nwomen\n \nand\n \nfeminized\n \nindividuals.\n \nThis\n \ntheme\n \nanalyzes\n \nthe\n \nrole\n \nfertility\n \nplays\n \nin\n \nSocialstyrelsens\n \nguidelines\n \nfor\n \nendometriosis.\n \n  This  theme  will  initially  be  explored  focusing  on  semantics  and  language.  When  motivating  \nthe\n \nsignificance\n \nof\n \ntreating\n \nendometriosis\n \nsymptoms\n \nin\n \nthe\n \nintroduction\n \nof\n \nthe\n \nguidelines,\n \nSocialstyrelsen\n \nwrites:\n  “Early  onset  treatment  of  suspected  or  confirmed  endometriosis  likely  has  large  \nsignificance\n \nfor\n \nfertility\n \npreservation\n \nand\n \ncounteracting\n \nthe\n \nrisk\n \nfor\n \nchronic\n \npain”\n \n(Sociastyrelsen,\n \n2018,\n \np.\n \n11)\n \n(my\n \ntranslation\n \nand\n \nemphasis)\n  \n27  \n\n \n“This  normalisation  of  sometimes  severe  pain,  leads  to  delayed  treatment  and  \ndiagnosis\n \n[8].\n \nThis\n \nin\n \nturn\n \nincreases\n \nthe\n \nrisk\n \nfor\n \nchronic\n \npain,\n \nand\n \nlikely\n \nalso\n \naffects\n \nfertility\n \nnegatively\n”\n \n(Socialstyrelsen,\n \n2018\n \np.\n \n13)\n \n(my\n \ntranslation\n \nand\n \nemphasis)\n  Here,  fertility  preservation  and  managing  chronic  pain  are  centralized  as  the  two  main  goals  \nof\n \nendometriosis\n \ntreatment.\n \nFertility\n \nis\n \nalso\n \nbrought\n \nup\n \nseveral\n \ntimes\n \nin\n \nthe\n \nmedical\n \nrecommendations\n \nwhich\n \ndiscusses\n \nsurgery\n \nand\n \npsychiatric\n \nevaluation\n \nas\n \ntreatment\n \noptions:\n  “Mental  health  is  also  likely  affected  by  difficult  pain  conditions,  which  affect  sleep,  \neveryday\n \nlife,\n \nsexual\n \nfunction,\n \nfertility\n \nand\n \nthe\n \ngeneral\n \nquality\n \nof\n \nlife”\n \n(Socialstyrelsen,\n \n2018,\n \np.\n \n42)\n \n(my\n \ntranslation\n \nand\n \nemphasis)\n  “Often  endometriosis  surgery  entails  specific  challenges.  These  are  identified  by   \ntechnical\n \ndifficulties,\n \nrisk\n \nof\n \naffected\n \nfertility\n \nand\n \ndifficulties\n \nto\n \nidentify\n \nendometriosis\n \nfoci”\n \n(Socialstyrelsen,\n \n2018,\n \npp.\n \n43-44)\n \n(my\n \ntranslation\n \nand\n \nemphasis)\n  “Healthcare  services  can  also  offer  surgical  removal  of  the  uterus  and  ovaries  to  \npeople\n \nwith\n \nendometriosis\n \nand\n \nlong\n \nterm\n \ntreatment\n \nresistant\n \npain\n \nwithout\n \nwishes\n \nof\n \npertained\n \nfertility.\n \nIt\n \nis\n \ncrucial\n \nfor\n \nthis\n \nrecommendation\n \nthat\n \nthe\n \ncase\n \nis\n \nespecially\n \nsevere\n”\n \n(Socialstyrelsen,\n \n2018,\n \np.\n \n45)\n \n(my\n \ntranslation\n \nand\n \nemphasis)\n   When  evaluating  the  risks  of  surgical  treatment  options,  Socialstyrelsen  states:    “Endometriosis  can  entail  more  or  less  acute  states,  which  can  make  it  difficult  for  \nthe\n \npatient\n \nto\n \nreceive\n \ninformation\n \nand\n \nbe\n \ninvolved\n \nin\n \nthe\n \ntreatment.\n \nSome\n \nsurgical\n \ntreatments\n \nalso\n \naffect\n \nfertility\n \nnegatively\n.\n \nIt\n \ncan\n \ntherefore\n \nbe\n \nimportant\n \nto\n \nlet\n \nsuch\n \ntreatment\n \nchoices\n \ntake\n \ngood\n \ntime”\n \n(Socialstyrelsen,\n \n2018,\n \np.\n \n78)\n \n(my\n \ntranslation\n \nand\n \nemphasis)\n  “Incomplete  endometriosis-surgery  entails  that  the  surgeon  does  not  remove  or  \ndestroy\n \nall\n \nprevalent\n \nendometriosis\n \nat\n \nthe\n \ntime\n \nof\n \nsurgery.\n \nThis\n \ncan\n \nbe\n \na\n \nconscious\n \nchoice\n \nto\n \nreduce\n \nrisk\n \nor\n \npreserve\n \nfertility\n”\n \n(Socialstyrelsen,\n \n2018,\n \np.\n \n94)\n \n(my\n \ntranslation\n \nand\n \nemphasis)\n   \n28  \n\n \nThese  quotes  convey  a  centralising  approach  to  fertility  in  the  document,  being  one  of  the  \nmain\n \nfactors\n \nconsidered\n \nboth\n \nwhen\n \nmotivating,\n \nsuggesting\n \nand\n \nevaluating\n \ntreatment\n \noptions\n \nfor\n \nendometriosis.\n \nFertility\n \npreservation\n \nis\n \na\n \ncommon\n \nconcern\n \nfor\n \nendometriosis\n \npatients,\n \nbeing\n \none\n \nof\n \nthe\n \nmost\n \nprevalent\n \ncauses\n \nfor\n \nseeking\n \ncare\n \naccording\n \nto\n \nformer\n \nresearch\n \n(Kalaitzapopulus\n \net\n \nal.,\n \n2021,\n \np.\n \n7)\n \nand\n \nSocialstyrelsen\n \nthemselves\n \n(Socialstyrelsen,\n \n2018,\n \np.\n \n12).\n \nIt\n \nis\n \ntherefore\n \nlogical\n \nthat\n \nfertility\n \nemerged\n \nas\n \none\n \nof\n \nthe\n \nthemes\n \nin\n \nmy\n \nreadings\n \nof\n \nthe\n \nguidelines,\n \nat\n \nthe\n \nsame\n \ntime\n \nas\n \nfertility\n \nis\n \na\n \ncomplicated\n \nconcept\n \ninterlinked\n \nwith\n \nsocial\n \nfactors\n \nof\n \noppression,\n \nespecially\n \nfor\n \nwomen\n \nand\n \nuterus-bearers,\n \nmaking\n \nit\n \nrelevant\n \nfor\n \nanalysis.\n \n \nFrom  a  feminist  critical  discursive  lens  it  can  be  observed  that  although  Socialstyrelsen  \ncentralizes\n \nfertility\n \nwhile\n \ndiscussing\n \ntreatment\n \noptions,\n \nthey\n \ndo\n \nnot\n \ncentralize\n \nthe\n \nsocial\n \nfactors\n \nwhich\n \nmight\n \ninform\n \nhow\n \nfertility\n \nis\n \ndealt\n \nwith\n \nin\n \nhealthcare\n \nsettings.\n \nTurkmendag\n \nstates\n \nin\n \nher\n \nbioethical\n \ntheories\n \non\n \nreproduction,\n \nthat\n \ncentralization\n \nof\n \nfertility\n \nin\n \nthe\n \nhealth\n \nissues\n \nof\n \nfeminized\n \npatient\n \ngroups\n \nrisks\n \nreproducing\n \ncertain\n \nstereotypes\n \nabout\n \npatients.\n \nFraming\n \nguidelines\n \nwithout\n \nsocial\n \nassumptions\n \nin\n \nmind,\n \nmay\n \ncontribute\n \nto\n \nhealthcare\n \nprofessionals\n \npaying\n \nattention\n \nand\n \nfactoring\n \nin\n \nfertility\n \nand\n \nreproductive\n \nqualities\n \nas\n \nthe\n \nmost\n \nimportant\n \nfunction\n \nof\n \nfeminized\n \nbodies,\n \nwhich\n \ncan\n \nin\n \nturn\n \nharbour\n \ngendered\n \npractices\n \nwithin\n \nhealthcare\n \n(Turkmendag,\n \n2022,\n \np.\n \n487).\n \nThe\n \nprimacy\n \nassociated\n \nwith\n \nreproduction,\n \nespecially\n \nwhen\n \nwomen\n \nand\n \nfeminized\n \nindividuals\n \nseek\n \nhealthcare,\n \ncan\n \noveremphasise\n \nreproductive\n \ncapacities\n \nas\n \nthe\n \ncentral\n \ngoal\n \nof\n \nuterus-related\n \nhealthcare.\n \nThese\n \ntendencies\n \nhighlight\n \nhow\n \nprevalent\n \nnotions\n \nof\n \nthe\n \nheterosexual\n \nmatrix\n \nshape\n \nguidelines\n \nfor\n \npublic\n \nhealthcare\n \n(Turkmendag,\n \n2022,\n \np.\n \n487;\n \nButler,\n \n2011,\n \npp.\n \nxi-xii).\n \nEven\n \nthough\n \nideas\n \nof\n \nreproduction\n \nwithin\n \nheterosexual\n \nmatrix\n \nare\n \nmostly\n \ndirected\n \nat\n \nwomen,\n \ncentralizing\n \nfertility\n \nin\n \nendometriosis\n \ncan\n \nalso\n \ncreate\n \nunaccounted\n \nhindrances\n \nqueer\n \nuterus-bearers\n \nwhen\n \nthey\n \nseek\n \nmedical\n \ncare.\n  \n  As  media  testimonies  of  endometriosis  experience  shows,  social  assumptions  on  fertility  \nplays\n \na\n \npart\n \nin\n \nhealthcare\n \ndiscrimination,\n \nsome\n \npatients\n \nbeing\n \ntold\n \nthat\n \n“the\n \nonly\n \nway\n \nto\n \nfix\n \nit\n \nis\n \nthrough\n \npregnancy”\n \n(McCann,\n \n2025).\n \nFormer\n \nresearch\n \nshows\n \nhow\n \nendometriosis\n \nclinicians\n \ntended\n \nto\n \nfocus\n \non\n \nfertility\n \ninstead\n \nof\n \npatient\n \nneeds\n \n(Eder\n \n&\n \nRoomaney,\n \n2024,\n \np.\n \n914),\n \nand\n \nequated\n \ntheir\n \npatients\n \nto\n \ntheir\n \nreproductive\n \nfunctions\n \n(Young\n \net\n \nal.,\n \n2018,\n \npp.\n \n349-350),\n \ndisplaying\n \nhow\n \ndiscursive\n \nideas\n \nprojected\n \nonto\n \nfeminized\n \nsubjects\n \nhave\n \nnegative\n \n29  \n\n \nconsequences  on  experiences  of  medical  services,  motivating  a  need  to  address  the  social  \nexpectations\n \nof\n \nfertility\n \nin\n \nthe\n \nguidelines.\n  What  are  the  implications  of  Socialstyrelsens  descriptions  of  fertility?  Due  to  \nSocialstyrelsens’\n \nposition\n \nin\n \nSwedish\n \nsociety,\n \nthey\n \nhave\n \ngreat\n \ndiscursive\n \npower\n \nover\n \nmedical\n \ndiscourses\n \nof\n \nfertility\n \nand\n \ngender,\n \nalso\n \ngiving\n \nthem\n \nresponsibility\n \nto\n \nensure\n \nthat\n \ntheir\n \nguidelines\n \nand\n \nhealthcare\n \nrecommendations\n \ncontribute\n \nto\n \ntheir\n \ngoals\n \nof\n \nequal\n \nhealthcare\n \nfor\n \nall,\n \nwhich\n \nrequires\n \naddressing\n \nthe\n \nsocial\n \nfactors\n \nwhich\n \nare\n \nembedded\n \nmedical\n \npractices.\n \nTherefore,\n \nby\n \nnot\n \nidentifying\n \nsocial\n \nfactors\n \nthat\n \naffect\n \nmedical\n \nviews\n \non\n \nfertility,\n \nthe\n \nrisk\n \nfor\n \ndiscriminatory\n \nand\n \nstereotyping\n \nencounters\n \nwithin\n \nendometriosis\n \nhealthcare\n \nrelated\n \nto\n \nfertility\n \nis\n \nnot\n \ndealt\n \nwith\n \ncomprehensively\n \nenough.\n \nSocialstyrelsen\n \nis\n \ntherefore\n \nat\n \nthe\n \nrisk\n \nof\n \nnot\n \naddressing\n \nhow\n \nhealthcare\n \nsettings\n \nreproduce\n \nideologies\n \nof\n \nreproduction,\n \nwhich\n \ncan\n \nbe\n \ndamaging\n \nfor\n \nwomen\n \nand\n \nfeminized\n \nindividuals.\n \nThe\n \nmedical\n \nsector\n \nproduces\n \nespecially\n \npotent\n \nversions\n \nof\n \nthese\n \nideologies,\n \nconsidering\n \ntheir\n \nprimary\n \nrole\n \nhistorically\n \nin\n \nmoderating\n \npopulations'\n \nbodies,\n \nbehaviour\n \nand\n \nmorale\n \nthrough\n \nbiopower\n \n(Foucault,\n \n2002,\n \np.\n \n142),\n \nmaking\n \nSocialstyrelsens\n \naddress\n \nof\n \nsocial\n \naspects\n \nof\n \nfertility\n \nespecially\n \nrelevant,\n \nto\n \nensure\n \nthat\n \nmedical\n \nauthority\n \nover\n \npopulations\n \nis\n \nnot\n \nused\n \nin\n \ndiscriminatory\n \nways.\n \n6.2  Access  to  care  and  pain  -  Whose  pain  is  taken  seriously?  \n \nNow  onto  the  theme  of  access  to  care  and  pain.  Endometriosis  is  a  disease  largely  \ncharacterized\n \nby\n \npain,\n \nbeing\n \nthe\n \nmost\n \ncommon\n \nsymptom\n \nof\n \nthe\n \ndisease\n \n(Socialstyrelsen,\n \n2018,\n \np.\n \n11).\n \nThis\n \nsection\n \nanalyses\n \nthe\n \nways\n \nthe\n \ndocument\n \ndeals\n \nwith\n \nthe\n \nconcept\n \nof\n \npain,\n \nas\n \na\n \nthreshold\n \nsymptom\n \nto\n \nreceive\n \ntreatment,\n \nas\n \nwell\n \nas\n \nthe\n \nquestion\n \n“Whose\n \npain\n \nis\n \ntaken\n \nseriously?”.\n  How  does  Socialstyrelsen  describe  the  issue  of  pain?  They  state  that  one  of  the  largest  issues  \nin\n \nendometriosis\n \nhealthcare\n \nis\n \nthe\n \nmisinterpretation\n \nof\n \npain-symptoms.\n \nWhen\n \ndiscussing\n \nsuch\n  \nmisinterpretations,\n \nthey\n \nstate:\n  “Symptoms  being  misinterpreted  is  often  related  to  ignorance  regarding  \nendometriosis\n \nboth\n \nfrom\n \ncare\n \nseekers\n \nand\n \ncare\n \ngivers”\n \n(Socialstyrelsen,\n \n2018,\n \np.\n \n13)\n \n(my\n \ntranslation)\n  \n30  \n\n \nIgnorance  and  a  general  lack  of  knowledge  regarding  endometriosis  is  therefore  framed  as  a  \nlarge\n \ncontributor\n \nto\n \nmisinterpreted\n \nsymptoms,\n \nwhich\n \nis\n \nalso\n \nbrought\n \nup\n \nlater\n \nin\n \nthe\n \ndocument\n \nwhen\n \ndiscussing\n \nyoung\n \npeople\n \nwith\n \nendometriosis:\n  “A  challenge  for  young  people  is  that  severe  menstrual  pain  is  normalized  by  people  \nin\n \ntheir\n \nsurroundings,\n \nboth\n \nby\n \nclose\n \nfamily\n \nand\n \nfriends\n \nand\n \nhealthcare\n \nprofessionals.\n \nThe\n \nnormalisation\n \nusually\n \nhappens\n \nbecause\n \nof\n \na\n \nlack\n \nof\n \nknowledge\n:\n \nMany\n \nstill\n \nthink\n \nthat\n \nthere\n \nis\n \nnot\n \nmuch\n \nto\n \ndo\n \nabout\n \nmenstrual\n \npain”\n \n(Socialstyrelsen,\n \n2018,\n \np.\n \n81)\n \n(my\n \ntranslation\n \nand\n \nemphasis)\n  The  connection  between  normalisation  of  pain  and  lack  of  knowledge  regarding  \nendometriosis\n \nis\n \nrecognised\n \nby\n \nSocialstyrelsens\n \nguidelines,\n \nas\n \nseen\n \nin\n \nthe\n \nquotes\n \nabove.\n \nSocialstyrelsen\n \nalso\n \nnotes\n \nthe\n \nimportance\n \nof\n \ntaking\n \npatients\n \npain\n \nseriously:\n  “A  person's  experience  of  pain  should  never  be  doubted,  and  subjective  experience  \ncan\n \nnot\n \nbe\n \nquestioned,\n \nbut\n \nshould\n \ninstead\n \nbe\n \nunderstood\n \nfrom\n \nthe\n \npatients\n \nconveyed\n \nexperience”\n \n(Socialstyrelsen,\n \n2018,\n \np.\n \n80)\n \n(my\n \ntranslation)\n  “In  addition  it  is  important  to  meet  patients  with  respect,  care  and  to  be  perceptive  of  \ncontributing\n \ncauses\n \nfor\n \nthe\n \npain\n \nand\n \nthe\n \ncurrent\n \npsychosocial\n \nsituation”\n \n(Socialstyrelsen,\n \n2018,\n \np.\n \n38)\n \n(my\n \ntranslation)\n  In  these  quotes  Socialstyrelesn  highlights  the  importance  of  respecting  subjective  experiences  \nof\n \npain,\n \nindicating\n \nan\n \nopen\n \napproach\n \nto\n \npain\n \nassessment.\n \nAt\n \nthe\n \nsame\n \ntime,\n \nall\n \nexcept\n \none\n \nof\n \nthe\n \n32\n \nhealthcare\n \nrecommendations\n \nare\n \ntargeted\n \nonly\n \nat\n \nsevere\n \nor\n \nespecially\n \nsevere\n \ncases\n \nof\n \nthe\n \ndisease,\n \nincluding\n \nthe\n \nright\n \nto\n \nreceive\n \nexpert\n \nhealthcare,\n \nearly\n \nonset\n \ntreatment\n \nand\n \nstructured\n \nfollow-ups\n \nof\n \ntreatment\n \nplans.\n \nSocialstyrelsen\n \nmotivates\n \nthis\n \nby\n \nstating\n \nthat:\n  “...healthcare  should  prioritize  those  with  the  largest  need  for  care ”  \n(Socialstyrelsen,\n \n2018,\n \np.\n \n79)\n \n(my\n \ntranslation\n \nand\n \nemphasis)\n  Here,  Socialstyrelsen  uses  a  vague  formulation  (“largest  need  for  care”)  which  leaves  room  \nfor\n \nconnotative\n \ninterpretation,\n \nsomething\n \nthat\n \nis\n \ndiscussed\n \nfurther\n \nbelow.\n \nFurther,\n \nwhen\n \n31  \n\n \ndiscussing  this  issue  of  young  people  not  being  able  to  access  endometriosis  healthcare,  \nSocialstyrelsen\n \nstate\n \nthat:\n  “...Sweden  has  a  long  tradition  of  positive  and  tolerant  attitudes  towards  young  \npeople’s\n \nsexuality”\n \n(Socialstyrelsen,\n \n2018,\n \np.\n \n79)\n \n(my\n \ntranslation)\n  To  then  write:   “There  are  for  example  young  people  who  live  under  honor-based  oppression  or  \nother\n \nfamily-based\n \ncontrol\n \nthat\n \ndo\n \nnot\n \ndare\n \nto\n \nseek\n \ncare\n \nat\n \nyouth\n \nhealthcare\n \ncentres\n \nsince\n \nthese\n \nfacilities\n \nare\n \nassociated\n \nwith\n \nsexual\n \nrelations\n \nand\n \ncontraceptives”\n \n(Socialstyrelsen,\n \n2018,\n \np.\n \n80)\n \n(my\n \ntranslation\n \nand\n \nemphasis)\n  In  these  quotes,  the  term  “honour-based  oppression  is  used”.  Within  the  Swedish  context,  \nsuch\n \nterms\n \nare\n \nusually\n \nassociated\n \nwith\n \nviolence\n \ntowards\n \nracialized\n \nand/or\n \nimmigrant\n \ngirls-\n \nand\n \nwomen\n \nfrom\n \ntheir\n \nfamily\n \nand/or\n \npartners,\n \ngiven\n \nhow\n \nit\n \nhas\n \nbeen\n \nused\n \nby\n \npolicy-makers\n \nand\n \npoliticians\n \nin\n \nthe\n \npublic\n \nsphere.\n \nThis\n \nmeans\n \nthat\n \nquotes\n \nabove\n \ninteract\n \nwith\n \nSwedish\n \ndiscourses\n \nsurrounding\n \nrace,\n \nimmigration\n \nand\n \nfamily\n \nhierarchies,\n \nwhich\n \nwill\n \nbe\n \ndiscussed\n \nfurther\n \nbelow.\n \n \nWhat  are  the  discursive  assumptions  infiltrating  these  discussions  on  pain  in  the  guidelines?  \nGiacomozzi\n \net\n \nal.\n \n(2024)\n \nand\n \nother\n \nformer\n \nresearch\n \nsuggests\n \nthat\n \nmisinterpreted\n \nsymptoms\n \nand\n \ndiagnostic\n \ndelay\n \nwithin\n \nendometriosis\n \nhealthcare\n \nreflects\n \ndiscrimination\n \nagainst\n \nwomen,\n \ntrans\n \nand\n \nintersex\n \npeople\n \nby\n \nnormalising,\n \ntrivilaizing\n \nand\n \ngaslighting\n \ntheir\n \npain\n \nsymptoms.\n \nThis\n \nsuggests\n \nthat\n \nsocial\n \ndynamics\n \nplay\n \na\n \npart\n \nin\n \npublic\n \nhealth\n \ncare\n \ndiscourse\n \non\n \npain,\n \nand\n \ncan\n \nelucidate\n \nthe\n \nimplicit\n \nassumptions\n \nabout\n \npatients\n \nand\n \ntheir\n \ncommunities\n \nwithin\n \nthe\n \nSocialstyrelsens\n \nguidelines.\n \n  Socialstyrelsens  mentions  that  patients'  pain  symptoms  must  be  taken  seriously,  using  words  \nlike\n \nsubjective\n \nexperience\n \nand\n \npsychosocial,\n \nwhich\n \nhave\n \ndiscursive\n \nconnotations\n \nto\n \ncare\n \nframeworks\n \nwhich\n \nencompass\n \nhow\n \nsocial\n \ninjustice\n \nshapes\n \nthe\n \nways\n \nour\n \nexperiences\n \nare\n \ninterpreted.\n \nOne\n \ncould\n \ntherefore\n \nclaim\n \nthat\n \nSocialstyrelsens\n \nguidelines\n \ntie\n \ninto\n \nideologies\n \nwhich\n \npromote\n \nawareness\n \nof\n \nhow\n \nsocial\n \ninjustices\n \nshape\n \nsubjective\n \nexperience,\n \nproviding\n \nhealthcare\n \nprofessionals\n \nwith\n \nsufficient\n \ntools\n \non\n \nhow\n \nto\n \navoid\n \nbelittling\n \nand\n \nunderstating\n \npain\n \n32  \n\n \nsymptoms.  However,  the  issue  of  normalized  pain  is  only  generally  described  in  the  \nguidelines,\n \nexcluding\n \nsocial\n \nfactors\n \nwhich\n \nshape\n \nthe\n \ndismissal\n \nof\n \npain-related\n \nsymptoms\n \nin\n \nhealthcare\n \nsettings.\n \n  Given  that  medical  issues  affect  people  with  endometriosis  differently,  generalized  \nframeworks\n \nare\n \npartially\n \njustified,\n \nin\n \norder\n \nto\n \nmake\n \nhealthcare\n \nrecommendations\n \nadjustable\n \nfor\n \nindividual\n \nsymptoms.\n \nHowever,\n \ndiscussions\n \nfollowing\n \nthe\n \nguidelines\n \nhealthcare\n \nrecommendations\n \ncan\n \nstill\n \naddress\n \nhow\n \nthe\n \nsocial\n \nsituatedness\n \nof\n \npatients\n \n(such\n \nas\n \nclass,\n \nsexuality,\n \nwork\n \nsituation,\n \ndisability)\n \nmight\n \nnegatively\n \naffect\n \ntheir\n \nhealthcare\n \nexperiences\n \nin\n \nrelation\n \nto\n \npain,\n \nsomething\n \nthat\n \nSocialstyrelens\n \nguidelines\n \nfor\n \nendometriosis\n \ngenerally\n \nlack.\n \nThis\n \nincreases\n \nthe\n \nrisk\n \nof\n \nsocial\n \nperspectives\n \non\n \nhealthcare\n \nbeing\n \ninvisibilized,\n \na\n \npoint\n \nwhich\n \nhas\n \nbeen\n \nbrought\n \nup\n \nin\n \nformer\n \nresearch\n \non\n \ntheir\n \nguidelines\n \n(Topot,\n \n2010,\n \npp.\n \n70-74).\n \n  Invisibilizing  social  factors  which  shape  pain  experience  is  problematic  because  it  excludes  \nimportant\n \nnuances\n \nwithin\n \nhealthcare\n \ndiscrimination,\n \nwhich\n \nneed\n \nto\n \nbe\n \nhighlighted\n \nin\n \norder\n \nto\n \ncounteract\n \ndiscriminatory\n \npractices\n \n(Zajacova,\n \nGrol-Prokopczyk\n \n&\n \nZimmer,\n \n2021,\n \np.\n \n303).\n \nAs\n \nsociology\n \nof\n \nchronic\n \npain\n \nsuggests,\n \npain\n \nis\n \nnot\n \nmerely\n \na\n \nphysiological\n \ncondition,\n \nbut\n \na\n \nsocial\n \nphenomenon\n \nshaped\n \nby\n \nstructures\n \nof\n \noppression\n \n(Zajacova,\n \nGrol-Prokopczyk\n \n&\n \nZimmer,\n \n2021,\n \np.\n \n303).\n \nWhose\n \npain\n \nis\n \ntaken\n \nseriously,\n \nwhat\n \nsubjective\n \nexperience\n \nis\n \nrespected\n \nand\n \nwhat\n \npain\n \nis\n \nleft\n \nuntreated\n \nis\n \nshaped\n \nby\n \nhierarchies\n \nof\n \npower,\n \ndisadvantaging\n \nthose\n \nat\n \nthe\n \nbottom.\n \nWho\n \nmight\n \nbe\n \nconsidered\n \nas\n \nsomeone\n \n“in\n \nlarge\n \nneed\n \nof\n \ncare”\n \nis\n \nnot\n \nan\n \nobjective\n \nmarker,\n \nbut\n \nrather\n \na\n \nthreshold\n \nshaped\n \nby\n \nthe\n \ndiscriminatory\n \nforces\n \nthat\n \nexist\n \nin\n \nsociety.\n \nWomen,\n \ntrans/intersex\n \npeople,\n \npeople\n \nof\n \ncolour,\n \ndisabled\n \npeople\n \netc.\n \nhave\n \nhistorically\n \nnot\n \nbeen\n \ntaken\n \nseriously\n \nfor\n \ntheir\n \nsymptoms.\n \nTheir\n \nexpressions\n \nof\n \npain\n \nhave\n \nbeen\n \nhystersized,\n \nstigmatized\n \nand\n \nlabelled\n \nas\n \n“dramatic”,\n \nundermining\n \ntheir\n \nepistemic\n \npositions,\n \nwhich\n \nis\n \ninformed\n \nby\n \nthe\n \nandrocentric,\n \ncisnormative,\n \nableist\n \nand\n \ncolonial\n \nheritage\n \nof\n \nthe\n \nmedical\n \nsciences,\n \na\n \nheritage\n \nwhich\n \ndiscursively\n \ninforms\n \ncurrent\n \nhealthcare\n \npractices,\n \nmaking\n \nit\n \nrelevant\n \nto\n \naddress\n \nin\n \ncurrent\n \nhealthcare\n \nguidelines.\n \n  Although  they  lack  nuance  and  explicitly,  the  guidelines  does  briefly  mention  women  and  \ntrans\n \npeople\n \nas\n \npossible\n \npatient\n \ngroups\n \nfor\n \nendometriosis\n \nhealthcare,\n \nwhereas\n \nfor\n \nexample\n \nracialized\n \npatients\n \nare\n \nnot\n \nmentioned\n \nat\n \nall.\n \nIn\n \norder\n \nto\n \nunderstand\n \nthe\n \ndiverging\n \nqualities\n \nof\n \nsocial\n \nmarginalisation,\n \naccounting\n \nfor\n \nall\n \nforms\n \nof\n \nhealthcare\n \ndiscrimination\n \n(going\n \nbeyond\n \ncategories\n \nof\n \ngender\n \nand\n \nsexuality)\n \nis\n \nkey\n \nfor\n \ndismantling\n \nthe\n \nsystems\n \nwhich\n \ncontinuously\n \n33  \n\n \nallow  this  discrimination  to  occur  (Shahvisi,  2022,  pp.  210-211).  This  ties  into  the  logics  of  \nintersectionality,\n \nwhich\n \nclaim\n \nthat\n \nsocial\n \noppressions\n \ndo\n \nnot\n \nexist\n \nisolated\n \nfrom\n \none\n \nanother,\n \nbut\n \nrather\n \nthat\n \nthey\n \noverlap\n \nin\n \nnuanced\n \nand\n \ncomplicated\n \nways,\n \nintertwining\n \nthem\n \nin\n \nways\n \nwhich\n \nrequire\n \ncritical\n \nanalysis\n \nto\n \nnot\n \nonly\n \nlook\n \nat\n \none\n \nbut\n \nmany\n \nintersecting\n \nforms\n \nof\n \noppression\n \nwhen\n \ndiscussing\n \nsocial\n \nissues\n \n(Shahvisi,\n \n2022,\n \npp.\n \n210-211).\n \nBy\n \nnot\n \naddressing\n \nthe\n \nissues\n \nof\n \nracialized\n \npatients,\n \nSocialstyrelsens\n \nguidelines\n \nweaken\n \nits\n \nintersectional\n \npotential,\n \nand\n \nmight\n \nalso\n \nbe\n \nat\n \nthe\n \nrisk\n \nof\n \nbeing\n \nblind\n \nof\n \nracial\n \nbias\n \nthemselves.\n  Quotes  above  which  address  “honour  based  oppression”,  could  be  seen  as  unproblematic  \nstances\n \nfor\n \nsexual\n \nliberation\n \nof\n \nyoung\n \npatients,\n \nand\n \nas\n \nencouragement\n \nfor\n \nhealthcare\n \nprofessionals\n \nto\n \nstand\n \ntheir\n \nground\n \nwhen\n \ndealing\n \nwith\n \nintolerant\n \nparental\n \nfigures.\n \nBut\n \nby\n \nstating\n \nthat\n \nSweden\n \n(encompassing\n \nthe\n \nnation\n \nas\n \nwell\n \nas\n \nthose\n \nconsidered\n \nas\n \nrepresentatives\n \nfor\n \nits\n \nvalues)\n \nhas\n \na\n \nlong\n \ntradition\n \nof\n \nencouraging\n \ntolerant\n \nattitudes\n \ntowards\n \nyoung\n \npeople’s\n \nreproductive\n \nhealth,\n \nit\n \nbecomes\n \ntricky\n \nto\n \nuse\n \nterms\n \nlike\n \n“honour-based\n \noppression”,\n \nsince\n \nthey\n \nindicate\n \nsocial\n \nbiases\n \nrelated\n \nto\n \nracialized\n \ncommunities.\n \nAs\n \nFoucault\n \nstates,\n \ndiscourse\n \nrelies\n \non\n \nassumptions,\n \nwhich\n \nconstitute\n \nhow\n \nthose\n \nwho\n \nexist\n \nwithin\n \ndiscourse\n \nview\n \nsubjects\n \nas\n \nwell\n \nas\n \nreality\n \nas\n \na\n \nwhole\n \n(Foucault,\n \n1972,\n \npp.\n \n37-38).\n \nWhat\n \ncontexts\n \nthat\n \n“honour\n \nbased\n \noppression”\n \nhas\n \nbeen\n \nused\n \nin\n \npreviously,\n \ndetermines\n \nwhat\n \nthese\n \nassumptions\n \nare\n \nconstituted\n \nby.\n \nAs\n \nmentioned\n \nabove,\n \n“honour-based\n \noppression”\n \nis\n \na\n \npolitically\n \nloaded\n \nterm,\n \nused\n \nin\n \nvarying\n \npolitical\n \ndiscourses\n \nsurrounding\n \nthe\n \noppression\n \nof\n \nprimarily\n \nimmigrant\n \nand/or\n \nracialized\n \nwomen-\n \nand\n \ngirls\n \nby\n \ntheir\n \nfamilies.\n \nWith\n \nor\n \nwithout\n \nintending\n \nto,\n \nframing\n \nyoung\n \npeople’s\n \nlack\n \nof\n \naccess\n \nto\n \nendometriosis\n \nhealthcare\n \nas\n \nrelated\n \nto\n \n“honour-based\n \noppression”,\n \nis\n \nat\n \nthe\n \nrisk\n \nof\n \ncreating\n \nbiases\n \ntowards\n \nracialized\n \ncommunities,\n \nwhich\n \nassumes\n \ntheir\n \nresistance\n \ntowards\n \n“modern”\n \nand\n \n“tolerant”\n \nmedical\n \nservices\n \nand\n \npatriarchal\n \nfamily\n \nstructures\n \nwithin\n \nthem,\n \naffirming\n \nracial\n \nstereotypes\n \n(Shahvisi,\n \n2022,\n \npp.\n \n210-211).\n \n  In  the  context  of  medicine,  biases  become  especially  potent  given  the  colonial  heritage  of  the  \nmedical\n \nsciences\n \n(Shahvisi,\n \n2022,\n \npp.\n \n210-211).\n \nBy\n \nnot\n \naddressing\n \nthe\n \nsocial\n \nbiases\n \nwhich\n \nexist\n \namongst\n \nmedical\n \nprofessionals,\n \nSocialstyrelsen\n \nis\n \n(as\n \npreviously\n \nmentioned)\n \nat\n \nthe\n \nrisk\n \nof\n \nincreasing\n \ndelays\n \nfor\n \ndiagnosis\n \nand\n \nmisinterpreted\n \nsymptoms,\n \ngiven\n \nthese\n \nissues\n \nlinkage\n \nto\n \none\n \nanother\n \naccording\n \nto\n \nformer\n \nresearch\n \nsuch\n \nas\n \nGiacomozzi\n \net\n \nal.\n \n(2024).\n \nThis\n \ndisplays\n \nthe\n \nimportance\n \nof\n \nintersectional\n \nanti-discrimination\n \nwork\n \nin\n \norder\n \nto\n \nmediate\n \nissues\n \nwithin\n \nthe\n \nmedical\n \nsector\n \n(Shahvisi,\n \n2022,\n \npp.\n \n210-211).\n \n \n34  \n\n \n6.3  Cost  efficiency  and  workfare  -  Patients  in  the  realm  of  the  neoliberal  order  \n \nIn  this  section,  I  discuss  cost-efficiency  as  a  guiding  principle  in  my  material,  as  well  as  its  \nlinkages\n \nto\n \nworkfare,\n \na\n \nterm\n \nreferring\n \nto\n \nneoliberal\n \norders\n \nof\n \nwelfare\n \npolicy\n \nwith\n \nactivation\n \nrequirements\n \nas\n \ndirect\n \nor\n \nmoral\n \nthresholds\n \nto\n \naccess\n \nwelfare\n \nservices.\n \n  When  discussing  the  benefits  of  endometriosis  treatment,  Socialstyrelsen  writes:   “The  goal  of  all  treatment  of  suspected  or  verified  endometriosis  is  that  the  patient     \nshould\n \nattain\n \na\n \ngood\n \nfunctionality\n \nlevel,\n \nwith\n \nmanageable\n \nsymptoms\n \nwithout\n \nsubstantial\n \nside-effects\n \nof\n \ntreatment.\n \nFor\n \npeople\n \nwith\n \npronounced\n \nsymptoms,\n \ntreatment\n \noften\n \nfocuses\n \nnot\n \nonly\n \non\n \nmaking\n \nsymptoms\n \nmanageable,\n \nbut\n \nto\n \nmake\n \nit\n \npossible\n \nfor\n \npatients\n \nto\n \nreturn\n \nto\n \nstudies,\n \nwork\n \nor\n \nother\n \noccupations\n \nas\n \nwell\n \nas\n \nto\n \nregain\n \nsocial\n \nfunction\n \nand\n \nlife\n \nquality”\n \n(Socialstyrelsen,\n \n2018,\n \np.\n \n14)\n \n(my\n \ntranslation\n \nand\n \nemphasis)\n  Here,  Socialstyrelsen  frames  being  able  to  return  to  one’s  occupation  and  regaining  a  “good  \nfunctionality\n \nlevel”\n \nas\n \none\n \nof\n \nthe\n \noverarching\n \ngoals\n \ntogether\n \nwith\n \nregaining\n \nsocial\n \nfunction,\n \nmaking\n \nsymptoms\n \nmanageable\n \nand\n \nincreasing\n \nlife\n \nquality.\n \n  To  further  motivate  the  guidelines,  Socialstyrelsen  writes:   “Endometriosis  entails  large  societal  costs,  both  direct  costs  for  healthcare  and  \nindirect\n \ncosts\n \nthrough\n \nsick\n \nleave.\n \nThese\n \nguidelines\n \nentail\n \nthat\n \nendometriosis\n \nhealthcare\n \nrequires\n \nmore\n \nresources\n \nin\n \nthe\n \nshort\n \nterm.\n \nThe\n \nrecommendations\n \nare\n \nhowever\n \nexpected\n \nto\n \nincrease\n \nthe\n \nquality\n \nof\n \nendometriosis\n \nhealthcare,\n \nso\n \nthat\n \nurgent\n \ncare,\n \ninlays\n \nand\n \nsick\n \nleave\n \ndecreases,\n \nwhich\n \nwill\n \nlower\n \ncosts\n \nin\n \nthe\n \nlong\n \nrun\n”\n \n(Socialstyrelsen,\n \n2018,\n \np.\n \n8)\n \n(my\n \ntranslation\n \nand\n \nemphasis)\n  Socialstyrelsen  therefore  justifies  the  increased  short  term  resources  needed  because  of  the  \nguideline\n \nrequirements,\n \nwith\n \nthe\n \nlower\n \ncosts\n \nthat\n \nincreased\n \nquality\n \nof\n \ncare\n \nwill\n \nlead\n \nto\n \nin\n \nthe\n \nlong\n \nrun.\n   \n35  \n\n \nThis  is  informed  by  the  principle  of  cost  efficiency,  from  the  three  principles  of  priority  of  the  \nproposition\n \n“Priorities\n \nwithin\n \nhealthcare”:\n  “Equal  healthcare  is  also  connected  to  the  three  principles  of  priority  which  are  \nincluded\n \nin\n \nthe\n \nethical\n \nplattform\n \nof\n \nthe\n \n“Priorities\n \nwithin\n \nhealthcare”\n \nproposition\n \n(prop.\n \n1996/97:60):\n \nthe\n \nprinciple\n \nof\n \nhuman\n \nvalue,\n \nprinciples\n \nof\n \nneed-\n \nand\n \nsolidarity\n \nand\n \nthe\n \nprinciple\n \nof\n \ncost\n \nefficiency\n.”\n \n(Socialstyrelsen,\n \n2018,\n \np.\n \n79)\n \n(my\n \ntranslation)\n  In  this  quote,  cost  efficiency  is  equated  with  the  principles  of  human  value  and  solidarity,  \ndisplaying\n \nfinancial\n \npriorities\n \nof\n \nthe\n \nstate.\n \nCost\n \nefficiency\n \nin\n \nthis\n \ncontext\n \nrefers\n \nto\n \nthe\n \ngeneral\n \nidea\n \nof\n \ntrying\n \nto\n \nminimize\n \neconomical\n \nlosses\n \nwhen\n \nplanning,\n \nexecuting\n \nand\n \nevaluating\n \nstrategies\n \nfor\n \nimprovement\n \nwithin\n \nwelfare,\n \nwhich\n \nties\n \ninto\n \nneoliberal\n \nideologies.\n \nThrough\n \nframing\n \nthose\n \nin\n \nneed\n \nof\n \nwelfare\n \nservices\n \nas\n \nsources\n \nof\n \ncost,\n \ntheir\n \nneeds\n \nare\n \nquantified\n \nto\n \nmake\n \nsure\n \nthat\n \nwelfare\n \npolicies\n \nare\n \nas\n \nprofitable\n \nas\n \npossible\n \nfor\n \nthe\n \nstate\n \n(Lodemel\n \n&\n \nGubrium\n \net\n \nal,\n \n2014,\n \np.\n \n344).\n  \nIn  quotes  above,  Socialstyrelsen  brings  up  “good  functionality”  (attained  through  entertaining  \none’s\n \nmain\n \nsource\n \nof\n \nincome)\n \nas\n \none\n \nof\n \nthe\n \ndesirable\n \neffects\n \nof\n \nendometriosis\n \ntreatment,\n \nwhich\n \nties\n \ninto\n \ndiscourses\n \nof\n \nworkfare.\n \nExpressions\n \nof\n \ndisability\n \nlike\n \nsick-leave\n \nand\n \ninlays\n \nare\n \nstigmatized\n \nby\n \nbeing\n \nportrayed\n \nas\n \ndeviant\n \nto\n \nnormal\n \nfunction\n \n(Soldatic\n \n&\n \nMeekosha,\n \n2012,\n \npp.\n \n142-143),\n \nwhen\n \ndegrees\n \nof\n \nwork\n \nabsence\n \nand\n \ninlays\n \nmight\n \nnot\n \nonly\n \nbe\n \nexpressions\n \nof\n \nfaulty\n \nhealthcare\n \nservices,\n \nbut\n \narticulations\n \nof\n \ndiffering\n \nabilities\n \nof\n \nthe\n \npopulation.\n \nIn\n \nformations\n \nof\n \nworkfare,\n \nactivation\n \nrequirements\n \nact\n \nas\n \neither\n \ndirect\n \nthresholds\n \nfor\n \nwelfare\n \nservices\n \n(Lodemel\n \n&\n \nMoreira,\n \n2014,\n \np.\n \n2)\n \nor\n \nas\n \nindirect\n \nmoralizing\n \ntactics\n \ndirected\n \ntowards\n \nthose\n \nwho\n \nseek\n \nwelfare\n \nservices\n \n(Soldatic\n \n&\n \nMeekosha,\n \n2012,\n \npp.\n \n142-143).\n \nSocialstyrelsen\n \nmight\n \ntherefore,\n \nthrough\n \ncentering\n \nwork\n \ncapabilities\n \nin\n \nrelation\n \nto\n \ntreatment\n \nsuccess,\n \nreinforce\n \npractices\n \nwhere\n \nwelfare\n \nservices\n \nare\n \ngatekept\n \nfrom\n \nworkless\n \nindividuals,\n \none’s\n \nability\n \nto\n \nwork\n \nis\n \nvalued\n \nover\n \none’s\n \nwell-being,\n \nand\n \nwhere\n \ntreatment\n \nsuccess\n \nis\n \nmeasured\n \nthrough\n \nactivation\n \nrates\n \nrather\n \nthan\n \npatients\n \nemotional\n \nexperience.\n \n  What  is  considered  as  “good  functionality”  is  also  discursively  formated,  informed  by  ableist  \nassumptions\n \nof\n \nwork\n \ncapabilities.\n \nCentering\n \n“good\n \nfunctionality”\n \nas\n \ngoals\n \nof\n \nendometriosis\n \nhealthcare,\n \nmight\n \ntherefore\n \nreinforce\n \nableist\n \nstereotypes\n \nof\n \nabjection,\n \nmaking\n \nthose\n \nunable\n \nto\n \nattain\n \nsocieties\n \ndemands\n \non\n \nfunctionality\n \ninto\n \nabject\n \nbeings\n \n(Soldatic\n \n&\n \nMeekosha,\n \n2012,\n \npp.\n \n36  \n\n \n142-143).  As  Soldic  &  Meekosha  (2012)  reason,  this  neoliberal  process  of  abjection  is  \ninformed\n \nby\n \ndisgust,\n \nnot\n \nonly\n \ntowards\n \nthe\n \ndisabled,\n \nbut\n \ntowards\n \nwomen,\n \nlower-class\n \nindividuals\n \nand\n \nothers\n \nconsidered\n \nlesser\n \ndeserving\n \nof\n \nwelfare\n \nservices\n \n(Soldatic\n \n&\n \nMeekosha,\n \n2012,\n \npp.\n \n142-143).\n \nFrameworks\n \nwhich\n \nallow\n \nthese\n \nfeelings\n \nof\n \ndisgust\n \nto\n \nexist,\n \nmight\n \nreinforce\n \ninstitutional\n \nand\n \nindividual\n \ndiscriminatory\n \npractices\n \nwhich\n \ndo\n \nnot\n \nonly\n \ndeem\n \nsome\n \nas\n \nundeserving\n \nof\n \nwelfare\n \nservices,\n \nbut\n \nunworthy\n \nof\n \nrespect\n \nand\n \ncare.\n \nAgain,\n \nthis\n \nis\n \nnot\n \nto\n \nsay\n \nthat\n \nSocialstyrelsen\n \nhas\n \nexplicit\n \nableist\n \nintentions\n \nwith\n \ntheir\n \nguidelines,\n \nbut\n \nthat\n \nthey\n \nthrough\n \nthe\n \nuse\n \nof\n \nableist\n \nlanguage\n \nmight\n \nreinforce\n \ndiscursive\n \nformations\n \nwhich\n \njustify\n \nmistreatment,\n \ninformed\n \nby\n \nableism.\n  The  principle  of  cost-efficiency  is  informed  by  workfare  discourse,  where  policy  makers  are  \nwilling\n \nto\n \ncapitalize\n \noff\n \npublic\n \nideas\n \nwhich\n \nconsider\n \nworkless,\n \npoor\n \nand\n \ndisabled\n \nindividuals\n \nas\n \nan\n \neconomic\n \nburden\n \non\n \nsociety\n \n(Lodemel\n \n&\n \nGubrium,\n \n2014,\n \np.\n \n344).\n \nSocialstyrelsen\n \nand\n \nthe\n \nSwedish\n \nstate\n \ncan\n \ntherefore\n \neconomically\n \nbenefit\n \nfrom\n \nactivation\n \nparadigms\n \n(on\n \nthe\n \nexpense\n \nof\n \nthose\n \nwhich\n \nmight\n \nnot\n \nreach\n \ntheir\n \nrequirements)\n \nwhich\n \ncan\n \nmotivate\n \nstate\n \ninstitutions'\n \nreluctance\n \ntowards\n \nremoving\n \nthe\n \nableism\n \nembedded\n \nin\n \ntheir\n \narguments.\n \nUltimately,\n \nthis\n \naffects\n \nendometriosis\n \npatients\n \nnegatively,\n \nconsidering\n \nthat\n \nthe\n \ndisease\n \n(for\n \nmany)\n \nis\n \ncharacterized\n \nby\n \nchronic\n \npain,\n \nwhich\n \nmight\n \n(even\n \nwhen\n \ntreated)\n \naffect\n \ntheir\n \nability\n \nto\n \nattain\n \nwhat\n \nis\n \ndiscursively\n \nconsidered\n \nas\n \n“good\n \nfunctionality”,\n \nwhilst\n \nstill\n \nmaintaining\n \ntheir\n \nlives\n \nand\n \nwellbeing.\n  Cost-efficiency  might  also  explain  Socialstyrelsen  centralizing  fertility,  as  described  in  the  \nfirst\n \nsection\n \nin\n \nthe\n \nanalysis.\n \nButler\n \ntheorizes\n \nthat\n \nstate\n \ninstitutions\n \nutilize\n \nbiopower\n \nto\n \nensure\n \nthe\n \ncontinued\n \nreproduction\n \nof\n \nthe\n \nlabour\n \nforce,\n \nmaking\n \nfertility\n \npreservation\n \na\n \nrelevant\n \nissue\n \nfor\n \nthe\n \ncapitalist\n \neconomy\n \n(Butler,\n \n2011,\n \npp.\n \nxi-xii).\n \nThis\n \nmight\n \nexplain\n \nwhy\n \nthe\n \nguidelines\n \nskew\n \ntowards\n \nboth\n \nupholding\n \nactivation\n \nstandards\n \nas\n \nwell\n \nas\n \nfertility\n \npreservation,\n \nconsidering\n \nthat\n \nboth\n \nof\n \nthese\n \ncan\n \nbe\n \nseen\n \nas\n \nstrategies\n \naimed\n \nat\n \nraising\n \nnativity\n \nand\n \nproductivity,\n \nwhich\n \nis\n \nespecially\n \nrelevant\n \nconsidering\n \nthat\n \nSweden\n \nis\n \na\n \ncountry\n \nwith\n \nlow\n \nbirth\n \nrates,\n \nincreasing\n \nstate\n \ninterests\n \nin\n \nhigher\n \nreproduction\n \nof\n \nits\n \npopulation.\n \n \n6.4  Gendered  ambivalence  -  Who  is  the  patient  group  for  endometriosis?   \nThis  last  theme  addresses  the  question  “who  is  the  patient  group  for  endometriosis?”  by  \nanalyzing\n \nhow\n \nSocialstyrelsen\n \nuses\n \ngendered\n \nlanguage\n \nto\n \ndefine\n \npatient-groups.\n  \n37  \n\n \nSocialstyrelsen  starts  off  the  guidelines  by  stating:    “Endometriosis  affects  one  in  ten  women  at  a  fertile  age.  That  means  that  \napproximately\n \n250\n \n000\n \nwomen\n \nin\n \nSweden\n \nhave\n \nthe\n \ndisease,\n \nbut\n \nnot\n \neveryone\n \nexperiences\n \nsevere\n \nsymptoms”\n \n(Socialstyrelsen,\n \n2018,\n \np.\n \n7)\n \n(my\n \ntranslation\n \nand\n \nemphasis).\n  Here,  on  the  very  first  page  of  the  guidelines,  women  are  framed  as  the  only  possible  patient  \ngroup\n \nfor\n \nendometriosis,\n \ncreating\n \na\n \nclear\n \nimage\n \nof\n \nwhat\n \ndemographic\n \nSocialstyrelsen\n \nconveys\n \nas\n \nrelevant\n \nfor\n \nthe\n \ndisease.\n \nWhen\n \ndiscussing\n \nthe\n \nissue\n \nof\n \nnormalized\n \npain,\n \nand\n \ndiagnostic\n \ndelay,\n \nSocialstyrelsen\n \nstates:\n  “It  is  therefore  vital  to  increase  awareness  regarding  the  state  of  primary  and  student  \nhealthcare,\n \nto\n \nbe\n \nable\n \nto\n \nprovide\n \ncare\n \nfor\n \nthose\n \ngirls\n \nand\n \nwomen\n \nthat\n \nexperience\n \nsymptoms\n \nconnected\n \nto\n \nendometriosis”\n \n(Socialstyrelsen,\n \n2018,\n \np.\n \n13)\n \n(my\n \ntranslation\n \nand\n \nemphasis)\n  In  this  quote  Socialstyrelsens  affirms  their  portrayal  of  endometriosis  as  a  women's  issue,  by  \ndescribing\n \nall\n \nwho\n \nexperience\n \nsymptoms\n \nconnected\n \nto\n \nendometriosis\n \nas\n \n“girls\n \nand\n \nwomen”.\n \nAnd\n \nwhen\n \nevaluating\n \ncurrent\n \nendometriosis\n \nhealthcare,\n \nSocialstyrelsen\n \nuses\n \ndata\n \nregarding\n \nthe\n \ntreatment\n \nof\n \nwomen:\n \n  “Socialstyrelsen  assess  that  approximately  62  000  women  with  endometriosis  are  \nundertreated\n \nand\n \nwould\n \nneed\n \nbasal\n \nhormonal\n \ntreatment”\n \n(Socialstyrelsen,\n \n2018,\n \np.\n \n61)\n \n(my\n \ntranslation)\n  “Today,  approximately  1500  women  with  endometriosis  are  operated  using  \nlaparoscopy”\n \n(Socialstyrelsen,\n \n2018,\n \np.\n \n63)\n \n(my\n \ntranslation)\n  “Socialstyrelsen  assess  that  approximately  25  000  women  with  pain  have  insufficient  \neffects\n \nof\n \nbasal\n \nhormonal\n \ntreatment”\n \n(Socialstyrelsen,\n \n2018,\n \np.\n \n63)\n \n(my\n \ntranslation)\n  All  of  the  quotes  mentioned  above  are  examples  of  the  feminization  of  endometriosis  in  the  \nguidelines.\n \nWomen\n \nare\n \nmentioned\n \nas\n \nthe\n \nonly\n \npossible\n \npatient\n \ngroup,\n \nand\n \ndata\n \nused\n \nto\n \nmake\n \n38  \n\n \nconclusions  regarding  current  healthcare  services  only  concern  women.  This  is  likely  \ninformed\n \nby\n \na\n \nlarger\n \ngovernmental\n \ninvestment\n \nin\n \n“women’s\n \nhealth”,\n \nwhich\n \ninformed\n \nthe\n \ngovernmental\n \ncommission\n \nfor\n \nSocialstyrelsens\n \nguidelines\n \nfor\n \nendometriosis:\n  “Socialstyrelsen  has  been  commissioned  to  produce  national  guidelines  for  \nendometriosis\n \nhealthcare\n \n(S2015/08111/FS\n \noch\n \nS2016/00846/FS\n \n(partially)).\n \nThe\n \nbackground\n \nfor\n \nthis\n \ncommission\n \nis\n \ngovernment\n \ninvestment\n \nin\n \nwomen's\n \nhealth\n”\n \n(Socialstyrelsen,\n \n2018,\n \np.\n \n9)\n \n(my\n \ntranslation\n \nand\n \nemphasis)\n  The  Swedish  government  labelling  endometriosis  as  a  women’s  issue  in  the  quote  above,  has  \ndiscursive\n \npower\n \nover\n \nthe\n \nfeminized\n \ndescriptions\n \nmade\n \nin\n \nthe\n \nguidelines,\n \nconsidering\n \nthe\n \npower\n \ngovernmental\n \nofficials\n \nhave\n \nover\n \nlabelling\n \npopulations.\n \n  However,  Socialstyrelsen  state  later  in  the  document  under  the  title  “norm  conscious  \ntreatment”\n \nthat:\n  “Endometriosis  is  a  disease  related  to  the  uterus  and  menstruation.  It  is  often  women  \nwho\n \nare\n \naffected,\n \nbut\n \nit\n \nis\n \nimportant\n \nto\n \nnote\n \nthat\n \npeople\n \nwith\n \nother\n \ngender\n \nidentities\n \nor\n \nexpressions\n \ncan\n \nseek\n \ncare\n \nfor\n \nendometriosis.\n \nIt\n \ncan\n \nfor\n \nexample\n \nbe\n \nuncomfortable\n \nfor\n \na\n \nman\n \nor\n \na\n \nperson\n \nwith\n \na\n \nnormative\n \nmasculine\n \ngender\n \nexpression\n \nto\n \nsit\n \nin\n \na\n \nwaitroom\n \nmostly\n \nmeant\n \nfor\n \nwomen.\n \nIt\n \nis\n \nthen\n \nimportant\n \nto\n \ntreat\n \npatients\n \nwith\n \nrespect\n \nand\n \nto\n \nnot\n \nquestion\n \nthe\n \ngender\n \nidentity\n \nof\n \nthe\n \nperson\n \nwho\n \nseeks\n \nhealthcare”\n \n(Socialstyrelsen,\n \n2018,\n \np.\n \n81)\n \n(my\n \ntranslation)\n  In  this  quote,  Socialstyrelsen  points  to  the  hardships  that  transmasculine  people  might  \nexperience\n \nwithin\n \nendometriosis\n \nhealthcare,\n \nreferring\n \nto\n \nthe\n \npossible\n \ndiscriminatory\n \neffects\n \nof\n \nforceful\n \nfeminization.\n \nBut\n \nsimultaneously,\n \nSocialstyrelsen\n \ncontributes\n \nto\n \nthis\n \nfeminization\n \nby\n \nframing\n \nwomen\n \nas\n \nthe\n \nonly\n \npossible\n \npatient\n \ngroup\n \nfor\n \nendometriosis\n \nhealthcare\n \nin\n \nother\n \nparts\n \nof\n \nthe\n \ndocument,\n \nas\n \nshown\n \nin\n \nthe\n \nquotes\n \nabove,\n \nsignalling\n \na\n \ngendered\n \nambivalence\n \nin\n \nthe\n \ndocument.\n  The  gendered  ambivalence  in  the  material  is  furthered  by  the  disperse  of  gendered  language  \nin\n \nthe\n \ndocument.\n \n“Women(s)”,\n \n“woman”\n \nand\n \n“girl(s)”\n \nare\n \nused\n \nin\n \nthe\n \ndocument\n \n33\n \ntimes,\n \nwhereas\n \nthe\n \ngender-neutral\n \nterm\n \n“people\n \nwith\n \nendometriosis”\n \nis\n \nused\n \n120\n \ntimes\n \n39  \n\n \n(Socialstyrelsen,  2018).  Gender  neutral  descriptions  of  patients  are  more  common  in  the  \nsections\n \nwhich\n \ndescribe\n \nhealthcare\n \nrecommendations\n \nand\n \nquantitative\n \nindicators\n \n(“People\n \nwith\n \nendometriosis”\n \nis\n \nused\n \n106\n \ntimes\n \nin\n \nthis\n \nsection\n \nand\n \n“women(s)”\n \nis\n \nused\n \nonly\n \n6\n \ntimes),\n \nwhereas\n \ngendered\n \nlanguage\n \nappear\n \nas\n \nmore\n \nfrequent\n \nthe\n \nother\n \nparts\n \nof\n \nthe\n \nmaterial\n \nwhere\n \nendometriosis\n \nhealthcare\n \nis\n \nevaluated\n \nand\n \ncontextualized\n \nin\n \nsociety\n \n(“People\n \nwith\n \nendometriosis”\n \nis\n \nused\n \n14\n \ntimes\n \nin\n \nthis\n \nsection\n \nand\n \n“women(s)”,\n \n“woman”\n \nand\n \n“girl(s)”\n \nis\n \nused\n \n27\n \ntimes).\n \nOne\n \ncan\n \ndismiss\n \nthese\n \nexamples\n \nof\n \nfeminization\n \nand\n \ngendered\n \nambivalence\n \nas\n \nsimply\n \nclumsy\n \nattempts\n \nat\n \ninclusivity,\n \nbut\n \nI\n \nthink\n \nthere\n \nlies\n \nsomething\n \ndeeper\n \nin\n \nthese\n \ntendencies.\n \n  Endometriosis  is  a  reproductive  disease,  related  to  the  uterus,  ovaries  and  menstruation.  \nThese\n \nare\n \nbodily\n \nfunctions\n \nwhich\n \nare\n \nconnected\n \nto\n \nwhat\n \nis\n \ndiscursively\n \nreferred\n \nto\n \nas\n \nthe\n \n“female\n \nsex”\n \n(including\n \npeople\n \nborn\n \nwith\n \na\n \nvagina,\n \nuterus,\n \novaries\n \nand\n \nXX\n \nchromosomes).\n \nButler\n \nreasons\n \nthat\n \nsexual\n \nfunction\n \nis\n \nnot\n \nviewed\n \nas\n \nmerely\n \nbiological\n \nwithin\n \nthe\n \nheterosexual\n \nmatrix,\n \nbut\n \nmanifestations\n \nof\n \ngender,\n \nexplaining\n \nhow\n \nsignifiers\n \nof\n \nthe\n \n“female\n \nsex”\n \noften\n \nare\n \nconsidered\n \ninterchangeable\n \nwith\n \nthe\n \nsocial\n \ncategory\n \nof\n \nwoman\n \n(Butler,\n \n2011,\n \npp.\n \nxi-xii).\n \nAlthough\n \nSocialstyrelsen\n \nmakes\n \nattempts\n \nat\n \nincluding\n \nother\n \ngendered\n \nembodiements\n \nthan\n \nwomen,\n \nit\n \nis\n \nlikely\n \nthat\n \ndiscursive\n \nideas\n \nof\n \nreproductive\n \nfunctions,\n \nsex\n \nand\n \ngender\n \ninforms\n \ntheir,\n \nand\n \nthe\n \nSwedish\n \ngovernments,\n \nlabelling\n \nof\n \nendometriosis\n \nas\n \nprimarily\n \na\n \nwomen’s\n \nissue.\n \n Butler's  theories  relies  on  the  idea  of  the  heterosexual  matrix,  an  ideology  which  promotes  \nheterosexuality\n \nand\n \nbinary\n \ngender\n \ncategories\n \nas\n \nthe\n \nstatus\n \nquo,\n \ninfiltrating\n \nall\n \nparts\n \nof\n \nsociety\n \n(Butler,\n \n2011,\n \npp.\n \nxi-xii).\n \nNormative\n \nsexuality\n \nand\n \ngender,\n \ninformed\n \nby\n \nthe\n \nheterosexual\n \nmatrix,\n \nare\n \nhighly\n \nnaturalized,\n \nmaking\n \nthe\n \nideology\n \ninvisibilized\n \nand\n \noften\n \nregarded\n \nas\n \nindisputable\n \nfact.\n \nTherefore,\n \ndominant\n \ndiscourses\n \nof\n \ngender\n \nin\n \nSweden\n \ndoes\n \nnot\n \nquestion\n \nthat\n \nall\n \npeople\n \nwith\n \nuteruses\n \nare\n \nwomen,\n \nbut\n \npromotes\n \nit\n \nas\n \na\n \nfact,\n \nwhich\n \ninforms\n \nthe\n \nfeminization\n \nof\n \nendometriosis\n \nmade\n \nin\n \nSocialstyrelsens\n \nguidelines.\n \nDiscursive\n \nformations\n \nthat\n \nquestion\n \nthe\n \nnaturalisation\n \nof\n \nsex\n \nand\n \ngender\n \nexist\n \nin\n \nSwedish\n \nsociety,\n \nbut\n \nare\n \nsubordinate\n \nto\n \nthose\n \nthat\n \ndo,\n \nespecially\n \nin\n \nmedical\n \nsettings,\n \nwhich\n \nmight\n \nexplain\n \ntheir\n \ngeneral\n \npresence\n \nin\n \nmy\n \nmaterial.\n  Although  sparse  Swedish  research  has  been  done  on  the  issue,  transnational  findings  show  \nthe\n \nprevalence\n \nof\n \nendometriosis\n \nin\n \ntrans\n \nand\n \nintersex\n \npatient\n \ngroups,\n \nas\n \nwell\n \nas\n \nthe\n \npressing\n \nissue\n \nof\n \nexacerbated\n \ndelays\n \nfor\n \ndiagnosis\n \nwithin\n \nthe\n \ndemographic\n \n(Jeffrey\n \net\n \nal.,\n \n2024,\n \np.\n \n3;Kaltsas\n \net\n \nal.,\n \n2024,\n \np.\n \n4;Eder\n \n&\n \nRoomaney,\n \n2024,\n \np.\n \n912;Carvalho\n \net\n \nal.,\n \n2024,\n \np.\n \n6).\n \nExcluding\n \ntrans-individuals\n \nand\n \nintersex\n \nindividuals\n \nwhich\n \ndo\n \nnot\n \nidentify\n \nwith\n \nthe\n \nlabel\n \nof\n \n40  \n\n \nwoman  in  most  parts  of  the  guidelines,  therefore  not  only  becomes  a  violent  practice  of  \ninvisibilizing,\n \nbut\n \nan\n \ninaccurate\n \ndescription\n \nof\n \nreality\n \nand\n \ntrans\n \nand\n \nintersex\n \npeople´s\n \nneed\n \nfor\n \ncare.\n \n  An  explanation  to  what  Socialstyrelsen  might  gain  from  the  process  of  gendering  \nendometriosis,\n \nand\n \nwhy\n \nit\n \nbecomes\n \nproblematic\n \ntowards\n \nqueer\n \npatients,\n \ncan\n \nbe\n \nfound\n \nin\n \nButler's\n \nterm\n \n“abject\n \nbeings”.\n \nIf\n \nsex\n \nis\n \na\n \nregulatory\n \nideal,\n \nwhich\n \nensures\n \nthe\n \nreproduction\n \nof\n \nthe\n \nlabour\n \nforce,\n \nthen\n \nupholding\n \nthe\n \nstability\n \nof\n \nsex\n \nand\n \ngender\n \nbecomes\n \na\n \nmission\n \nof\n \nexclusion.\n \nThrough\n \nexcluding\n \nsubjects\n \nwhich\n \nchallenge\n \nthe\n \nheterosexual\n \nmatrix\n \n(“abject\n \nbeings”),\n \nstate\n \ninstitutions\n \nunder\n \ncapitalism\n \nhave\n \nhistorically\n \nbeen\n \nable\n \nto\n \nensure\n \nits\n \ncontinuous\n \nexistence\n \nby\n \npertaining\n \nthe\n \nstability\n \nof\n \nnormative\n \ngender\n \nand\n \nsexuality\n \n(Butler,\n \n2011,\n \npp.\n \nxi-xii).\n \n  Socialstyrelsen,  as  a  state  institution,  might  therefore  be  less  likely  to  question  the  \nheterosexual\n \nmatrix\n \n(through\n \ncomprehensive\n \ninclusion\n \nof\n \ntrans\n \nand\n \nintersex\n \npatients),\n \nbecause\n \nthis\n \nmatrix\n \nhas\n \nhistorically\n \nbenefited\n \nand\n \ncontinuously\n \nbenefits\n \ntheir\n \nproliferation.\n \nThis\n \nis\n \nnot\n \nto\n \nsay\n \nthat\n \nSocialstyrelsen\n \nhas\n \na\n \nclear\n \nanti-queer\n \nagenda\n \nin\n \ntheir\n \nguidelines\n \nfor\n \nendometriosis,\n \nbut\n \nrather\n \nthat\n \nthey,\n \nthrough\n \nenforcing\n \nmarkers\n \nof\n \nunintelligibility\n \nfor\n \npatients\n \nwhich\n \nare\n \nnot\n \nwomen\n \n(by\n \nnot\n \ncomprehensively\n \nquestioning\n \ngendered\n \ndivisions\n \nof\n \nendometriosis\n \nhealthcare),\n \nfurther\n \nthe\n \nsocial\n \nmarginalisation\n \nof\n \nqueer,\n \ntrans\n \nand\n \ngender\n \nnon-conforming\n \nindividuals\n \nwithin\n \nhealthcare.\n \nAs\n \nshown\n \nin\n \nthe\n \nintroduction,\n \nmedia\n \nsources\n \ndisplay\n \nhow\n \nthe\n \nfeminization\n \nof\n \nendometriosis\n \nis\n \na\n \nsource\n \nof\n \nunsafety,\n \nexhaustion\n \nand\n \ndysphoria\n \nfor\n \ntrans-patients\n \n(Landry,\n \n2021;\n \nStovicek,\n \n2018;\n \nWithers,\n \n2023;Melin,\n \n2025).\n \nA\n \nSwedish\n \ntrans\n \nman\n \nwas\n \nrefused\n \nendometriosis\n \nhealthcare,\n \nbeing\n \ntold\n \nthat\n \nbecause\n \nhe\n \nwas\n \nnot\n \na\n \nwoman\n \nhe\n \nhad\n \n“nothing\n \nto\n \ndo\n \nthere”\n \n(Melin,\n \n2025),\n \nwhich\n \ndisplays\n \nthe\n \nmaterial\n \neffects\n \nof\n \nthe\n \nabjection\n \nof\n \ntrans\n \nand\n \nintersex\n \nin\n \nthe\n \nfeminized\n \nfield\n \nof\n \nendometriosis.\n  So  why  might  gendered  language  be  more  common  in  sections  discussing  social  aspects  of  \nendometriosis\n \nhealthcare\n \nthan\n \nin\n \nthe\n \nmedical\n \nrecommendations?\n \nFoucault\n \nstates\n \nthat\n \nbiopower\n \nhas\n \nto\n \ndo\n \nwith\n \nthe\n \nconditioning\n \nof\n \nindividuals\n \nthrough\n \nstate\n \npractices\n \nof\n \nindoctrination,\n \nto\n \nuphold\n \nthe\n \nstatus\n \nquo\n \n(Foucault,\n \n2002,\n \np.\n \n142).\n \nIn\n \norder\n \nto\n \nindoctrinate\n \nyou\n \nneed\n \nto\n \ngain\n \nrespect\n \nfrom\n \nthe\n \npublic,\n \nwhich\n \nstate\n \nintuitions\n \ncan\n \nacquire\n \nthrough\n \nutilizing\n \nlanguage\n \nwhich\n \naligns\n \nwith\n \ncurrent\n \ndiscursive\n \nmarkers\n \nof\n \nintelligibility.\n \nSocialstyrelsen\n \ncan\n \nacquire\n \nthis\n \nintelligibility\n \nthrough\n \nmostly\n \ngendering\n \nendometriosis\n \nas\n \na\n \nwomen’s\n \nissue,\n \nwhich\n \n41  \n\n \naligns  with  cis-normative  constructions  of  the  body.  At  the  same  time,  aligning  with  \nneoliberal\n \nclaims\n \nof\n \ninclusivity\n \nthrough\n \nbrief\n \nmentions\n \nof\n \nqueer\n \npatient\n \ngroups,\n \nframes\n \nSocialstyrelsen\n \nas\n \nan\n \ninstitution\n \nthat\n \nprioritizes\n \nwomen’s\n \nhealthcare,\n \ndisplaying\n \nsocial\n \nawareness\n \nand\n \nprogressivity,\n \nwhilst\n \nnot\n \nchallenging\n \ncisnormativity\n \ncomprehensively.\n \nSocialstyrelsen\n \ncan\n \ntherefore\n \nbenefit\n \nfrom\n \na\n \nprogressive\n \nimage,\n \nwhilst\n \nsimultaneously\n \nnot\n \nthreatening\n \nthe\n \nstatus\n \nquo\n \nof\n \nthe\n \nheterosexual\n \nmatrix.\n \nThis\n \naligns\n \nthe\n \ninstitution\n \nwith\n \nsocietal\n \nmorality\n \ntales\n \nof\n \nsexuality\n \nand\n \ngender,\n \nwhose\n \nstrategic\n \nexclusion\n \nof\n \nqueer\n \nindividuals\n \nis\n \na\n \nprerequisite\n \nfor\n \nstate\n \ncontrol\n \nover\n \nreproduction\n \n(Sudenkaarne,\n \n2022,\n \np.\n \n167;\n \nButler,\n \n2011,\n \npp.\n \nxi-xii).\n  In  the  sections  with  medical  recommendations  and  quantitative  indicators,  Socialstyrelsen  \nmight\n \nutilize\n \ngender\n \nneutral\n \nformulations\n \n(such\n \nas\n \n“people\n \nwith\n \nendometriosis”)\n \nto\n \nappear\n \nmore\n \nobjective\n \nand\n \nutilitarian\n \nin\n \ntheir\n \nrecommendations\n \nfor\n \nhealthcare\n \npractices,\n \nby\n \nexcluding\n \ngender\n \nas\n \na\n \nmarker\n \nthat\n \ndefines\n \npatient\n \ngroups\n \noverall.\n \nUtilitarian\n \ngoals\n \nof\n \nobjectivity\n \nin\n \nthe\n \nmedical\n \nrecommendations\n \nrelate\n \nto\n \nHarraways\n \ndiscussions\n \non\n \nscientific\n \npositivist\n \ntradition,\n \nand\n \nits\n \nusual\n \nexclusion\n \nof\n \nsocial\n \nfactors\n \nto\n \nensure\n \nobjectivity\n \nstandards\n \n(Harraway,\n \n1988).\n \nIn\n \nthe\n \nmedical\n \nsciences\n \nespecially,\n \nthere\n \nis\n \na\n \nlong\n \ntradition\n \nof\n \npositivist\n \nclaims\n \nof\n \nobjectivity\n \nwhich\n \nultimately\n \nbleed\n \ninto\n \npolicy-framework\n \nwhich\n \nengages\n \nwith\n \nhealthcare\n \nissues.\n \nTherefore,\n \nthe\n \nguidelines\n \nuse\n \nof\n \ngender\n \nneutral\n \nformulations\n \nappears\n \nas\n \nan\n \nexample\n \nof\n \nmedical\n \nutilitarianism,\n \nwhich\n \ntogether\n \nwith\n \nlittle\n \nmention\n \nof\n \nsocial\n \nfactors\n \nwhich\n \ninform\n \nendometriosis\n \nrelated\n \nissues,\n \ndisplay\n \nthe\n \ntendency\n \nto\n \ninvisiblize\n \nsocial\n \npower\n \nrelations\n \nwithin\n \nutilitarian\n \nprojects\n \nin\n \nhealthcare\n \nsettings\n \n(Rogers\n \net\n \nal.,\n \n2022,\n \npp.\n \n18).\n \n  The  inclusive  potential  in  the  gender-neutral  language  is  also  halted  by  the  fact  that  \nSocialstyrelsen\n \ngenders\n \nendometriosis\n \nas\n \na\n \nwomen’s\n \nissue\n \nin\n \nalmost\n \nall\n \nparts\n \nof\n \nthe\n \ndocument.\n \nSame\n \ngoes\n \nfor\n \nmany\n \nof\n \nSocialstyrelsens\n \nattempts\n \nto\n \naccount\n \nfor\n \nthe\n \nsocial\n \nin\n \ntheir\n \nguidelines:\n \nclaims\n \nof\n \ninclusivity\n \nare\n \nweakened\n \nby\n \nthe\n \nlack\n \nof\n \ndepth\n \nand\n \nconsistency\n \nin\n \nexisting\n \ndiscussions\n \nregarding\n \nsocial\n \ncategories\n \nwhich\n \nshape\n \npatient\n \nencounters\n \nin\n \nendometriosis\n \nhealthcare.\n    \n42  \n\n \n6.5  Suggestions  for  future  endometriosis  guidelines  \n \n“Equal  healthcare  means  that  social  treatment,  healthcare  and  medical  treatment  is  \nperformed\n \nand\n \noffered\n \non\n \nequal\n \nconditions\n \nto\n \neveryone\n \nindependent\n \nto\n \nfactors\n \nsuch\n \nas\n \npersonal\n \nqualities,\n \nresidence,\n \nage,\n \ngender,\n \ndisabolites,\n \neducation,\n \nsocial\n \nstatus,\n \nethnic\n \nor\n \nreligious\n \nbackground\n \nor\n \nsexual\n \norientation”\n \n(Socialstyrelsen,\n \n2018,\n \np.\n \n79)\n \n(my\n \ntranslation)\n  This  is  expressed  in  the  guidelines  as  an  overarching  goal  of  Socialstyrelsens  work  with  \nissues\n \nrelated\n \nto\n \nhealthcare.\n \nTo\n \nmake\n \nsure\n \nthat\n \nthe\n \nmarginalized\n \nidentities,\n \naddressed\n \nin\n \nthe\n \nquote\n \nabove,\n \ndo\n \nnot\n \nnegatively\n \naffect\n \nhealthcare\n \nexperience,\n \nfeminist\n \nperspectives\n \nare\n \nrelevant\n \nfor\n \nthe\n \ndevelopment\n \nof\n \nfuture\n \nrenditions\n \nguidelines\n \nfor\n \nendometriosis.\n \nMotivated\n \nby\n \nthe\n \nconclusions\n \nraised\n \nby\n \nthis\n \nthesis,\n \nI\n \nin\n \nthis\n \nsection\n \npresent\n \nsuggestions\n \nfor\n \nimprovement\n \nintended\n \nfor\n \nfuture\n \nversions\n \nof\n \nSocialstyrelsens\n \nguidelines\n \nfor\n \nendometriosis\n \nhealthcare,\n \nso\n \nthat\n \nnew\n \nrenditions\n \ncan\n \nbecome\n \nmore\n \naligned\n \nwith\n \ngoals\n \nof\n \nequal\n \ntreatment\n \nin\n \nhealthcare\n \nmentioned\n \nabove.\n  Firstly,  I  encourage  Socialstyrelsen  to  use  more  gender  inclusive  language.  One  strategy  for  \nthis\n \nis\n \nto\n \nformulate\n \nfuture\n \nrenditions\n \nof\n \nendometriosis\n \nguidelines\n \nmore\n \nopenly,\n \nwith\n \nmore\n \ngeneralised\n \nlanguage\n \nregarding\n \npatient\n \ngroups.\n \nAnother\n \nstrategy\n \ncould\n \nbe\n \nto\n \ninclude\n \nsections\n \nwhich\n \naddress\n \nrelevant\n \npatient\n \ngroups\n \n-\n \nsuch\n \nas\n \ntrans\n \nyouth,\n \nintersex\n \npeople,\n \nmiddle\n \naged\n \npatients,\n \nracialized\n \npatients\n \nor\n \nworkless\n \nindividuals.\n \nIn\n \nmy\n \ncritique\n \nof\n \nthe\n \nfeminization\n \nof\n \nendometriosis,\n \nI\n \ndo\n \nnot\n \nmean\n \nto\n \ncriticize\n \nguidelines\n \nbringing\n \nup\n \nthe\n \nissues\n \nwomen\n \nface\n \nin\n \nendometriosis.\n \nHowever,\n \nthese\n \ndescriptions\n \nmust\n \nbe\n \naccompanied\n \nby\n \ndiscussions\n \nof\n \nthe\n \nissues\n \nthat\n \nother\n \npatient\n \ngroups\n \nface,\n \nto\n \nensure\n \nthat\n \nfuture\n \nguidelines\n \nare\n \nas\n \ninclusive\n \nas\n \npossible.\n \nSections\n \nwhich\n \naddress\n \npatient\n \ngroups\n \nshould\n \nalso\n \naim\n \nto\n \nbe\n \nreflexive,\n \nby\n \nreflecting\n \non\n \nhow\n \nsocial\n \nmarginalization\n \nmight\n \naffect\n \nthe\n \nways\n \nprofessionals\n \ndeal\n \nwith\n \nand\n \nperceive\n \npatients.\n \nI\n \nalso\n \nencourage\n \nSocialstyrelsen\n \nto\n \nbe\n \nmore\n \nreflexive\n \non\n \ntheir\n \nown\n \nrole,\n \nas\n \na\n \npowerful\n \ninstitution\n \nin\n \nendometriosis\n \nhealthcare.\n  By  not  highlighting  the  social  issues  which  inform  the  normalisation  of  pain  within  \nendometriosis\n \nhealthcare\n \nconsistently,\n \nSocialstyrelsens\n \nrecommendations\n \nbecome\n \ninsufficient\n \nin\n \ncombating\n \nthe\n \nissues\n \nprevalent\n \nin\n \ncurrent\n \nendometriosis\n \nhealthcare.\n \nThey\n \nalso\n \nlack\n \nexplicit\n \ntools\n \nnecessary\n \nfor\n \nhealthcare\n \nprofessionals\n \nto\n \nutilize\n \nin\n \norder\n \nto\n \ndeal\n \nwith\n \ntheir\n \nown\n \nprejudice\n \n43  \n\n \n(so  that  it  does  not  negatively  affect  patient  encounters),  a  critique  which  is  echoed  in  former  \nresearch\n \non\n \nSocialstyrelsens\n \nguidelines\n \nfor\n \nhealthcare\n \n(Andersson\n \n&\n \nKindevåg,\n \n2024,\n \npp.\n \n130-131).\n  I  urge  Socialstyrelsen  to  describe  strategies  for  healthcare  professionals  to  deal  with  \nprejudice,\n \nas\n \nto\n \nensure\n \nthat\n \nthese\n \ndo\n \nnot\n \naffect\n \npatient\n \nencounters\n \nnegatively\n \nthrough\n \nmedical\n \ngaslighting,\n \ndiscrimination\n \nor\n \nharassment.\n \nProviding\n \ncritical\n \ntools\n \nfor\n \nmedical\n \nstaff\n \ncould\n \naid\n \nSocialstyrelsens\n \nexplicit\n \ngoals\n \nof\n \nminimizing\n \nwaiting\n \ntimes\n \nand\n \nmisinterpretation\n \nof\n \nsymptoms\n \nin\n \nendometriosis\n \nhealthcare,\n \ngiven\n \nthe\n \nlinkage\n \nthese\n \nissues\n \nhave\n \nwith\n \nhealthcare\n \ndiscrimination,\n \naccording\n \nto\n \nformer\n \nresearch\n \n(Giacomozzi\n \net\n \nal.,\n \n2024).\n \nFor\n \nexample,\n \nwhen\n \ndealing\n \nwith\n \nwomen\n \nwho\n \nmight\n \nnot\n \nwant\n \nto\n \nhave\n \nchildren,\n \nendometriosis\n \nhealthcare\n \nprofessionals\n \nshould\n \nbe\n \ninformed\n \non\n \nhow\n \nto\n \ndeal\n \nwith\n \nfertility\n \npreservations\n \nwhilst\n \nnot\n \nassuming\n \nthat\n \nthe\n \npatients\n \nwill\n \nchange\n \ntheir\n \nmind\n \nor\n \nthat\n \nwanting\n \nto\n \nbe\n \na\n \nparent\n \nis\n \n“natural”.\n \n When  dealing  with  trans-  and  gender  non-conforming  patients,  healthcare  professionals  \nshould\n \nnot\n \nassume\n \nthat\n \nthe\n \npatient\n \nwill\n \nnot\n \nwant\n \nto\n \ncarry\n \na\n \nchild,\n \nor\n \nmisgender\n \nthem,\n \nbecause\n \ntheir\n \nidentity\n \ndoes\n \nnot\n \nfit\n \ninto\n \nthe\n \nfeminized\n \nstereotype\n \nof\n \na\n \nbirth\n \ngiver.\n \nWhen\n \ndealing\n \nwith\n \nracialized\n \npatients,\n \npractitioners\n \nshould\n \nnot\n \nassume\n \nthere\n \nis\n \ngoing\n \nto\n \nbe\n \na\n \nlanguage\n \nbarrier.\n \nAlthough\n \nhealthcare\n \ndiscrimination\n \nis\n \nforbidden\n \nby\n \nlaw\n \nin\n \nSweden\n \n(DO,\n \n2024),\n \nmost\n \ninstances\n \nend\n \nup\n \nunreported\n \n(DO,\n \n2023),\n \nmotivating\n \nSocialtjänsten\n \nto\n \nact\n \nprecautionarily\n \nthrough\n \neducating\n \nmedical\n \nstaff\n \non\n \nanti-discrimination\n \npractices.\n \n  Another  example  of  a  relevant  exercise  for  endometriosis  health-providers,  would  be  to  \ndefine\n \nand\n \nsuggest\n \nexercises\n \nto\n \ndecrease\n \nthe\n \nprevalence\n \nof\n \nmedical\n \ngaslighting,\n \nwhich\n \nformer\n \nresearch\n \nsuggests\n \nas\n \nmain\n \ncharacteristic\n \nof\n \nnegative\n \nencounters\n \nin\n \nendometriosis\n \nhealthcare\n \nfor\n \nwomen\n \nand\n \ntrans/intersex\n \nindividuals\n \n(Lightbourne\n \net\n \nal.,\n \n2024,\n \npp.\n \n312),\n \n(Eder\n \n&\n \nRoomaney,\n \n2024,\n \np.\n \n914-916),\n \n&\n \n(Carvalho\n \net\n \nal.,\n \n2024,\n \np.\n \n2).\n \nMaking\n \nhealthcare\n \nprofessionals\n \naware\n \nof\n \ntheir\n \nown\n \nprejudice,\n \nand\n \nhow\n \nit\n \nrelates\n \nto\n \nsocietal\n \nmodes\n \nof\n \noppression,\n \nis\n \nkey\n \nto\n \npromoting\n \nintersectional\n \nanti-discrimination\n \nwork,\n \nwhich\n \nis\n \nin\n \nline\n \nwith\n \nSocialstyrelens\n \noverarching\n \ngoals\n \nfor\n \nhealthcare.\n \n  The  last  suggestion  for  future  guidelines  is  to  be  less  restrictive  regarding  medical  \nrecommendations.\n \nBeing\n \nable\n \nto\n \naccess\n \nexpert\n \nmedical\n \nstaff,\n \nearly\n \nonset\n \ntreatment\n \nand\n \nstructured\n \nfollow\n \nups\n \nof\n \ntreatment\n \nplans\n \nare\n \nall\n \ngreat\n \nrecommendations\n \nto\n \nmend\n \ncurrent\n \nissues\n \nof\n \nendometriosis\n \nhealthcare.\n \nBut\n \nby\n \nlimiting\n \nthese\n \nrecommendations,\n \nwhich\n \nwould\n \nbenefit\n \nall\n \n44  \n\n \nendometriosis  patients,  to  only  severe  and  especially  severe  cases  of  the  disease,  \nSocialstyrelsen\n \nis\n \nat\n \nthe\n \nrisk\n \nof\n \ngatekeeping\n \nnecessary\n \nhelp\n \nfrom\n \npatients\n \nbased\n \non\n \nwhose\n \ncase\n \nis\n \nconsidered\n \nas\n \nsevere\n \nenough.\n \n \n7.  Concluding  discussion  \n Onto  the  final  section  of  the  thesis,  containing  three  subsections.  The  first  section  summarizes  \nthe\n \nanalysis\n \nand\n \ndraws\n \nconclusions\n \nfrom\n \nits\n \nfindings,\n \nas\n \nwell\n \nas\n \nrelating\n \nthe\n \nfindings\n \nto\n \nthe\n \nresearch\n \nquestions\n \nof\n \nthe\n \nthesis.\n \nThe\n \nsecond\n \nsection\n \ndescribes\n \nsuggestions\n \nfor\n \nimprovement\n \nfor\n \nSocialstyrelsens\n \nfuture\n \nguidelines\n \nfor\n \nendometriosis.\n \nLastly,\n \nthe\n \nthird\n \nsubsection\n \nincludes\n \nmy\n \nreflections\n \naround\n \nthe\n \nresearch\n \nproject\n \nas\n \nwell\n \nas\n \nsuggestions\n \nfor\n \nfuture\n \nresearch\n \non\n \nthe\n \ntopic\n \nof\n \nendometriosis.\n \n \n7.1  Summary  and  conclusions  \n \nIn  this  section,  I  summarize  the  findings  of  the  thesis  and  relate  them  to  the  project’s  research  \nquestions,\n \nto\n \nthen\n \npresent\n \nand\n \ndiscuss\n \nconclusions\n \nmade\n \nfrom\n \nthe\n \nanalytical\n \nthemes.\n \nThe\n \nproject's\n \nresearch\n \nquestions\n \nare:\n \n1)\n \nHow\n \nis\n \nendometriosis\n \ndefined\n \nin\n \nSwedish\n \npublic\n \nhealthcare?\n \n2)\n \nHow\n \ncan\n \nwe\n \nexplore\n \nthe\n \nsocial\n \naspects\n \nof\n \nendometriosis\n \nby\n \nexamining\n \nSocialstyrelsens\n \nguidelines?\n \nAnd\n \n3)\n \nHow\n \ncan\n \nfeminist\n \ntheories\n \nhelp\n \nin\n \nconducting\n \na\n \ncritical\n \ndiscourse\n \nanalysis\n \nof\n \nSocialstyrelsens’\n \nguidelines?\n \nThese\n \nwere\n \nanswered\n \nthrough\n \nthe\n \ntheoretical\n \nanalysis\n \nof\n \nSocialstyrelsens\n \nguidelines,\n \nwhose\n \nfindings\n \nI\n \nsummarize\n \nbelow.\n \n  The  analysis  consisted  of  four  primary  themes.  The  first  theme  addresses  the  centrality  of  \nfertility,\n \nhighlighting\n \nhow\n \nfertility\n \nis\n \ncentralized\n \nin\n \nSocialstyrelsens\n \ndescriptions\n \nof\n \nsymptoms,\n \ntreatment\n \nand\n \nhealthcare.\n \nIt\n \nthen\n \ndiscusses\n \nthe\n \nlack\n \nof\n \nsocial\n \nperspectives\n \nin\n \nthese\n \ndescriptions\n \nof\n \nfertility\n \npreservation,\n \nwhich\n \nexcludes\n \nhow\n \nthe\n \nsocial\n \nmight\n \ninfluence\n \nreproductive\n \nstereotypes.\n \nIn\n \nline\n \nwith\n \nTurkmendags\n \nbioethical\n \ntheories,\n \nreproductive\n \nstereotypes\n \nare\n \nconnected\n \nto\n \npatriarchal\n \nand\n \nheteronormative\n \nexpectations\n \non\n \nfeminized\n \nbodies,\n \nand\n \ncan\n \nreproduce\n \noppressional\n \ngendered\n \ndynamics\n \nwithin\n \nhealthcare.\n \n  The  second  section,  ‘Access  to  care  &  pain  -  Whose  pain  is  taken  seriously?’,  revealed  the  \nrestrictive\n \nattitudes\n \nto\n \nhealthcare\n \nrecommendations\n \nin\n \nthe\n \nguidelines,\n \nmost\n \nonly\n \ntargeted\n \nat\n \nsevere\n \nor\n \nespecially\n \nsevere\n \ncases\n \nof\n \nendometriosis.\n \nSocialstyrelsen\n \nhighlights\n \nthe\n \nneed\n \nto\n \n45  \n\n \nrespect  subjective  experience  of  pain,  but  does  not  mention  social  relations  which  might  \ncompromise\n \nwhose\n \npain\n \nis\n \nconsidered\n \nvalid\n \nand\n \nwho\n \nis\n \nconsidered\n \nas\n \nin\n \nthe\n \nlargest\n \nneed\n \nof\n \ncare.\n \nBy\n \nexcluding\n \nsocial\n \ncategorisations\n \nwhich\n \nshape\n \npain\n \nexperience,\n \npain\n \ngets\n \nreduced\n \nto\n \nindividual\n \npatients'\n \nexperiences\n \nrather\n \nthan\n \nan\n \nissue\n \nlinked\n \nto\n \nthe\n \nlarger\n \nsocietal\n \nissues\n \nof\n \npain\n \nand\n \nmarginalisation,\n \na\n \npoint\n \nsupported\n \nby\n \ntheories\n \non\n \nthe\n \nsociology\n \nof\n \npain.\n \nSocialstyrelsens\n \nuse\n \nof\n \nthe\n \nterm\n \n“honour-based\n \noppression”\n \nis\n \nalso\n \ndiscursively\n \nanalyzed,\n \nconsidering\n \nits\n \nconnotations\n \nin\n \nSwedish\n \npolitical\n \ndiscussions\n \non\n \nrace\n \nand\n \nimmigration.\n \nBy\n \nnot\n \naccounting\n \nfor\n \nthe\n \nsocial\n \naspects\n \nof\n \npain,\n \nSocialstyrelsen\n \nis\n \nat\n \nthe\n \nrisk\n \nof\n \nnot\n \nadequately\n \npreventing\n \nfurther\n \ndiagnostic\n \ndelay\n \nand\n \nmisinterpreted\n \nsymptoms,\n \nin\n \nline\n \nwith\n \nformer\n \nresearch.\n \nThis\n \nhighlights\n \nthe\n \nneed\n \nfor\n \nintersectional\n \nanti-discrimination\n \nwork\n \nto\n \nmediate\n \nhealthcare\n \nissues.\n  The  third  section,  ‘Cost  efficiency  &  workfare  -  Patients  in  the  realm  of  the  neoliberal  order,’   \ndiscussed\n \nhow\n \nthe\n \nprinciple\n \nof\n \ncost-efficiency\n \ninformed\n \nSocialstyrelsens\n \nframing\n \nof\n \nendometriosis.\n \nSocialstyrelsen\n \nmotivate\n \nthe\n \nhigher\n \ncosts\n \nfor\n \nendometriosis\n \nhealthcare\n \nthat\n \nthe\n \nguidelines\n \nwould\n \nrequire\n \nshort-term,\n \nby\n \nthe\n \nsocietal\n \neconomical\n \ngain\n \nthat\n \nlong-term\n \nconsequences\n \nof\n \nimproved\n \nendo-healthcare\n \n(through\n \nincreased\n \nwork\n \npresence,\n \nas\n \nwell\n \nas\n \ndecreased\n \ninlays\n \nand\n \nsick-leave).\n \nThrough\n \nthese\n \nlogics\n \nof\n \ncost-efficiency,\n \nSocialstyrelsens\n \nguidelines\n \ntied\n \ninto\n \nlogics\n \nof\n \nworkfare,\n \nwhich\n \ngatekeeps\n \nwelfare\n \nservices\n \nfrom\n \npeople\n \nwho\n \ndo\n \nnot\n \nreach\n \nactivation\n \nrequirements,\n \neither\n \ndirect\n \nor\n \nthrough\n \nmoralising\n \npractices.\n \nAbleist\n \nnotions\n \nwhich\n \ndeem\n \nsome’s\n \nfunctionality\n \nas\n \ndeviant,\n \nalso\n \ntied\n \ninto\n \nSocialstyrelsens\n \nlogics\n \nof\n \nworkfare.\n \nThis\n \nwas\n \nillustrated\n \nby\n \none\n \nof\n \nthe\n \nguidelines\n \ngoals\n \nfor\n \npatients\n \nto\n \nregain\n \n“good\n \nfunctionality”.\n \n“Good\n \nfunctionality”\n \nexclude\n \nthose\n \nwhich,\n \neven\n \nwhen\n \nreceiving\n \nproper\n \ntreatment,\n \nmight\n \nhave\n \ndiffering\n \nabilities\n \nto\n \nwork\n \nconsidering\n \ntheir\n \nendometriosis\n \ndiagnosis.\n \nAbleist\n \nnotions\n \nof\n \nworkfare\n \nare\n \ninformed\n \nby\n \nneoliberal\n \nnotions\n \nof\n \ndisgust,\n \nnot\n \nonly\n \naffecting\n \ndisabled\n \npeople\n \nbut\n \nalso\n \nwomen,\n \npeople\n \nof\n \ncolour\n \nand\n \nothers\n \nconsidered\n \nless\n \nworthy\n \nof\n \nwelfare\n \nservices.\n \nSocialstyrelsen\n \nbenefit\n \nfrom\n \nthese\n \nableist\n \nnotions\n \nof\n \nworkfare\n \nby\n \ncapitalizing\n \noff\n \nthe\n \nnotion\n \nthat\n \npeople\n \nwho\n \ndon’t\n \nwork\n \nare\n \nan\n \neconomic\n \nburden\n \non\n \nsociety.\n  The  fourth  and  last  subsection,  ‘Gendered  ambivalence  -  Who  is  the  patient  group  for  \nendometriosis?’,\n  \ndiscussed\n \nthe\n \nways\n \nSocialstyrelsen\n \ngendered\n \npatient\n \ngroups\n \nfor\n \nendometriosis.\n \nIt\n \nfound\n \nthat\n \ngendered\n \nlanguage\n \nwas\n \nmore\n \ncommon\n \nin\n \nsections\n \nthat\n \nevaluated\n \nhealthcare\n \nservices\n \nand\n \nlocated\n \nendometriosis\n \nin\n \nsociety,\n \nthan\n \nin\n \nsections\n \ndescribing\n \nquantitative\n \nindicators\n \nand\n \nmedical\n \nrecommendations,\n \nwhere\n \ngender\n \nneutral\n \nlanguage\n \nappeared\n \nas\n \nmore\n \ncommon.\n \nThis\n \nwas\n \nsuggested\n \nas\n \nlinked\n \nto\n \ngendered\n \nintelligibility\n \nand\n \n46  \n\n \nmedical  utalitarinism,  as  well  as  claims  of  progressivity,  partially  explaining  the  gendered  \nambivalence\n \nof\n \nthe\n \ndocument.\n \nGendering\n \nendometriosis\n \nas\n \nmostly\n \na\n \nwomen’s\n \nissue\n \nwas\n \nlinked\n \nto\n \nthe\n \nheterosexual\n \nmatrix\n \naswell\n \nas\n \ncisnormative\n \ndefinitions\n \nof\n \nbodies\n \nand\n \nreproductive\n \nfunctions,\n \nexcluding\n \npatient\n \ngroups\n \nwhich\n \ndo\n \nnot\n \nidentify\n \nas\n \nwomen\n \nand\n \naligning\n \nwith\n \ndiscursive\n \nmoralites\n \nregarding\n \ngender\n \nand\n \nsexuality.\n \nThis\n \nfurthers\n \nthe\n \nabjection\n \nof\n \ntrans\n \nand\n \nintersex\n \nendometriosis\n \npatients,\n \ncontributing\n \nto\n \ndiscriminatory\n \npractices\n \nand\n \nexclusion.\n  To  answer  the  first  research  question  on  how  endometriosis  is  defined  in  Swedish  public  \nhealthcare,\n \nfindings\n \nshow\n \nhow\n \nthe\n \ndisease\n \nis\n \ndefined\n \nas\n \nprimarily\n \na\n \nwomen’s\n \nissue\n \nin\n \nthe\n \nguidelines,\n \nalthough\n \nthere\n \nare\n \nsome\n \nambivalent\n \ntendencies.\n \nCurrent\n \nhealthcare\n \nfor\n \nthe\n \ndisease\n \nis\n \nevaluated\n \npå\n \nSocialstyrelsen\n \nas\n \ninsufficient,\n \nand\n \nsuggested\n \nmeasures\n \nindicate\n \na\n \nneed\n \nfor\n \nmore\n \nexpert\n \nstaff.\n \nThe\n \nrecommendations\n \nin\n \nthe\n \nguidelines\n \nare\n \nframed\n \nas\n \nsolutions\n \nto\n \ndiagnostic\n \ndelay,\n \nmisinterpreted\n \nsymptoms\n \nand\n \nalso\n \nlesser\n \ncosts\n \nsocietally\n \nin\n \nthe\n \nlong\n \nrun.\n \nThe\n \nsecond\n \nresearch\n \nquestion\n \n(How\n \ncan\n \nwe\n \nexplore\n \nthe\n \nsocial\n \naspects\n \nof\n \nendometriosis\n \nby\n \nexamining\n \nSocialstyrelsens\n \nguidelines)\n \nallowed\n \nme\n \nto\n \ninvestigate\n \nhow\n \nthe\n \nsocial\n \nis\n \nboth\n \nintegrated\n \nand\n \nvacant\n \nin\n \nthe\n \ndocument.\n \nAlthough\n \nsome\n \nsocial\n \naspects\n \nare\n \ndiscussed,\n \nmarginalized\n \nidentities\n \nare\n \nnot\n \nmentioned\n \nconsistently\n \nenough\n \nto\n \naid\n \nthe\n \ninclusivity\n \nproject\n \nposed\n \nas\n \nthe\n \noverarching\n \ngoal\n \nof\n \nthe\n \ninstitution's\n \nhealthcare\n \npolicies.\n \nThe\n \nlast\n \nresearch\n \nquestion\n \n(How\n \ncan\n \nfeminist\n \ntheories\n \nhelp\n \nin\n \nconducting\n \na\n \ncritical\n \ndiscourse\n \nanalysis\n \nof\n \nSocialstyrelsens’\n \nguidelines?)\n \nallowed\n \nme\n \nto\n \nanalyze\n \nboth\n \nthe\n \nmentions\n \nand\n \nvacancies\n \nof\n \nsocial\n \nperspectives,\n \nrevealing\n \ninsights\n \non\n \ngendered\n \nambivalence,\n \nformations\n \nof\n \nworkfare\n \nand\n \ndiscussions\n \non\n \npain\n \n&\n \nfertility\n \nin\n \nthe\n \ndocument.\n  Tying  all  these  analytical  themes  together  is  the  broader  tendency  of  lacking  social  \nperspectives\n \nin\n \nthe\n \nguidelines.\n \nAlthough\n \nsome\n \nsocial\n \naspects\n \nof\n \nendometriosis\n \nhealthcare\n \nare\n \nbrought\n \nup,\n \nsuch\n \nas\n \nwomen’s\n \nstruggles\n \nof\n \nnot\n \nbeing\n \ntaken\n \nseriously\n \nfor\n \ntheir\n \npain,\n \nand\n \ntrans\n \npeople’s\n \ndiscomfort\n \nwhile\n \nexisting\n \nin\n \nspaces\n \nstrictly\n \nmarked\n \nfor\n \nwomen,\n \nthe\n \ndocument\n \nlacks\n \na\n \npervasive\n \nand\n \nintegrated\n \nsocial\n \nperspective\n \nshowing\n \nhow\n \ncomplex\n \nmarginalized\n \nidentities\n \nshape\n \npatient\n \nexperience.\n \nSocialstyrelsen\n \nhas\n \nexplicit\n \ngoals\n \nof\n \ninclusive\n \nhealthcare\n \nservices,\n \nbut\n \npersistently\n \ngenders\n \nendometriosis\n \nas\n \na\n \nwomen’s\n \nissue,\n \nwhich\n \nabjects\n \ntrans\n \nand\n \nintersex\n \npatients\n \nand\n \ninvisibilizes\n \ntheir\n \nexperiences\n \nof\n \nthe\n \ndisease.\n \nNormalized\n \npain\n \nis\n \nbrought\n \nup\n \nas\n \na\n \ncentral\n \nconcern\n \nin\n \nendo-healthcare,\n \nbut\n \ndiscussions\n \nregarding\n \nhow\n \nsocial\n \nprejudice\n \nshapes\n \nwhat\n \npain\n \nis\n \ntaken\n \nseriously\n \nare\n \nvacant.\n \nFertility\n \nis\n \ncentral\n \nwhen\n \ndiscussing\n \ntreatment\n \noptions\n \n47  \n\n \nand  symptoms,  but  discussions  on  social  expectations  on  reproduction  are  idle.  Being  able  to  \nreturn\n \nto\n \none’s\n \nprimary\n \nincome\n \nsource\n \nis\n \nseen\n \nas\n \na\n \nprimary\n \ngoal\n \nof\n \nendometriosis\n \nhealthcare,\n \nbut\n \ndisability\n \nas\n \na\n \nmarginalized\n \nidentity\n \nis\n \nnot\n \nconsidered.\n \n  \n7.2  My  thesis’  contributions   \n \nThis  thesis  aims  to  expand  the  research  fields  relevant  and  continue  the  tradition  of  critical  \nfeminist\n \nresearch\n \nof\n \nendometriosis.\n \nThe\n \namount\n \nof\n \nstudies\n \ndone\n \non\n \npeople’s\n \nexperience\n \nwith\n \nendometriosis\n \nis\n \nextensive,\n \nat\n \nthe\n \nsame\n \ntime\n \nas\n \nit\n \nis\n \na\n \nhistorically\n \nunder\n \nresearched\n \ntopic,\n \nparticularly\n \nfor\n \ntrans\n \nand\n \nintersex\n \npeople\n \n(Eder\n \n&\n \nRoomaney,\n \n2024,\n \np.\n \n911;\n \nKaltsas\n \net\n \nal.,\n \n2024,\n \np.\n \n2).\n \nResearch\n \ncentering\n \nqueer\n \nand\n \ntrans\n \nand\n \nintersex\n \nexperience\n \nof\n \nendometriosis\n \nin\n \nSweden\n \nis\n \nespecially\n \nmarginal,\n \nfurther\n \nmotivating\n \nthe\n \nsignificance\n \nof\n \nthe\n \nqueer\n \nperspectives\n \nin\n \nthis\n \nthesis.\n \nThis\n \nstudy\n \nalso\n \nprovides\n \na\n \nunique\n \nperspective\n \nby\n \ninvestigating\n \nnot\n \nthe\n \nconcrete\n \nexperience\n \nof\n \npractitioners\n \nor\n \npatients,\n \nbut\n \nthe\n \nguidelines\n \nthat\n \nthese\n \nexperiences\n \nare\n \nshaped\n \nby.\n  By  analysing  Socialstyrelsens  guidelines  for  endometriosis,  material  which  according  to  this  \nproject's\n \nliterature\n \nreview\n \nappears\n \nas\n \nunder\n \nresearched,\n \nI\n \naim\n \nto\n \nfurther\n \nthe\n \ntradition\n \nof\n \ncritical\n \nanalysis\n \nof\n \nSocialstyrelsens\n \nguidelines,\n \nSwedish\n \ninstitutional\n \npolicy\n \nand\n \ncritical\n \nstudies\n \nof\n \nstate\n \npractices.\n \nThis\n \nthesis\n \nalso\n \ndevelops\n \nabove\n \nstated\n \nresearch\n \nby\n \nproviding\n \na\n \ndiscourse\n \ntheoretical\n \nperspective\n \non\n \nguidelines\n \nfor\n \nendometriosis\n \nhealth\n \ncare,\n \nexamining\n \nthe\n \nlanguage\n \nand\n \ndiscursive\n \nformations\n \nrather\n \nthan\n \nquality\n \nof\n \ntreatment\n \nrecommendations.\n \nIt\n \nalso\n \nprovides\n \nfeminist\n \ntheoretical\n \nperspectives\n \non\n \nthe\n \nguidelines,\n \nhighlighting\n \npower\n \nrelations\n \nrelated\n \nto\n \ngender,\n \ndisability,\n \nrace,\n \nwork-status\n \netc.\n \n7.3  Reflections  and  future  research  \nWhen  writing  this,  I  am  overwhelmed  with  news  of  the  rise  of  facism,  genocide,  anti-trans,  \nanti-immigration\n \nand\n \nanti-humanist\n \npolicies\n \nin\n \nlarge\n \nparts\n \nof\n \nthe\n \nworld\n \n.\n \nEmotionally,\n \nsuch\n \npolitical\n \ndevelopment\n \nis\n \nhurtful\n \nand\n \nexhausting,\n \nat\n \nthe\n \nsame\n \ntime\n \nas\n \nI\n \nknow\n \nthat\n \nthe\n \nfight\n \nfor\n \ncollective\n \nemancipation\n \nis\n \nmore\n \nimportant\n \nthan\n \never.\n \nLegal\n \nand\n \ninstitutional\n \ninfringement\n \nof\n \nthe\n \nrights\n \nand\n \nfreedoms\n \nof\n \nmarginalized\n \npopulations\n \nneed\n \nto\n \nbe\n \ncontinuously\n \ncritiqued\n \nby\n \nscholars\n \nand\n \nactivists,\n \nconsidering\n \ntheir\n \nviolent\n \nand\n \nstigmatizing\n \nconsequences.\n \n \n48  \n\n \nMy  thesis  is  written  to  support  this  cause,  and  to  contribute  to  making  future  renditions  of  \nSocialstyrelsens\n \nguidelines\n \nfor\n \nendometriosis\n \nmore\n \ninclusive\n \nof\n \nthe\n \nsocial\n \naspects\n \nof\n \nhealthcare\n \nexperience.\n \nIn\n \nmy\n \ncritique\n \nI\n \ndo\n \nnot\n \nmean\n \nto\n \nminimize\n \nthe\n \nimportance\n \nof\n \nthe\n \npublication\n \nof\n \nthese\n \nguidelines.\n \nEndometriosis\n \nhas\n \nbeen\n \nhistorically\n \nneglected,\n \nand\n \nSocialstyrelsen\n \ninvesting\n \nin\n \nthe\n \ncause\n \nis\n \ndefinitely\n \npositive.\n \nHowever,\n \nas\n \ntestimonies\n \nof\n \nexperience\n \nindicate,\n \nthere\n \nis\n \nstill\n \na\n \nlong\n \npath\n \ntowards\n \ninclusive\n \nhealthcare.\n \nPatients\n \ncontinue\n \nto\n \nbe\n \nneglected\n \nand\n \ndismissed,\n \nsome\n \nhaving\n \nto\n \nwait\n \nmore\n \nthan\n \na\n \ndecade\n \nto\n \nreceive\n \ndiagnosis\n \nand\n \nrelated\n \ntreatment.\n \nPatients\n \nare\n \nconstantly\n \nmisgendered,\n \ndismissed,\n \nstereotyped\n \nand\n \nmisunderstood.\n \nTo\n \nmediate\n \nthese\n \nissues,\n \ninclusion\n \nof\n \nfeminist\n \nand\n \nsocial\n \nscience\n \nperspectives\n \nare\n \nvital.\n  It  is  my  wish  that  the  critique  raised  in  this  thesis,  and  other  research  projects  and  testimonies  \non\n \nendometriosis\n \nhealthcare,\n \nwill\n \nchange\n \nthe\n \nmedical\n \nfield\n \nfor\n \nthe\n \nbetter.\n \nDecade\n \nlong\n \nwaiting\n \ntimes,\n \nlack\n \nof\n \nexpert\n \nhealthcare\n \nstaff,\n \nmedical\n \nprofessionals\n \ndismissing\n \nexcruciating\n \npain\n \nas\n \n“normal”\n \nand\n \nsystematic\n \nmisgendering\n \npractices\n \nare\n \nsimply\n \nunacceptable.\n \nPain\n \nis\n \nnot\n \njust\n \nexperienced\n \nphysically,\n \nbut\n \nmentally\n \nwhen\n \none\n \nis\n \nnot\n \nbelieved\n \nand\n \ntaken\n \nseriously.\n \nMinimizing\n \npain\n \nis\n \ntherefore\n \nnot\n \nonly\n \na\n \nrelevant\n \ngoal\n \nfor\n \nmedical\n \ntreatments,\n \nbut\n \nalso\n \nfor\n \nissues\n \nof\n \nrecognition\n \nand\n \nmedical\n \ngaslighting.\n \nThere\n \nis\n \ngreat\n \ninclusivity\n \npotential\n \nin\n \nfuture\n \nrenditions\n \nof\n \nthe\n \nguidelines,\n \nby\n \nexpanding\n \nhow\n \nendometriosis\n \nis\n \nlabelled\n \nin\n \na\n \ngender\n \ninclusive\n \nand\n \nsocially\n \naware\n \nmanner,\n \nwhich\n \nwould\n \ngreatly\n \nbenefit\n \nmarginalized\n \nindividuals\n \nin\n \nendo-healthcare.\n \nAll\n \nthose\n \nseeking\n \ncare\n \nfor\n \nendometriosis\n \nshould\n \nbe\n \nmet\n \nwith\n \nrespect,\n \nknowledge\n \nand\n \ncompassion,\n \nwhich\n \nI\n \nthink\n \nimproved\n \nguidelines\n \ncan\n \ncontribute\n \nto.\n \n  Endometriosis  is  a  feminized  field,  where  transphobia  and  ‘TERF-ism’  (trans-exclusionary  \nradical\n \nfeminism)\n \nare\n \nat\n \nthe\n \nrisk\n \nof\n \ninforming\n \nwho\n \nis\n \nconsidered\n \nentitled\n \nto\n \ndiagnosis\n \nand\n \ntreatment.\n \nIt\n \nwas\n \nreported\n \nin\n \nApril\n \nthis\n \nyear\n \nhow\n \nthe\n \nUK\n \nSupreme\n \ncourt\n \ndecided\n \nthat\n \ntrans\n \nwomen\n \nwere\n \nto\n \nbe\n \nexcluded\n \nfrom\n \nthe\n \nlegal\n \nterm\n \nwoman\n \n(Haq,\n \n2025),\n \na\n \ndecision\n \npartially\n \nfueled\n \nby\n \nthe\n \nlobbying\n \nof\n \nTERF\n \nfeminists\n \nin\n \nthe\n \nUK\n \ncontext\n \nand\n \nglobally.\n \nTERF-ism,\n \njust\n \nlike\n \nall\n \nprejudice,\n \nis\n \nfueled\n \nby\n \nignorance.\n \nIn\n \nlight\n \nof\n \ndecisions\n \nlike\n \nthese,\n \nit\n \nis\n \nvital\n \nto\n \nhighlight\n \nthat\n \nwomen\n \nare\n \nnot\n \nless\n \nlikely\n \nto\n \nbe\n \nbrutalized,\n \ndiscriminated\n \nagainst\n \nand\n \nneglected\n \nbecause\n \nof\n \nthe\n \nexclusion\n \nof\n \ntrans\n \nand\n \nintersex\n \nindividuals,\n \nin\n \nendometriosis\n \nhealthcare\n \nor\n \nanywhere\n \nelse\n \nin\n \nsociety.\n \n  \n49  \n\n \nIn  the  logics  of  intersectionality,  the  emancipation  of  trans-people  go  hand  in  hand  with  \nelevating\n \nmisogyny.\n \nIn\n \nthe\n \nsame\n \nway\n \nthat\n \nthe\n \nemancipation\n \nof\n \ntrans\n \nand\n \nintersex\n \npeople\n \ngo\n \nhand\n \nin\n \nhand\n \nwith\n \ndismantling\n \ncolonial\n \nvalues,\n \nracism,\n \nand\n \nableism.\n \nOur\n \nstruggles\n \nare\n \naligned,\n \nnot\n \nopposing.\n \nThis\n \nproject\n \naims\n \nto\n \nfurther\n \nthe\n \nimportance\n \nof\n \nintersectionality\n \nwhen\n \ndealing\n \nwith\n \nsocial\n \nissues\n \nin\n \nhealthcare.\n \nTo\n \ndeal\n \nwith\n \nhealthcare\n \ndiscrimination,\n \nSocialstyrelsen\n \nneeds\n \nto\n \naccount\n \nfor\n \ndiverging\n \nforms\n \nof\n \nsocial\n \nidentities,\n \ntheir\n \nhierarchical\n \nimplications\n \nand\n \nhow\n \nit\n \naffects\n \nhealthcare\n \nexperience.\n \nIt\n \nis\n \nonly\n \nthrough\n \nrecognition\n \nof\n \nexisting\n \nprejudice\n \nin\n \nhealthcare\n \nsettings\n \nthat\n \ndiscrimination\n \nissues\n \ncan\n \nbe\n \nmended,\n \ndemanding\n \nmore\n \ncomprehensive\n \nsocial\n \nperspectives\n \nin\n \nfuture\n \nrenditions\n \nof\n \nSocialstyrelsens\n \nguidelines\n \nfor\n \nendometriosis.\n  Future  research  done  on  the  topic  of  endometriosis  should  strive  to  encompass  the  \nexperiences\n \nof\n \ndiffering\n \npatient\n \ngroups\n \nin\n \nthe\n \nintersectional\n \nlandscape\n \nof\n \noppression.\n \nMore\n \nresearch\n \nalso\n \nneeds\n \nto\n \nbe\n \ndone\n \non\n \nendometriosis\n \nguidelines,\n \nand\n \ntheir\n \nrole\n \nin\n \ncurrent\n \nissues\n \nof\n \nendo-healthcare.\n \nConsidering\n \nthe\n \nissues\n \nof\n \nlong\n \nwaiting\n \ntimes\n \nand\n \noverall\n \nlacking\n \nendometriosis\n \nhealthcare\n \nglobally,\n \ncontinued\n \nacademic\n \nwork\n \ndone\n \non\n \nendometriosis\n \nhealthcare\n \nis\n \nvital\n \nto\n \narticulate\n \nthe\n \nproblems\n \nwhich\n \nneed\n \nto\n \nbe\n \nmended\n \nin\n \norder\n \nto\n \nassure\n \nhealthcare\n \nservices\n \nare\n \neffective,\n \naccessible\n \nand\n \nequal\n \nfor\n \nall.\n \nThis\n \nthesis\n \nprovides\n \none\n \nof\n \nstarting\n \npoints\n \nto\n \ncritically\n \nand\n \ndiscursively\n \nanalyse\n \nSocialstyrelsens’\n \nguidelines\n \non\n \nendometriosis\n \nthrough\n \na\n \nfeminist\n \nperspective\n \nand\n \nto\n \nbuild\n \ninclusive\n \nresearch\n \nand\n \ninfrastructures\n \nfor\n \nhealthcare.\n           \n50  \n\n \n8.  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(2024),  “Kritisk  diskursanalys  som  feministisk  metod”  in  Kolankiewicz,  M.,  \nLiinason,\n \nM.\n \n&\n \nSager,\n \nM.\n \n(2024)\n \nGenusvetenskapliga\n \nforskningsmetoder,\n \nNordic\n \nAcademic\n Press.  (DOI:  https://doi.org/10.37852/oblu.260)   Butler,  J.  (2011),  Bodies  that  matter  -  On  the  discursive  limits  of  sex” ,  London:  Routledge,  1st  edition.  (DOI:  https://doi.org/10.4324/9780203828274)   Carvalho,  A.S.,  Lapa,  T.  &  Pascoal,  M.P  (2024),  “The  Need  to  Look  at  Transgender  and  \nGender\n \nDiverse\n \nPeople's\n \nHealth:\n \nA\n \nPreliminary\n \nDescriptive\n \nReport\n \non\n \nPain,\n \nSexual\n \nDistress,\n \nand\n \nHealth\n \nProfile\n \nof\n \nFive\n \nTransmasculine\n \nPeople\n \nand\n \nOne\n \nNon-Binary\n \nPerson\n \nwith\n Endometriosis”,  Healthcare  12:12,  1229  (DOI:10.3390/healthcare12121229)   Centrum  för  epidemiologi  och  samhällsmedicin,  “Smärta”.  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(2018),  “The  double-edged  \nexperience\n \nof\n \nhealthcare\n \nencounters\n \namong\n \nwomen\n \nwith\n \nendometriosis:\n \nA\n \nqualitative\n \nstudy”,\n Journal  of  Clinical  Nursing  27:1-2,  pp.  205-211.  (DOI:10.1111/jocn.13872)   \n53  \n\n \nGrundström,  H.  (2020),  \"A  protracted  struggle\"  -  A  qualitative  blog  study  of  endometriosis  \nhealthcare\n \nexperiences\n \nin\n \nSweden”,\n \nAustralian\n \nJournal\n \nof\n \nAdvanced\n \nNursing\n \n37:4,\n \npp.\n \n20-27.\n (DOI:10.37464/2020.374.75)   Grundström,  H.,  Engman,  L.,  Rimhagen,  E.,  Söderstierna,  C.  &  Flink,  I.  (2023),  “Experiences  \nof\n \ncommunication\n \nin\n \nwomen\n \nwith\n \nendometriosis:\n \nperceived\n \nvalidation\n \nand\n \ninvalidation\n \nin\n \ndifferent\n \ncontexts,\n \nand\n \nassociations\n \nwith\n \nhealth-related\n \nquality\n \nof\n \nlife”,\n \nJournal\n \nof\n \nPsychosomatic\n \nObstetrics\n \n&\n \nGynecology\n \n44:1,\n \npp.\n \n1-7.\n (DOI:  10.1080/0167482X.2023.2264483)   Gubrium,  E.,  Harslof,  I.,  &  Lodemel,  I.  (2014),  “Norwegian  Activation  Reform  on  a  Wave  of  \nWider\n \nWelfare\n \nState\n \nChange:\n \nA\n \nCritical\n \nAssessment”,\n \nin\n \nLodemel,\n \nI.\n \n&\n \nMoreira,\n \nA.\n \n(2014),\n \nActivation\n \nor\n \nWorkfare?\n \nGovernance\n \nand\n \nthe\n \nNeo-Liberal\n \nConvergence\n,\n \nOxford\n \nUniversity\n \nPress.\n (DOI:  https://doi.org/10.1093/acprof:oso/9780199773589.001.0001)   Gunaratnam,  Y.  (2024),  “Efter  reflexivitet”  in  Kolankiewicz,  M.,  Liinason,  M.  &  Sager,  M.  \n(2024)\n \nGenusvetenskapliga\n \nforskningsmetoder,\n \nNordic\n \nAcademic\n \nPress.\n (DOI:  https://doi.org/10.37852/oblu.260)   Hallström,  I.  (2024),  “Endo  Episteme:  Epistemic  Injustice  and  the  Misrecognition  of  \nEndometriosis”,\n \nFeminist\n \nPhilosophy\n \nQuarterly\n \n10:4,\n \nArticle\n \n2.\n (DOI:https://ojs.lib.uwo.ca/index.php/fpq/article/view/16491/17305)   Haq,  N.S  (2025),  “UK  Supreme  Court  says  legal  definition  of  ‘woman’  excludes  trans  \nwomen,\n \nin\n \nlandmark\n \nruling”,\n \nin\n \nCNN\n \nWorld.\n \n16th\n \nof\n \nApril.\n \n(Link:\n https://edition.cnn.com/2025/04/16/uk/uk-supreme-court-ruling-definition-woman-intl)  (derived  16/5  2025)   Hirsch  M.,  Begum,  MR.,  Paniz,  É;  Barker,  C.,  Davis,  CJ  &  Duffy,  JMN  (2017),  “Diagnosis  \nand\n \nmanagement\n \nof\n \nendometriosis:\n \na\n \nsystematic\n \nreview\n \nof\n \ninternational\n \nand\n \nnational\n \nguidelines”,\n \nAn\n \nInternational\n \nJournal\n \nof\n \nObstetrics\n \nand\n \nGynaecology\n \n125:5,\n \npp.\n \n556-564.\n (DOI:https://doi.org/10.1111/1471-0528.14838)   \n54  \n\n \nHållstam,  A.;  Stålnacke,  B.M;  Svensen,  C  &  Löfgren,  M  (2018),  “Living  with  painful  \nendometriosis\n \n-\n \na\n \nstruggle\n \nfor\n \ncoherence:\n \na\n \nqualitative\n \nstudy”,\n \nSexual\n \n&\n \nReproductive\n HealthCare  17,  pp.  97-102.  (DOI:https://doi.org/10.1016/j.srhc.2018.06.002)   Harraway,  D.  (1988),  “Situated  Knowledges:  The  Science  Question  in  Feminism  and  the  \nPrivilege\n \nof\n \nPartial\n \nPerspective”,\n \nFeminist\n \nPerspectives\n \n14:3,\n \npp.\n \n575-599.\n (DOI:https://doi.org/10.2307/3178066)   Jeffrey,  S.,  Ashton,  L.;  Ferfolja,  T.  &  Armour,  M.  (2024),  “Transgender  and  gender  diverse  \npeople\n \nwith\n \nendometriosis:\n \nA\n \nperspective\n \non\n \naffirming\n \ngynaecological\n \ncare”,\n \nWomen's\n \nHealth\n Vol  20,  pp.  1-7 .  (DOI:10.1177/17455057241251974)   Kalaitzopoulos,  D.R.,  Samartzis,  N.,  Kolovos,  N.G.,  Mareti,  E.,  Samartzis,  P.E.,  Eberhard,  \nM.,\n \nDinas,\n \nK.\n \n&\n \nDaniilidis,\n \nA.\n \n(2021),\n \n“Treatment\n \nof\n \nendometriosis:\n \na\n \nreview\n \nwith\n \ncomparison\n \nof\n \n8\n \nguidelines”,\n \nBMC\n \nWomen’s\n \nHealth\n \n21:1,\n \npp.\n \n1-9.\n (DOI:https://doi.org/10.1186/s12905-021-01545-5)   Kaltsas,  A.,  Stavropoulos,  M.,  Symeonidis,  N.E.,  Kratiras,  Z.,  Zachariou,  A.,  Zikopoulos,  A.,  \nChrisofos,\n \nE.E.,\n \nDimitriadis,\n \nF.,\n \nSofikitis,\n \nN.\n \n&\n \nChrisofos,\n \nM.\n \n(2024),\n \n“Endometriosis\n \nin\n \nTransgender\n \nMen:\n \nBridging\n \nGaps\n \nin\n \nResearch\n \nand\n \nCare—A\n \nNarrative\n \nReview”,\n \nBiomedicines\n \n12:7,\n \n1481.\n \n (DOI:  https://doi.org/10.3390/biomedicines12071481)   Kirk,  U.B.,  Bank-Mikkelsen,  A.S.,  Rytter,  D.,  Hartwell,  D.,   Marschall,  H.,  Nyegaard,  M.,  \nSeyer-Hansen,\n \nM.\n \n&\n \nEjgaard\n \nHansen,\n \nK.\n \n(2024),\n \n“Understanding\n \nendometriosis\n \nunderfunding\n \nand\n \nits\n \ndetrimental\n \nimpact\n \non\n \nawareness\n \nand\n \nresearch”\n \nin\n \nNPJ\n \nWomen’s\n \nHealth\n \n2:45,\n \n(DOI:\n https://doi.org/10.1038/s44294-024-00048-6)   Landry,  J.  (2021),  “Trans,  gender-diverse  people  with  endometriosis  fight  'double  battle'  \nagainst\n \npain\n \nand\n \nlack\n \nof\n \nrecognition”,\n \nin\n \nCBC\n \nNews.\n \n31st\n \nof\n \nMarch.\n \n (Link:https://www.cbc.ca/news/canada/british-columbia/endometriosis-transgender-gender-diverse-non-binary-double-battle-1.5970374)  (derived  16/5  2025)   \n55  \n\n \nLeach,  M.  (2024),  “Doctors  wouldn't  take  Julie  Snook  seriously  for  six  years.  New  data  \nproves\n \nshe's\n \nnot\n \nalone”,\n \nin\n \n9\n \nNews,\n \n21st\n \nof\n \nNovember.\n \n (Link:https://www.9news.com.au/national/women-report-fewer-positive-hospital-experiences-than-men-julie-snook/83ccd297-2695-41ba-9bb2-d1026fc3f9a2)  (16/5-2025)   Lightbourne,  A.,  Foley,  S.,  Dempsey,  M.  &  Cronin,  M.  (2024),  “Living  With  Endometriosis:  \nA\n \nReflexive\n \nThematic\n \nAnalysis\n \nExamining\n \nWomen’s\n \nExperiences\n \nWith\n \nthe\n \nIrish\n \nHealthcare\n \nServices”,\n \nQualitative\n \nHealth\n \nResearch\n \n34:4,\n \npp.\n \n311-322.\n (DOI:  10.1177/10497323231214114)   Lind,  S.  (2024),  ”Smärtan  golvar  en”  –  Sandra  i  Orsa  väntade  11  år  på  diagnos  för  \nendometrios”,\n \nSVT\n \nNyheter.\n  (Link:https://www.svt.se/nyheter/lokalt/dalarna/smartan-golvar-en-sandra-i-orsa-vantade-11-ar-pa-diagnos-for-magsmartorna)  (derived  17/4-2025)   Lindemann,  H.  (2022),  “Feminist  Bioethics  -  Where  we’ve  come  from”  in  Rogers,  A.Wendy;  \nLeach\n \nScully,\n \nJackie;\n \nCarter,\n \nM.Stacy;\n \nEntwistle,\n \nA.\n \nVikki\n \n&\n \nMills,\n \nCatherine\n \n(2022),\n \nThe\n \nRoutledge\n \nHandbook\n \nof\n \nFeminist\n \nBioethics,\n \nRoutledge,\n \n1st\n \nedition.\n (DOI:https://doi.org/10.4324/9781003016885)   Lodemel,  I.  &  Moreira,  A.  (2014),  Activation  or  Workfare?  Governance  and  the  Neo-Liberal  \nConvergence\n,\n \nOxford\n \nUniversity\n \nPress.\n (DOI:  https://doi.org/10.1093/acprof:oso/9780199773589.001.0001)   Mani,  S.  (2024),  “Why  Don’t  We  Take  Period  Pain  Seriously?  2  Women  Share  Their  Painful  \nEndometriosis\n \nJourneys”,\n \nin\n \nThe\n \nBetter\n \nIndia.\n \n10th\n \nof\n \nOctober.\n (Link:https://thebetterindia.com/369628/endometriosis-gynaecologists-womens-health-pain-periods-menstrual-cramps-devleena-chatterjee-sneha-khedkar/)  (derived  16/5  2025)   McCann,  S.  (2025),  “Endometriosis:  Hundreds  of  patients  share  their  heartbreaking  stories  -  \nand\n \nwhy\n \nthe\n \nNHS\n \nis\n \nfailing\n \nthem”,\n \nin\n \nThe\n \nScotsman.\n \n11th\n \nof\n \nApril.\n (Link:https://www.scotsman.com/health/heartbreaking-stories-of-those-living-with-endometriosis-5077570)  (derived  16/5  2025)   \n56  \n\n \nMelin,  Q.M  (2025),  “Transmannen  Jonny,  45:  “Jag  har  endometriosis”,  in  Aftonbladet .  14th  \nof\n \nApril.\n (Link:https://www.aftonbladet.se/nyheter/a/VzMe2d/transmannen-johnny-45-jag-har-endometrios)  (derived  16/5  2025)    Monzón,  P.  (2024),   “Athena  väntade  åtta  år  på  sin  endometriosdiagnos:  ”Föll  ihop  och  skrek  \nav\n \nsmärta”,\n \nSVT\n \nNyheter.\n \n4th\n \nof\n \nApril.\n (Link:https://www.svt.se/nyheter/lokalt/stockholm/athena-vantade-atta-ar-pa-sin-endometriosdiagnos-foll-ihop-och-skrek-av-smarta)  (derived  17/4-2025)   Piña-Romero,  J.  (2023),  “Citizen  science  “from  the  margins”:  epistemologies  of  ignorance  in  \nthe\n \nMovement\n \nof\n \nWomen\n \nwith\n \nEndometriosis\n \nin\n \nMexico”,\n \nTapuya:\n Latin  American  Science,  Technology  and  Society  6:1.   (DOI:  https://doi.org/10.1080/25729861.2023.2247834)   RFSU  (2022),  “Endometrios”  (Link:https://www.rfsu.se/sex-och-relationer/for-dig-som-undrar/kropp-och-kon/mens/endometrios/)  (derived  17/4-2025)   Rogers,  A.W.,  Leach  Scully,  J.,  Carter,  M.S.,  Entwistle,  A.V.  &  Mills,  C-  (2022),  The  \nRoutledge\n \nHandbook\n \nof\n \nFeminist\n \nBioethics,\n \nRoutledge,\n \n1st\n \nedition.\n (DOI:https://doi.org/10.4324/9781003016885)   Shahvisi,  A.  (2022),  “Toward  an  anticolonial  feminist  bioethics”  in  Rogers,  A.Wendy;  Leach  \nScully,\n \nJackie;\n \nCarter,\n \nM.Stacy;\n \nEntwistle,\n \nA.\n \nVikki\n \n&\n \nMills,\n \nCatherine\n \n(2022),\n \nThe\n \nRoutledge\n \nHandbook\n \nof\n \nFeminist\n \nBioethics,\n \nRoutledge,\n \n1st\n \nedition.\n (DOI:https://doi.org/10.4324/9781003016885)   Skanung,  E.  &  Svensson,  B.  (2024),  “Vård  av  unga  med  könsdysfori  och  unga  med  \nintersexvariationer\n \n-\n \nEn\n \nkomparativ\n \nWPR-analys”,\n \nBachelor\n \nthesis,\n \nSchool\n \nof\n \nSocial\n \nwork,\n Lunds  Universitet.  (Link:https://lup.lub.lu.se/student-papers/search/publication/9163435)   \n57  \n\n \nSocialstyrelsen  (2018),  “Nationella  riktlinjer  för  vård  vid  endometriois  -  Stöd  för  styrning  och  \nledning”.\n (Link:https://www.socialstyrelsen.se/kunskapsstod-och-regler/regler-och-riktlinjer/nationella-riktlinjer/riktlinjer-och-utvarderingar/endometrios/)  (17/4-2025)   Socialstyrelsen  (2023),  “Nationella  riktlinjer”.  (Link:https://www.socialstyrelsen.se/kunskapsstod-och-regler/regler-och-riktlinjer/nationella-riktlinjer/)  (17/4-2025)   Soldiac,  K.  &  Meekosha,  H.  (2012),  “The  Place  of  Disgust:  Disability,  Class  and  Gender  in  \nSpaces\n \nof\n \nWorkfare”,\n \nSocieties\n \n2:3,\n \npp.\n \n139-156.\n \n (DOI:  https://doi.org/10.3390/soc2030139)   Stovicek,  A.  (2018),  “He  Is  1  in  10:  A  Trans  Man  Shares  What  Life  is  Like  With  \nEndometriosis”,\n \nin\n \nThe\n \nEndometriosis\n \nFoundation\n \nof\n \nAmerica.\n \n4th\n \nof\n \nJune.\n (Link:https://www.endofound.org/he-is-1-in-10-a-trans-man-shares-what-life-is-like-with-endometriosis)  (derived  16/5  2025)   Sudenkaarne,  T.  (2022),  “Toward  a  queer  feminist  bioethics  of  sexuality”  in  Rogers,  \nA.Wendy;\n \nLeach\n \nScully,\n \nJackie;\n \nCarter,\n \nM.Stacy;\n \nEntwistle,\n \nA.\n \nVikki\n \n&\n \nMills,\n \nCatherine\n \n(2022),\n \nThe\n \nRoutledge\n \nHandbook\n \nof\n \nFeminist\n \nBioethics,\n \nRoutledge,\n \n1st\n \nedition.\n (DOI:https://doi.org/10.4324/9781003016885)   Topor,  A.  (2016),  Medikaliseringen  av  det  psykosociala  fältet.  Om  en  \nkunskapssammanställning\n \nfrån\n \nSocialstyrelsen,\n \nIMS”,\n \nSocialvetenskaplig\n \ntidskrift\n \n17:1,\n \npp.\n 67-81.  (DOI:https://doi.org/10.3384/SVT.2010.17.1.2487)   Turkmendag,  I.  (2022),  “Exploitation  and  control  of  women’s  reproductive  bodies”  in  \nRogers,\n \nA.Wendy;\n \nLeach\n \nScully,\n \nJackie;\n \nCarter,\n \nM.Stacy;\n \nEntwistle,\n \nA.\n \nVikki\n \n&\n \nMills,\n \nCatherine\n \n(2022),\n \nThe\n \nRoutledge\n \nHandbook\n \nof\n \nFeminist\n \nBioethics,\n \nRoutledge,\n \n1st\n \nedition.\n (DOI:https://doi.org/10.4324/9781003016885)     \n58  \n\n \nWithers,  C.  (2023),  “As  Is  seeks  treatment  for  endometriosis,  their  gender  dysphoria  has  \nmade\n \ngetting\n \nhelp\n \nmore\n \ndifficult”,\n \nin\n \nThe\n \nAustralian\n \nBroadcasting\n \nCompany.\n \n30th\n \nof\n March.(Link:https://www.abc.net.au/news/2023-03-31/being-transgender-with-endometriosis/102164446)  (16/5  2025)   Young,  K.,  Fisher,  J.  &  Kirkman,  M.  (2019),  ‘‘Do  mad  people  get  endo  or  does  endo  make  you  mad?’’:  Clinicians’  discursive  constructions  of  Medicine  and  women  with  endometriosis”,  Feminism  &  Psychology  29:3,  pp.  337-356.   (DOI:  https://doi.org/10.1177/0959353518815704)   Zajacova,  A.,  Grol-Prokopczyk,  H.  &  Zimmer,  Z.  (2021),  “Sociology  of  chronic  pain”,  \nJournal\n \nof\n \nHealth\n \nand\n \nSocial\n \nBehavior\n \n62:3,\n \npp.\n \n302-317.\n (DOI:https://www.jstor.org/stable/48635315?seq=1)     \n59","source_license":"CC0","license_restricted":false}