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Bargaining and calibration: How SGM people navigate intersectional oppression in healthcare

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  • Hsieh, Ning
  • Shuster, Stef M.

Abstract

Sexual and gender minority (SGM) people experience far-reaching health inequities, yet their responses to such oppression remain underexplored. Related, recent scholarship has called for more intersectional analyses of SGM health. Drawing on interviews with a diverse sample of 40 SGM individuals, this study investigates participants’ experienced and anticipated barriers to care, the strategies employed to navigate these challenges, and how an intersectional lens offers a different vantage point to analyze their experiences. We identify bargaining – giving up or downplaying aspects of identities and relevant health information – and calibration – adjusting actions in anticipation of oppression – as two strategies participants used to navigate healthcare under intersecting inequalities related to sexuality, gender, and race/ethnicity. These ongoing strategies helped participants manage healthcare barriers and anticipated discrimination but came with significant costs to their health. We contribute to medical sociology by introducing the concepts of bargaining and calibration as agentic responses to healthcare inequities.

Suggested Citation

  • Hsieh, Ning & Shuster, Stef M., 2026. "Bargaining and calibration: How SGM people navigate intersectional oppression in healthcare," Social Science & Medicine, Elsevier, vol. 403(C).
    • Handle: RePEc:eee:socmed:v:403:y:2026:i:c:s0277953626004600
    DOI: 10.1016/j.socscimed.2026.119384
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