Identifications in flux: sexual-minority women’s healthcare encounters viewed through the lens of identitarian articulations

In the USA, sexual-minority women experience disparities in healthcare access, quality, and outcomes, shaped by entanglements of gender/sex, sexuality, and institutional norms. While intersectionality has been central to understanding these structural inequities, it does not always account for the shifting, situational nature of how identifications develop in specific encounters. Drawing on identitarian articulations theory, this study explores how sexual-minority women's identifications are differentially activated across healthcare settings. Based on in-depth interviews with fifteen US-based sexual-minority women aged 31 to 73 years, the analysis reveals how identifications materialise through intra-actions with human and non-human elements, including provider attitudes, spatial arrangements, medical protocols, and affective atmospheres. Findings highlight five analytic advantages of this approach: capturing the contingency of identifications, recognising non-human elements, accounting for differential articulation, emphasising affective dimensions, and expanding intervention possibilities. This perspective moves beyond static identity frameworks and individual-level solutions, offering a flexible, relational model for understanding and transforming healthcare practices and environments.