Fat and Furious: Interrogating Fat Phobia and Nurturing Resistance in Medical Framings of Fat Bodies

"You want people to listen to you": Patient experiences of women's healthcare within the Veterans Health Administration

OBJECTIVE

To identify constructs that are critical in shaping Veterans' experiences with Veterans Health Administration (VA) women's healthcare, including any which have been underexplored or are not included in current VA surveys of patient experience.

DATA SOURCES AND STUDY SETTING

From June 2022 to January 2023, we conducted 28 semi-structured interviews with a diverse, national sample of Veterans who use VA women's healthcare.

STUDY DESIGN

Using VA data, we divided Veteran VA-users identified as female into four groups stratified by age (dichotomized at age 45) and race/ethnicity (non-Hispanic White vs. all other). We enrolled Veterans continuously from each recruitment strata until thematic saturation was reached.

DATA COLLECTION/EXTRACTION METHODS

For this qualitative study, we asked Veterans about past VA healthcare experiences. Interview questions were guided by a priori domains identified from review of the literature, including trust, safety, respect, privacy, communication and discrimination. Analysis occurred concurrently with interviews, using inductive and deductive content analysis.

PRINCIPAL FINDINGS

We identified five themes influencing Veterans' experiences of VA women's healthcare: feeling valued and supported, bodily autonomy, discrimination, past military experiences and trauma, and accessible care. Each emergent theme was associated with multiple of the a priori domains we asked about in the interview guide.

CONCLUSIONS

Our findings underscore the need for a measure of patient experience tailored to VA women's healthcare. Existing patient experience measures used within VA fail to address several aspects of experience highlighted by our study, including bodily autonomy, the influence of past military experiences and trauma on healthcare, and discrimination. Understanding distinct factors that influence women and gender-diverse Veterans' experiences with VA care is critical to advance efforts by VA to measure and improve the quality and equity of care for all Veterans.

Reproductive governance and the affective economy

The governance of reproductive practices, processes, decision-making, experiences, desires, subjectivities, and bodies has received and continues to receive significant attention in feminist efforts to name and resist reproductive oppression. And over the last 30 years, articles published in Feminism & Psychology have made significant contributions to the visibilisation and critique of this form of oppression. In this Virtual Special Issue on Reproductive Governance and the Affective Economy, we apply repronormativity and affect to our reading of 20 articles published in Feminism & Psychology. Collectively, these articles provide a glimpse of the wide-ranging scope of reproductive regulation (including that which is re-produced by/within feminism itself), and the various work that repronormativity and affect do in this governance. The challenging of reproductive governance notwithstanding, we conclude by arguing that the centring and circulation of certain reproductive subjects and their experiences within feminist knowledge production is itself a part of and upholds repronormativity and forecloses the possibility of reproductive freedom for all.