Gender Diverse, Autoethnographic Perspective of Epistemic Injustice During Endometriosis Care

Graziano TA, Teresa A Graziano, Teresa Graziano
Journal of obstetric, gynecologic, and neonatal nursing : JOGNN · 2026 · doi:10.1016/j.jogn.2026.09.002 · PMID:42785378 · W7214218871
Other OA: closed public-domain-us
View on OpenAlex View on PubMed View at publisher
⚙ AI-generated summary by qwen3.7-flash, 2026-09-29 ⓘ

An autoethnographic analysis of a gender diverse individual with endometriosis reveals that epistemic injustice, including misgendering and dismissal, compounded diagnostic delays and psychological distress during chronic pelvic pain care.

One-sentence paraphrase of the abstract; not a substitute for reading it. No clinical advice. How this works

Abstract

OBJECTIVE: To examine the epistemic injustice experienced by a gender diverse individual during diagnosis for chronic pelvic pain and endometriosis. DESIGN: Autoethnography. SETTING: Five health care institutions across four northeastern states. PARTICIPANT: I am a White, non-Hispanic nurse with private health care insurance who was assigned female at birth (AFAB) and identifies as gender diverse. I have chronic pelvic pain and endometriosis. METHODS: I used autoethnography to situate my experience within broader social, cultural, and institutional contexts. My personal journal, text messages, e-mails, health records, and memory are the sources of data that I used. I reflexively and critically engaged with my data through reading, memo writing, and thematic analysis to balance autobiography and cultural critique. RESULTS: I experienced many psychological consequences of a delayed diagnosis of endometriosis as a gender diverse health care professional who was AFAB. Despite my significant health care literacy and access, my persistent pain was repeatedly minimized, which led to profound self-doubt and internalized medical invalidation. I found that gender misrecognition in clinical care and documentation compounded my experiences of dismissal and exclusion. Humor with friends often served as a coping mechanism but did not address the aftereffects of frequent misgendering in clinical environments. CONCLUSION: Transgender and gender nonconforming individuals may be doubly affected by epistemic injustice when they seek treatment for chronic pelvic pain. Whereas many challenges are faced by cisgender women with endometriosis, my experience highlights the distinct intersection of chronic pain, delay in diagnosis, and transgender and gender nonconforming invisibility in health care systems and support spaces. Nurses can address these disparities through targeted interventions to promote inclusion.

My notes (saved in your browser only)

Citation neighborhood (2-hop)

Papers in the corpus that this work cites (lower rings, blue) and that cite this one (upper rings, green). Dot size scales with the paper's in-corpus citation count — bigger dot = more influential within the endo/adeno field. Click a dot to open that paper. Outer rings show 2-hop neighbours — papers reached through the immediate citers/citees. [ collapse to 1-hop ]

References (26)

Source provenance

europepmc
last seen: 2026-10-21T06:16:17.486033+00:00
openalex
last seen: 2026-10-21T06:08:36.303631+00:00
pubmed
last seen: 2026-10-21T06:10:10.231556+00:00
unpaywall
last seen: 2026-10-20T06:27:24.728081+00:00
License: public-domain-us · commercial use OK · attribution required
Courtesy of the U.S. National Library of Medicine