From Pathologization to Participation: Trans Influencers, Gender Joy, and the Socioecological Reimagining of Health Communication

In the context of increasing anti-trans health misinformation and legislative attacks on gender-affirming care, this study examines how transgender and gender-diverse (trans) social media influencers are reshaping health communication. Drawing on qualitative interviews with ten trans and nonbinary influencers, we explore how participants use their platforms to advocate for health equity, challenge biomedical gatekeeping, and promote gender-affirming narratives. Anchored in the socioecological model of health, our analysis reveals how influencers operate across individual, relational, community, and societal levels-bridging personal storytelling with systemic critique. While existing health communication research often neglects the role of community-based digital actors, this study positions trans influencers as vital agents in countering misinformation, building trust, and redefining what constitutes "health" in marginalized communities. We conclude with recommendations for integrating influencer insights into healthcare practice, policy, and public messaging, emphasizing the need for participatory, relational, and culturally attuned health communication strategies.