Social and Behavioral Sciences Commons^™

The Psychiatric Burden Of Hidradenitis Suppurativa: A Trinetx Analysis Of Sex-Specific Disparities In Mental Health And Medication Use, Emily Sheetz, Julia Feord, Collette Sholi, Parker Adams, Tamas Gal, Susan G. Kornstein, Arturo Saavedra

Department of Medicine Faculty Publications

Background:

Hidradenitis suppurativa (HS) is a chronic inflammatory skin condition associated with physical and psychological burden. Prior research has shown increased rates of depression and anxiety among individuals with HS; however, sex-based disparities in the prevalence of these mental health conditions in patients with HS remain underexplored.

Objective:

To evaluate sex-based differences in the prevalence of major depressive disorder (MDD), generalized anxiety disorder (GAD), and the prescribing of antidepressants and anxiolytics among patients with HS.

Methods:

Using the TriNetX database, we identified patients over the age of 18 who had a recorded diagnosis of HS. Propensity score matching based on …

Visit Complexity Differs Between Scarring And Nonscarring Alopecia: A 5-Year Dataderm Analysis, Ian Noel Encarnacion, Noelle Desir, Nicholas Schell, Apoorva Mehta, Temitayo Ogunleye, Susan Taylor

Department of Medicine Faculty Publications

[Introduction] Accurate coding is a critical component of dermatologic practice, influencing reimbursement and documentation of clinical complexity. Although alopecia has significant psychosocial and financial burdens, Current Procedural Terminology (CPT) coding patterns in alopecia management remain largely understudied. Our population-level study using the American Academy of Dermatology's DataDerm clinical registry¹ evaluates alopecia CPT coding trends, pre-2021 and post-2021 evaluation and management (E/M) CPT coding updates,² aiming to inform coding practices and visit complexity, which have significant reimbursement implications.

Criterion Validity Of The Functional Status And Pain Assessment Scale Versus Pain And Length Of Stay In Hospitalized Adults With Scd, Wally R. Smith, Daniel M. Sop, Yue May Zhang, Margaret S. Guy, Rehan Qayyum

Department of Medicine Faculty Publications

Objectives

In prior research we demonstrated face, construct, discriminant, and preliminary convergent validity of the newly developed, 10-item Functional Status Pain Assessment (FSPA) scale (0-50) in adult SCD patients hospitalized with VOC. We aimed in this study to further demonstrate criterion validity of the FSPA.

Methods

This was a prospective observational study of 561 daily functional and pain assessments from 91 hospitalized adults with SCD from January 2018 to June of 2019. Principal Component Analysis (PCA) Partial Least Squares (PLS) models determined the relationship between LOS, pain intensity, and FSPA. A Generalized Linear Model (GLM) to quantified the impact of …

Persistent Peristomal Pain Due To An Exposed Cutaneous Nerve, Iain Noel Encarnacion, Kaylin Beiter, Natasha Hakkal, Emily Hejazi, Paul Hernandez, Melissa Laughter, Shannon Nugent, Samir Thaker, Xiaowei Xu, Misha Rosenbach

Department of Medicine Faculty Publications

[Introduction]

Case description

A 25-year-old woman with a history of ulcerative colitis treated with multiple abdominal surgeries complicated by peristomal pyoderma gangrenosum (PPG) presented with severe peristomal pain and ulceration. Treatment course was complicated; disease control was achieved via combination infliximab 10 mg/kg every 4 weeks, corticosteroids (topical triamcinolone 0.1% ointment, intralesional 10 mg/ml injections, and oral prednisone 30 mg daily with a gradual taper), and cyclosporine 125 mg tapering by 25 mg every 3 weeks, ultimately tapered to infliximab monotherapy.

Determinants Of Patient Satisfaction In An Academic Primary Care Setting: A Cross-Sectional Study Of The Postpandemic Era, Alvin Maliakal, Rajita Kanapareddy, Zooha Altaf, Janani Anbazhagan, Kristin Olson, Cynthia Avila, Rehan Qayyum

Department of Medicine Faculty Publications

Background

Patient satisfaction, a key indicator of healthcare quality, is associated with improved adherence, continuity, and outcomes. However, limited evidence describes determinants of patient satisfaction in contemporary primary care settings reflecting the postpandemic era, when care delivery models and patient expectations have evolved substantially.

Objective

To evaluate the sociodemographic and clinical factors associated with patient satisfaction in an academic primary care setting following the postpandemic era.

Methods

We conducted a cross-sectional survey of adult patients (≥18 years) attending a primary care clinic. Participants completed a self-administered questionnaire including the Visit-Specific Satisfaction Questionnaire (VSQ-9) and measures of sociodemographic and clinical characteristics. …

Missed Opportunities For Stroke Prevention In Patients With Hypertension: A Retrospective Case-Control Study, Huanhuan Yang, Yuntian Liu, Chungsoo Kim, Chenxi Huang, Mitsuaki Sawano, Patrick Young, Jacob Mcfadden, Mark Anderson, John S. Burrows, Harlan M. Krumholz, John E. Brush Jr., Yuan Lu

Department of Medicine Faculty Publications

Background

Hypertension is the leading modifiable risk factor for ischemic stroke, yet the adequacy of preventative hypertension care in routine clinical practice remains suboptimal, potentially representing missed opportunities for stroke prevention. We evaluated the association between hypertension care delivery and incident ischemic stroke.

Methods

 We conducted a retrospective, matched, nested case-control study among adults with hypertension using data from a large regional health system (2010-2024). Patients with a first-ever ischemic stroke were matched 1:2 to controls on age, sex, race and ethnicity, and calendar time. Three care metrics were assessed: (1) outpatient visits with blood pressure measurement per year; (2) …

Improving Documentation Of Sexual Orientation, Gender Identity, And Pronouns In Electronic Medical Records Among Heart Failure Patients, Daiwik Munjwani, Colleen Schinderle, Rehan Qayyum, Amin Yehya

Department of Medicine Faculty Publications

Background

Documentation of sexual orientation, gender identity (SOGI), and pronouns in electronic medical records (EMRs) is essential to providing inclusive, patient-centered care, but remains incomplete in many health systems. At our institution, a system-wide diversity, equity, and inclusion (DEI) educational program was launched in September 2023 to emphasize the importance of collecting and documenting SOGI and pronouns.

Aims and objectives

Our objective was to evaluate the effect of a hospital-wide diversity-focused educational initiative on documentation of SOGI and pronouns in the EMR for patients discharged with heart failure (HF).

Methods

We conducted a single-center, retrospective chart review which included adults …

Issue 23: A Rights-Based Migration Strategy For Canada: Addressing Inequities In A Time Of U.S. Political Repression, Marika Jeziorek

International Migration Research Centre

This brief argues that the growing appeal of Canada to highly skilled professionals fleeing rights-based repression in the United States presents a unique opportunity to strengthen its skilled migration strategy through an equity-focused and economically sustainable approach. As U.S. professionals—particularly women, racialized individuals, healthcare providers, and academics—seek safety, professional autonomy, and legal protection, Canada has emerged as a key destination (Favaro, 2025; Levinthal, 2024; Malkin, 2016; Jackson, 2024). This appeal is rooted in Canada’s reputation as a rights-based society, one that contrasts sharply with the erosion of freedoms in parts of the U.S. To uphold and deliver on this perception, …

Factors Influencing Vaping Behaviors Based On Social Cognitive Theory: A Qualitative Study Among Mexican-American College Students, Bara S. Bataineh, Liza Talavera-Garza, Alexandra Loukas, David J. Badillo, Sherman Chow, Geronimo B. Cardenas, Erika Garza, Anna Wilkinson

Psychological Science Faculty Publications

Background: Vaping rates among Mexican-American college students are high, yet the contributing personal and environmental factors remain understudied. The current qualitative study applies Social Cognitive Theory to examine how personal factors (e.g., self-efficacy, beliefs, and outcome expectations) and environmental influences (e.g., social norms and social media) shape vaping behaviors in this vulnerable population. Methods: We conducted semi-structured interviews with 19 Mexican-American college students (ages 18–25 years), 68% of whom were female, and all were current vapers. Participants discussed the personal and social contexts of their vaping experiences, with questions exploring their beliefs and outcome expectations. Interviews were recorded, transcribed, and …

Heat Misers, Snow Misers, And Cognitive Misers: The 'Nukewarm' Perceptions Of Nuclear Power, Tyler Williams

Dissertations and Theses

Rising energy demand in the United States necessitates alternatives to fossil fuels, yet renewable energy sources alone are insufficient to meet this demand. Nuclear power presents a promising option but faces persistent public hesitancy. This study examines how heuristic-based biases relate to American's risk-benefit perceptions towards nuclear power. Guided by the heuristic-systematic model. Results indicate that competence and affect are related to risk-benefit perceptions, and naturalness shows no relationship with risk perceptions but does correlate with benefit perceptions. Implications highlight the importance of affect-driven communication strategies for nuclear communicators, while also underscoring the need for participatory approaches that foster trust …

Sociolinguistic Challenges To The Academic Inclusion Of Latin American Immigrants Of Legal Age And Spanish In High Schools In Minnesota: A Qualitative Study On The Learning Of English As A Second Language, Geanella Margarita Ochoa Veloz

All Graduate Theses, Dissertations, and Other Capstone Projects

This research analyzes and exposes the experiences of Latin American adult migrants who, having recently arrived in the United States, have resumed their studies in high schools in the State of Minnesota as a strategy to learn the English language by immersion. The study was based on the contributions of the sociology of migration and the sociology of education, which, incorporating as a methodological strategy “the case study” combined with “the life story”, managed to collect and share reflections regarding the barriers faced by migrants during the process of adaptation and insertion into American society, thus adopting a critical approach. …

Examining The Impact Of Trauma-Informed Mindfulness Meditation On Posttraumatic Growth Following Interpersonal Trauma: A Randomized Controlled Trial, Margaret Poandl

Theses and Dissertations

Research on interventions designed to increase posttraumatic growth (PTG) among interpersonal trauma survivors is limited. The purpose of this study was to examine the impact of a six-week trauma-informed mindfulness meditation intervention on PTG. Additionally, I examined outcomes of posttraumatic stress (PTS) and loneliness, as well as analyzed the variables of dispositional mindfulness, hope, spirituality, and self-compassion to understand their potential role as mechanisms of change within the intervention on PTG. To answer these research questions, I conducted a randomized controlled trial study with 113 adults from a community sample who reported experiencing interpersonal trauma. Utilizing linear mixed modeling and …

Follow The Cyclists: Everyday Navigation Of Richmond's Bike Infrastructure, Emily E. Schreer

Theses and Dissertations

This thesis explores the embodied experience of cycling in Richmond, emphasizing the importance of centering firsthand, lived experience in cycling research and urban planning. While traditional transportation planning can often myopically prioritize efficiency and safety metrics to evaluate infrastructure, this project argues that such approaches overlook essential experiential, sensory, and emotional dimensions of cycling that determine how infrastructure is perceived, used, and ultimately succeeds or fails.

Through an ethnographic approach combining field observation of cyclist behavior and mental mapping sessions with Richmond cyclists, this study positions people who bike in Richmond as expert knowledge holders. Participant contributions, combined with observations …

Putting The L In Elsi: Legal Methods For Bioethics Research, Anya E R Prince, Benjamin Berkman, Donald Ford, Dov Fox, Christi Guerrini, Amy Koopmann, Natalie Ram, Jessica L Roberts, Kayte Spector-Bagdady, Sonia Suter

Center for Medical Ethics and Health Policy Staff Publications

Lawyers and law professors are increasingly involved in interdisciplinary scientific teams and grant research to answer ethical, legal and policy questions related to biomedical topics. Yet, the methods that lawyers use to conduct legal research and analysis are not always familiar to scientists and social scientists conducting peer review of a proposed project with legal aims or a publication reporting a legal study. To better facilitate interdisciplinary ethical, legal, and social implications collaboration, there is a need to better explain how legal research methodologies can provide robust tools to address a range of nuanced biomedical questions. This paper explores …

Differences Between Government, Consortium, And Private Database Stewards Impacting The Genomic Data Market: A Survey Of U.S. Academic Genetic Researchers., Amanda K Greene, J Denard Thomas, Kaitlyn Jaffe, Luyun Chen, Kerry A Ryan, Brian J Zikmund-Fisher, J Scott Roberts, Amy L Mcguire, Katherine Hendy, Kayte Spector-Bagdady

Center for Medical Ethics and Health Policy Staff Publications

Background: Despite major shifts in U.S. federal government data sharing requirements, their impact, and relation to researcher choice of database, are underexplored. This study surveyed genetic researchers regarding trends, priorities, perceptions of quality, impact on research outcomes, and genomic data sharing and use across government, consortium, and private databases.

Methods: As part of an exploratory sequential mixed methods project, we surveyed 294 U.S.-based genomic academic researchers.

Results: Genetic researchers generally have a choice between databases, which allows them to prioritize data quality. This might explain recent trends toward the use of government and consortium databases away from private ones. Respondents …

Access To Digital Health Technologies: Personalized Framework And Global Perspectives, Sanjiv M Narayan, Mina K Chung, Demilade Adedinsewo, Luisa C C Brant, Leslie L Davis, David Duncker, Jennifer L Hall, Janet K Han, Carolyn S P Lam, Eldrin Lewis, Joseph Loscalzo, Manlio F Márquez, Vasiliki Rahimzadeh, Fatima Rodriguez, Prashanthan Sanders, Emma Svennberg, Kenneth Stein, Mintu Turakhia, Clyde Yancy, Antonis A Armoundas

Center for Medical Ethics and Health Policy Staff Publications

The emergence and rapid adoption of digital health technologies (DHT) present unprecedented opportunities to democratize and reduce disparities in health care by monitoring health and disease at the point of care in all patients. However, limited access to DHT is becoming a major obstacle to realizing these goals. Access to DHT is influenced not only by well-recognized social determinants of health, but also by digital determinants of health, such as digital literacy and the need for broad access to digital infrastructure, as well as commercial and economic factors. Addressing these challenges and designing unbiased systems of care are essential to …

Imagining Genomics And Population Health In 2050: Anticipating Future Research, Policy, And Governance Needs, Bartha Maria Knoppers, Yann Joly, Ma Apos N H Zawati, Habiba Alsafar, Jeffrey C Barrett, Laura Blackburn, Brian Hon-Yin Chung, Martina C Cornel, Edward S Dove, David Glazer, Calvin Wai-Loon Ho, Muin J Khoury, Anna C F Lewis, Anneke Lucassen, Peter F R Mills, Colin Mitchell, Nicola Mulder, Ainsley J Newson, Anthony Ng, Paul D P Pharoah, Vasiliki Rahimzadeh, Megan C Roberts, Saskia C Sanderson, Jeffrey M Skopek, Ron Zimmern, Eric M Meslin

Center for Medical Ethics and Health Policy Staff Publications

No abstract provided.

Nuclear Deterrence And Nuclear Modernization: A Strategic Analysis Of Global Nuclear Threats And U.S. Policy, Abraham Morland

Graduate Theses/Dissertations

The nuclear imperative comes from the idea that all three legs of the Triad must be retained to ensure a viable deterrent posture, provide flexibility in a response, and give decision makers options to create uncertainty in an adversary’s decision calculus. The nuclear imperative is the need to fund suggested shortfalls in the nuclear enterprise and modernize the U.S. Triad, not just one or two legs, but all three, due to the ever-increasing nuclear risk. To understand the current state in which the United States finds itself and the need for the nuclear modernization program, this thesis will review nuclear …

Drone Dichotomy: Investigating The Application Of Unmanned Aerial Systems For Offensive And Defensive Chemical, Biological, Radiological, And Nuclear-Related Tasks, Evan Jacob Martinovitch

Graduate Theses/Dissertations

This thesis investigates the application of unmanned aerial systems (UAS) for both offensive and defensive chemical, biological, radiological, and nuclear (CBRN) tasks to determine if they serve as a force multiplier on the modern battlefield. As CBRN weapons reemerge as realistic threats alongside the rapid proliferation of UAS, the intersection of these fields presents unique challenges and opportunities. Through a methodology that examines the history of the UAS-CBRN intersection, military doctrine, and the status of UAS technology, this research evaluates the capability of current and emerging UAS against specific CBRN delivery, reconnaissance and surveillance, and decontamination tasks. The analysis conducted …

Northern Luzon In A Taiwan Flashpoint: The Philippines’ Place In U.S. Strategy, Carson Keller

Graduate Theses/Dissertations

While the defense of Taiwan from a potential invasion by the People’s Republic of China (PRC) has long been a topic of debate and scrutiny in U.S. strategic thinking, the role of its southern neighbor, the Philippines, has received far less attention. This thesis argues that northern Luzon would constitute key terrain in a cross-strait conflict and may become an early target of People’s Liberation Army (PLA) operations. Its proximity to Taiwan and position along the Luzon Strait, particularly the Bashi Channel, places it at the center of efforts to control access to the hypothetical battlespace. Drawing on PLA and …

The Use Of Performance Feedback To Decrease Latency Of Clinical Documentation, Taylor Reynolds

Graduate Theses/Dissertations

Organizational behavior management (OBM) applies behavior-analytic principles to workplace settings. This study evaluated the effects of performance feedback on documentation latency among full-time staff in an ABA clinic. Reducing documentation latency is intended to improve the timeliness and accuracy of clinical documentation and to reduce risk related to non-reimbursement and liability. An ABABC design was used to evaluate the effects of performance feedback and the addition of a lottery reinforcement system on documentation latency. For each participant, the sequence consisted of a standard feedback phase (A), an enhanced feedback phase (B), a return to standard feedback phase (A), a reintroduction …

Gene Editing And The Accessibility Of Bioterrorism: Rethinking Global Biosecurity In The Post-Covid-19 Era, Nicholas Morales

Graduate Theses/Dissertations

COVID‑19 demonstrated how a single biological event can strain health systems, disrupt supply chains, undermine national security, and erode public trust. This shock occurred as biotechnology became dramatically more accessible: gene editing and synthetic biology tools once limited to specialized laboratories are now widely available through inexpensive equipment, open‑source data, and decentralized expertise.

This expanded access accelerates innovation but also broadens the threat landscape. The ability to reconstruct pathogens using publicly available sequences and mail‑order DNA shows that complex biological synthesis is no longer confined to state programs. These risks are amplified by opaque biotechnology activities in China, Russia, and …

Spatial Patterns And Morphometric Evolution Of Sinkholes In Response To Watershed Hydrogeomorphology: Examples From A Karst Landscape In The Missouri Ozarks, Usa, Marcell Tóth

Graduate Theses/Dissertations

Sinkholes are characteristic enclosed depressions with internal drainage connecting the surface and subsurface karst hydrologic system. Their morphological evolution involves gradual subsidence of the ground surface and hazardous collapses. Therefore, understanding sinkhole morphometry and linked spatial distribution is critical for managing geohazards in karst watersheds. Sinkhole occurrence shows spatial variability based on watershed geomorphological attributes, surficial hydrological patterns, hydrogeological and geological settings. The aim of this research is to investigate morphometric properties and distribution of sinkholes in the carbonate karst-dominated lands of Mark Twain National Forest in Missouri, USA. The specific objectives were to (1) identify sinkhole clusters based on …

Confucian Thought As A Strategic Veil: How Western Strategy Should Correctly Compete With China, Owen Miller

Graduate Theses/Dissertations

The rise of the People's Republic of China as a peer competitor to the United States constitutes the defining geopolitical challenge of the twenty-first century, but even so, Western strategic analysis has consistently failed to engage China on its own terms. The recurrent pattern of Western misinterpretation results from projecting Western assumptions onto a state whose institutional and cultural drivers operate under fundamentally different premises, where key elements of Chinese strategic culture and the Chinese Communist Party’s (CCP) instrumentalization of Confucianism as a moral veil are instruments of domestic legitimacy and external strategic narrative. The United States must recognize that …

Europe In The Indo-Pacific - Implications For The United States, Joshua G. Zinicola

Graduate Theses/Dissertations

Within the last five years the Indo-Pacific has become a region of increasing interest to European NATO members. In particular, the United Kingdom, France, and Italy have assigned strategic importance for their national security to the region, signing cooperative agreements with regional allies of the United States and deploying significant forces to the region. These agreements include commitments to jointly develop new technologies and combat systems for employment in both Europe and the Indo-Pacific, such as the Global Combat Air Programme (GCAP), and the Trilateral security partnership between Australia, the United Kingdom, and the United States (AUKUS). They also include …

The Ones Who Watched: Technology, Proxy Warfare, And The Testing Ground Hypothesis, Sean J. Oliver

Graduate Theses/Dissertations

Great powers need laboratories for war. This thesis argues that great powers find these laboratories in proxy forces. Proxy warfare is not just a tool for strategic influence. It is a machine for experimentation. This study posits a central testing-ground hypothesis. It contends that great powers deliberately use surrogates to vet emerging technologies, doctrines, and mobilization schemes under the pressure of real combat. The analytical methodology is historical. It traces patterns from the ancient world's proxy forces and the innovations of the Crusades to the Cold War and the digital age. The thesis examines enduring patterns, including the tension between …

Climate Change In Gilgit-Baltistan: Satellite-Based Land Use/Land Cover Change Detection, Socio-Economic Dimensions, And Adaptation Strategies, Ali Muhammad

Graduate Theses/Dissertations

Climate change is increasingly transforming the cryosphere, hydrology, and human landscape of Gilgit-Baltistan, a highly climate-sensitive mountain region in northern Pakistan. This thesis investigates these transformations through satellite-based land use/land cover (LULC) change detection in four representative tehsils of Gilgit-Baltistan—Ali Abad, Gilgit, Nagar, and Sikander Abad—selected to span a gradient of human pressure and cryospheric exposure within the region. Using summer, cloud-free (< 10%) imagery from USGS Landsat 7 (2000) and Landsat 8 (2025), it conducts a multi-temporal comparison of environmental and socio-spatial change. After atmospheric correction and band compositing, the imagery is classified in ArcGIS Pro into six classes—Water, Barren land, Vegetation, Snow, Glacier, and Built-up—using a Support Vector Machine (SVM) classifier, with Maximum Likelihood Classification and Random Forest also tested but found less suitable for the final workflow. The analysis detects a pronounced reduction in mapped glacier-class area alongside a comparatively stable snow class, together with built-up expansion, while examining how temperature, precipitation, tourism, and population dynamics relate to observed LULC transitions. The results reveal a pattern of cryospheric decline and urban growth, with implications for water availability, ecological stability, hazard exposure, and settlement pressure. By integrating geospatial change detection with climatic and socio-economic interpretation, the thesis moves beyond mapping to explain interacting environmental and human drivers of landscape transformation and provides a reproducible remote-sensing baseline for monitoring land-surface change in heterogeneous mountainous terrain. It recommends integrated water-resource management, climate-resilient land-use planning, watershed and glacier monitoring, and sustainable tourism governance, supporting evidence-based decision-making by the Government of Gilgit-Baltistan and organizations working on climate adaptation, disaster risk reduction, and sustainable regional development.

Development And Validation Of The Ipip-Ocean: A Hierarchical Facet-Level Measure Of The Big Five, Caleb Niccum

Graduate Theses/Dissertations

This study focused on developing a mid-range, hierarchical, five-factor, 20-facet personality inventory (the IPIP-OCEAN) composed of 100 items drawn from both the IPIP-NEO-300 and the Abridged Big Five Circumplex. Hierarchical confirmatory factor analysis was used to validate the factor structure. Depression and anxiety, measured with the PHQ-9 and GAD-7, were used to further validate the measure through discriminant and convergent validity by examining whether the domains and facets of the IPIP-OCEAN produced findings consistent with those reported for similar scales in prior depression and anxiety research. Numerous factor analyses were conducted on the IPIP-OCEAN dataset (N = 1,058), and a …

Organ Chips And Translational Research: Identifying And Examining New Ethical Issues, Melanie Jeske

Center for Medical Ethics and Health Policy Staff Publications

Organ chips, also known as organ-on-a-chip devices, tissue chips, or microphysiological systems, have emerged over the last decade as a promising translational technology amidst growing concern about the translational crisis between laboratory research and patient bedside. Pointing to high rates of failure between nonhuman animal models and safety and efficacy in humans, organ chips and similar new approach methods have attracted substantial public and private investment. As human-cell-based alternatives to animal models, organ chips promise more predictive, efficient, and ethical platforms for pharmaceutical and toxicity testing. Engineered cultivation systems that enable cells to assemble into tissue-like structures (e.g. kidney, brain, …

Anything But Endo: Diagnostic Buck-Passing In Endometriosis Diagnosis, Rita Dexter, Megan Kitts, Heather Welty, Melanie Jeske

Center for Medical Ethics and Health Policy Staff Publications

People living with endometriosis, a disease in which tissue similar to the lining of the uterus grows elsewhere in the body, often experience prolonged diagnostic journeys because of symptom variability, normalisation of period pain and other symptoms, and lack of awareness of the condition. In this article, we analyse the endometriosis diagnostic journey through the lens of epistemic injustice. Drawing on in-depth interviews with 52 people living with endometriosis in the United States, we introduce the concept of diagnostic buck-passing to characterise the phenomenon wherein individuals who seek treatment for their symptoms end up stuck in a cycle of seeing …