TOWARD A VIRULENT COMMUNITY LITERACY: CONSTELLATING THE SCIENCE, TECHNOLOGY, AND MEDICINE OF QUEER SEXUAL HEALTH By Wilfredo Antonio Flores A DISSERTATION Submitted to Michigan State University in partial fulfillment of the requirements for the degree of Rhetoric and Writing – Doctor of Philosophy 2022 ABSTRACT TOWARD A VIRULENT COMMUNITY LITERACY: CONSTELLATING THE SCIENCE, TECHNOLOGY, AND MEDICINE OF QUEER SEXUAL HEALTH By Wilfredo Antonio Flores Toward a Virulent Community Literacy: Constellating the Science, Technology, and Medicine of Queer Sexual Health is a qualitative study (informed by Indigenous and decolonial methodologies) of how queer and trans people of color generate and share knowledge about their sexual health on Twitter with regards to HIV/AIDS. With a Twitter archive of 15,000 discrete tweets built with the keywords “Truvada,” PrEP,” and “HIV,” three datasets were derived comprising general utterances from queer users of color, public health officials using social media for outreach, and organizations sharing research findings. Focusing on the data subset comprising 300 discrete users of color and relevant media (i.e., news articles, public health advertisements, other emergent artifacts from the data), this dissertation recounts three case studies focusing on: the rollout of HIV prevention advertisements within queer-centered media; the patent breaking of Truvada, a once-daily medication for preventing HIV; and the use of social media to take to task bad actors and misinformed healthcare providers. The data are used as part of an argument that the manner by which medicine and public health interface with queer and trans people of color hinges on ongoing colonization via the medical and outreach practices derived from colonial practices. Moreover, using a theoretical argument derived from Black and Native technology studies (as well as Black Feminist Thought, Anishinaabe cosmology, settler colonial studies, and digital rhetorical theory), the data was reviewed through a protocol for understanding identity construction amid technology use. The results revealed three rhetorical strategies: 1) continuing community-born public health practices created during the HIV/AIDS crisis of the 1980s and 90s by deploying descriptive hashtags to challenge stigma; 2) creating emergent whisper networks for sharing information about dealing with healthcare providers, navigating insurance networks, and communicating the symptoms of taking the medication; and 3) recognizing and countering the complex systems of late capitalist biomedicalization that prioritize profit over life. To contribute to ongoing commitments within writing and rhetoric studies to create equitable healthcare experiences, an HIV/AIDS health literacy framework follows the data results, which allows for outreach in non-clinical settings through relational design, or a participatory communication design process that incorporates community voices via an attunement to social media such as Twitter. This dissertation contributes to ongoing incursions within technical and professional communication, as well as the rhetoric of health and medicine, to upcycle disciplinary savvy into building better public health and clinical experiences for queer and trans people of color. Copyright by WILFREDO ANTONIO FLORES 2022 To my mother, whose life I’ve pieced together from the stories shared to me. She was a friend to queer people amid the HIV/AIDS crisis, and I cannot help but think what life I would have lived as a queer man with her in my life. The purview of time and death keeps us apart. But I think of you always, and I have to hope that means we are together in some way. And to my friends and queers everywhere, too—this is for the girls. v ACKNOWLEGDMENTS Back in the sun of South Texas, I feel acutely the warmth of the community that has facilitated my completing this degree—after nearly dropping out three (?) times. Byron, the roads we have chosen diverged from us each other for so long—and they persist in our distance. But still, I love you and thank you for loving me and all of my faults. My time and success as a graduate student would not have been possible without your support and input and warmth. Looks like Sophie has a degree now too, just like Paquita! I thank, too, my wonderful dissertation committee, Drs. Natasha Jones, Kristin Arola, Malea Powell, Jacqueline Rhodes, and Elizabeth LaPenseé. Learning from this circle of Black, Indigenous, and queer women has been one of the immense joys of my life, and I am forever thankful for all of your input, guidance, and help. To my friends and colleagues, words alone cannot express how grateful I am to the following people who opened their homes, hearts, lives, schedules, and thoughts for someone like me: Nerli Paredes Ruvalcaba, Everardo Cuevas, Thomas Díaz, Les Hutchinson Campos, Alba Lamar, Santos Ramos, Angélica de Jesús, Marcos de Jesús, Chamelia Moore, and McKinley Green. To my friends in Queering Medicine who showed me what being in community and, more importantly, caring for that community can look like—Mauricio Franco, Wyatt Boothby-Shoemaker, Francis Yang, Grey Pierce, and Daniel Wheeler-Pfau—thank you. And to my friends, mentors, and models in doing reciprocal, responsible, and relational community engagement—Estrella Torrez, Dylan Miner, and Theresa Rosado—I hope to one day do the work you all do and be the guide for the next generation of community organizers and activists. My eternal thanks to all those listed above; I release your well-intentions for my life into the flow of the academic cycle—love across the world and to those who come after me. vi TABLE OF CONTENTS LIST OF FIGURES ix CHAPTER 1: STORYING A VIRULENT PROJECT: THREE THREADS FOR NARRATIVE IGNITION 1 Introduction 1 Story 1: HIV, The Problem of Risk, and Contextualizing “The Pill” 5 Story 2: Big City, A Broken Condom, and a Tumblr Account 9 Story 3: Queering Medicine and Community Knows Best for Itself 14 Overview of the Dissertation 15 CHAPTER 2: QUEER REFUSAL: INSURGENT PARADIGMS AND METHODOLOGIZING AMID SETTLER COLONIALISM 19 Standing on Different Ground 19 Paradigmatic Insurgency (or Deep Caring) 22 Orienting Myself to New Ground 26 Defining Cultural Rhetorics 26 Principle 1: Practices Are Specific to Community and to Place 27 Principle 2: Research Itself Is a Practice 29 Principle 3: Cultural Rhetorics Involves Ethical Reflection on Academic Practices 31 Who Am I on Different Ground? 33 Methodology: Overview of the Research Project 34 Data Collection & Analysis 35 Ethical Considerations 36 Pre-Coding 37 Case Studies 39 Case Study 1: “What? Straight white people don’t get AIDS?” 41 Case Study 2: “Big pharm doesn’t give a fuck” 42 Case Study 3: “My blood cells when I take my Truvada” 42 Conclusion: Centering Community, Centering Joy 43 CHAPTER 3: THE INTERSECTIONAL INTERNET AS LAND: THEORIZING DIGITAL RHETORICAL SOCIO-MATERIALITY VIA BLACK AND INDIGENOUS STUDIES 46 Introduction: Technology ↔ Colonization 46 Making Theory with Rhetorico-Technofeminist Building Blocks 53 Who are the Users of Technology? Living On/As the Internet 56 The Intersectional Internet and Human Life (or, Who Is the Human User?) 57 The Internet as Land and Technological Agency (or, Who Is the Technology User?) 65 Conclusion: Taking Material Inventory of Research 72 CHAPTER 4: UNSETTLING EPISTEMIC HUBRIS: RUPTURING RISK-INFORMED HEALTH LITERACY, REFRAMING RISKY LIVING 77 Introduction: The Problem of Epistemic Hubris 77 vii Attuning to the Settler Colonial Biopolitics of Debility: An Ideographic Methodology 83 Rhetorical Excavations: Settler Colonial Biopower in the Flexner and Lalonde Reports 86 The Flexner Report: Three Examples 90 The Physician and 90 The Lalonde Report: Three Examples 93 Public Health and 93 Logical Incursions: Using Health Literacy to Unsettle Epistemic Hubris 96 Rupturing Epistemic Hubris: Reframing the Cultural Politics of Health Literacy 97 Conclusion: Talking about Sexual Health Online is a Community Health Literacy 102 CHAPTER 5: BLOOD CELLS, DRAG QUEENS, AND DIGITAL FAGGOTRY: THREE CASE STUDIES (OR TOWARD A COMMUNITY FRAMEWORK OF VIRULENT LITERACY 103 Toward a Virulent Community Literacy 103 Case Study 1: “What? Straight white people don’t get AIDS?” 110 Case Study 2: “Big pharm doesn't give a fuck” 116 Case Study 3: “My Blood cells when I take my Truvada” 121 Conclusion: Community Knows Best for Community 132 CHAPTER 6: CONCLUSION: HOTWIRING TECHNICAL COMMUNICATION IN THE THIRD UNIVERSITY (NOTES ON RELATIONAL DESIGN 133 Building a Better World: Plans for the Future 133 REFERENCES 141 viii LIST OF FIGURES Figure 1 A figure demonstrating the intersectional internet as land 51 Figure 2 A screenshot of a YouTube video for a Truvada commercial 114 Figure 3 An image of drag queen Shangela Laquifa Wadley 123 Figure 4 A meme of singer Ariana Grande inhaling poppers 127 ix CHAPTER 1: STORYING A VIRULENT PROJECT: THREE THREADS FOR NARRATIVE IGNITION We are part of a system, it would seem, that sanctions death as the unavoidable cost of our own living and livelihood: economically, medically, geopolitically, in war, under global capitalism, and so on. Adrian Guta, Stuart Murray, and Alex McClelland, “Global AIDS Governance, Biofascism, and the Difficult Freedom of Expression” (2011, p. 19). Introduction Disease backgrounds this project, lingering around what might otherwise be a joyful life. Through the primacy of coloniality (Mignolo, 2011), the lives of queer and trans Black, Indigenous, and People of Color (QTBIPOC) are covered with virus and surveillance, forming a terrible mixture: a system of control. We are at once told that we should take better care to stay dry and that we do not know how to do so; as we live our lives, we are filed within rhetorical regimes that foreclose full lives, shifting around in what Sunera Thobani (2014) calls the “empire of terror.” The systems of white supremacist cisheteropatriarchy coil dual virulencies (i.e., a microscopic undeath and the holdovers of European colonization), concomitantly structuring a queer necropolitical surveillance. The human immunodeficiency virus (HIV) materially and rhetorically spreads—lingering throughout the commonplaces of our everyday lives. 1 1 The acronym BIPOC has received general attention for its misappropriation when talking about the discrete experiences of racialized groups of people within Western settings, especially for the political struggle of Black folks. Here, I clarify my use of the term and its coalescence via the thinking of U.S. Third World Women of Color Feminism and especially within the relational upcylcling of the coalitional politics of Black feminism. Chela Sandoval (2000) marks the discrete identive markers of sociopolitical difference as limitations toward freedom— divisions that likewise lend to the apartheid of knowledges within the academy (p. 77). Third World Women of Color Feminists, however, have modeled the collative, relational beingness I foster in my community organizing 1 Sexual health is an integral aspect of life for QTBIPOC, but talking about sex for us— and really just our health in general—always rhetorically invokes disease. Our experiential/cultural corporealities are inextricably linked to HIV (via the rhetoricity of risk). And yet, amid the kairotic moment of this dissertation, I am critically imagining a world (Royster, 2005) in which they are not—a whole new world where we can live in a manner so that the virus does not physically and rhetorically settle within our embodied realties. To clarify, I do not focus in this project on the microscopic virus, though it certainly lingers; rather, I instead take issue with the rhetorical spread of HIV and the acquired immunodeficiency syndrome (AIDS) into the lives of QTBIPOC. Through marketing campaigns on social media, fliers hung in traditionally queer spaces, and algorithmically attuned advertisements, the virus has shaped all manner of public health interactions within the lives of QTBIPOC. I argue this point through different vantage points in Chapters 3, 4, and 5, but more generally, QTBIPOC experience quite a different internet: we navigate numerous platforms and are targeted with ads assuming we are either HIV positive or on the cusp of infection. Frankly, I am tired of the virus and its rhetorical import in my life, and I can only imagine the exhaustion from others who are negative yet have such messaging inundated in their lives—and especially for those who have seroconverted, or have tested positive for HIV, who now find their lives and identities conscripted into the project of and, likewise, in my scholarship. This work forces a doubly focused examination of identity politics as both a force for keeping our communities safe and a result of the oppressive forces that lend to our discrete—but interlaced— struggles. Black feminist thinker Patricia Hill Collins (2000) says well how I approach my uptake of the term BIPOC: “Since Black women cannot be fully empowered unless intersecting oppressions themselves are eliminated, Black feminist thought supports broad principles of social justice that transcend U.S. Black women’s particular needs” (p. 22). As the iconic Combahee River Collective (1977) put it, “"If Black women were free, it would mean everyone else would have to be free since our freedom would necessitate the destruction of all the systems of oppression.” As such, when I use the term BIPOC, I am therefore signaling attention to the broader forces at play that discretely impact the lives of the groups comprising the term BIPOC. In my writing, I will spotlight such groups when speaking to their unique struggles, so please bear this approach in mind. 2 preventive public health (Spieldenner & Castro, 2010). I uptake this core issue and unfold it in the following chapters to reveal a longstanding logical schema between QTBIPOC and public health. The project I built for this work hinges on the everyday practice of tweeting about one’s life, which I argue is a literacy practice that has thus far been glossed over in contemporary medical- and health-related writing and rhetoric and public health scholarship. For example. many outreach tools (i.e., practices meant to assess user knowledge) examine the interplay between health literacy (aligned with outdated alpha- numeracy concepts) and the social determinants of health (conceived during and through ongoing colonization), a move incompatible with the lived realities and embodied knowledges of many QTBIPOC. I therefore constructed this project in contradistinction to such approaches: what happens when we treat the everyday rhetorical practices of QTBIPOC on social media as a valid form of health knowledge and meaning making? I pose this question because I believe that, when we examine the everyday, mundane rhetorical practices of QTBIPOC, we see a slow unraveling: the social/digital technologies of settler colonialism—control and death—dissipate amid a joyful appropriation.2 2 Here, I offer a long note on how I uptake the term settler colonialism within this dissertation. Aimé Césaire (2000) states that “colonization = ‘thingification’ . . . societies drained of their essence, cultures trampled underfoot, institutions undermined, lands confiscated, religions smashed, magnificent artistic creations destroyed, extraordinary possibilities wiped out” (p. 42-44). As such, Patrick Wolfe (2006) defines settler colonialism as “the dissolution of native societies . . . [and erecting] a new colonial society on the expropriated land base—as I put it, settler colonizers come to stay: invasion is a structure not an event” (p. 388). In this way, Wolfe (2006) argues that settler colonialism operates on a logic of elimination as part of the colonization process. Unangax̂ scholar Eve Tuck and K. Wayne Yang (2012) further outline that colonization and settler colonialism must be defined in their specificities: “In North America and other settings, settler sovereignty imposes sexuality, legality, raciality, language, religion and property in specific ways. Decolonization likewise must be thought through in these particularities” (p. 21). I constellate with these scholars here to delimit—if in a truncated version—the genealogy of settler colonial studies, and as such I follow this definition from Aimee Carrillo Rowe and Eve Tuck (2017), whose invaluable definitional work contextualizes settler colonialism within the project of academic enterprise: “Settler colonialism has meant genocide of Indigenous peoples, the reconfiguring of Indigenous land into settler property. . . . It has also meant the theft of people from their homelands (in Africa) to become property of settlers to labor on stolen land” (p. 4). In this chapter and throughout the dissertation, I mean to spotlight settler colonialism as the structure energizing many of the oppressions QTBIPOC face, though I do so carefully (at least, I hope I do). Tuck and Yang (2012) point out that racial capitalism, carcerality, biopower, and other systems of ordering and control do the dirty work of settler colonialism—the social ordering that hierarchizes the white settler as the top of the echelon. Thus, when I speak 3 In the subsequent chapters, I work to answer the above question in a manner that reveals the interlaced, wicked problems of science, technology, and medicine with which I contend in the realm of QTBIPOC sexual health. By this dissertation’s conclusion, I will have produced rhetorical scholarship and used technical communication to do the work of critically imagining a world in which HIV/AIDS is rhetorically dissolved from the arena of QTBIPOC sexual health— where our embodied knowledges are accounted for in public health outreach. Below, I offer three stories that limn the global-to-local contours of my work and each narrativized within my academic constellations (i.e., health and medical rhetorics, digital cultural rhetorics, and technical and professional communication, respectively). With these stories, I showcase the delicate balance of leveraging at-riskness with narratives and methods of self-empowerment, interventions that writing and rhetoric scholars—across our interrelated disciplinary scapes (i.e., rhetoric, composition, literacy, technical and professional communication)—are primed to foment and what I hope to do in this dissertation. First, I story the rhetoricity of HIV/AIDS to reveal what I deem to be the onto-rhetorical problem with risk. After, I offer a story from my own sexual health that exemplifies why locating empowerment within technology use is a viable strategy for making a world where QTBIPOC about settler colonialism here and throughout this dissertation, I do so for rhetorical utility; I do not mean to use settler colonialism as a stand-in for multivalent oppressions but to instead signal the deep linkages between colonization and marginalizing forces. Finally, settler colonial studies offers a useful but fraught framework for understanding both the material and social features of the United States and other settler empires (Mikdashi, 2013). As such, I do not deploy the settler–native–slave triad as theorized with settler colonial studies as it has received ample criticisms, and as I say in an earlier footnote, I take an expansive approach for approaching the interrelated oppressions that Black, Indigenous, and People of Color face. As such, I offer here another note about semantics and terminology. Following la paperson (2017), I do not mean to use the term “settler” as a stand-in for whiteness. Indeed, as he puts it, “‘Settler’ is not an identity; it is the idealized juridical space of exceptional rights granted to normative settler citizens . . . by which the settler state exerts its sovereignty. The ‘settler’ is a site of exception from which whiteness emerges” (paperson, 2017, p. 10). In that vein, I follow Tiffany Lethabo King (2020) and her elsewhere formations of settler colonial studies away from “(White settler) subjectivity [which have] become rubrics of analysis that are elaborated on and theorized through a resuscitation of Marxist, Foucauldian, queer, and other humanist continental theory” (p. 70). For more, please see la paperson’s (2017) A Third University is Possible, King’s The Black Shoals, and Tapji Garba and Sara-Maria Sorentino’s “Slavery is a Metaphor: A Critical Commentary on Eve Tuck and K. Wayne Yang’s ‘Decolonization is Not a Metaphor.’” 4 can thrive. I end with a story of how I became a community organizer and how, during a particular moment, I realized the totalizing limitations of current public health approaches for QTBIPOC, including how we work to take care of each other offers a liminal space for rhetorical interrogation. In offering these stories, I exercise a world-building praxis: each resonates with the broader forces I contend with, and they strengthen my academic throughline—my weaving together of an academic constellation (Powell, 2012). In truth, I could dedicate this whole dissertation (or at the very least this chapter) to the legacies of the HIV/AIDS epidemic as they relate to public health outreach directed toward QTBIPOC, but I have more work to do than space allows. So, here are some stories. Story 1: HIV, The Problem of Risk, and Contextualizing “The Pill” At the start of and during the crisis surrounding HIV/AIDS in the 1980s and 90s, sexual health for QTBIPOC underwent rhetorical transformations that persist today. Though initial public health efforts sought to culturally decouple the virus from QTBIPOC life through community-led public health initiatives and revised respectability politics (Mitchell, 2019), sex was eventually subsumed by prophylactic logics, which ran counter to the sexual liberation underway at the time. Memoirist Paul Lisicky (2020), in his reflection of the virus’ rhetorical proliferation during the 1990s, calls HIV/AIDS a consumptive specter, eagerly gobbling up queer sexuality and leaving the husk of abstinence and safe sex (condoms, masturbation, and, to a degree, oral sex). Terror over the virus changed sexual mores for the decades to follow, and the holdovers of the HIV/AIDS epidemic resulted in the project of conscripting the lives of QTBIPOC into a fraught relationship with public health in the United States (Shahani, 2016; Spieldenner & Castro, 2010). Now, discussions of sexual health as they relate to the lived 5 experiences of QTBIPOC always rhetorically invoke disease (Lloyd, 2017).3 Data from the Centers for Disease Control and Prevention ([CDC], 2020) indicate that Black and Latinx people of varying sexualities and genders (including, of course, trans folks) are the most at risk for new HIV infections based on extant rates. Of more importance, though, are the ways white supremacy and cisheteropatriarchy convene to preclude a higher quality of life: a hostile world wherein colonial legacies delimit worsening health outcomes, including higher infection rates for QTBIPOC. Of course, the transmissibility of HIV/AIDS through the biologics of queer sex are one factor, but within public health outreach efforts, the mere statistical fact of who accounts for new infections becomes reified in how risk is integrated into healthcare and public health contexts. Within the communication design for outreach, these narratives of risk regarding QTBIPOC are prioritized and are then compounded by how identities are co-opted via logics of risk and epidemiological practice (Teston et al., 2019). A rupture in QTBIPOC sexual health that occurred in the early 2010s best demonstrates this proliferation within the communicative array of outreach: the advent of pre-exposure prophylaxis (PrEP), a daily medication regimen that users undertake to prevent a new infection of HIV. Core to PrEP is Truvada, a small blue pill and the primary medication in the regimen. Much of the early campaigns for Truvada implemented a practice of un-naming, wherein PrEP was marketed as taking “The Pill” (Fitzsimons, 2018) and was likened to birth control. This un- naming served, in a sense, to subsume contemporary QTBIPOC sexuality within the jurisdiction of shame and timidity—to hide the biologics of queer sex while couching it in a rhetoric of care. 3 As one example that exemplifies much of my argumentation here and later in Chapter 4, I searched for the full wording of the acronym “HIV” on Google to quickly copy and paste the text to save myself time recounting the correct spelling. The blurb Google offers accompanying the definitions of HIV includes a dark-skinned, ethnically ambiguous man who could be Black or Latino (or Afro-Latino). This example is one of many that show how the disease is tied to queer men of color specifically, though to the image’s credit, it does portray a Black woman as a physician, perhaps lending to the problematics bound up in the multicultural visual rhetorics of the image. 6 Contemporary sexual mores, though, have correspondingly alternated away from safe practices to those of the so-called Truvada Whore, a rhetorical turn of phrase meant to signal a rejection of public health standard of so-called safe sex (Scott, 2016). As a result, the “focus on sex as a potentially ‘unhealthy’ activity continues. . . . [and] particularly after the rise of HIV/AIDS, we have witnessed an explosion of public health interventions focused on ‘risky’ or ‘unsafe’ sexual behavior” (Gupta, 2011, p. 129). In this manner, public health outreach misaligns with the community practices around sexual health, a point I unravel further in Chapter 4. For now, as one example, recommendations from the International Classification of Diseases, Tenth Revision, Clinical Modification (CDC, 2021) offer outdated if somewhat offensive approaches to assessing sexual health practices among QTBIPOC. Following these guidelines, many medical coding systems, including counties with substantive queer and trans populations such as New York City and Los Angeles, do not designate specific billing codes for PrEP, instead defaulting to categories such as “high-risk homosexual/bisexual behavior.” This operationalization of risk within health care also corresponds to a larger trend within public health. Indeed, much of the visual rhetorical work of stemming the crisis tide (i.e., advertisement visuals) hinges on showcasing QTBIPOC as either on the precipice of seroconversion or pushed past the edge. Put simply, risk is too often centralized within all aspects of HIV prevention and especially within its communication design. Through this centrality, QTBIPOC must navigate HIV in the myriad ways the virus rhetorically shapes our lives, what Andrew Spieldenner (2016) calls our HIV/AIDS literacy, or our ability to discern how the virus is made legible to QTBIPOC through the rhetoricity of sex as established by public health practice. This onto-rhetorical matriculation of HIV/AIDS within the healthy lives of QTBIPOC functions through what I term a risky regime. In essence, QTBIPOC 7 lives are overly prioritized within public health (sometimes for good reason, of course), becoming a precarious public that is “surveilled, fetishized, and surveyed to death (Teston et al., 2019, p. 326). This over-prioritization lends to the rhetorical conscription of QTBIPOC lives. At the fore of these efforts is Gilead Inc., the pharmaceutical company that developed Truvada. The company has sought to engage and to foster user adoption among QTBIPOC for the daily regimen (and therefore Truvada, increasing profits for the pharmaceutical giant). The company has also continued the visual rhetorical trend of spotlighting particular populations more susceptible to new HIV infections as determined by the social determinants of health to foment adoption of PrEP. QTBIPOC are understandably fed up with this approach—and they have begun to voice their frustrations (Guta et al., 2011), which have especially ramped up over the past three years. Beyond these frustrations, discussions regarding the problematics of Gilead’s stranglehold on QTBIPOC health have likewise surged, with many focused specifically on the patent for Truvada. Gilead has been accused of increasing the price of Truvada, thereby precluding wider adoption amongst those QTBIPOC who lack health insurance (i.e., profits are prioritized over actual user adoption). However, through a court ruling, the patent was broken in the United Kingdom with most public health officials seeing a move to increased access to PrEP and reduced HIV infection rates (Fitzsimons, 2018). Similar efforts have also ramped up in the United States, and many see the patent breaking as a means for stemming the gradual uptick in new HIV infections (Summers, 2018). In November 2019, for example, the Trump Administration sued Gilead on the company’s patent use, and some have argued that increased access might come about as an unintended side effect (Summers, 2018). All of these goings-on 8 have led to a heightened buzz about PrEP and Truvada across a variety of social media.4 These developments background this dissertation, establishing both the parameters of how I engage in these conversations and the argumentative stakes. I go into detail about the problematics of risk within the sexual health of QTBIPOC in Chapter 4, tying this hyperfocus on risk to settler colonialism as a biomedicalizing force, but for now, I showcase how my own HIV/AIDS literacy played out early in my life as a queer Mexican American man living in a large, primarily Mexican American, metropolitan city. I offer this story to both show how this dissertation came about and also how I have taken this particular approach to understanding the importance of social media to the sexually healthy lives of QTBIPOC. Before I begin, however, talking about sex can be uncomfortable for many people, and if talking about sex can be uncomfortable, then reading about it certainly can be, too. Please note, then, that the story below recounts a story of sexual health that some might find uncomfortable, though this story is not graphic and exemplifies key points in the subsequent sections. If you so choose or need, you can skip this story and proceed to the next section. Story 2: Big City, A Broken Condom, and a Tumblr Account I am interested in sex and sexual health because it shaped much of my experiences as a gay man (18-24 years old) living in a large, metropolitan city in South Texas until I moved for graduate school. From 2007 to 2013, during my late teens and early twenties, the gay-focused dating app Grindr became immensely popular, though I had been on other sites such as Adam4Adam, Gay.com, Squirt, and Manhunt since turning 18.5 Grindr and the aforementioned 4 That said, Gilead has since introduced a replacement medication for Truvada called Descovy, and it has concerted its efforts on fostering adoption of this medication. The company’s rush for user adoption hinges on marginal differences in terms of kidney- and bone-related issues between the two medications—differences that are mostly statistically insignificant (San Francisco AIDS Foundation, 2019). However, because the company controls the Descovy patent, it has touted lessened side effects as a viable reason for users to switch away from generic Truvada for Descovy, again ensuring the company continues to profit off the sexual health of queer and trans people. 5 Like many other millennials, I grew up alongside a likewise growing internet—so much so that who I am as a 9 sites, including other apps such as Jack’d and Scruff, make up an online sexual arena colloquially called The Apps among gay men. Reflecting back on my sexual encounters as a young gay man, in truth, I cannot remember the number of other men I met up with through The Apps, though after each of these encounters, I frequented the local testing site (which conveniently was down the street from my apartment). This number, however, is not the point of this story. Rather, one moment in particular led to me becoming interested in sexual health knowledge and how it circulates amongst a group of people via a social media platform. Despite my presence on The Apps, I met a man on Myspace (we had become friends by the sheer number of mutual friends, which is a typical practice queer technology users do to expand their relational networks). This man, M, and I corresponded regularly, and when I moved out of my foster parents’ trailer and lived on my own (with roommates), he and I made plans to eventually meet. These plans actually took time to happen, and after our first encounter (in a public place in his car at night), we continued to meet to either play video games or have other sorts of fun. We played safe, to use the terminology of gay hookup culture, always using condoms. Growing up in the 90s and early 2000s and reading about queer sex and being ingratiated into the cultural-sexual politics of hookup culture amid the holdovers of the HIV/AIDS crisis—“Do you play safe? Bareback?”—safe sex was foregrounded repeatedly, and I likewise adopted it as regular practice. However, during one instance, I had forgotten to purchase condoms, and the one M brought had broken. Because we were no longer strangers—I thought I could trust him—we proceeded without any protection (much to his delight as the top). After, we played some games and parted ways. person also exists in some online capacity. As such, as is the case with many queer kids, I also spent my time in gay chat rooms, forums, and other websites, sometimes illegally and not. I will never admit to such activities outside of this dissertation, though. 10 A few weeks later, I was hanging out with a friend named J, who had helped me to move some plants into my apartment that I had purchased from my workplace. After moving things, we sat around and casually talked about dating and The Apps. While perusing Grindr, J saw M’s profile and immediately expressed disgust: “Ugh, that whore.”6 At first, I thought it might be drama between the two, but after asking J what the issue was (I am nosy), he told me that M was HIV positive and, though he was undetectable, refused to disclose his status to others. I was shocked, unaware at the time that undetectable meant virtually untransmittable.7 After J went home, I immediately went to the HIV-testing clinic and awaited the report. Eventually, I learned that I was negative, but the moment was harrowing. Looking back at my interaction with J, had he not shared his knowledge about M with me, I likely would have continued having unprotected sex with M, meaning I could be exposed to the virus if he ever lapsed in his treatment. Later, a similar knowledge-sharing moment occurred. Months passed, and while on The Apps to cruise (the term we use to mean seeking out anonymous sexual encounters), I came across someone asking for a threesome with a friend of his. As is common practice, I asked for photos of his friend—“Any pics?”—only to discover that it was M. I asked this person if he planned to play safe with M, and he responded with, “It depends, why?” In this moment, I relayed the information J shared with me and reached out to M: “Hey, I found out from a friend that you’re positive, and that’s totally cool, and I’m negative still, but you need to play safe.” M apologized but made excuses for himself, including telling me that, because he was undetectable and circumcised, he could not infect other people (“But I’m cut, lol”). These reasons and others he gave me do not excuse his behavior, of course—nor 6 This dialogue should be read with the contempt of an especially critical gay man. 7 When a person has seroconverted and is undetectable, the virus itself cannot be found within bodily fluids, meaning the risk of infection via the exchange of bodily fluids is almost impossible. Achieving undetectable status is the primary goal of HIV treatment. 11 are some of them even true—and I relayed as much to him and pressed him to do some research about his health, his body, and his status (I had already researched all of these aspects of M’s body, his status, my body, and HIV as I am a worrier). Meanwhile, the man who had contacted me thanked me and said he would talk more with M. That was the last I heard from him. When speaking to another friend later about that incident, he showed me a Tumblr account dedicated to gay culture in the city, sending me a post about M. On that post, a warning was issued: M was an HIV-positive man and would not disclose that fact unless pressed: “Know your status!” Further examinations of the site, which has since been deleted because of Tumblr’s changing policies, showed posts offering the latest gossip of who had sex with who, who was cheating, who was closeted and had a girlfriend, who had recently opened up their relationship, who could get someone into the clubs if under the age of 21, and other warning posts similar to M’s. Beyond the scare of having unprotected sex with M, our interaction stayed with me as a learning moment: the internet can be a tool for talking about community-specific sexual health information: a site rife with community-based literacies of sexual health (i.e., HIV/AIDS literacies). Indeed, from the early days of the internet to the 2010s, The Apps have ignited new sexual schemas for gay men (Faris, 2018), lending to both the surge of public health outreach (many ads I have encountered, for example, were on Grindr and other gay dating—hookup— apps) and revised sexual mores. Of course, some of these sexual health practices—the outing of HIV-positive people without consent, for example—misalign with how a community might enact measures of safety beyond invocations of the carceral state. However, in this way, the rhetorical, platformed work of gay men coming together—for sex and/or friendship—functions through what sociologist of technology David Beer (2009) calls the technological unconscious, or the slip of different community-specific relations into digital spaces. 12 That said, this story should not be read as one in which I was scared straight, as it were, to always practice safe sex (in truth, I have not). Rather, this story demonstrates the experiences I have had that led to my interest in social media and technology platforms as places where knowledge—in this case, about sexual health—communicatively circulates amongst a group of people with a shared cultural background. Years later, while scrolling on Twitter one night before my partner and I went to bed, I came across a tweet in which a user joked about how a drag queen in a bubble (as part of her costume) represents his blood cells while on Truvada: “My blood cells when I take my Truvada.” That joke became fairly viral with other QTBIPOC, given that users often tweet with an imagined audience in mind that matches their own algorithmic attunement to the technological unconscious (Marwick & boyd, 2011; Humphreys et al., 2014). Twitter in particular has become a generative space regarding these communicative instances. In my time as a Twitter user, I’ve noticed similar jokes about sexual health told through references to gay culture, popular media, and queer of color sensibilities. Beyond their hilarity, these jokes are fascinating to me because, oftentimes, the crux of their messaging represents some aspect of sexual health that is typically factually correct but also has been translated, in a sense, to the communicatively engaging format of a memetic joke: the culturally specific community literacy practices at play with QTBIPOC communities as they converse online. In addition to such jokes and memes, I have also noticed that QTBIPOC often take to Twitter to express frustration over how risk presents itself within their lives. Returning to the visual rhetorical work of risk, I have seen numerous viral tweets in which a user will point out the limited logics energizing these approaches to public health outreach—in essence people are paying attention to how their identities are being co-opted within health and medical contexts. One other moment in particular helped me to realize just how frustrated other queer and trans 13 people are—and just how fed up I am. Story 3: Queering Medicine and Community Knows Best for Itself In the middle of the Fall 2017 semester, during the coldest winter of my life (or the first real winter I’ve ever experienced as a South Texan), I met with Mauricio Franco, Wyatt Boothby-Shoemaker, Daniel Wheeler Pfau, and Linden Brown-Wren, and Felix Brown in a house near downtown Lansing, MI. Together, we comprised a group of graduate and undergraduate students, medical students, community organizers, Latinx (Mexican and Salvadoran), white, queer, nonbinary, and trans people. Through the night, we reviewed our interests in medicine, health communication, activism and organizing, and queer community, eventually coming to a consensus and drafting a mission statement. That night, we officially launched Queering Medicine with the mission of improving queer health in the Lansing area. Over the past several years organizing with Queering Medicine, I have offered my particular skillset as a copyeditor and writing consultant, medical rhetorician, and technical and professional communicator to the group, helping with multiple public-facing projects. For example, I have built a born-digital directory, which lists providers in the area that are either queer and trans or are friendly to such groups. In the lead-up to this project, other Queering Medicine organizers and I were tuned into ongoing conversations between different community members—people who were doing the rhetorical work of keeping each other safe— so-called tactical technical communication (Kimball, 2017). Whether this work was a private message on Facebook—“Hey, don’t see this doctor as they’re actually trans-antagonistic and do not respect pronouns”—or talks during queer brunch, people worked to inform each other and ensure a higher quality of healthcare experiences. Such efforts resonate with the everyday communicative work of circulating knowledge within community spaces to contend with the 14 broader queer and transphobia abound in the world (Edenfield et al., 2019). In another relevant example, I helped conduct a focus group discussion in the Salus Center, Lansing’s queer resource and community center, listening to the stories of folks dealing with healthcare systems and providers. Together, a group of nine resilient queer and trans people recounted stories of pronouns and identities being dismissed or discounted, of being labeled as at-risk solely because of their queer/trans identities despite other aspects of their health, of being normatively questioned within strict confines of gender, sex, and identity, and of being told they do not know what is best for them. Amid the group’s diversity of identities and experiences, one commonality emerged: going to the doctor or entering into any medical context was uncomfortable and made them feel like they were putting themselves at risk. This tension—of feeling risk and discomfort, of feeling abnormal in clinical settings, of feeling exposed to an unsympathetic affect—belies a paternal logic underpinning much of health and medicine that hierarchizes the patient-provider relationship. This top-down approach to health care exposes the rhetorical contours of control; we supposedly never know what is really going on with our bodies, and we do not know to best understand what is actually going on. As this story and the above ones demonstrate, the ways QTBIPOC have gone about keeping each other healthy cannot be spotlighted within the analytical purview of public health. Simply put, QTBIPOC talking amongst themselves in socio-digital spaces is by default discounted as a viable lifeway regarding sexual health knowledge. My work in this dissertation is thus meant to act as a corrective—a reframing of both how such knowledges are valid and rhetorically rich and how public health might tune into these conversations in their outreach efforts. Overview of the Dissertation More than anything, I hope that the stories above delimit the global-to-local schema I 15 seek to tap into with this project—and that they reveal the somewhat mundane moments wherein complex knowledges circulate and QTBIPOC flourish. Colonial histories shape what Malea Powell (1999), Walter Mignolo (2011), and Boaventura de Sousa Santos (2018) call a cognitive empire—the ontological power that keeps settler states driving forward—leading to the settler colonial technologies (paperson, 2017) of science, technology, and medicine, which then inflect biomedicine and public health, all of which disproportionately affect QTBIPOC. Though of course such inflections might take the form of a variety of ills—over-policing, forced sterilizations, unemployment, houselessness, hate crimes, state-sanctioned murder—I enter via sexual health because it is an issue to which I can most readily attend (given my training, experiences, and identities). So, to conclude, I overview the dissertation project to show how plan to approach this task within the scope of this dissertation. In Chapter 2, I outline my approach to methodologizing this project via a cultural rhetorics orientation to research as a practice. I foreground queer relationality—supplanting a base queer politics—as a method of centering BIPOC futurities and constellating knowledge in theory crafting and project building. By refusing research and operationalizing insurgency for a social justice methodology, I detail a data collection method and coding schema that attunes to the rhetorical-relational work of community knowledge circulation amid socio-digital technologies. I also use this chapter to review the overall approach to constructing the three internet case studies that both resonate with the stories above and comprise my overall research project, including how I bound the cases and reviewed ethical considerations. In Chapter 3, I offer a theoretical framework I term the intersectional internet as land. I use this framework to actualize the notion that the internet stands as a relational network comprising biopoliticized, so-called resources when grounded—quite literally—through Black 16 epistemologies and Indigenous cosmologies. By framing the internet in this way, I cast a hyperfocus on the internet’s material demand, including its concomitant issues (i.e., land grabbing, climate change, water usage), and the Indigenous concept of material relationality. In the interrelated beingness of internet (and technology use), I argue that online communities are extensions of their real-life counterparts and not habituated, shared cyberspace. This viewpoint allows for expansive coding processes when this theoretical framework steers relational methodologies, which I argue leads to richer analysis of social media-based data (such as tweets, which comprise my data source). In Chapter 4, I reveal the epistemic hubris core to biomedicine and public health, attending to settler colonialism as the innervating force of the many wicked problems to which writing and rhetoric scholars might direct their attention. By focusing on two documents crucial to the establishment of biomedical training and epidemiological practice on the North American continent, I pivot away from theories of biopower and Western biopolitics—decentering Europe—to the material reality of white supremacy and cisheteropatriarchy as the structure of modern-day medicine, foregrounding settler culpability as a generative space of interrogation. I trace lingering issues of medical antagonism to the actual colonial histories the United States and Canada as settler empires, outlining the temporal plasticity of both medical racism and cisheteropatriarchy within current construals of health literacy, which intersect to affect QTBIPOC. To conclude, I outline a model of unsettling epistemic hubris by redefining health literacy within the frame of rhetoric, composition, and literacy studies. In Chapter 5, I present key findings from the results of my data analysis, springboarding off the reconceptualization of health literacy in the prior chapter to outline a non-clinical public health tool that accounts for the rhetorical-relational communication of sexual health knowledge 17 on social media. With this tool, I extend conceptions of e-health literacy to disrupt current alphanumeric configurations that elide the culturally distinct, rhetorical practices of talking about sexual health on social media. Moreover, I use this tool to nudge attention on the sites of health literacy (e.g., health and medical blogs, specialized forums, targeted documentation) to the realms of everyday community goings-on (i.e., social media spaces such as Twitter). In Chapter 6, I spotlight technical communication as a practical means of deploying the non-clinical health literacy assessment tool. In essence, I use communication design practices steered by social justice-informed technical communication to energize user-centered design practices, establishing a bidirectional network between ongoing public health outreach efforts and the reception of such work on social media. In presenting the results of the data analysis, I articulate how the knowledge of sexual health that users circulate online can be accounted for in academic and industry practice—hot-wiring disciplinary practices, in a sense, to do the mundane work of advancing a healthy future for QTBIPOC. 18 CHAPTER 2: QUEER REFUSAL: INSURGENT PARADIGMS AND METHODOLOGIZING AMID SETTLER COLONIALISM We can’t dismantle colonized forms of knowledge production using colonial methodologies; we need to both develop a critique and then turn our gaze toward Indigenous tools and knowledge. Critiques of colonialism in research, historically and currently, are paramount in contextualizing Indigenous re-search today. We must make our oppressions visible and tell the stories of how the intellectual authority powerhouses try to shapeshift us into eurowestern thinkers and reproducers of their worldviews and paradigms. — Kathleen Absolon, Kaandossiwin: How We Come to Know (2011, p. 243). Standing on Different Ground Settler colonialism methodologizes to persist. With a totalizing purview, research disintegrates worlds—a publication flies out into space, lost in a flurry. I bristle when I think about the history of the academy and its socio-material, structural processes: lifeways have collapsed so a project can be enacted and a document written. Ngāti Awa and Ngāti Porou scholar Linda Tuhiwai Smith (2012) tells us that, amid the structural processes of settler colonialism, “what counts as Western research draws from an ‘archive’ of knowledge and systems, rules and values which stretch beyond the boundaries of Western science to the system now referred to as the West” (p. 93). How we come to know via methodology—the colonial, paradigmatic dripping of positivism into the world-building enterprise of empire via the 19 scientific method—is also likewise implicated (Maracle; 1990; Absolon, 2011). On that note, queer and feminist thinker Sara Ahmed (2006) says the ground “into which we sink our feet is not neutral: it gives ground to some more than others. Disorientation occurs when we fail to sink into the ground, which means that the ‘ground’ itself is disturbed, which also disturbs what gathers ‘on’ the ground” (p. 160). For me, queerly refusing research as a means of standing on different ground means a moving away from the centrality of Europe, its cross-landmass movements, and its cognitive empires (de Sousa Santos, 2018). Standing on this different ground means understanding that “research is . . . a performance of inquiry in order to acquire legitimacy. . . . In cases in which an intervention is needed, there are many other ways of developing and communicating ideas” (Tuck & Yang, 2013, p. 236). It means standing on different ground wherein the joy, liberation, and thrivance of Black, Indigenous, and People of Color (BIPOC) is central and self-apparent. What I hope to do, then, is to showcase community perspectives in a manner that refuses a colonial interpretation.8 As a piece of rhetorical scholarship, I use this chapter to delve into productive methodological tensions that arise when refusing research, or “making the spectator the spectacle, and turning settler colonial knowledge back on itself” (Tuck & Yang, 2013, p. 244). Refusal offers a spatial-temporal unlocking, an actionable disarticulation of how the world should be: calcified, categorized, repetitive, linear. Rather, my queer refusal of research acts as an onto-rhetorical constellation wherein I upcycle knowledges circulating in the world, bringing them together to limn a gateway to a queer world, entering into it through action (rhetorical, digital, technical communicative). This refusal springs from my own queer ontology attuned with 8 Chi Miigwetch to Dr. Beth LaPenseé for guiding my readings in our Indigenous methodologies course and an independent study and helping me strategize my approach to methodologizing in this chapter—and for thinking deeply about care and community. 20 land, a reposal spurred in contradistinction to settler colonial knowledge systems and lifeways— a drenched appreciation of a storm with a windy sway or stopping for quiet snowfall when I am already late for a meeting. When queerness is configured as anticolonial action (Eng & Puar, 2020; Morgensen, 2010; Puar, 2007) rather than a dialectic with normative regimes (Alexander & Rhodes, 2012), I fail to listen to a white supremacist, cisheteropatriarchal world that tells me I cannot do the things I want to do. To be clear, I do not mean to trivialize the use of the word “ground” nor elide the fact that I am a researcher doing just that: research. Rather, core to methodology for me is the notion of being landed (Arola, 2018; Ríos, 2015)—of recognizing the historicity of place and the agency of non-humans and attending to their immediacy within my work (more on this concept below and in Chapter 3). Generally, I structured this dissertation through a concerted effort to stand on this different ground (i.e., developing the methodology and building theory away from Western interpretative traditions), and I came to this orientation via a cultural rhetorics understanding of research as a practice (Riley-Mukavetz, 2014). My use of the adjective “rhetorical” above in the second paragraph, then, signals my effort to deliberately build a research project that disentangles extraction from research methods, centralizes community-born knowledge as self- apparent and valid, and appropriates the practicality of the academy to do good in the world.9 Attending to my own intellectual genealogy (Ahmed, 2017; Royster, 2005), I follow the lead of cultural rhetoricians and Black and/or Indigenous thinkers (within and outside of writing and rhetoric) whose energetic hotwiring of the university has produced scyborgian practices for methodologizing in ways that unsettle the structurating processes of colonization within 9 Métis scholar Max Liboiron (2021) frankly says that this appropriative, methodological work is hard, and it requires an embodied attunement to our discrete interventionist strategies based on our practical repertoires. For them, this work starts under a microscope. For me, it starts in appropriating writing and rhetoric studies’ research methods to so-called properly present some aspect of the world. 21 academia (Kynard, 2020; paperson, 2017). Research practices are, after all, derived from the establishment of Black fungibility (Césaire, 2000; King, 2019; Rusert, 2019; Weheliye, 2014; paperson, 2017)10 and Indigenous extermination (Absolon, 2011; Tuck and Yang, 2013; Moreton-Robinson, 2015). And yet, with this methodology, I seek to work in the paradoxical liminality of research’s meaningful appropriation: the space wherein colonial energies are supplanted with insurgent, de/anticolonial ones. In what follows, I outline my approach for creating the methodology of this dissertation and review the overall research project. I begin by detailing my insurgent intention with creating a methodology in this manner, outlining a research paradigm infused with social justice that influences my overall approach to this project. After, I review a tripartite cultural rhetorics orientation to research, including how it steers my approach to crafting a research project. To conclude, I detail the overall methodology of the project, including the bounding of three case studies, data collection and analysis, ethical considerations, and research intentions. Paradigmatic Insurgency (or Deep Caring) Because of my positionality (i.e., queer, Chicano, orphan) and position in the academy— a fairly well-funded graduate student in an R1, land-grant university—I have engaged in identity- based community work for some time beyond my academic work (i.e., the course-taking, 10 Tiffany Lethabo King (2020) says Black fungibility, as opposed to the concept of enslaved people as solely only labor, “represents the unfettered use of Black bodies for the self-actualization of the human and for the attendant humanist project of the production and expansion of space” (p. 24). King (2019), expanding on theorizations from Sylvia Wynter, Saidiya Hartman, and Frank B. Wilderson III, argues that “in very much the same ways that Black fugitivity morphs and changes according to the vicissitudes of power, [Black] fungibility and its modes of manipulating Blackness respond to Black fugitivity” (p. 26). In essence, this conception allows for more adventive thinking rather than succumbing to the totalizing power of settler colonialism as it reductively signifies Black life today as nothing more than labor. King (2019) notes that “reclaiming fungibility as a resource for Black enslaved people rather than an impediment to Black practices of . . . freedom stretches Blackness’s terrain” (p. 26). As such, I follow with King (2019) here and the remainder of this dissertation when talking about Black life as more than just what has been colonized. This definitional upending serves the purpose of positioning Black folks as, essentially, whatever they wish to be rather than just colonial subjects, as King (2019) argues. 22 tutoring, and other miscellaneous activities that comprise my experience). I have learned much from those who have shown me insurgent methods of funneling university resources to the communities that need them,11 and this unidirectional process reconfigures extraction as a process that primarily affects the university and its material and cultural capital. Community ideally is protected in that the university only receives fragmented, ersatz forms of what it seeks—knowledge saved from analysis, from misinterpretation, from appropriation. I seek to mirror this approach in my methodology. With this project, then, I uptake methods—for data collection and analysis—in a manner that signals work has been done to gather data, to interpret it (in a sense), and to report the findings out to a broader audience. Because this project is an examination of rhetorical strategies used in online spaces, my methodology likewise corresponds: I establish internet case studies, I construe tweets as data, I interpret them through qualitative analysis software. However, in the background to these selections is a hot-wiring that primes empowerment as the operative telos; extraction is secondary, and I mean to use these methods in a way that reduces extraction as much as possible. For this reason, as I say later in this chapter, I have built into this methodology the requirements of community empowerment and centrality. For me, this approach marks a deep caring about community—deep enough to shape an entire dissertation—and I operationalize this paradigmatic care to forge a methodology. When I use the word “methodology,” I mean to echo Opaskwayak Cree scholar Shawn Wilson (2008), who says that it “refers to the theory of how knowledge is gained, or in other words the science of finding things out” (p. 34). Put another way, “methodology is thus asking, 11 I am forever grateful to Drs. Estrella Torrez, Dylan Miner, Mauricio Franco, Elizabeth LaPenseé, and Les Hutchinson Campos, as well as Oprah Jrenal, Morgan Doherty, and Everardo Cuevas for showing me how to do the work of community. 23 ‘How do I find out more about this reality’” (Wilson, 2008, p. 34)? To answer that question within the scope of my research project, I also uptake Alicia Gaspar de Alba’s (2014) concept of an activist methodology, and the overall approach to my project is “for a specific political purpose: to raise awareness, to effect social change, to represent, to give voice, to make visible, to expose, to problem-solve, to bridge community needs with academic resources” (p. 4). All of these perspectives shape my research paradigm, which in turn temper my methodological considerations. Wilson (2008) says research paradigms comprise “labels that are used to identify sets of underlying beliefs or assumptions upon which research is based. These sets of beliefs go together to guide [our] actions” (p. 33). I thus also follow Métis scholar Adam Gaudry (2011) and his four components for establishing an insurgent methodology: “1) by explicitly employing Indigenous worldviews; (2) by orienting knowledge creation toward Indigenous peoples and their communities; and (3) by seeing our responsibility as researchers as directed almost exclusively toward the community and participants” (p. 114). Gaudry’s (2011) final component also resonates with my approach to deep caring as an integral force for methodologizing: “promoting community-based action that targets the demise of colonial interference within our lives and communities” (p. 114). Simply put, I methodologize via this insurgent research paradigm to foreground community perspectives that both speaks to the colonial forces of the academy while limiting further extraction. On that note, I am oriented to this approach by my own investments and training in cultural rhetorics, which I discuss further in the next section to outline why I approach this dissertation in this manner. Before doing so, however, I offer definitions for terms I have thus far deployed and will use in writing here in this chapter and others: terms such as “oppression,” “marginalization,” “empowerment,” and “social justice.” I use these words in a manner that 24 resonates with their formations within Black Feminist Thought as articulated by Rebecca Walton, Kristen Moore, and Natasha Jones (2019). Most immediately, in a project that centralizes social justice, I follow Walton et al.’s (2019) parameters for such work: • Recognizing injustices, systems of oppression, and our own complicities in them, • Revealing these injustices, systemic oppressions, and complicities to others as a call-to-action and (organization/social/political) change, • Rejecting injustices, systemic oppressions, and opportunities to perpetuate them, • Replacing unjust and oppressive practices with intersectional, coalition-led practices. (p. 133). These keywords—recognize, reveal, reject, replace—underpin the research paradigm I work from within this project. To talk about and enact change within a social justice framework, then, I adopt the following definitional schema from Walton et al. (2019). When I use the word “oppression”—and likewise discuss specific instances of harm done to different groups of people—I mean the discrete though interrelated manifestations of “marginalization, cultural imperialism, powerlessness, violence, and exploitation. These faces of oppression overlap in social institutions and structures, affecting the lives of oppressed people in myriad ways” (Walton et al., 2019, p. 19). When I use the word “marginalization,” I spotlight insidious intentionality in social organizing that “excludes particular groups from meaningful participation in society, relegating shamefully large numbers of people to the societal margins” (p. 19). When I discuss the particularities of settler colonialism within the world, I highlight the cultural imperialism(s) that “often functions as a ‘gateway oppression,’ serving as an excuse and paving the way for other forms of oppression such as marginalization, exploitation, and violence” (p. 22). 25 This definitional schema guides my research paradigm, which I actuate in my research project via a cultural rhetorics orientation. Thus, in what follows, I outline key principles of cultural rhetorics to advance several positions about research as an academic practice contextualized within my broader goals. In so doing, I make explicit the moves I took to craft the project, including the research focus and its disciplinary boundaries, the selection of scholarly work shaping this project, and the deliberation over data gathering and coding. Put another way, this first section served to elucidate the “work that makes apparent how cultural rhetorics is embodied and employed theoretically and methodologically” (Cobos et al., 2018, p. 150). As such, I offer below my orientation to this apparency by contextualizing the research paradigm within cultural rhetorics. Orienting Myself to New Ground Defining Cultural Rhetorics Simply put, cultural rhetorics can be understood as an orientation to understanding rhetoric and culture as one and the same, with both shaped and changed through practice, which are in turn shaped by numerous other aspects of human and non-human life. Phil Bratta and Malea Powell (2016) state this concept best: “all rhetoric is a product of cultural systems and . . . all cultures are rhetorical (i.e., they have meaning-making systems that are meaningful and that can be traced synchronically, diachronically, and a-chronically).” Furthermore, cultural rhetoricians operate with the “understanding [that] the specificity of the bodies and subjectivities engaged in those practices must be central” (Bratta & Powell, 2016). Distilled together, cultural rhetorics might be best understood as the following: rhetoric is cultural, culture is rhetorical, and both are a practice. This concept underpins three principles as delimited by cultural rhetorics scholarship. 26 Principle 1: Practices Are Specific to Community and to Place At the core of a cultural rhetorics orientation is place, which I interpret to mean the idea of being landed. Cultural rhetoricians have shown that practices are tied to the space and places on and through which they take place. For example, Powell (2012) states that a space12 is “a place that has been practiced into being through the acts of storied making, where the past is brought into conscious conversation with the present and where—through those practices of making—a future can be imagined” (p. 388). In this way, “spaces . . . are made recursively through specific, material practices rooted in specific land bases, through the cultural practices linked to that place, and through the accompanying theoretical practices that arise from that place” (Powell, 2012, p. 388). By attending to place, space, and land, cultural rhetoricians often foreground community in their research by focusing on the place of that community, working with the assumption that community itself is a set of relationships vis-à-vis Indigenous concepts of relationality and materiality (Riley-Mukavetz, 2014), which are helpful in articulating the complexity of life through a constellation or situatedness in space and time. Through his story of enacting solidarity through community organizing with and for Chicano and Black Lives Matter activists, Xicano scholar Santos Ramos (2016) defines such community-based cultural rhetorics work as “situating beliefs and practices within the cultural contexts from which they derive, [and] cultural rhetoricians prioritize accountability to the communities whose meaning-making we investigate” (para. 5). Similarly theorizing accountability as there-ness, Andrea Riley-Mukavetz (2014) argues that “to be there is to be 12 When using the words “space” and “place,” I mean to echo Eve Tuck and Marcia McKenzie’s (2015) concept of critical place inquiry: “places . . . themselves [are] mobile, shifting over time and space and through interactions with flows of people, other species, social practices” (p. 19). What I do not want to convey is a metaphoric use of the words. As Tuck and McKenzie (2015) say, “Metaphors are never politically neutral nor benign; they are never empty of significance. Use of place- and space-derived metaphors does little to attend more responsibly to issues of place. Instead, metaphorical representations of place invoke place superficially, too easily” (p. 18). 27 visible, present, and active in the communities we belong to” (p. 14). Like her, “I prefer the term there-ness instead of the ethics practices our disciplines rely on because it allows me to talk about the experiences that are difficult to classify and categorize” (Riley-Mukavetz, 2014, p. 14). Practically, tying there-ness to relationality entails an active, action-based commitment to any community under academic inquiry while relying on community-bred knowledges. For me, then, this reliance takes the form of having insider knowledge on the communicative practices queer and trans BIPOC (QTBIPOC) use as a queer Chicano in community.13 Beyond there-ness, these cultural rhetoricians show that research should focus on the practices that arise from and comprise a cultural community, which exists in a space or place, and the land14 is tied to the people in both what and why they do what they do. Thus, putting concepts of relationality with a material accounting of a space and place leads to the following takeaway: practices are tied to a place or space, these practices arise out of historical contexts and cultural communities, and these practices are inherently bound up in the history tied to a space and place. With a commitment to Indigenous knowledges and lifeways, cultural rhetoricians also often affix a hyperfocus on colonization as the machinating force behind the 13 Here, I do not mean to perform a flattening, ontological entreaty into the practices of QTBIPOC. Queer experiences do of course communicatively flourish across multiple racialized communities (i.e., the use of terminology such as “girl” and “sis” and the appropriation of words such as “bitch” and “faggot/ maricon/joto” in everyday slang). However, the misappropriation of terminology and their experiential formations loom—take for instance the bevy of white queer men who now use words such as “shade,” “reading,” and “tea” when those words were formulated by poor trans women of color and gay Black men and Latinos in the 1980s and 90s. Thus, when I say I am able to rely on my own personal, communicative knowledge here to navigate the meaning-making practices of QTBIPOC, I mean I can rely on my past experiences as a queer Chicano to springboard into deeper understanding. For more on the communicative idiosyncrasies of QTBIPOC, please see Seth Davis’s (2019) work on fierce literacies of queer Black embodied practice. 14 By using the word “land,” I mean to invoke Gabriela Raquel Ríos (2015), who uses the term “to shift the ontological presuppositions inherent in the term ‘ecology’ . . . referring to an ontological position that sees humans as ‘the Earth being conscious of itself.’ This is an indigenous concept of relationality that . . . relies on a relational ontology at the level of kinship quite literally” (p. 64). Building off of Ríos, Kristin Arola (2018) further states that “Land is not a metaphor, it is a living thing that our rhetoric, digital or otherwise, exists on, with, and through” (p. 212). These cultural rhetoricians outline well a point I hope to make in my methodologizing and in my theoretical framework later on. In this way, I follow Aimee Carrillo Rowe and Eve Tuck 2017 who say that, “For Indigenous societies, land is peoplehood, relational, cosmological, and epistemological. Land is memory, land is curriculum, land is language. ‘Land’ also refers to water, sky, underground, sea” (p. 5). 28 many wicked problems affecting the cultural communities with whom they work. On that note, cultural rhetorics itself has coalesced from various aspects of writing and rhetoric and cultural studies, which entails some baggage. Principle 2: Research Itself Is a Practice Cultural rhetoricians have shown that research itself is a practice that can be understood as a specific set of actions derived from the history and spaces/places of a cultural community. In this case, the overall community comprises specialized academic fields, with scholars reading, building, and learning from each other. The places of scholarly work are expansive: universities, hotels, houses, coffee shops, cafes, bars, social networking sites, text messages, calls, Zoom or Skype calls. We can construe these as physical and conceptual structures built on stolen land, and the legacies of settler colonialism consequently carry over into the research that scholars conduct, as I touched on above. Such deliberation on research as a practice also functions as a specific protocol for conducting a research project. As academicians, cultural rhetoricians advance principles through a particular researcherly stance tied to citational practice and adherence. In this way, they work to build a capacious definition of not only rhetoric (i.e., rhetorical theory or a critical understanding of varying rhetoricities in the world), but writing and rhetoric studies writ large, affording a constellative method of building argument, theory, purpose, and intention across relevant fields. As one example, cultural rhetorics itself is housed in numerous academic spaces, both in the material buildings comprising numerous academic institutions and in the embodied knowledges of working cultural rhetoricians.15 Beyond the localities, cultural rhetorics itself is indebted to the 15 I use the phrasing “working as academics” to mean quite literally that we academics are imbricated in complex settler systems by merely working in the academy. Dylan Miner (2015) points out that, “From the moment we wake up in the morning until the time we drift off to sleep, our bodies maneuver through a system contained by the limits of colonialism and its twin brother, capitalism” (p. 234). Of course, as part and parcel of settler colonialism, 29 infusions of critical theory and perspectives via cultural studies, ethnic studies, postcolonial studies, and related fields. Here, I home in on cultural studies, which Aimee Carrillo Rowe and Eve Tuck (2017) argue often advances “projects [that] are often grounded in assumptions that presume and erase settler colonial epistemologies so that even in our best attempts to challenge systems of exclusion and privilege [we] unwittingly reify . . . settler colonial[ism]” (p. 7). Similarly, spotlighting writing and rhetoric, Powell (2012) argued that the field “founds itself at the heart of the narrative of modernity and it is deeply mired in the muck of the logic of coloniality” (p. 393). At the core of writing and rhetoric, then, ties “the underlying logic of the foundation and unfolding of Western civilization from the Renaissance to today of which historical colonialisms have been a constitutive, although downplayed, dimension” (Mignolo, 2011, p. 2). Consequently, Western theories and epistemologies—comprising what Boaventura de Sousa Santos (2018) calls the cognitive empire—are often centralized within research. Powell (2012) calls this move the “biggest colonizing trick of them all,” as the continental tradition of critical theory too often operates by “erasing real bodies in real conflict in the real world by separating mind from body, theory from practice to keep us toiling away in the service of a discourse that disadvantages almost every one of us” (p. 401).16 As a salve, cultural rhetoricians have advanced the notion that ethical research and scholarship involves a deep commitment to capitalism affects our lives differently at the axes of race, gender, queerness, and ability. As an inherently white supremacist and heteropatriarchal system, life under capitalism is always inequitable and unequal. 16 I do not wish to decontextualize Powell’s argument here. As she states, “I am talking about the actual students in our classrooms—their bodies, how their bodies are marked and mobilized in dominant culture, their language and how their language is represented in dominant culture” (Powell, 2012, p. 401). Moreover, Powell (2012) particularly homes in on “their lives and how their lives are denigrated as not quite good enough without the fix of Western literacy instruction” (p. 401). Her argument surrounding literacy, composition instruction, and disciplinary values is central to her overall argument, and I follow in more detail her argument in chapter 3. For now, Powell’s assertion that our field has much to do with the settler colonial legacies of the universities across the United States is central to my methodologizing here. 30 divesting from colonial knowledge ways Indeed, cultural rhetoricians often situate their work “within a larger Indigenous movement that challenges colonialism and its ideological underpinnings . . . working from within Indigenous frameworks to reimagine the world by putting Indigenous ideals into practice” (Gaudry, 2011, p. 117). In this manner, cultural rhetoricians often play the double-agent role of insurgent researchers, “[finding] a balance between academic methods and traditional methods [and] thus developing a system of education that is equitable and valuable to all” (Rheault, 1999, p. 43). In this case, “traditional knowledge teaches respect for all life. It fosters a relationship with all living beings, allowing one to find his or her place in the world but also allowing the necessary foundation for the examination of that world” (Rheault, 1999, p. 84). That said, writing and rhetoric has taken up many non-Indigenous worldviews pertinent to understanding the materiality of community, marking a steep incline amid numerous publication venues. Principle 3: Cultural Rhetorics Involves Ethical Reflection on Academic Practices This dissertation comes at the heels of a debate over ethical citational practices for building rhetorical theory, and of note to my methodologizing are the numerous concepts and ideas comprising object-oriented ontology, critical posthumanism, new materialism, or affect studies, what Finnish and Anishinaabe (Keweenaw Bay Indian Community Lake Superior Band of Chippewa Indians) scholar Kristin Arola (Sackey et al., 2019) acronymizes as OOO/PH/NM/AS. As she says, “When I encounter OO/PH/NM/AS, I find myself staring into a constellation of meaning whereby the citation practices and ideas and sub-field protocols . . . work to make a point that, to me, has always been part of my matrix” (Sackey et al., 2019, p. 386). Arola (Sackey et al., 2019) points to a collection of American Indian thinkers who together showcase knowledges of land, materiality, relationality, and human life that run parallel—though 31 they are much older—to OOO/PH/NM/AS. The latter, however, has experienced a greater trajectory in the academy.17 As Arola (Sackey et al., 2019) puts it, “OOO/PH/NM/AS its own constellation, disconnected and distanced from American Indian epistemologies and ontologies, it lies elsewhere, it constellates a different matrix” (p. 387). Returning to the point above regarding the colonial legacy of academia, I am suspicious of the OOO/PH/NM/AS uptake, asking “What other story could be told here? What other language is not being heard? Whose space is this, and who is not here” (Todd, 2015, p. 244)? This tension represents a key factor of doing cultural rhetorics work as outlined by the above cultural rhetoricians: adhering to a de/anticolonial, accountability-based approach to writing and rhetoric research “outside of the limitations and structures of colonialism and cultural relativism” (Cushman et al., 2019, p. 2). Ahmed (2017) stories a salient example of the colonial centrism of critical theory: “As a student of theory, I learned that theory is used to refer to a rather narrow body of work. . . . A citational chain is created around theory: you become a theorist by citing other theorists that cite other theorists” (p. 8). Understanding theory in this way means academics make commitments— chaining themselves—when selecting one theory over another. Thus, cultural rhetoricians often work with “a purposeful epistemological shift in mind, [beginning] with epistemic ‘delinking’ 17 Métis scholar Zoe Todd (2016) says that many academics who find themselves within the realm of OOO/PH/NM/AS and the so-called ontological turn are, in essence, “celebrating and worshipping a European thinker for ‘discovering,’ or newly articulating by drawing on a European intellectual heritage, what many an Indigenous thinker around the world could have told you for millennia: the climate is a common organizing force” (p. 8). Though Todd’s (2016) argument spins out from Bruno Latour’s impact on a wide breadth of cultural studies, her overall criticism is highly relevant to my point here: “When we cite European thinkers who discuss the ‘more- than-human’ but do not discuss their Indigenous contemporaries who are writing on the exact same topics, we perpetuate the white supremacy of the academy” (p. 18). Similarly, Vanessa Watts (2013) says that understanding human relation to nature and the world through Western thought (read, settler colonial intellectuality as moved through continental philosophy) is inherently limited. Through a review of non-Indigenous theories of materialism (i.e., Donna Haraway, Bruno Latour, Immanuel Kant, Rene Descartes, and Stacy Alaimo), Watts (2013) argues that, despite attempts to repatriate human beings into nature within multiple academic arenas, such attempts foreground the human as the center of nature (being the one with so-called knowledge), bifurcating the two into discrete parts. The cosmological hope of the world being one again is lost; the Western human cries. 32 from the colonial matrix of power” (Cushman et al., 2019, p. 2). The work of creating a research project that examines a practice through a cultural rhetorics orientation requires a deep commitment to non-Western knowledges, pivoting away from the cognitive legacies of settler colonialism and actively working against them.18 Who Am I on Different Ground? In reviewing these cultural rhetorics principles, I swirl them with my insurgent intentions and my careful research paradigm. Together, they inform the meta-processes that in turn inflect my methodological process, or the way I went about creating this project. Beyond these two layers, my identity in the world helps me to build my cultural rhetorics orientation on new ground. My life as a queer, light-skinned Chicano (with heritage in Mexico and El Salvador) raised in a Mexican American community in South Texas shapes my theory in the flesh (Moraga, 1983), crystallizing a broader set of identitarian politics into a coalitional literacy rife with “new ways of understanding, learning, imagining, and being in relation to others’ stories, interests, and contexts” (Licona & Chávez, 2015, p. 96). To put it in terms of my Chicano identity and experiences, Kelly Medina-Lopez (2018) calls such a move a rasquache rhetoric, which “is synonymous with potential. It encourages us to renew, recycle, upcycle, renovate, and reimagine” (p. 14). Through my work with and for Indigenous peoples living in Midwest, I take 18 A caveat stands at the core of this work. Unangax̂ scholar Eve Tuck and K. Wayne Yang (2012) point to “the settler intellectual who hybridizes decolonial thought with Western critical traditions . . . emerges superior to both Native intellectuals and continental theorists simultaneously. With his critical hawk-eye, he again sees the critique better than anyone and sees the world from a loftier station” (p. 16). Tuck and Yang (2012) are critically cynical in this statement, though Mohawk and Anishinaabe scholar Vanessa Watts (2013) speaks more matter-of-factly about borrowing from Indigenous epistemologies and cosmologies to supplant Western critical theory in the service of new or inventive research: “[Indigenous] stories are often distilled to simply that—words, principles, morals to imagine the world and imagine ourselves in the world. In reading stories this way, non-Indigenous peoples also keep control over what agency is and how it is dispersed in the hands of humans” (24). When non-Indigenous people adapt Indigenous thinking with no critical reflection—without believing that all stories are true—then an academic colonialism is perpetuated. My intention here and in this dissertation is not to perpetuate colonialism but to say that I believe the story of Sky Woman to be true. I am happy to have been told this story by Watts through readings from Thomas King, and in conversation with Indigenous friends in Lansing, MI. Believing this story has forced me to rethink how I see the world and myself in it and has spurred a fervor within to actualize as a cultural rhetorician. 33 seriously this cultural rhetorics orientation—it has thoroughly steered this project. In Chapter 1, I offered stories relaying why I am interested in how QTBIPOC communities talk about their sexual health on Twitter. I echo those stories here to conclude with the fact that I bring several perspectives to the fore in this inquiry about queer life and sex as refracted through my identity as a gay Chicano who has sex with other men. My life—small snippets of which shimmer through the aforementioned stories—serves as a vital, collative force in my methodologizing. Attending to my cultural rhetorics orientation, then, my goals as an academic hinge on creating practical interventions based on the findings of my project: I seek to ask questions and to articulate answers in relation to and opposition to colonial violence. In the following chapter, I outline at length what this commitment looks like when building theory, and the methodology below mirrors that theoretical framework in terms of thinking insurgently about life amid technology and colonialism. With that in mind, in the remainder of this chapter, I review the research project of this dissertation, beginning with the research questions and moving to how I answer them. Methodology: Overview of the Research Project Taking the stories in Chapter 1 together, I created this project by first asking the following research questions, each steered in part by my research paradigm and my own disciplinary training and commitments. In other words, I posed research questions that could both be used to craft a project contingent on social justice and that could be answered by work done via my disciplinary throughline in technical and professional communication, digital and cultural rhetorics, and health and medical rhetorics. The questions are as follows: • R1) What are the rhetorical practices of queer and trans Black, Indigenous, and People of Color who tweet about their sexual health practices online? 34 • R2) How might these practices be ethically integrated into public health outreach? To answer these questions, I followed Heidi McKee and James Porter (2009), taking a multi- stage approach to create this research project. These stages were: 1) data collection, 2) pre- coding, which involved slowly reading through the tweets in an extant archive, excluding those that were retweets and from organizations, clinicians, providers, or other public health officials (i.e., applying exclusion criteria),19 and pre-coding those relevant to the research project to derive thematics; and 3) establishing three case studies based on these themes that showcase how users utilized a reconfigured definition of health literacy to make meaning of their sexual health (more on this in Chapters 4 and 5). Data Collection & Analysis Using an insurgent appropriation, I adapted internet- and social media-based methods for gathering and analyzing the data. As such, tweets were gathered as data by using an automated, self-populating Twitter Archiving Google Sheet (TAGS), a system developed by Martin Hawksey that uses Google Sheets’ functionality and Twitter’s open API to conduct a keyword search across public Twitter users. This search began in Fall 2018 and continues, refreshing every hour.20 The keywords used were the hashtags #PrEP and #Truvada, and these were used specifically to attune the data collection to those users talking about their sexual health in relation to ongoing changes surrounding medication, culture, and health. These keywords were 19 My reasoning for casting these as the exclusion criteria stem from the nature of this study. In essence, I seek to understand how non-medically trained persons discuss their public health on Twitter, and thus, the aforementioned categories would only complicate the data. That said, tweets that were responses to the excluded categories were factored in as they demonstrate and engagement with health in active, rhetorical ways. I discuss this matter further in Chapter 3. 20 Because TAGS is only able to search back in time for seven days, I first compiled an initial repository using Twitter’s Moments feature, scrolling back through the search up to May 1, 2018, and adding tweets up until October 15, 2018, the day I first ran the TAGS system. The tweets from the Moment were later added to the TAGS archive. After initiating the TAGS archive, I ran the program to renew itself every hour, which it has done for the past two years leading to the present moment. 35 also selected as they have been prominent in the cultural milieu of QTBIPOC for the past three years (as outlined in Chapter 1). Tweets collected through the TAGS system were aggregated in a Google Sheets document, along with usernames, user-made bios, timestamps, avatars, and locations (when available). Ethical Considerations With this metadata, I created this project in a manner consistent with McKee and Porter (2009) and the Association of Internet Researchers’ (2019) ethics of internet research, asking myself how data would be traceable and if it could be potentially harmful to the Twitter users when published and whether identifying information was required. As I argue in my theoretical framework in Chapter 3, identity is integral to internet and technology use: anonymizing the data would lead to poor conclusions regarding my research questions.21 I also grounded my work in a relational ethics (themselves tied to the theoretical framework), which steered my use of the semi-public tweets as data in as much as I am attempting to constellate these tweets amongst broader forces of oppression. As Dawn Opel (2018) says, an online space such as Twitter “creates rich possibilities for observation and analysis, but these possibilities are rife with quandaries. Forums, boards, groups, hashtags, and communities must be regarded as vibrant, liminal spaces where people organize themselves by their affinities and afflictions” (p. 176). Meta-data thus allows me to cross-check that the cultural content that users generated and frequented in their discrete Twitter feeds corresponded with QTBIPOC communicative practices 21 Dawn Opel (2018) points out that internet researchers must maintain a “vigilant commitment to . . . ethics as recommended by the AoIR. Despite potential satisfaction of legal requirements and IRB approval . . . a researcher must always look to possible future harm that may be caused by the use of health and medical data” (p. 183). I mention this aspect as the data I sought were not discussions of illness (in this case, HIV/AIDS), but the prevention of this disease. In this manner, my research goals, as they align with empowerment, seek to resolve the top-down approach typical of public health outreach, and by drawing on how Twitter users assert their online health literacy through discussions of bodily reactions to medications, sex practices, and other relevant information, I maintain this tension throughout the project. For a discussion of how users use rhetorical strategies to make meaning of their sexual health after seroconverting, please see McKinley Green’s (2020) work on youth of color living with HIV. 36 (i.e., checking to see who the user is and what they talk about online confirms their self- identification as queer, trans, Black, Indigenous, or a Person of Color).22 Following the above guidelines, I therefore present the data in this dissertation—and subsequent publications—in a manner that only recounts identive aspects of users as derived from contextual elements, including: usernames, locations, other tweets, bios, and photos. I do not use twitter usernames, show avatars, or use any other identifying information in my writing. In addition to these practices, I act as a steward for users’ data by using encrypted and password-protected hard drives and secure storage. Pre-Coding Because data is self-populated as users generate content, I created a copy of the overall archive and effectively ended data collection for this project in June 2020. From this document, which contains at the moment of writing this sentence nearly 32,000 tweets, pre-coding was conducted following inclusion/exclusion criteria. With about 300 individual tweets remaining, I carefully read through each, highlighting ones that sparked an interest and were seemingly related to the research questions. During this stage, I also expanded on some tweets, delving into the conversational context in some cases and storing these tweets for further investigation. I also included analytic memos left in the form of comments on specific cells containing interesting tweets, and they were later factored into analysis. When this stage was completed, included 22 Lee Humphreys et al. (2014) point out that “the publicness of Twitter is unlike other popular social networking sites . . . [because] unidirectional connections are unique on Twitter. Non-reciprocal connections encourage the reading of tweets beyond one’s personal and professional networks” (p. 843). Moreover, as Alice Marwick and dana boyd (2011) advance, “Twitter affords dynamic, interactive identity presentation to unknown audiences” (p. 116). As such, “a variety of imagined audiences stems from the diverse ways Twitter is used: as a broadcast medium, marketing channel, diary, social platform, and news source. It is a heavily-appropriated [sic] technology, which participants contextualize differently and use with diverse networks” (Marwick & boyd, 2011, p. 122). As my results show in Chapter 5, users tweeting about their sexual health have indeed invoked this imagined audience, specifying their messages, requests, jokes, and more to those whose queerness algorithmically brings them together across various online arenas. I argue this point more fully in Chapter 5. 37 tweets and their accompanying meta-data were compiled in a Microsoft Excel spreadsheet and manually entered into Dedoose, a qualitative coding software. Coding was conducted in line with constructing grounded theory, following a two-cycle approach (Saldaña, 2009), which derived three overarching thematics across the data that in turn showcased three contextual factors that garnered the most attention on Twitter. Following Johnny Saldaña (2009) and as part of the first cycle of constructing a grounded theory, holistic coding was used as it “is applicable when the researcher already has a general idea of what to investigate in the data . . . [and can be] preparatory groundwork for more detailed coding of the data” (Saldaña, 2009, p. 119). In this round of coding, then, I analyzed the selected tweets and accompanying meta-data, which I construe as experiential data that fleshes out the tweet given that they form contextual vignettes for conveying information. As such, in this initial coding stage, I derived initial codes such as HUMOR, EDUCATION, or CRITICISM, in addition to others based on an assumed purpose of the tweet. With these initial codes, I then moved to the second round of coding. With axial coding as the second cycle, I prioritized “properties (i.e., characteristics or attributes) and dimensions (the location of a property along a continuum or range) of a category” (Saldaña, 2009, p. 159). As the follow-up to the first cycle of coding, axial coding allows me to dwell in those “components [of] the conditions, causes, and consequences of a process—actions that let [me] know ‘if, when, how, and why’ something happens” (Saldaña, 2009, p. 159). In other words, axial coding affords an interconnected approach to data, including parsing through tweets related to the specific utterances gathered in the finalized data set, constellating them amongst each other and the broader forces at play that led to the specific instance of the tweets. Thus, through this round of coding, I was able to derive codes based on the contemporaneous 38 events, cultural complexities, and oppressive forces tied to them that led to the tweets themselves. With the coding and memos, I derived three thematics, which were then used to construct the case studies comprising the project. These thematics were: 1) recognizing and countering the overrepresentation of QTBIPOC as always at risk; 2) rhetorically recognizing and navigating the complex systems of late capitalism in both clinical and non-clinical settings; and 3) spotlighting bodily reactions to medication despite stigma or shame to inform or seek such knowledge from community and deploying descriptive hashtags such as #U=U (undetectable = untransmittable) or #TruvadaWhore to push against restrictive sexual mores and stigma regarding serostatus. Case Studies With these themes, I established the following three case studies: 1) the proliferation of a pre-exposure prophylaxis (PrEP) advertisement campaign across social media and television; 2) the patent breaking of Truvada as part of PrEP and its consequent effects on QTBIPOC sexual health; and 3) the everyday mundane act of tweeting about one’s life, what I term the everyday case study (below, I detail in full how I approached the third case study given its contextual ambiguity).23 With each case study, I incorporated what John Gallagher (2019) outlines as the spatial, temporal, and relational boundaries of an internet-based case study, bounding each to the 23 Coming to this project, I already had a fairly large data set to work with as I had launched a pilot study—a truncated version of this one titled “My Blood Cells When I Take My Truvada’: Examining Twitter Users’ Engagement with PrEP, Truvada, and Sexual Health”—in Dr. Dawn Opel’s medical rhetoric and writing course in 2018. Titled after a fairly viral tweet, the project that I launched has undergone many iterations—first as a conference paper, then as a manuscript for a journal (which I did not submit to a journal), a previous approach to data analysis, and now this form. For me, what each of these stages represent is a precoding, of sorts, through which I have thought on how to best present the data in some meaningful way. Frankly put, my prior approach did not do enough to avoid the extractive core of academic research. That said, pouring over the data for so long, I realized that these three contextual elements showcased themselves. By using the academic language of a case study, I am able to best showcase the rhetorical strategies used in response to the above occurrences in a manner that allows for integration into public health outreach while avoiding a misconfiguration of community knowledge. I detail these moves further when describing each of the case studies in this section. 39 contextual limits of the topic at hand. Spatial boundaries in this case refers to the platform spaces in which a researcher is conducting a study (in my case, Twitter). Temporal boundaries refer to, quite simply, the time during which a study is conducted, including when data is gathered. In my case, the temporal boundaries are the moments in which data correspond to larger, though slow-moving developments in QTBIPOC sexual health. Relational boundaries are the mechanisms by which users interact with each other and with whom they interact. As outlined above, the relational boundaries in this case would be the rhetorical-relational work of tweeting to and for others who would fall under the QTBIPOC umbrella. In essence, these case studies help me to “create bounded systems to help organize data, thereby providing cohesive, detailed narratives” of the thematics derived from pre-coding (Gallagher, 2019, p. 2). Each component of the case studies allows for an approach by which researchers can “view their object of inquiry as a bounded system . . . [and] a single case study looks at [an] . . . event in-depth” (Gallagher, 2019, p. 2). In other words, I am using these case studies to present three instances of how QTBIPOC make meaning of their sexual health in relation to broader forces at play in the world, letting the data story itself, in a sense, when contextualized within a non-clinical health literacy framework (which I detail in Chapter 5). In that manner, I present three goings-on in the world that users made meaning of in relation to their sexual health, so- called interpretation of the data within an insurgent purview that merely recounts the communicative instance of a tweet against the backdrop of the forces seeking to detract from the user’s quality of life. This approach strains epistemological, definitional limits of health literacy rather than reframing the tweets within extant definitional schemas. Below, I detail each component of the case studies and their bounding, using altered text from key tweets that 40 elucidate the core findings of the case study. For a full scope of the results, please see Chapter 5. Case Study 1: “What? Straight white people don’t get AIDS?” With this case study, I segmented the data to only encompass tweets created from early 2018 to late 2019, which was during the time Gilead Inc., began rolling out an extensive advertising campaign to foster adoption of Truvada. Much of the data during this time likewise corresponded to this rollout, and users focused specifically on a commercial on Hulu, advertisements on gay locative media such as Grindr and Scruff, and targeted ads on social media (i.e., Facebook and Twitter). Moreover, many users took to Twitter to express their frustrations with the ad campaigns. As such, I bounded the case with the following parameters: • Spatial: Twitter is the spatial boundary of Case Study 1, as it is the primary source of communicative action (with space being construed as the platformed arena of rhetorical possibility). Other internet-based platforms and technologies comprise secondary nodes, wherein users experience things related to their sexual health and then take to Twitter to discuss them with an imagined audience in mind. These secondary nodes are factored into data analysis in as much as they affect the communicative aims of the tweet (i.e., to talk generally about an experience, ask questions, or harp on a pressing issue the user faces). • Temporal: June 2018 – December 2019 • Relational: The relational boundary in this case is open. I rely on the concept of the imagined audience here to understand that users are likely taking to Twitter to express their sentiments about sexual health advertising, which I then construe as a health literacy act. 41 Case Study 2: “Big pharm doesn’t give a fuck.” With this case study, I segmented the data to show tweets from the months of September 2018 to December 2018, when the Truvada patent was broken in the United Kingdom, and then from November 2019 to May 2020, when the patent was disrupted in the United States. These two discrete moments in time garnered perhaps the most attention online in relation to a major occurrence specific to the sexual health of QTBIPOC. During these times, users specifically homed in on the systems of late capitalism that prioritize profits over life and the legal schema that constrains multiple entities (i.e., governments, policymakers, and public health organizers) from stemming the tide of new HIV infections. With these considerations, I bounded the case with the following parameters: • Spatial: Broadly, the semi-public act of everyday people using Twitter serves as the spatial boundary of Case Study 2, though I also home in on particular instances wherein users respond to both politicians and news outlets to express frustration with the ongoing issues over Truvada’s patent. Much like in the node- based approach with Case Study 1, I present findings in a manner both showing the contextual specificities of each communicative instance and relating to the overarching theme at hand. Put another way, I bounded this case to user timelines and other tweets where users talked amongst each other to make meaning of their sexual health (often in terms of finance, navigating insurance, and the hope for cheaper medications). • Temporal: September 2018 – December 2018, November 2019 – May 2020 • Relational: The relational boundary in this case is open (i.e., imagined audience). Case Study 3: “My blood cells when I take my Truvada.” For the final case study, I did not segment any of the data. Rather, I zeroed in on the everyday communicative practice of 42 users tweeting about their sexual health to their imagined audiences, relying on the data gathered after applying exclusion criteria. As such, I focused primarily on tweets from users that were not replies to others (i.e., viral tweets, news stories, politicians, or any other user). Moreover, with Case Study 3, or what I term the case study of the everyday, I homed in on tweets with no apparent contextual factors other than an occurrence happening in the users’ lives (i.e., taking the medication for the first time, talking with their doctors and other medical providers, discussing PrEP and Truvada with their friends). Because I included tweets wherein people talked about their experiences with Truvada and PrEP with no apparent or specific intent, I bounded this case with the following parameters: • Spatial: Like with the prior cases, I spatially bound this case to Twitter and the discrete timelines of users who tweeted about their sexual health with no prompts from other users. In essence, I am weaving together multiple Twitter timelines and the act of tweeting what is on one’s mind to form a rhetoric of sexual health based on mundane practice. • Temporal: May 2018 – June 2020 (i.e., when data collection was finalized) • Relational: The relational boundary in this case is open (i.e., imagined audience). Conclusion: Centering Community, Centering Joy By creating the project in this manner, I follow Jennifer Sano-Franchini’s (2015) suggestion for conducting research in online spaces that focuses on the everyday rhetorical- relational work of building community in relation to marginalizing forces. By integrating a cultural rhetorics orientation to methodologizing—with my insurgent intention with internet- based research methods—I bring together “'hack’ and ‘yack’—practice and theory—in fluid ways” (Sano-Franchini, 2015, p. 49). Regarding theory, I speak at length about how I construe 43 social media, cyberspace, and the internet, including how this theorizing deeply informs the methodology I present here. However, to conclude this chapter, I offer Sano-Franchini’s (2015) critical question for data interpretation, one that has been integral to my approach thus far: “What becomes visible when we locate rhetorical situations as existing within cultural frames” (p. 53)? Because I am looking at online communication with a specific purpose (i.e., health literacy acts), I reframe that question within Judy Segal’s (2009) statement that “rhetorical study resituates internet health in its contexts” (p. 365). I thus have cast Twitter itself as a platform vital to the communication of health matters, wherein the context is the very fact of an utterance—construed as a tweet—which both instantiates and precedes the need for information among users. Put another way, when people tweet about a topic, they at once create a need to know and fulfill that need by informing the reader. Frankly, because I am merely tuning into this communicative work, I have approached this project with cultural rhetorics in mind because it allows for a clear articulation of researcherly moves that tune into such communicative work. For that reason, I have constellated this methodology for researching online spaces, presenting analytic strategies that allows me to foreground self-apparency, and describing findings in a manner that forces epistemological shifts on the part of public health. I have touched on this fact briefly thus far in this dissertation, but I do all this work in such a manner because this work is what I know and do best. I am a researcher trained in cultural rhetorics, technical and professional communication, and digital rhetorics, and I am committed to queer and trans health. This dissertation thus echoes Bernadette Longo (2002) and what she says about technical communication being “the mediator between technology and what we have come to call ‘users,’” (p. 17). As Longo (2000) also rightly says, technical communicators must put “humans—in all our complexity—at the center of our practices” (p. 168). Here, at the end of this 44 chapter, I offer this centrality as a deep, epistemological requirement of my methodology; some things must be safe from purview of the academy in my work. Much of what I have found in the data, as it were, is joy—the bliss of QTBIPOC being in community despite everything in the world, including the technologies that bring them together, tearing them down. This joy is precious, and it must be protected. I hope that what outline in this chapter shows the manner by which I work in those liminal spaces that lets community be what it is—joyful work that rescinds the wickedness too often central to how the world works. 45 CHAPTER 3: THE INTERSECTIONAL INTERNET AS LAND: THEORIZING DIGITAL RHETORICAL SOCIO-MATERIALITY VIA BLACK AND INDIGENOUS STUDIES A fear of the body, aversion to nature, a desire for salvation and transcendence of the earthly plane has created a need for cyberspace. The wealth of the land almost plundered the air dense with waste, the water sick with poisons: there has to be somewhere else to go. — Loretta Todd, “Aboriginal Narratives in Cyberspace” (1996, p. 182). We need to shed light on what is happening with our digital media and the internet and denaturalize the idea that these “tools” are apolitical or without consequence. — Safiya Umoja Noble, “A Future for Intersectional Black Feminist Technology Studies” (2016, para. 22). Introduction: Technology ↔ Colonization Settler colonialism technologizes to persist. The waiting glow of a screen radiates a wicked heat—electricity becomes more than just atomic kinesis. In a revised schema wherein matter is more than its Western commonplace, the screen, the human, the machine, and the energy become a relational network with a deep history of cross-landmass movements—bodies, lives, worlds—and colonization. Put another way, the internet becomes more than just a communicative network when materially inventoried, a move I seek to enact through theory in 46 this chapter. Indeed, through resource extraction, racial technohierarchies, and paternal exploitation, settler colonialism can be technologically unearthed in often unseen, mundane settings when we cross-examine the internet: data servers built on stolen land and cooled with stolen waters (Edwards, 2020), white settlers benefitting from former colonial subjects testing and making new internet-based technologies (Benjamin, 2019), and toxic waste shipped to a foreign somewhere away from the metropole (Hogan, 2018). In her keynote for EPIC2019, Sareeta Amrute (2020) advances a critical truism of the globalized, technological, and infrastructural regime of so-called modern life: “In the realm of science and technology, risks are generally borne by colonial subjects while metropolitan elites assume the role of developers and innovators of new technologies.” Mar Hicks (2021), in a franker utterance, says best the central issue I unpack and counter through theory in this chapter: “most of the technological advancements we’ve seen over the course of the nineteenth and twentieth centuries . . . involve some amount of literal or figurative shit-eating by average [people]” (p. 14). The colonial drive for innovation and for so-called modernization—tech colonialism as Anjuan Simmons (2015) and Amrute (2020) calls it—relegates what we call modern life in the Global North to the march of settler technofuturities (Duarte, 2017). Technology users are seldom privy to the colonial histories endemic to their devices and their uses (Ramos, 2014). Indeed, as Dustin Edwards (2020) astutely posits, “the material infrastructures of the internet and connected platforms and devices are tangled up with lands, waters, energies, and histories that are often unseen, unfelt, or unacknowledged in our everyday lives” (p. 60). The internet as techno-sociological infrastructure (Harvey & Luka, 2019) functions through the march of tech colonialism, especially within the context of empire on the North American continent (Hu, 2017). With a formative starting point in the militarism of the 47 modern United States (Chun, 2011), many scholars of race, new media, infrastructure, rhetoric, and technology have noted how the internet’s developmental horizon is marked by settler colonial futurity, algorithmic insidiousness, data commodification, surveillant teloi, and material theft (Benjamin, 2019; Brock, 2020; Brown, 2019; Hu, 2015; Mejia, 2016; Noble, 2016; Todd, 1996). On that note, Unangax̂ scholar Eve Tuck and K. Wayne Yang (2012) point out that “colonialism [comprises] global and historical relations” (p. 21), and if Gayatri Chakravorty Spivak is to be taken seriously, “If you don’t train the soul, the global/digital cannot be used right” (Paulson, 2016). I take Spivak’s comment here to mean that we must take a particular stance grounded in de/anticolonial relations when examining technology against the backdrop of discrete though globally linked colonialisms. I believe such a move counters what Amrute (2020) spotlights in her incisive analysis of technology’s colonial impetuses: “the malevolent paternalism of colonial relations means that solutions are always proffered in the name of and for the good of the colonized, yet the colonized themselves are not recognized as full and legitimate participants in producing those solutions.” My inclusion of Amrute’s (2020) technological skepticism here, however, should not be read as my deploying a cynical analysis of technology within this chapter, though the capacity to do so is quite extensive. Many technologies are too often harmful to Black, Indigenous, and People of color (BIPOC), but Amrute (2020) points out that critique should not steer critical interrogations of technology. Rather “to undo tech colonialisms, we must reframe the stories of tech inevitability and fixedness in our patterns of engagement with the world” (Amrute, 2020). We must reconfigure the narrative core of tech colonialism—the settler colonial technofuturity that marches forward at planetary expense—to be a means of glimpsing the shimmers of de/anticolonial potential that 48 come about through technology use. This narrative reframing of technology echoes the call from Tuck and Yang (2013), who call on us to reconsider the fixity of settler colonialism: “we must [refuse] the master narrative that colonization was inevitable and has a monopoly on the future” (p. 243). To avoid the trap of mere critique, then, I situate the people who are disproportionately affected by tech colonialism as users who limn an otherwise technoworld through technological use despite its colonial nature. In other words, what I offer in this chapter is a critical approach to technology, and specifically the internet, that at once spotlights and admonishes its connection to settler colonialism as a marginalizing force while foregrounding how BIPOC use technology to disrupt injustice and empower themselves, often in their everyday communicative practices. I call this move taking material inventory, or accounting for the rhetorical-relational matter of our technology uses; this socio-material, excavational approach I take to the internet is the work of building a digital/cultural/material rhetorical theory of the material intimacies revealed through cosmological reordering.24 In this chapter, I unfold a two-part theoretical intervention into current understandings of the internet's social and material infrastructure as a means of taking this material inventory. Specifically, I outline a theoretical argument for revising the internet's popularized and metaphorized definitional schemas (Frith, 2020) within Black epistemologies25 and Indigenous cosmologies—an attunement to the cyborgian relationalities created when matter (the 24 Here, I mean to close the divide in the discrete but interlinked subfields of digital rhetorics, cultural rhetorics, digital cultural rhetorics, material rhetorics, and digital material rhetorics. What I hope to do in this chapter is reveal how the three—the digital, the cultural, the material—are not so easily divided and, instead, are readily collapsible. 25 By drawing from the literature of Black and Indigenous thinkers, as well as other marginalized thinkers, I am better able to approach technology, identity, and human-material life in the colonial, Western landscape as it relates to my project. Put simply and frankly, I mean to attune my work to those most affected by ongoing colonization, which I hope signals an investment in the analytical potency of BIPOC knowledgeways, which as I noted earlier in this dissertation, I have sought to epistemologically underpin in my work. Alicia Garza (2014), in her recounting of why she co-founded #BlackLivesMatter, says simply how these moves influence my methodologizing and my broader goal of empowerment: “When Black people get free, everybody gets free” (para. 13). 49 nonhuman) and the human collate to rupture settler colonial technofuturities (for a visual of this framework, please see Figure 1).26 Through this framework, what I term the intersectional internet as land,27 I advance the notion of emplacing,28 a theoretical tool for attuning research to the critical junctures of human and non-human life in technology use. I advance emplacing as a method of collapsing the social and material facets of the internet into socio-materiality (here and elsewhere, I integrate the two adjectives into a compound modifier to signal this collapse) in a move that revises the internet as the internet as things.29 As a theoretical force, I ground (quite literally) the theoretical method of emplacing in digital/cultural/material rhetorics (Arola, 2017; Arola, 2018; Edwards & Gelms, 2018; Edwards, 2020; Haas, 2018), using the concept of the intersectional internet as land to reconfigure the digital infrastructure of the internet into a relational network for both humans to come together 26 With this cross weaving, I mean to signal my attention to the formations between Black and Native studies, what Tiffany Lethabo King (2019) terms the Black Shoals. Her attention to the cross-sea trade routes and the Black life lost overboard during the Atlantic Slave Trade—core to North American settler colonialism—mirrors my own interpretation of the internet as an intercontinental and intercolonial network (Starosielski, 2015). Human and planetary death rush around fiber optic cables amid these formations along the ocean floor; liquid histories swirl into a settler archive wherein we might locate climate catastrophe in the here and now as it resonates with the temporal plasticity of slavery and genocide (Jackson, 2020). But, maybe, we can locate something more down in the water, a mixture that dissolves the “normative processes of white human self-actualization” (King, 2019, p. xv). 27 Chi Miigwetch, again, to Dr. Beth LaPenseé for guiding my readings in Indigenous methodologies and helping me strategize my approach to theorizing in this chapter and for the terminology of “internet as land.” Thank you for helping me think through these more-than-concepts. On that note, with the term “intersectional internet,” I extend its theorizations from Safiya Umoja Noble and Brendesha Tynes (2016). I detail further my extension of the intersectional internet later in this chapter. 28 Many thanks to Dr. Dustin Edwards for offering insight and his thoughts to help me think through emplacing while contextualizing it as a theoretical force within rhetoric and writing scholarship. 29 This term, perhaps obviously, shares the similar nominal construction with the popularized “Internet of Things” (IoT). Matt Burgess (2018), a technology privacy and surveillance journalist for WIRED, states that “In the broadest sense, the term IoT encompasses everything connected to the internet, but it is increasingly being used to define objects that ‘talk’ to each other” (para. 4). In essence, IoT is the networked connection between devices with disparate functions connected through wired/wireless connections. Burgess (2018) points out that that, though the IoT is often advertised and framed as the next logical step of the internet and broader technological innovation, “an argument has been raised that only because something can be connected to the internet doesn't mean it should be . . . [because] each device collects data for a specific purpose that may be useful to a buyer and impact the wider economy.” In essence, the IoT stands as the rhetorical springboard for the next stage in commodification, which in this case comprises the personal data of internet users (Pendergrast, 2019). Much has been said about this commodification, and though I cannot hope to fit these arguments here, I bring these issues up to say I have conceptualized the materiality of the internet in contradistinction to the commodifying capacity of multibillion/trillion-dollar corporations that contribute immensely to human and planet death. 50 and for non-human actants to find different purpose within a decolonial spark of human companionship and energy. With this revised material formula, the beingness of digital infrastructure—when digitally/materially/rhetorically excavated, or materially inventoried—is at once re-landed and agentially reinvigorated via the focus on the relational agency of the non- human things that make up the internet’s socio-material infrastructure despite colonial appropriation (Duarte, 2017). Thus, I offer emplacing as a theoretical method within digital/cultural/material rhetorics research with which we can trace what Robert Mejia (2016) spotlights as “the complex interplay of anxiety and desire” within the epidemiology of digital infrastructures (p. 237). Figure 1: A figure demonstrating the intersectional internet as land. In this figure, the components of the intersectional internet as land are shown, with arrows connecting aspects of human life to an agentially re-invigorated internet. The blue represents the overall components of the internet’s digital infrastructure, and the black and brown boxes represent the human and the land comprising the internet, respectively. The term "cyborgian relationality," along with the green connective box, are used in the center to signal the collative forces bringing both halves of the theoretical framework together. In what follows, I outline a critical attunement to “animals (including nonhumans), technologies, and landbases” (Haas, 2018, p. 421) that functions as a theoretical framework for conducting a material inventory of the internet and assessing its use as a force for good. 51 Following the stories I offered in Chapter 1, I provide this theoretical framework because I believe how queer and trans BIPOC (QTBIPOC) use technology and the internet specifically delimits an appropriated use of technology as a technology of settler colonialism, offering glimpses into the everyday, mundane settings of syborgian acts (i.e., the co-construction of identity and culture in cyberspace despite oppression; paperson, 2017). In other words, if we want to know what technology can do apart from the colonial, capitalist drive of innovation amid ongoing settlement, we must look at what QTBIPOC communities are doing with, in, and through technology.30 First, I review key building blocks integral to how I have created this framework, uptaking concepts from rhetorical scholarship (specifically, platform rhetorics, digital rhetorics, and technofeminism) that serve as useful interrogative entryways for understanding human life on/with the internet. After, I redefine the internet along a two-pronged schema, wherein the human user and the technological tool are respectively configured against the backdrop of settler colonial formations. Focusing on humanness and matter via Black studies and intersectional theory via Black Feminist Technology Studies, I disentangle the anti-Black nature of technology (in both its material constituency and utility) by showing how identity forms with and through technology and becomes an integral power for joyful appropriations of technology. After, centering Anishinaabe cosmology, I redefine cyberspace itself as a material place comprising the network of cables, servers, computers, and other devices that bring into relation humans and non- 30 Here, I do not mean to use capitalism as a stand-in for colonialism; both are intrinsically linked but discrete forms of control over marginalized peoples. Rather, I follow Red River Métis scholar Max Liboiron (2021) and their analysis of settler conquest as it relates to land, resources, and capitalism: “colonial quests for Land are different than capitalist goals for capital . . . [and] socioeconomic systems other than capitalism also create environmental pollution and waste, but what is more important for understanding the relationship between capitalism and colonialism is that many different economic systems depend on access to Indigenous Land” (p. 13). As an extension, when I talk about the internet as a thing comprising expropriated lands, I mean to locate the critical teleology of a landed analytics as a means of attending to the historicity of technological development and formations within and through settler colonial technologies of control over Black and Indigenous life (paperson, 2017). 52 humans (via tightening agential realtionalies amid biospheric transformations), effectively collapsing the divide between the social and the material to create a socio-material internet. I conclude by offering examples of the considerations afforded through the concept of emplacing, using my research project and methodology as a demonstration. This theoretical framework steers my approach to the methodology outlined in the prior chapter, the methods for collecting and analyzing data, and the attention to specific groups of people. Continuing the conversation from Chapter 2, much of my theorizing here also serves to constellate my work within and through a broad swath of disciplines relevant to my research project. Thus, when I say I am theorizing in this chapter, I echo la paperson (2017) in that I am opting for an elsewhere creation of an academic endeavor that coalesces into a project built on empowering others. This theoretical framework thus primarily functions via my own disciplinary purview across writing and rhetoric studies, which I believe offers thrust to the theoretical force of the intersectional internet as land. Making Theory with Rhetorico-Technofeminist Building Blocks Technology and the digital underpin my theorizing, and both have occupied writing and rhetoric’s disciplinary imaginary for quite some time. As Jonathan Alexander and Jacqueline Rhodes (2018) storied in the introduction to The Routledge Handbook of Digital Writing and Rhetoric, technology profoundly changed writing and communication (the former being an expression of the latter in this instance and of interest to me). As they ask, because “our experiences of writing and being rhetorical seem to have changed,” we as a field dedicated to writing in its various forms must ask: “If writing is indeed changing, how is it changing in response to the digital platforms that currently enable many contemporary composing practices . . . what do we really mean when we say ‘digital writing’ or ‘digital rhetoric’” (Alexander & 53 Rhodes, 2018, p. 2)? For my own interests, this question springboards well into Indigenous scholar Angela Haas’ (2018) concept of digital cultural rhetorics as several inquisitive tracks spin out into my theorizing.31 Specifically, Haas (2018)—contributing to a cadre of other cultural rhetoricians bridging cultural rhetorics into digital/material rhetorics—advances the following definition: “Digital cultural rhetorics . . . recognize and make explicit the plurality of embodied, technological, and rhetorical negotiations within specific cultural contexts and asymmetrical power relations” (p. 412). Her formative work bridging these two subfields reveals a critical focus for my theorizing: “digital rhetoric requires a negotiation—an interfacing—between bodies, identities, rhetoric, and technology” (p. 412). To study digital life, then, is to study life as embodied experiences mediated via multiple platforms,32 digital technologies, and compositional modes, including all of the additional aspects of life that these foci entail. Technofeminists working and theorizing within the purview of digital rhetorics and platform studies thus offers much to my interrogation of identity and life with and amid technology. For example, a prime argument of technofeminist criticism within writing and rhetoric is that “the mere presence of technologies does not account for or eliminate difference in terms of access, embodiment, intersectional identities, or lived experience” (Bates, Macarthy, Warren- 31 Rather than get bogged down in the differential complexities of digital writing and digital rhetoric, I follow Haas’ (2018) assertion that “digital rhetoric broadens our focus beyond production-driven processes toward rhetorically situated digital praxis, informed by rhetorical principles, including audience, ethos, purpose, context, media, and content usability, among others” (p. 412). In this sense, praxis might include writing or any other compositional practice done through the use of digital technologies. Finally, for clarity, when I use the word “digital” here and elsewhere, I mean to invoke Haas’ (2007) work again: “To explain, ‘digital’ refers to our fingers, our digits, one of the primary ways (along with our ears and eyes) through which we make sense of the world and with which we write into the world” (p. 84). 32 Bridget Gelms and Dustin Edwards (2019) assert that “the rise of the platform—a bundled term that describes an economic model, a set of computational procedures, and a semi-public space from which to write and engage—has reconfigured the conditions of the web” (“Introduction”). With these new conditions comes the notion that online life on the internet might be best understood as platformed, or the notion that “the screen or interface or program or code alone [includes] the bodies [that are] often abstracted from most people’s everyday engagements with platforms” (Gelms & Edwards, 2019, “Material”). 54 Riley, 2019, “Future”). To articulate this framework and parse through the multiple considerations I took to build this framework, then, I turn to Bridget Gelms and Edwards (2019), who provide key tenets for technofeminist inquiry33 within the scope of digital rhetorics research: 1. Social Inequalities. This tenet should inquire into “how platforms re/create social inequalities along axes of gender, sex, race, sexuality, class, location, and disability.” 2. Labor. This tenet means looking into “how platforms reinforce inequitable global labor practices . . . are often concealed by logics of ‘sharing.’” 3. Material Infrastructures. This tenet calls for an inquiry into “how the material maintenance of platforms . . . compromises land, water, and community resources and are entangled in logics of colonialism.” 4. Networks of Support and Activism. This tenet calls for researchers to understand how “how counter-hegemonic discursive spaces emerge and ways we can (re)ascribe value to such populations, identities, and practices.” 5. Lived Experiences. As the final tenet, Gelms and Edwards as researchers to think about “how the lived experiences and emotional labor of [our lives] has bearing on the research process, especially in light of [our] likely ‘insider knowledge’” (Gelms & 33 With my upcycling of technofeminism into my theoretical building blocks, I mean to divest from whitestream technofeminism in a manner consistent with la paperson’s (2017) theorizing in the break. More specifically, I follow Rhita Dhamoon’s (2015) question as she articulates the struggle of intersectional de- and anticolonial feminism within white feminism: “How should feminists respond to considerations of difference between and among gendered racisms and colonialisms that are created and governed by state-based practices and global hegemonies, specifically to account for varying degrees of penalty and privilege in the margins” (p. 26)? My investment in technofeminism is therefore not without heavy considerations given that, from my readings, primary literature in technofeminism seems to suffer from a general inattention to Third World Women of Color Feminism, Black Feminisms, and Indigenous Feminisms. In essence, technofeminism appears to be steeped in whiteness, and I cannot in good faith drawn from primary literature while also adhering to the third principle of cultural rhetorics outlined in the prior chapter. Nicole Marie Brown (2019) says well my issue through her critique of cyberfeminism, cyborg feminism, and by extension technofeminism: “Black women too often are absorbed, rather than included, into White middle-class feminist traditions” (p. 57). Following the third principle of cultural rhetorics outlined earlier, I am deliberate in my citations of technofeminist scholarship, and much of how I approach the “feminism” portion of the term comes from the aforementioned traditions, which I review later in this chapter. 55 Edwards, 2019, “Introduction”). By upcycling these tenets, I spin out two lines of inquiry central to my theoretical method of emplacing and my concept of the intersectional internet as land, which start at the human user of the internet and continue into the internet as user of the human. Below, I detail further this bidirectional relationship, beginning at the human user and moving to the internet. In so doing, I detail the core conceits of the intersectional internet as land, forged through the above tenets though theoretically linked to worldbuilding projects integral to understanding human life with technology in the so-called modern day. Who are the Users of Technology? Living On/As the Internet Both the human and technology are two interwoven tales of feeding a hungry, white machine; they occur simultaneously and linger in seemingly innocuous places. As one salient example, the fairly recent controversy over an automated soap dispenser’s inability to recognize people with dark skin (Fussel, 2017) exemplifies one of the undoubtedly many failures of technology stemming from colonial histories and the creation of a human user rooted in anti- Blackness. At the time of writing this sentence, similar issues have arisen regarding mHealth devices such as Apple Watches and such smart trackers: they fail to read the pulse of people with dark skin (Sjoding et al., 2020). The issues with these and other devices exemplify how the human is configured with and through technology, offering a singular question that unravels centuries of settler colonialism: “Who are the users of technology?” In this section, I thus examine the plastic/ity34 of human life with and against, respectively, the configurations of Blackness and Western onto-rhetorical formations of the human and technology to recover the internet as a socio-material network. This move precedes my full articulation of the intersectional 34 Here and elsewhere, I use the neologism “plastic/ity” to signal a use of the words “plastic” and “plasticity,” each in turn corralling inquisitive tracks from Native studies and Black studies, respectively. 56 internet as land. With the question I offer above—“who are the users of technology?”—I cast a hyperfocus on the plastics of technology (Liboiron, 2021), or the colonially appropriated land(s) comprising both the internet and its constituent devices (i.e., phones, laptops, servers, cables, modems), as they propel the colonial horizon of settler technofuturity. This narrative strand serves as one part of the colonial tale of technology, and it leads to the other, one in which the plasticity of the human (Johnson, 2020; King, 2019) rests on the Black fungibility needed for creating the liberal subject (King, 2019; Rusert, 2019; Weheliye, 2014). In essence, by answering the question of technology users, I argue that humanness and materiality can be disentangled from the anti-Black formations of both within settler colonialism, and I use the internet as a means of reforming the dialogics between the 1) human user of technology and 2) the technological user of the human, wherein the human becomes a technology for land35 to find new purpose despite its colonized state. In those sparks of joy— part of what I describe later as joyful appropriations—the human becomes a decolonial proxy for land to find new purpose while it is away from its/their original home(s): underwater, in Arctic ice, in deserts—new worlds that persist because of and in spite of new/old colonialisms. The Intersectional Internet and Human Life (or, Who Is the Human User?) In bifurcating the question of who the users of technology are, I extract this component related to the human (“Who is the human user?”) to outline two propositions: 1) the onto- 35 Eve Tuck et al. (2014) have been extremely helpful for me as I have thought through the ties to land and how to ethically theorize such a connection. Regarding land, they say that it “is personhood for some, for others, a ceremony of becoming. Land is also mnemonic: a relationship to land is both an obligation of care to the land itself, and a method for remembering the truths about place, culture, and identity” (p. 70). Furthermore, they argue that “the terms of relationship . . . must grow from the longings and desires of those who need the definitions to help communicate to each other the ways they walk together, struggle together, and experience life and death together” (p. 70). This approach is central to how I have approached my theorizing as it lies at the center of Black and Indigenous coalition building, futurity, and sovereignty. 57 formation of the human has been appropriated by the settler and 2) material utility (or how we use things) has been configured by settler colonialism. With the former, I spotlight the human and its inception within settler colonial ontology, wherein an attention to the plasticity of Black fungibility reveals the rhetorical dialectics integral to the human while offering a way out of the bind (Wynter, 2003). In other words, Black epistemologies—disciplinarily located within Black psychoanalysis, African, Black & Caribbean studies, Black Feminist Thought, and Black science and technology studies36—offer a singularly incisive point of entry into configuring the human user of technology as a person who uses a colonial technology to disrupt colonial technologies. I use the latter proposition on utility to argue that, though technological use is too often imbricated within settler colonial structures (i.e., cisheteropatriarchal, white supremacist capitalism), otherwise uses prime a deeply revised technoworld. Two critical aspects of the Western landscape hinge on how both the human and technology are coconstructed; time here is elastic and stretches but snaps when the band is torn, the metaphysical rupture of critical inquiry. The literal technologies of settler colonialism foment the ontological ordering of the liberal subject as human and user (via the histories of chattel slave labor). Indeed, as Sylvia Wynter (2003) locates the formation of man (i.e., the liberal human subject) against the long history of European thought, she traces the temporal stretch of the settler’s ordering of the world, which demarcates the divide between the human and the natural (both integral to the world-ordering power of technology today). As Frantz Fanon (2008) also argued, the colonial formations of the human have coalesced against the violence (material, 36 My constellating across these disciplines, which have been integral in configuring the liberal human subject as a site of analysis while offering discrete analytics for interrogating white/settler culpability, is intentional as I am seeking to address the global colonialisms of the world within a critical purview. Like Zakiyyah Iman Jackson (2020), I broadly approach analysis because, despite my work being centered on QTBIPOC, the systems of oppression intermingle across multiple imperial projects. As she puts it: “The cultural production examined [in my book] spans three continents and three centuries because antiblackness has been central to establishing national borders and readily crosses them” (Jackson, 2020, p. 19). 58 psychic, temporal) enacted against the Black subject and the backdrop of European imperialism in Africa, continuing into the present moment and its settler empires (i.e., the US, Canada, Mexico, Australia, South Africa, Israel, among others). As he puts it, “Man is human only to the extent to which he [sic] tries to impose his existence on another man in order to be recognized by him” (p. 168).37 Within this Hegelian dialectic—the settler who is ascribed whiteness and its possessives via its formative engagements with Blackness (Moreton-Robinson, 2015)—we might trace long histories of technocolonialisms, what Britt Rusert (2019) calls the laboratory life of the plantation, through which white settler life and neo-European technoscientific taxonomies were replicated, enacted, and extended. One key taxonomy—that developed in contradistinction to Indigenous cosmologies (detailed in the next section)—divides the human from land, which entails the non-human constituents of the human purview (animals, dirt, grass, trees, water, minerals). The settler colonial episteme configures the non-human as a natural repository,38 which in turn is synthesized against settler perception, an act energized by anti-Blackness. In other words, the world (i.e., land) is apart from the Western human because 1) the human itself is conceived within/through global anti-Blackness (and Indigenous extermination), 2) the settler has used Black fungibility as a world-ordering power, meaning 3) both have congealed to cast 37 That said, Fanon’s analytics extend as much as the interrogative thrust of psychoanalysis. I include his thoughts here, though, because they are vital to understand how Black fungibility makes space for a lens with which we might examine the labor done on the internet as a settler colonial technology and the new formations of human identity on the internet. 38 Tung-Hui Hu (2015) points out how “even as digital networks seem to annihilate or deterritorialize physical space, space seems to continually reappear, often as an unwanted flaw in the system” (p. 3). Hu (2015) focuses on the ever-expanding need for more land and so-called resources to expand the internet, as well as the cumulative effects on health related to continuous construction. As such, he reframes the internet as a “resource-intensive, extractive technology that converts water and electricity into computational power, leaving a sizable amount of environmental damage that it then displaces from sight” (Hu, 2015, p. 146). Though Hu (2015) focuses on the occluding logic of the cloud metaphor, his insight here is useful for thinking through how such logic perpetuates the internet’s ever-expanding move to gobble minerals, water, animals, and human lives. 59 nature (i.e., materiality and non-humanness) as a means of ordering Black fungibility via animalism and the colonial violence of enforced labor through enslavement (Jackson, 2020). Today, multiple points of human life and labor articulate this anti-Black ordering. Wynter and Katherine McKittrick (2015) call this taxonomy the Third Event, from which nature was ordered via the settler’s understanding of it. Time collapses within this critical purview when we focus on how technologies develop in tandem with settler colonial technologies (paperson, 2017). Colonial violence precedes/supersedes enslaved and/or colonized peoples; temporality becomes amorphous as new forms of carcerality and surveillance—death— emerge, such as “Nazi racism and the other forms of biopolitics . . . those perfected in colonialism, indigenous genocide, racialized indentured servitude, and racial slavery, for instance” (Weheliye, 2014, p. 59). Put simply, technology develops to order the world according to anti-Blackness (and, as I argue below, Indigenous extermination) and to foreclose anticolonial options. This ordering, however, offers new questions that help delimit the disjuncture for joy (how technology is repurposed for thrivance): “Who and what are fixed in place to enable innovation in science and technology? What social groups are classified, corralled, coerced, and capitalized upon so others are free to tinker, experiment, design, and engineer the future” (Benjamin, 2019, p. 4)? Today, we use phones, computers, and other devices born from genocides that linger when we send a text—expropriated lands and inequitable labor practices, factories built near Black and brown neighborhoods. American imperialism continues; the mere idea of Silicon Valley signifies a gash in the biosphere, wounding deeply our shared futures. These technocolonial goings-on coincide with the formation of the human subject in the settler’s quest for progress and modernization. But I do want to linger too long in the violence and death—in 60 the sad state of colonial wickedness. Rather, through these formations, we might locate a resuscitated human figure whose use of technology ruptures a seemingly static world. In this manner, I follow Wynter (2006) and her extensions of Fanon’s arguments regarding the human to locate the temporal protogenesis of a new human configured against both anti-Black world ordering and liberal humanism configured within Indigenous displacement.39 Wynter (2006) does the indelible work of turning Western thought onto itself to locate the Western human—an epistemological collapse wrought from Black being and the shuffling of perspectives wherein the conqueror becomes a prime analytical locus, a move that provides the liminal space for new categories of humans to emerge. Wynter (2006) and McKittrick (2021) locate the emergence of this new human within the lodgings of Black critical inquiry amid identity-based freedom struggles (i.e., the development of ethnic studies departments in tandem with the on-the-grounds activisms of Black Power groups). This slow, paradoxical work (Fanon, 1994) of revising the human within an anticolonial framework requires, as Métis scholar Michelle Murphy (2017b) says, “destroying the version of the human that histories of deep violence have created” (p. 4). As such, much like how Wynter ( 2006) roots the new human within the activisms of Black folks in the 1960s and 70s, I locate the worldbuilding potential of technological use—what I call joyful appropriations, which are technological uses that disrupt settler colonial technologies—within the identive purview of Black life on the internet, which forges new interconnections everyday: the intersectional internet (Lockett, 2021; Noble & Tynes, 2016; Tynes et al., 2016).40 39 King (2020) calls this brand of human the conquistador-settler, which “invokes both the violence enacted on the Indigenous and Black body and the possession of land” (p. 212). King’s dual approach to settler colonial analytics is useful here in locating Wynter’s (2006) own temporal rupture of the anti-Black human. 40 I have touched on my approach to thinking about BIPOC collative politics amid the particularities of different marginalized groups earlier in this dissertation. But to repeat, I focus primarily on Black life on the internet to locate a revised technology user that, if only in fleeting moments, dissolves the anti-Blackness core to the ontoconfiguration of the human technology user. At the risk of over-repeating myself, I make this move because I 61 Though the internet as technology finds itself in developmental concert with the subjugation of Black and Indigenous life, its use as a force for good reveals a schema for revising the internet as an intersectional network through which the on-the-grounds work (literally, as I argue in the next section) of identity politics might be enacted (construed from the lineage of Black feminist thought; Collins, 2000; Tynes et al., 2017). André Brock Jr. (2020a) describes such moves as distributed Blackness, or “the protean nature of Black identity as mediated by various digital artifacts, services, and practices” (p. 5),41 which act as a force for erupting the material constraints of identity (developed through settler systems and their structurations). Similarly, Safiya Umoja Noble’s (2016) attunement to Black life on the internet via Black feminist thought and technology writ large shakes the narrative core of tech colonialism to reveal cracks wherein Black joy abounds. Her analytical mixture, which squares it critical potency within the critical epistemological framing of the world in Black feminist thought, offers a “useful and anti- essentializing lens for understanding how both race and gender are constituted through historical, social, political, and economic processes, creating openings for challenging research questions and new analytical possibilities” (Noble, 2016). This interrogative purview—identity and its historical formations and concomitant lifeways—reveal new possibilities on the internet in a seek to spotlight the marginalizing forces at play that bind together the acronym BIPOC, wherein the people comprising this acronym likewise intermingle within the identity-based activisms that revise the social world to be a better place. José Esteban Muñoz (2020), to my point, highlights the interconnections between Black Power movements with Chicano/a and Brown Power movements as one example of the collative, relational possibilities that emerged when we think about our lives as inherently linked together. Again, when Black folks get free, we all get free (Collins, 2000; Garza, 2014). This work is required for the generative engineering of a gorgeous, full world. 41 Here, I mean to reveal how identity is integral to technology use today, as well as how technology lends to identity formation. I spotlight this interplay within the realm of Black life as revealed by several scholars to mark how BIPOC writ large form the coalitional politics—which often take the form of mundane internet use—necessary for a revised technoworld. In essence, Black folks have long paved the way for other marginalized peoples to move toward liberation (Kynard, 2020; McKittrick, 2021; Wynter, 2006), and so I attend to how Black life on the internet reveals a departure of its very anti-Blackness, even if in the fleeting moment of a tweet. 62 manner that limns likewise revised technoworlds wherein the human user is fully human. Brendesha Tynes, Joshua Schuschke, and Safiya Umoja Noble (2016) point to the #BlackLivesMatter movement and its fomentation on social media, and I argue here that we might locate the emergence of new technoworlds within such actions (wherein the full human emerges from the human and non-human interplay of technology; Wynter, 2003). The bevy of activisms around the world that flourish through and with the internet in addition to #BlackLivesMatter, such as the Missing and Murdered Indigenous Women (#MMIW) initiative, the #SayHerName campaign for state-targeted Black women, or the hashtags revolving around the Standing Rock protests of the Dakota Access Pipeline (including #NoDAPL, #StandWithStandingRock, and #WaterIsLife), represent the numerous interruptions of the internet’s narrative as a commodifying force tied to tech colonialism’s need for expansion and consumption. Through these acts, I locate the emergent strands of new cyborgs (Brown, 2019) that show us how the intersectional internet works in the world—though I do not mean to solely theorize the intersectional internet within the activist examples I offer above. Such approaches too often hinge, I think, on the trauma that BIPOC respond to through their internet use—the violence(s) we face are many. I also do not make any claims that the internet—especially social media platforms such as Twitter—is bereft of racism and anti- Blackness. Indeed, the internet, for all its good, is “a social structure [that] represents and maintains white, masculine, bourgeois, heterosexual and Christian culture through its content” (Brock, 2011, p. 1088) while functioning on what Nicole Marie Brown (2019) calls algorithmic architecture, or the assembling, so-called objective computational forces that “expose how power in decisioning is being organized within the social world” (p. 56). The internet, as a technoformation of settler colonial futurity, is still a connective tool steeped in a colonial history 63 of militarism and capitalism, both of which propel the anti-Black nature of technology and its uses. Rather, we might think of these examples as larger, wide-scale instances of how the intersectional internet comes to be—how people bring the fullness of their lives and identifies within their technology use despite the colonial impetuses (Tynes et al., 2016).42 These grander moments, in addition to the mundane, everyday uses of the internet on the part of BIPOC, reveal the work of creating the intersectional internet; it is already here.43 So, to answer the question of who the human user of technology, I have worked here to show how 1) the human and technology have both been conceived through anti-Blackness and 2) how the use of technology (i.e., utility) has a formative edge within anti-Blackness. When BIPOC are on and use the intersectional internet, however, their identities—race, gender, 42 For Marisa Parham (2019), however, the digitized human subjectivity of Black life on the internet, which likewise swirls at the core of the intersectional internet, can serve as a mutinous framework, revealing how Black people live, play, and organize online around and against algorithmic forces, which serve as a stand-in for the oppressive impetus of technology itself. It also serves as an antenarrative of technology, recasting it as a tool for empowerment despite its colonial genealogy and the deployment and ubiquitous, stereotypic narratives of Black technology use (in addition to other such stereotypes on the part of Indigenous folks and other people of color). Brown (2019) claims that this analytic represents “one’s ability to reflect and reframe hir narrative voices, [which] can be liberating when used in service to purposefully creating, owning, and controlling depictions of one’s social self” (p. 57). Of note to my theorization of the intersectional internet, then, is the narrative reframing of the internet as solely a colonial tool (including its constituent algorithms, platforms, devices), the centering of one’s actual use of the internet, and how identity factors into the relationship between the two: the intersectional internet, as its name suggests, forms amid these movements. I speak on this aspect below when I discuss the human as a technology for the material constituents, but for now, I spotlight the everyday instantiations of other technoworlds to highlight the affordances of thinking of the internet (as a means of interrogating technology) as more than just what it is. Humans and utility—both are vital for understanding different configurations of the world when both are rearticulated via revised human action and, perhaps more importantly, the critical love that binds BIPOC against a world that seeks to undo them (Sandoval, 2000). 43 Indeed, Parham (2019) argues that “to be haunted [and thrive despite colonization] is to experience other people’s memories with the affective impact of personal, firsthand experience, to both survive and operationalize the glitch, the break, the experience of blackness” on social media (p. 104). Despite the overwhelming whiteness of the internet (i.e., its formations through anti-Black settler technologies), Black life, expression, and joy as they exist online bring “social media into the realm of human experience, as a social media timeline algorithmically tunes itself to the rhythms and materialities of any user’s own prior physical presence” (Brown, 2019, p. 104). In essence, “each of these embodied actions produces a material trace, as participation in social media transmutes both the work of daily living and the mediation of that living into different kinds of distributable emotional, cognitive, and cultural capital” (Parham, 2019, p. 105), all of which forges new lifeways when the internet is used. Parham’s (2019) notion of operationalizing the glitch underpins my theorization of the intersectional internet (as one half of my full theoretical framework), which is what the internet becomes—a tool for self-expression and empowerment—when it is joyfully appropriated. 64 sexuality, class, ability—are at once bound up in the history of settler colonialism endemic to digital infrastructure while simultaneously complicating the here and now that results from such histories. Though these colonial legacies are present everywhere in technology (quite literally, as I argue in the next section), the intersectional internet reveals itself when such marginalized communities use technologies despite their imbrication amid myriad oppressions to disrupt the normative functions of technology within settler colonial structuration and how they come to be in community despite the digital damage of settler colonialism (Edwards, 2020). To use this theoretical framework, then, we must recast the internet as a tool for deep community building, and in many cases, empowerment, a shift that requires a selfsame move toward accountability. Simply put, this commitment lays the groundwork for using emplacing as a theoretical tool for research, which entails 1) attuning a digital/cultural/material rhetorics research project to the intersectional internet, 2) readily attending to the immediacy of identity within research, 3) centering joy and thrivance, and 4) actively working to interrupt settler colonialism and its immediate invocations within our practical repertoires as academics. For now, in answering the question of the human user, I have worked to tunnel through the social layers of the internet to attend now to its materiality, which is not quite so easily separated from the prior. In what follows, I work to collapse such a divide, which yawns in the wake of old and new colonizations. The Internet as Land and Technological Agency (or, Who Is the Technology User?) This second question resonates with the one I posed above, and I use this component related to technology to slip between the cosmological stranglehold that the Western human has over materiality. In asking, “Who is the technology user?” I outline two propositions: 1) in addition to being configured with anti-Blackness, the nonhuman’s agency has been appropriated 65 by the settler and 2) the nonhuman must be cosmologically reframed as an active participant in worldmaking technopractices to locate and to reinvigorate its agency. With the former proposition, I mean to locate such appropriation within ongoing settlement, wherein land has become a biopolitical subject vis-à-vis settler colonial technologies (paperson, 2017) that can only be used as a so-called resource (i.e., the settler’s repository which, in this case, is used for creating and maintaining a digital infrastructure). With the latter, I advance Indigenous cosmology as a corrective to settler configurations of materiality and, by extension, the internet, which becomes a relational network when reframed as a living thing made of things with spirit and life, needs, wants.44 As part of the work of priming a revised technoworld, I use this half of the question to advance the idea that the internet as things can use the human as a technology for renewed purpose away from settler colonial appropriations. The radiant heat of settler colonialism sparks out in two distinct circuits—one in the sociality of the internet and another in its materiality—that energize an anticolonial option when appropriated by syborgian machines (paperson, 2017). The ignition of a new technoworld fires when we revise the social and the material into socio-materiality, and the cosmological formations of the internet’s beingness become landed when we pivot ontoformations of embodiment away from the idea that human interactivity is inherently embodied because someone is using a device somewhere (Frith, 2020, Haas, 2008). Our bodies carry histories (Powell et al., 2012), of course, and these histories reveal complexly colonial movements: 44 I do not mean here that we need to reframe our thinking in some mundane, innocuous way. I do not also mean to supplant understandings of materiality (via a continental tradition) with Indigenous theory. Sisseton Wahpeton Oyate scholar Kim TallBear (2011) has spoken on the remarkable similarities of OOO/PH/NM/AS (as outlined via Kristin Arola’s [Sackey et al., 2019] thoughts in the prior chapter) with Indigenous knowledge by specifying her own knowledge context, but she extrapolates to these commonly shared beliefs amongst Indigenous people. As such, TallBear (2011) states well my intention with citing Indigenous thinkers in my work: “The academy is now being infiltrated by non-indigenous voices articulating the idea that life/not life is too binary and restrictive. This indicates greater scope at this moment in history for bringing Indigenous voices to the conversational table.” 66 landgrabbing, corporeal theft, lifeways disintegrated. But, through a revised grammar, when the possessive determiner “our” becomes capacious enough for the human and the non-human, we might find better relations at the core of “us.” As I highlight above, though, the settler beings comprising “us” have excised the Black and/or Indigenous human; oppressions are multitudinous but specific, and as Métis scholar Zoe Todd (2015) reminds in her critique of contemporary discourse surrounding the so-called Anthropocene, “Not all humans are equally implicated in the forces that created the disasters driving contemporary human-environmental crises” (p. 244). Cree and Metis filmmaker and scholar Loretta Todd (1996), in her treatise on cyberspace, the internet, and Native life, summarizes well the colonial nature of the internet as it relates to the commodification of land and how, when we attune to its material demands (Edwards, 2020; Haas, 2018), we are ready to learn about its deeper tolls: “The hunger of Western culture is threatening and frightening. We have had to feed that hunger, with the furs of animals and flesh of fish and the gold and silver of our lands and ourselves” (p. 183). Cross land-mass colonization continues—300 years pass—and somewhere in the Artic ice and massive oceans, (Starosielski, 2015), cables burrow down and carry messages and make worlds—the wicked heat again. The internet is now an intercontinental network of cables carrying more information everyday than humans produced in our entire history before the information age (Starosielski, 2015). How might we understand such a network in a manner that allows us to “foster and sustain more ethical, positive, and just relationships between rhetoric, bodies, cultures, communities, and technologies in our disciplines, organizations, communities, and the world” (Haas, 2018, p. 420)? Condensed into another question, though, we might ask: Are the cables cold in the water? This question, like the others I posed above, ruptures settler ontologies that construe the cables as just a utile network. Understanding the internet as land, however, reveals adventive possibilities 67 for relational thinking amid disaster. In articulating the internet as land, I enunciate its parameters within Anishinaabe cosmology, meaning that, through the ancient typologies of relationality (Riley-Mukavetz, 2014), we might best understand the constituent elements of the internet as things as land— colonized nonhuman subjects taken from lithium-laden volcanos, copper mines, crystal repositories, and “waters of empire” (Anand et al., 2018; Edwards, 2020; Hu, 2017; Mejia, 2016). As such, Anishinaabe scholar (Chippewa of Thames First Nation Band) Andrea Riley- Mukavetz (2014) tell us that, “to practice relationality is to understand one’s position in the world, one’s relationship to land, space, ideas, people, and living beings” (p. 112). It means being a good person with your relatives—both human and otherwise. Anishinaabe (Bizhiw Doodem / Lynx Clan) philosopher D’Arcy Rheault (1999), in describing Mino-Bimaadiziwin, the Anishinaabe philosophy of The Way of a Good Life, tells us that this relational goodness is “how we as humans should behave toward our relations. This relationship is based on the view that all life is related; whether mineral, plant, animal and/or spirit” (p. 30).45 As it stands, we might understand the internet as nonhuman relatives locked in a colonized state, which has much to do with the cross land-mass movements that comprise contemporary settler colonies that in turn diminish the lives of Black and Indigenous people, as well as other people of color to an extent.46 When land is taken from its home and used to make colonial technologies (literal and 45 Rheault (1999) also says that “the Anishinaabeg do not see Mino-Bimaadiziwin as something that lies within the realm of simple process, but rather, that Mino-Bimaadiziwin is the way as well as the result, the means and the end, of being a good person” (p. 145). In this way, by citing Rheault (1999) and incorporating Anishinaabe cosmology into my theorizing here, I mean to be a good person. 46 Anishinaabe (Flying Post First Nation) scholar Kathleen Absolon (2011) says that “the concept ‘we are all related’ informs the wholistic and relational nature of Indigenous methodologies. Indigenous thought and knowledge guides how we search for knowledge—a search that considers reciprocity and interdependence” (p. 30). To my earlier notes about breaking from the continental theory and the empires that comprise the human/non-human, TallBear (2011) and Arola (Sackey, 2019) point out that OOO/PH/NM/AS writ large has been playing the game of catch-up to Indigenous peoples for quite some time. Recounting the metaphysics of Vine Deloria Jr. and Charles Eastman, with whom she shares tribal and knowledge affiliations, TallBear (2011) states that Indigenous people “think the material 68 figurative, which also are not so easily separable), we must invent new ways of honoring the agency of our internet relatives and helping them move toward freedom. With the internet as land, then, I argue that we must attend to relationality by always linking it to the non-human relatives that allow us to come together in cyberspace to work, play, and be in community. Beyond the immediacy of climate disaster—the severity of which I do not mean to lessen here—we might also think of our online communities as being more than just humans sharing cyberspace. Todd (1996), drawing on the Cree philosophy of keeping the land clean (i.e., in balance) and rupturing Western thinking related to cyberspace and the internet, argues that bodies still matter—quite literally—in cyberspace, including the non-human components of the internet. As she says, “all in the universe is endowed with spirit and intelligence, from which ideas flow. . . . In this world view there is no separation of body, mind, spirit, and heart” (p. 180). The internet as land reframes cyberspace itself a mediation made possible only by the connective instantiation of the body and the land: “Of course, [when] we are in a virtual environment and the space and time are no more than 1s and 0s organized in front of our eyes, on the screen, the fire never burns out” (p. 191). The heat persists. My work here is to imagine through theory the internet as literal interconnectedness, meaning that internet users are in relation—whether they are aware—with other users beyond online community spaces in that they share a physical space through the minerals, lands, wires, and the social are co-constituted. . . . We see sociality and materiality as . . . as together making ‘composites,’ as cohabiting one another, or feeding one another, or making and re-making one another.” The internet as land can only be understood within these cosmological parameters. More specific to my own interrogations of life with and through technology, I turn to Pascua Yaqui scholar Marisa Duarte (2017), who points out that “relating systems of devices and information flows to colonialism requires integrating the material and tangible aspects of information systems with sociological explanations of the mechanisms of colonialism. It requires reading Indigenous theories of colonialism and decolonization” (p. 18). The internet as land cannot be used when the user does not center Black and Indigenous lifeways and worldviews; failing to do so does little more than perpetuate what Todd (2015) terms academic exploitation. The energy might power the same machine—the destination reached regardless of theoretical force—but the Western oil in the machine is dirty (Murphy, 2017a). 69 metals, waters, and humans that comprise the internet’s socio-materiality. Focusing on the Haudenosaunee/Anishinaabe concept of Place-Thought, Mohawk (Bear Clan, Six Nations) and Anishinaabe scholar Vanessa Watts (2013) forwards the “premise that land is alive and thinking and that humans and non-humans derive agency through the extensions of these thoughts” (p. 21). She contends that “habitats and ecosystems are better understood as societies from an Indigenous point of view, meaning that they have ethical structures [and] inter-species treaties and agreements” (p. 23). Moreover, if “non-human beings are active members of society … they also directly influence how humans organize themselves into that society” (Watts, 2013, p. 23). This cosmological loosening of the Western internet primes the internet as land to be a theoretical tool for extending our networked beingness—we are humans on the internet insofar as we are allowed to be by the non-humans that make up the internet. Rheault (1999) articulates well my conceptualizing here in his story of Anishinaabe philosophy as it manifested in his life: “I am at the center of a community of relations that moves from my immediate family to the whole of the population of the world, this population including humans and non-humans alike” (p. 135). As he explains, “All things are interconnected; one’s place in Creation brings balance and belonging in the world. Nevertheless, since one interacts with the world in a mainly physical way, it is very difficult to see the physical-spiritual unity of Creation” (Rheault, 1999, p. 112). As the intersectional internet arises from the settler machinations—the wicked heat—of modern technologies, so too does the internet as land animate from our attention to the non- human relatives; it is more a nudge toward cyborgian, relative acknowledgement than a metaphoric play on words. The fan hiss of a machine warming up coveys more than small parts activating to keep up with activity, our fingers flurried across a keyboard and too many open applications; instead, we might feel the fan wind as our non-human relatives working hard to 70 keep us connected. Much like the “us” I point to earlier, the “we” here means more than just the humans; this conceptualization also recasts the internet as more than just its parts. As Watts (2013) says, “Spirit is contained within all elements of nature and therefore, we, as humans, know our actions are intrinsically and inseparably tied to land’s intentionality—quite a counter position from notions of diluted formulations of agency” (p. 30). Part of this formulation includes the demand for an ethics tied to land and its agency. The internet as land counters the settler colonial legacy of land’s biopoliticization into a settler repository (in all its particularities). If the internet as things is lonely, then we are lonely, and if we do not see/feel that loneliness, then we must work to recognize a landed agency that affords a new option to the non-human. This work is hard, but we must strive to become a likewise technology for the internet as land to find a de/anticolonial option as it does for us. This line of thinking leads us to the adventive thinking made possible via the internet as land. Finnish and Anishinaabe (Keweenaw Bay Indian Community Lake Superior Band of Chippewa Indians) scholar Kristin Arola (2017) tells us that “everything is related, and our place within these relations is constantly shifting. Issues of identity and truth are terms best understood through how we conceive of our relations” (p. 217). By theorizing the internet as a relational network, then, I intend to pick up Todd’s (1996) hopeful conclusion regarding the future of the internet and its constituent devices: “perhaps the universe will be imagined in ways that reflect our interconnectedness” (p. 193). I have worked here to imagine through theory the internet as literal, deep, meaningful interconnectedness. That said, using the internet as land brings to the fore the environmental concerns that are themselves tied to how technology propels settler colonialism (Edwards, 2020; Haas, 2018). To use the internet as land, then, is to understand that the internet, though a useful tool for community, has an extensive impact on the environment 71 that is bound up in the settler colonial agendas of capitalism, land-grabbing, and commodification—the lock of colonization. But as before, I do not want to linger in death and colonization’s overreach. To echo my earlier words of moving past critique, my intention with theorizing the internet as land is to prime a space with which to think critically about our commitments as digital/cultural/material rhetorics researchers. Noble (2019) states best my goal with this move: “the cumulative effects of mass-scale digital infrastructures, products, and engagements require a debt of energy and resources that we cannot collectively repay to the earth or to humanity” (p. 34). Instead, “only radical reinvestment of the largesse of these projects and company profits back into collective, public interventions on these debts has the potential for renewal and reparation” (Noble, 2019, p. 34). The disaster(s) of climate crisis surfaces the buried and often hidden colonial logics of land’s agentic erasure, but the internet as land should not be understood as merely a means of talking about the internet and its materiality. I foreground socio-materiality here to argue that a digital/cultural/material rhetorics research project should have at its center a deep care for the non-human elements of our lives and research scopes. This commitment, integral to using this theoretical framework, entails an active combatting of settler colonialism’s machinations within our discrete works, including how we conceive of human identity within and through different uses of technology. In the next section, I conclude this chapter by reviewing how, when combined, both halves of the theoretical framework—forming the intersectional internet as land—shaped this dissertation via the theoretical tool of emplacing. Conclusion: Taking Material Inventory of Research To use emplacing as an analytic guide, we must start at the socio-material conditions that require reparation in the first place (i.e., settler colonialism and resultant oppressions; Noble, 72 2019) and move to how the internet itself is used for empowerment. Tying reparation to my theory building here, I ground the second aspect of emplacing in the materiality of the internet as an entrypoint to understanding life on and with the internet. Emplacing acts a method of tracking both the physical nature of the internet, which in this configuration functions more as a literal network, and the cyberspace/place of an internet user. In this way, emplacing operationalizes the through-line between Black epistemologies and Indigenous cosmology as a theory of embodiment that ties the body to the land (i.e., place), which surfaces the immediacy of identity with(in) technology use. Using emplacing thus requires a commitment on the part of the researcher to think deeply about the internet as both a method of identive data collection and as a means of empowerment—of combatting the settler colonial oppressions affecting BIPOC. To conclude this chapter, I outline the ways using emplacing (or taking material inventory) as a theoretical tool steers my work in this dissertation. I believe the internet can be more than a colonial tool. Much like how I argue that technology’s colonial history is part and parcel to biomedicine and public health’s own colonial nature and history in the next chapter, this tension serves as a frictional though productive crux. Indeed, the ever-increasing bulk of research, special journal issues, edited collections, and other academic productions focused on both online activisms and the parameters of digital infrastructure attest to an academic interest in how the internet can serve both as an organizing tool and insidious technology. More important to my work, however, is the bevy of activisms around the world—locally discrete but globally linked—that flourish through and with the internet. Considering the internet as the intersectional internet as land rips open adventive junctures for examining how—despite the weight of history on their shoulders—certain cultural communities come together online to work against these forces. 73 Of course, these insidious actors press the tempered moments of BIPOC life—in the grander and mundane theaters—as the swelling field of privacy and surveillance studies demonstrates (Beck & Hutchinson Campos, 2021; Benjamin, 2019). And yet, people persist in their efforts, bringing the fullness of their lives to cyberspace and making community. These glitches of social media platforms (Parham, 2019) drive my work forward. This dissertation represents my own goal of seeing past despair and pessimism (because the state of the world leaves much to be desired) and toward a brighter future (in this case, understanding how colonization and technology have much to do with the everyday act of BIPOC posting on social media). I have no qualms that I am merely one academic trying to retune the forces of academia to better serve those cultural communities that need it. But this attunement must happen. To take a material inventory of a project is to constellate through the conceptual multilayers that stack into a research project: who the participants are, where the research site is, what the rhetorical-relational data consists of, and the other ingredient strands that mesh into a project. I make this point in the prior chapter on methodology, but when we researchers do our work, we invoke the long history of cognitive empires (the intellectual work of settler colonialism; de Sousa Santos, 2018; Powell, 2002) that make up the contemporary arena of academic work. These strands fly out and interlace the histories of the human and the non- human, and so, we might think of taking material inventory as a means of tuning into these histories and their concomitant requirements of relational research. Put another way, we must foreground the peoples most impacted by settler colonialism, extend their lifeways (in whatever way we can without being appropriative), and attend to the immediacy of an anticolonial future. Much like early internet research, which typically viewed the internet as a communicative network that erased bodies—meaning identity categories did not matter in 74 cyberspace—thinking of embodiment as solely tied to technological use follows the same utopian and metaphoric logics of communicative togetherness. At its inception lies the idea that community can be conceived of as merely shared cyberspace on the internet. Although a useful premise, I use emplacing as a means of closing the gap between the social and the material, and though my approach is not new (indeed, much has been discussed about the materiality of the internet), I argue that reconfiguring our understanding of the internet with socio-materiality allows for richer theorizing, data collection, and analysis. If we think of the intersectional internet as land in this way, we can in turn reconfigure our understanding of community as not merely a group of users sharing cyberspace through the use of multiple devices and platforms with bodies somewhere in that composite. Rather, we can understand them as in relation with each other and the non-human components of the internet. With this theory break, I mean to say that, if we consider emplacing as a theoretical move to understand the place of an internet user and how it impacts their identity, we can understand online connectivity past prior theories of embodiment, leading to better analysis and, ideally, empowerment amid oppression. Through my theory of the intersectional internet as land, I operate within the in-between of calamity and prosperity, tugging at the thin line to move closer to the latter outcome. In essence, the theoretical framework of the intersectional internet as land serves to work in the ebbs and flows of coloniality as they shape the internet and steer its expansion, spotlighting those glitches and allowing for meaningful engagement with communities affected by the colonial legacies of anti-Black white supremacy and cisheteropatriarchy. Thus, the concepts laid out here directly shape the methodology I outlined in Chapter 2. For example, the concept of slow coding represents my attention to the fact that digital expressions of life are not merely communicative instances but rather extensions of life online. Moreover, the coding schema outlined represents 75 my close attention to intersectional theory as it pertains to online life, and I push against the textual notion of anonymized data—which voids those meaning-rich cultural expressions of daily life online—because of this focus. Finally, emplacing also steers the method by which I collapse the divide between the social and the material in my overall project; the case studies I present demonstrate massive bounds that correspond to the colonialisms happening around the world and their symptoms within the national, local theater; complexities that I grasp by seeing a more complete picture. In the next chapter, I delve more deeply into science and technology studies to outline the core argument of this dissertation as it pertains to my research project and the discussion of the results in Chapter 5. This theoretical framework thus undergirds those positions advanced in the following chapter, and many points I bring up here are interwoven into those related to public health and online health literacy. Thus, this theoretical framework also frames my argument in Chapter 4, outlining key stances to online life, community knowledge, and how both work against colonial forces, pushing them at bay while riding the choppy currents of colonization’s far-reaching impact. For now, I conclude by again stating that, more than anything, this framework represents my hope for meaningful academic work for and with communities thriving amid the current state of the world. I am attuned to hope; it drives me forward. 76 CHAPTER 4: UNSETTLING EPISTEMIC HUBRIS: RUPTURING RISK-INFORMED HEALTH LITERACY, REFRAMING RISKY LIVING For more than five hundred years, Western law functioned as biopower in relation to ongoing practices of European settler colonialism. Settler colonialism has conditioned not only Indigenous peoples and their lands and the settler societies that occupy them, but all political, economic, and cultural processes that those societies touch. Settler colonialism directly informs past and present processes of European colonization, global capitalism, liberal modernity, and international governance. If settler colonialism is not theorized in accounts of these formations, then its power remains naturalized in the world that we engage and in the theoretical apparatuses with which we attempt to explain it. — Scott Morgensen, “The Biopolitics of Settler Colonialism” (2011, p. 53). Introduction: The Problem of Epistemic Hubris Settler colonialism biomedicalizes to persist. Through the primacy of colonial logics (Mignolo, 2011) and the rhetorical regime of at-riskness (Teston et al., 2019), the lives of queer and trans Black, Indigenous, and People of Color (QTBIPOC) are covered with virus and surveillance, forming a terrible mixture: a system of control. The HIV/AIDS crisis of the 1980s and 90s persists in its bio/necropolitical form today (Guta et al., 2011), becoming an eager specter within the sexual lives of QTBIPOC. Seeking care related to our sexual health—indeed, every medical interaction we have across both clinical and nonclinical settings—always 77 rhetorically invokes disease (Lloyd, 2017). Regardless of our ailments when we seek care from providers, we are asked how often we get tested, when was the last time we had sex, and how many sexual partners we have. We are told we need to be more diligent. Perhaps a more insidious affront to our agential possibilities, we are filed within identive jurisdictions that foreclose our own knowledges of our health. Indeed, disease backgrounds this chapter, lingering in the mundane, cornering, staying out of sight but in mind. Living while being a queer and/or trans person of color is to embody risk. Through what I later argue are the epistemic processes of biomedicalization (energized by settler epistemologies), risky identities are rife with assumptions about bodily autonomy, health practices, and sexual proclivity that categorize them as eventually positive. When applied to the context of HIV, whether someone with a risky identity has seroconverted becomes meaningless, as the invasion of biomedicalization rhetorically slips the virus beyond the results of a test, past a negative or positive. Put another way, having sex while having a risky identity (for example, my identity as a gay, cisgender Latino—Mexican American—who has sex with other men) invokes a categorical web of meaning via settler colonial biomedicalization that centralizes HIV within sex acts regardless of the virus’ material presence or absence. This rhetorical propagation follows the HIV/AIDS crisis as the numbers of infected fluctuate across cultural communities, but as part of this process, the complexities of oppression are flattened within the rhetorical construction of at-riskness, itself a double-bind for racialized queer people who simultaneously live with the legacies of settler colonialism as manifested in white supremacist cisheteropatriarchy, which in turn affects their social determinants of health. To my point here about so-called risky behavior, Andrew Spieldenner (2016) has contended that the deployment of risky identities typically follows along somewhat basic identity 78 categories: “as if gay men cannot be people of color, substance users use only one substance, or women cannot be included in other groups. These reductions can be detrimental in understanding how different groups understand and experience HIV” (p. 1685). I bring up these aspects of sexual health not to recount the long history of sexual health in relation to QTBIPOC but instead to show how risky identities can be simplistically construed, which elides the vibrant and multitudinous nature of QTBIPOC identity and culturally specific practices surrounding sexual health. My concern here is the totalizing rhetorical capacity of a risky identity to subsume individual health under the regime of disease and infection—a self-fulfilling prophecy that follows someone tirelessly throughout their sexual life. To clarify, though, I do not focus here mainly on the material virus; rather, I instead take issue with the rhetorical spread of HIV into the lives of QTBIPOC. Indeed, as we shift around in what Sunera Thobani (2014) calls the “empire of terror,” the systems of white supremacist cisheteropatriarchy coil dual virulencies (i.e., a microscopic undeath and the holdovers of European colonization), concomitantly structuring a queer necropolitical surveillance. HIV rhetorically spreads as such—lingering throughout the commonplaces of our everyday lives. Through public health marketing campaigns, fliers hung in traditionally queer spaces, and the algorithmic architecture of social media platforms, the virus has shaped all manner of public health interactions within the lives of QTBIPOC as officials tend to our risky lives. This top-down structure of public health and biomedicine—which casts the physician and epidemiologist at the top of the hierarchy and the patient and/or citizen at the bottom—functions via epistemic hubris (Teston et al., 2019; Valles, 2018), which delegitimizes too often self and community knowledge—especially for marginalized communities who contend daily with the wicked problems of settler colonialism in health and medical contexts 79 (i.e., medical racism and cisheteropatriarchy; Bailey & Peoples, 2017; Hoberman, 2012).47 Epistemic hubris forecloses actionable possibilities that are based on what we know about our own and our communities’ standards for and practices of healthiness—our embodied, community-born knowledges that rhetorically circulate in local/digital networks of care—all of which are vital to how QTBIPOC care for themselves and for one another (Alexander & Edenfield, 2021; Cavalcante, 2016; Dich et al., 2016; Edenfield et al., 2019; Johnson, 2019; Malatino, 2020). This top-down approach also inflects public health outreach, which functions on a Western notion of precarity wherein specific populations must be saved from their own identive and cultural behaviors, as I touched on above. Most readily, epistemic hubris circulates within public health as those social determinants of health that put some at more risk than others, which then become vital components of epidemiological research. A cycle perpetuates: barriers to care, most often reviewed through health literacy assessment frameworks, are examined, data is gathered and presented, nothing changes. Instead, this cycle of what I call top-down outreach merely contributes to the rhetorical creation of precarious publics, which Christa Teston et al. (2019) argue “have, in some ways, been surveilled, fetishized, and surveyed to death” (p. 326). 47 Here, I mean to especially spotlight epidemiology as the scientific theory energizing public health. Nancy Krieger, in her discussion of science as an epistemoligizing construct, states that science operates on an assumption of “a commonly shared biophysical world [which] is a precondition for science. . . . Depending on people’s specific characteristics and worldviews, individuals within and across different societies and time periods may vary in their perceptions and interpretations of any given biophysical phenomenon” (p. 23). That said, Anishinaabe (Flying Post First Nation) scholar Kathleen Absolon spotlights the disastrous consequences of settler colonialism on Indigenous science: “Undeniably, the waning of traditional science among Indigenous peoples was not voluntary or spontaneous. It was caused by the historical denial, degradation and even destruction of [Indigenous knowledges]” (p. 28). Thus, through the process of colonization and the structuration of settler colonialism within the United States, “Truth was then explained within European paradigms” (Absolon, 2011, p. 28). To my point, at the core of epidemiology is what Krieger (2011) calls scientific theory, comprising a thoroughly Western notion of science that encapsulates a methodology of Truth finding. In one example of how Western science has harmed many communities, Krieger (2011) points to how epidemiology has been weaponized in the past and, as I argue later, in the present: “scientific racism and eugenics and their views of innately biologically inferior and superior ‘races’ . . . were widely accepted and promoted by leading scientists in the nineteenth and the first half of the twentieth centuries” (p. 27). She also argues that “their lingering influence on how epidemiologists and others analyze racial/ethnic—and also socioeconomic—health inequities remains a topic of considerable concern” (p. 27). Public health as epidemiological practice, then, operates on the same settler colonial logics as tied to and defined by Western or traditional science, leading to what I believe are many limitations for community empowerment. 80 Teston et al. (2019) argued that, when researchers operate with this limited notion of precarity, they elide the lived realities of people with so-called risky identities, leading to a seemingly never-ending cycle of oppressions, research, and then outreach.48 As they say, “risk, harm, vulnerability—these are rhetorical constructs with real implications . . . [and] identifying when a person is at risk, in harm’s way, or vulnerable is, itself, a rhetorical act that requires value-laden acts of delimiting identity-based categories” (Teston et al., 2019, p. 322). To clarify, though, when I say the Western notion of precarity, I upcycle Teston et al.’s (2019) definition and likewise target the history of colonization on the North American continent and its role in the establishment of precarious publics—both via the cultural process of settler futurity (Morgensen, 2011) and the material conditions of life for QTBIPOC (Thobani, 2014). So, rather than rely on the typical framing wherein queer and trans communities of color are more precarious because of shared behavior across identive strands, we might think of the holdovers of European imperialism—settler colonialism and its systems—as that which lends to both worse health outcomes for queer and trans people of color and the hyper-surveillance of their health. The relationship between precarious publics and public health (operating on epistemic hubris) is rife with wicked issues related to health, access, and care, presenting a rhetorical problem to which I argue rhetoricians of health and medicine can readily attend (technical communicators can of course do so, too, and I speak more on this in the final chapter of this dissertation). To contend with this rhetorical problem, I advance two premises in this chapter: 1) settler colonial biomedicalization can be rhetorically excavated in the formative documents of so-called 48 Core to the idea of a precarious public is the rhetorical concept of precarity, which Wendy Hesford et al. (2018) state is a useful “analytic tool for recalibrating how we understand, assume, and reconfigure divisions between liberal personhood/rights, inclusion/exclusion, victimization/agency, vulnerability/resistance, and human/nonhuman” (p. 3). Hesford et al. (2018) outline core concepts of precarity that resonate well with my discussion in this chapter: “[Precarity] makes possible a politics of solidarity that is based on an understanding of shared precarity. And it recognizes ways in which vulnerability and precariousness may be mobilized as forms of resistance” (p. 3). 81 modern day settler empires (in this case, the United States and Canada), and 2) when such colonial logics are spotlighted, they likewise surface the rhetorical problems of biomedicine and public health (as the scientific and social faces of care). These premises afford a focused incision into the rhetorical problematics of both at-riskness and precarious publics, formed through the biomedical processes integral to the formation of categories such as heterosexual and homosexual. These categories, of course, collapse the dynamism of human sexuality and identity, but I use them to contend that the formulation of the normative body inscribed with whiteness and hyper-ability coincides with the establishment of what Amanda Littauer (2018) has called the “apex of heterosexuality,” or that the creation of extant biomedical and public health models and their resultant effects on biomedicine and public health coincides with the debilitating nature of at-riskness—especially as these models formed during the 20th century, which of course culminated with the HIV/AIDS epidemic (Batza, 2018). In what follows, then, I rhetorically prime two documents, which serve as formative exemplars of epistemic hubris, as useful interrogative sites for demarcating the conceptual limits of epistemic hubris that likewise preclude actionable possibilities in public health, using ideographic analysis to excavate three colonial logics in each respective document. Unraveling the epistemological limits of Western science, I argue these logics inherently limit contemporary public health outreach toward QTBIPOC, which prevents the epistemic reordering needed for deep community care work. To counter this limitation, I lay the groundwork for a public health framework of HIV/AIDS that attends to the central power of community via critical disability studies. After, to build out this framework, I outline a reconfiguration of health literacy as a public health tool that accounts for discounted community knowledges that runs counter to the precarious public model, attending to the corrective power of women of color feminisms. To do 82 so, I reframe the core of health literacy—the politics of literacy—via invigorations from rhetoricians and literacy scholars of color to build a community-based framework of health literacy. I conclude by outlining how, when this framework is deployed as a research tool, it allows for the acknowledgement of the oftentimes overlooked, undervalued, or derided practices that QTBIPOC use to share information about and make meaning with regarding their sexual health. I make this move to carve out epistemic space, as it were, within the practices of public health to account for my research project results, which are detailed in the next chapter. Attuning to the Settler Colonial Biopolitics of Debility: An Ideographic Methodology Wrangling something as rhetorically ambiguous as the formative rhetorical structuration of today’s biomedical and public health models can prove challenging. But, to do this messy work, I deploy ideographic analysis to locate “ideology in practice [which] is a political language, preserved in rhetorical documents, with the capacity to dictate decision and control public belief and behavior” (McGee, 1990, p. 5). 49 Ideography is useful for my work here as it allows me to trace “key terms and phrases used repeatedly . . . to garner an understanding not only of the significance of the term, but of ideas and ideals influencing society within specific historical contexts” (Stassen-Ferrara, 2017, p. 682). Ideographs are rhetorical expressions that then become materialized through cultural practice, diachronically assembling sociopolitical protocol, and their analysis thus serves as a rhetorical tool for delimiting the modes of life that shape how cultural groups perceive themselves and their sociopolitical surroundings and, more importantly, practice them into being via established protocol in key documents (McGee, 1990). 49 For those unfamiliar, rhetorical scholars have long used ideographic analysis as a rhetorical methodology. This work often takes the form of keywords surrounded by chevrons——to demarcate the cultural and ideological processes at play within language. The chevroned words work as rhetorical stand-ins for the complexities of the language-culture interplay, which in this case are the cultural values of settler colonialism as I touched on above (Stassen-Ferrara, 2017). 83 Through these processes, “individuals ultimately know how they are supposed to believe, act, and feel based on the rhetoric distributing ideology even if those actions are in opposition to common sense or against what might otherwise be individual tendencies” (Stassen-Ferrara, 2017, p. 682). That said, to delimit epistemic hubris and to contend seriously with the rhetorical problems of settler colonialism as the organizing force of health and medical settings, I upcycle the methodological force of critical disability studies, which provides appropriate analytics given the task at hand. I home in on critical disability studies (via its formations within queer crip of color critique, women of color feminisms, and decolonial theory; Kim, 2017) given its critical potential as its methodologies afford an appropriate purview for my work in this chapter. My broader concern centers HIV/AIDS rhetorics and literacies (Spieldenner, 2016), and queer and trans people of color, women of color, queer women of color, and queer trans women of color have long squared against HIV/AIDS as a rhetorical problem in addition to its material, social, public, problems—all of which are, of course, mixed together. Critical disability studies “involves scrutinizing not bodily or mental impairments but the social norms that define particular attributes as impairments, as well as the social conditions that concentrate stigmatized attributes in particular populations” (Minich, 2016). This move away from the identity politics of disability (Who is disabled?) to structural issues of power, culture, and ideology (What forces disable the body?) is particularly salient, and with this shift, I close in on the concept of debility, or “injury and bodily exclusion that are endemic rather than epidemic or exceptional” (Puar, 2017, p. xvii). Following Jasbir Puar (2017) and her uptake of Mel Chen’s thoughts on how language indexes the material work of settler colonial biopower, I approach my ideographic analysis with a close attention to those logics that allow for the rhetorical slippage of HIV into 84 the lives of those who have not seroconverted, locating the debilitating ideology that lends to the current use of health literacy within public health outreach toward QTBIPOC, which follows a logical line wherein queer and trans people of color will eventually seroconvert because they can never have high enough levels of health literacy. 50 In terms of HIV and its categorization as a disability, the virus also rhetorically primes at- riskness as a rhetorical conglomerate comprising primarily the identity, cultures, and practices of QTBIPOC. Indeed, as Spieldenner (2019) contended, “Due to the vagaries of capitalist and nationalist regimes, some of us are meant to suffer in specific ways” (p. 78). The debilitating force (Puar, 2017) of settler colonial biopower has tightened its grip on HIV/AIDS to where the tension squeezes out the conceptual limits of who becomes disabled from the virus; it now rhetorically spills over to the lives of the at-risk—those who have not even seroconverted but never know best for themselves and will eventually become infected according to the hierarchical logics of public health. And so, if HIV is rhetorically ambiguous in its capacity to debilitate even those who have not seroconverted, then we must attend to its epistemic domain through critically attuned methods. What I use, then, is an ideography infused with the analytical potency of critical disability theory in that I am focused on those conceptual parameters that, through their role in conceptualization of the normal body/patient/citizen, preclude healthiness for QTBIPOC as they will always be at risk for HIV (through the biologics of sex and their status as a precarious public). With these documents, then, I pay close attention to those moments of cultural establishment that resonate into today’s healthcare and public health models to rupture the stranglehold epistemic hubris retains in the so-called modern health and medical landscape. This approach lays the groundwork of the following section, wherein I trace contemporary 50 I zero in on health literacy as a conceptual site rich with definitional possibility because it is what I can most immediately attend to with my own disciplinary and pragmatic training. 85 understandings of health literacy to their formations in epistemic hubris, collapsing the temporality of the documents to reveal their health and medical commonplaces. The documents I selected for analysis (detailed below) have undeniably shaped today’s health and medical theaters, and so I attend to the synchronic affordances of ideographic analysis, which refer to how “an ideograph remains constant with diachronic uses or expands the functional definition . . . [and] becomes inextricably intertwined with other ideographs. Maintaining practical definitions and relationships to other ideographs indicates a continuation of the culture’s ideology” (Stassen-Ferrara, 2017, p. 683). My particular incision into the language of the documents in question therefore cuts into the pragmatic forces of settler colonialism as revealed by critical disability studies, which rhetorically lend to the settler biopower endemic to both biomedicine and public health. Put in other terms, these documents have much to do with the cohering of empire and its biomedical/ epidemiological models. Thus, I use these documents to do the double work of locating these logical remnants in the everyday settings of public health and medicine to perform the conceptual rupturing of health literacy, an argumentative intervention that primes a space for the community-born, embodied knowledges of QTBIPOC to be seriously accounted for in such contexts. Rhetorical Excavations: Settler Colonial Biopower in the Flexner and Lalonde Reports Throughout the 20th century in North America, biomedicine and public health, respectively, reconciled developmental shakiness to form the extant models of today. In 1910, Abraham Flexner, an education specialist and reformer funded by the Carnegie Foundation, released Medical Education in the United States and Canada: A Report to the Carnegie Foundation for the Advancement of Teaching (hereafter the Flexner Report). This document established the extant model of medical education in North America, which rhetorically propels 86 the construction of a physician’s professional ethos via a totalizing scientific theory and an unwavering commitment to science (i.e., discovery and innovation, which are rhetorical devices used to likewise extend settler futurity; Amrute, 2019; Duffy, 2011). Later in the century, in 1974, then Canadian Minister of National Health and Welfare Marc Lalonde published A New Perspective on the Health of Canadians (hereafter the Lalonde Report). Although the Lalonde Report received a cool reception in Canada, it quickly set the stage for shaping public health outreach for decades to come in the United States (Braveman & Gottlieb, 2014; Hancock, 1986). Lalonde, in his nearly 80-page report, extended the domain of health beyond the medico- scientific to include the social lives of patients. More importantly, the Lalonde Report laid out the conceptual framework on which the notion of at-riskness operates (via the social determinants of health), fundamentally shaping the oftentimes surveillant practices of public health as the social face of medicine (Duffy, 2011; Frohlich & Potvin, 2008). Though these documents were so-called groundbreaking in their respective periods, both rhetorically construct models of precarity that are core to how Western scientific theory functions (Krieger, 2011). Indeed, homing in on the colonial currents of terminology such as “groundbreaking,” the history of colonization on the North American continent and its role in creating the contemporary medical landscape, including current-day public health and biomedicine, have much to do with both reports (Bailey & Peoples, 2017; Greene et al., 2013; Sylvestre et al., 2019). I highlight the interconnectedness of two settler empires (i.e., the U.S. and Canada) to reveal how the advancement of public health as a set of practices contributes to the staying power of Western precarity models of public health.51 I make this move to reveal the 51 As Chippewa Nation descendant and Palestinian scholar Maya Mikdashi critically notes, “in the United States, settler colonialism has been so complete and so successful that the world has forgotten that South Africa, Canada, Australia, and Israel are all modified reproductions, different variations of the triumphant American mode” (p. 29). As such, the operative components of settler colonialism, though locally discrete, are bound up in global webs of 87 epistemic space needed for a reconfiguration of health literacy as a potential site for the likewise onto-rhetorical reordering required for positioning QTBIPOC as experts of their own health who can leverage such expertise in meaningful ways (Green, 2021). The colonial formations of the U.S. and Canada have much to with colonial medicine, or the practices of care and the conceptions of health derived through what Brit Rusert (2019) calls the laboratory life of the plantation, health practices derived through the commodification of Black life and Indigenous extermination.52 Indeed, Jeremey Greene et al. (2013) argued that “it is no accident that the redefinition of public health and biomedicine as scientific professions coincided with the moment at which European powers began to build empires” (p. 35). Settler colonial biopower—conferred through time in the particularities of medical education and public health best practices—proliferates within the Flexner and Lalonde Reports, which serve as exemplars of a broader biopolitical settler archive, rhetorically constructing a healthy liberal subject and consequently healthiness along biological, social, and racial lines that, together, advance a singular human placeholder—a fully living beingness through which only the white, male, abled, cisgender, heterosexual man can reasonably fit (Bailey & Peoples, 2017; Clare, 2017; Schalk, 2017). These documents also demonstrate the logical germination of today’s healthcare and public health models, both of exported oppressions, all of which are rooted in Indigenous erasure and the subjugation of Black life. 52 Specific examples of such violences are, sadly, many. For a specific reference, Moya Bailey and Whitney Peoples (2017) offer an elucidating review of how Black women have suffered trauma throughout the history of medicine. I do not include this review here, however, because I am not a Black woman, and I feel incorporating such pain—the deep, visceral traumas that resonate throughout time across bodies—only serves to engender a gross fetishization of Black trauma (and the traumas of other folks of color) solely for clarification, argumentation, or any other academic purpose. Indeed, as Ann DuCille notably stated of the white appropriation of Black women’s fiction within cultural studies, “to be valid—to be true—Black womanhood must be legible as white or male; the texts of Black women must be readable as maps, indexes to someone else’s experience, subject to seemingly endless process of translation and transference” (p. 49). In that sense, I avoid recounting these specific traumas (i.e., the gory specifics of the founding of obstetrics and gynecology, the advancement of cancer treatments, the subjugation of non-Western knowledges) to prevent the reading of these occurrences other than what they are: the anti-Black brutality of settler colonialism specific to the experiences of Black people and, more specifically, Black women. 88 which preclude meaningful dialogues between the patient/citizen and the healthcare provider or public health official, most readily exemplified when providers speak over patients, dismiss patients’ research, or discount past experiences in favor of data recognizable within Western epistemological frames. Ableism, cisheteropatriarchy, and white supremacy become the logical core energizing health and medicine, meaning this spectrum too often misaligns with the lifeways, bodies, and identities of QTBIPOC. As Greene et al. (2013) outlined in their analyses of health crises around the world and their institutional responses, “the legacy of colonial medicine has a long reach: both global empires and the institutions of colonial medicine persisted well into the second half of the twentieth century and, in some regards, persist today” (Greene et al., 2013, p. 34). Put another way, the ideological production of medicine via these documents founds itself at the nexus of multiple oppressions that follow along the commodification of health and its consequent tendrils in the well-being for many marginalized communities, and these documents map out the historical construction of settler colonial biopolitics (Morgensen, 2011). Together, however, the Lalonde and Flexner Reports offer much in excavating the rhetoricity of North America’s public health and biomedical models as they are constructed with(in) ongoing colonizations. Indeed, though both documents were published about 70 years apart, Scott Morgensen (2011) tells us that “colonialism is intrinsic to processes of biopower in the past and present” (p. 55). To trace epistemic hubris within its contemporaneous formations, then, I focus on two instances within both documents. With the Flexner Report, I focus on “Chapter 2: The Proper Basis of Medical Education,” wherein Flexner (1910) focuses on establishing the ethoic properties of a physician that lend to the overreach of epistemic hubris. In the Lalonde Report, I 89 focus on “Chapter 6: Populations at Risk,” wherein Lalonde (1974) forwards his prescription for resolving the medico-social divide between biomedicine and public health, which in turn operationalizes the rhetoricity of risky identities. With my analysis, I begin with the overarching ideograph to signal that the language in the document is forwarding the cultural value of the expert scientist, a disciplinary proxy for the hierarchy that now precludes QTBIPOC from becoming self-made experts based on their experiences and community-born knowledges. I then use the following ideographs to trace the constituent elements of epistemic hubris as they forge modern-day biomedicine and public health: , , and . I use to signal the material demands of Western science that bound health to capitalist systems, which forwards so-called developments in health care along Western modes of care that prevent otherwise models of both care and public health that might center community at their core rather than the physician or epidemiologist (Clare, 2017; Piepzna- Samarasinha, 2018). With , I locate moments where such values flourish as rhetorical powers that solidify the top-down models of today, wherein the expert can be the sole authority regardless of the patient/citizen’s extant knowledge base (Valles, 2018). Finally, I use as a stand-in for Western science, which closes off traditional, community, and self knowlegdes of the world, the body, and modes of care, practices derived through the forging of Western science via the enslavement and extermination of Black/Indigenous peoples (Absolon, 2011). I use all three sub-ideographs to demonstrate how the overarching emerged from both reports. The Flexner Report: Three Examples The Physician and . As I mention above, The Flexner Report is rife with the colonial logics of epistemic hubris, signaled here via ; indeed, Flexner (1910) invokes 90 the legitimating processes of liberal democracy in the US and Canada in the third paragraph to begin his argument on the need for medical education reform. Of course, democracy in this mode merely consolidates land and power for the settlers occupying stolen lands (Mikdashi, 2013). I focus here, then, on the section of the Flexner Report that performed the bulk of the conceptual work that led to the establishment of modern medical education and biomedicine: “Chapter 2: The Proper Basis of Medical Education.” Beyond the obvious advancement of a settler colonial futurity throughout the introduction, Chapter 2 outlines Flexner’s (1910) vision for the proprietary domain of medicine, which served as the formative force for medical education reform at the time. This example of within these chapter is the overarching ideograph at the moment where its three constituent ideographs converge. In Chapter 2, Flexner (1910) advances a contemporaneous corrective for what he deemed to be medicine’s ethos conundrum, grounding the advancement of medicine as a scientific endeavor in the demands of modernity; that is, he argues that prior models of medical education, which he reviewed in Chapter 1, should be revised in favor of the demands of modern science, which require a total commitment to empiricism and of eschewing of folk and self knowledges, as well as an all-in participation with the rush of what was then the rush of modernity. Such demands hinge on the medical student becoming primed via his53 education to be the above-and- beyond expert regarding the practical application of science. Likening the physician’s training and ingratiation into the workforce to that of an engineer, Flexner (1910) contends that the physician must become the commensurate scientist, who “handles at one and the same time elements belonging to vastly different categories: physical, biological, psychological elements” 53 Flexner fails to use pronouns other than he, him, and his despite writing about the inclusion of women in medical education elsewhere; presumably, the ideal candidate for the serious, stern physician trained thoroughly in science is a man (who is also white as he cordons off alternatives with a chapter solely dedicated to Black physicians). 91 (p. 23). Moreover, Flexner (1910) says that “the recent graduate in engineering is not at once exposed to a decisive responsibility; to that he rises slowly through a lengthy series of subordinate positions that search out and complete his education” (p. 23). In this example, Flexner (1910) makes the case for consolidating the cultural power across the sciences into the discipline of the physician (i.e., the reframing of the physician within public perception), divesting it away from other workers in the sciences because “the training of the doctor is . . . more complex and more directly momentous than that of the technician” (p. 24). Essentially, Flexner (1910) argues that the physician should move beyond diagnosis and cure into the domain of the social, taking the place as both community leader and expert, a move that forges a new ethos for the physician: “Upon him society relies to ascertain . . . conditions that prevent disease and make positively for physical and moral well-being. It goes without saying that this type of doctor is first of all an educated man” (p. 26). Here, we see emerge to create the hierarchy grounded in in that the physician-as-scientist has been integrated into the public domain as the only problem solver regarding health because of his scientific mastery (meaning science is a thing that can be mastered); patients cannot do anything more than receive care in this configuration because their agency has been subsumed by the physician. The physician here tops the hierarchy core to given that he has mastered Western science (as revealed by ) and has integrated the social into the medical arena only insofar as it affects the overall health of the patient. The patients’ understandings of their social lives, including their past experiences and community-born knowledges, become irrelevant. Social actors can only live in a manner to appease the definitional norms of the physician, who forwards such bodily mores via his training, mastery, and know-how. Indeed, such a move corresponds to Julie Minich’s (2016) argument that, “in health care, 92 neoliberalism codifies the idea that health status results from personal choices, a notion of the body as personal property whose care is an individual (not public) responsibility.” Given that, throughout Chapter 2, Flexner (1910) is advancing his notes on the ideal process of medical education, which eventually materialized and continued into the models of today, we can see Flexner extending the epistemic domain of the physician to subsume the individual’s self- knowing capacity, which becomes imbricated both in the work of the physician (via both and ) and the epistemological ordering core to medicine. In other words, the patient is responsible for their health, but they cannot know it well enough to care for themselves. Chapter 2 thus serves as perhaps the best exemplar of locating . That said, this ordering permeates the clinical setting, though as I touch on below, its domain is amorphous. Though Flexner (1910) worked to extend the physician’s domain to annex the social, public health as the social face of medicine does the bulk of such work. Thus, I turn to the Lalonde Report to extend my analysis here of hierarchical logics into the work of public health. The Lalonde Report: Three Examples Public Health and . As mentioned before, the Lalonde Report was published nearly 70 years after the Flexner Report, during the latter part of the century when medical advancement mingled with scientific innovation and increasing neoliberal policy to create extant models of biomedicine and public health (Batza, 2018; Guta et al., 2011). In this chapter, Lalonde (1974) argues that, “When a population at risk is identified, it is necessary to spell out the characteristics of its profile, so that risk factors can be assessed” (p. 39). In this case, he makes the case for extending a metric dimensionality regarding easily identifiable biomarkers, such a white, cisgender man who is 40 to 70 years old, locating the thrust of public health’s social model (what he terms the “Health Field Concept”) in the notion of surveilling practices 93 that lend to worse health outcomes. By pointing to activities such as smoking, consuming alcohol, and other risky behaviors, Lalonde (1974) argues that “In dealing with risk one does not profess to make predictions about individuals but about the likelihood of an event occurring in a population of given characteristics” (p. 40). Though seemingly benign, this statement sets the stage for hyper-surveillant practices that coalesce to form extent public health outreach for QTBIPOC given that the idea of risk itself here flattens through the biologics of gay sex54 and identity. As the logical core of social medicine (i.e., public health), Lalonde (1974) advances a critical truism that carries forward today in public health: precarious publics must be stopped from their own behavior. Though short, this chapter thus serves as the logical ignition of epistemic hubris core to modern public health. Indeed, much of the practices derived from the implementation of epistemic hubris are mapped out in this chapter of Lalonde’s (1974) working document, wherein he wrangles the statistical nature of risk calculation to forge a logic built for surveilling those most at risk for disease and, eventually, death. Through this calculus—what I argue is a biomedicalized form of the cruelty endemic to plantation logics as Katherine McKittrick (2014) advances—the experiential qualities of those with risky identities become quantified and used to both justify the rhetorical domain of public health and the epistemic hubris core to the ordering that precludes those with risky identities to care for themselves and each other. In this manner, reveals itself as the onto-rhetorical ordering of Western science, wherein the dynamism of human experience collapses against what McKittrick (2014) terms breathless mathematics, or the straining of human experience through the logical portal of Truth finding. In this manner, 54 Here, I use the phrase “gay sex” to mean broadly the variety of penetrative and otherwise sex practices frequently conducted among queer people. Anal sex, for example, is often the most popular form of sex act between queer men, and yet the risk of HIV is not divvied equally amongst those partaking in the act given that the bottom (or recipient of penetration) is biologically at higher risk for HIV given the thin-layer nature of the anal canal. 94 as an ideograph reveals the importance to settler biomedicalization of treating human experientiality as a quantifiable and predictable model, which as I have argued, results in the hyper-surveillance of QTBIPOC. This utterance also perhaps best encapsulates the of settler colonial ontology, given that Lalonde (1974) propels a model of public health and that seeks to only surveil, access, recommend, and repeat. As he puts it, public health should be mainly concerned with creating “programs [that] reduce risk factors among high-risk populations. ... [T]he target is a particular part of the overall population, rather than the individual episode of sickness” (p. 42). In this case, much like with Flexner’s (1910) model, Lalonde (1910) proposes a top-down approach to public health wherein the public must be statistically arranged, dissected, assessed, and controlled, revealing the logics of that now prevent QTBIPOC from being considered serious actors in terms of maintaining their own sexual health in terms of HIV outreach. Much like the physician model that Flexner (1910) advances, Lalonde (1974) advances a public health model that wherein the public health expert tops the patient-provider hierarchy, itself attuned to measurable, quantifiable outcomes used to assess success regarding outreach. Moreover, Lalonde (1974), again similar to Flexner (1910), advances a model of public health attuned to neoliberal, capitalist policies regarding health that meld its potential only to extant forms of healthcare models that, of course, are terribly inequitable: “The identification of high- risk populations as targets for national risk reduction programs depends on a number of factors including the gravity and incidence of various kinds of sickness and death, the availability of practical measures, and the costs” (p. 40). By excavating the rhetorical nature of public health via the Lalonde Report, we can therefore see as the logical energy of public health, meaning that citizens should be surveilled in a manner that only coincides with what capitalism 95 allows; put another way, public health can only exist in its current manner because other models, such as community care networks that are typically discounted by public health officials, have been precluded. Moreover, as swirls together with the organizing energy of , the germination of epistemic hubris core to medicine as established by Flexner (1910) proliferates into today’s model of public health, which propels itself via , foreclosing any otherwise models of care that might be established, those that do not require those aspects of current biomedicine and public health (i.e., insurance, a doctor’s office, a formally trained expert). Logical Incursions: Using Health Literacy to Unsettle Epistemic Hubris Through this analysis, I do not mean to say that public health is insidious by merely being organized according to epistemic nature revealed by these ideographs and their presence in the Flexner and Lalonde Reports. However, I do mean to suggest that the practices of public health are inherently limited in vital ways because of the sociopolitical protocol born from settler colonial structuration as revealed in these documents. In terms of my broader project scope and aims, the manner through which public health occurs often subsumes community efforts relevant to improving a cultural community’s health. As one example, Adrian Guta et al. (2011) argue that many of the corporations that “share a commitment to funding biomedical and technological innovations and interventions to curb the tide of the [HIV] epidemic … [are] implicated in empire building, and may serve to govern people around the world” (17). Moreover, as they outline, “Over the course of the 30 years of HIV response efforts, the increasing role of the state and of high-powered funding bodies … has resulted in the increasing institutionalization, bureaucratization, and construction of ‘appropriate’ forms of intervention and research” (Guta et al, 2011, p. 17). Guta et al. (2011) call this regime of subsumption biofacism, a term whose 96 usage serves as “a rhetorical form of activism, one remaining tactic for activists and researchers who, however marginalized by State Science, seek to sway public opinion and to expose the workings of power at play” (p. 18). I risk repetition here, but I mention Guta et al.’s (2011) concept of biofacism because it serves as both the regime of biomedicalization that I hope to work against with my work and a reason why public health outreach often is incommensurable with community practices surrounding health (in the case of my broader project, using social media to share information related to their sexual health). And so much of my work thus far has interrogated the processes of public health (which are in turn shaped by those in biomedicine). Above, I have worked to show how settler colonialism weaves through each of these processes—including setting the conditions on which such processes can function—leading to limitations with popular modes of public health outreach. Thus, in what follows, I spotlight health literacy as a particularly useful though somewhat deficient mode of community engagement for increasing community health primarily because of its logical limitations. In particular, I focus on health literacy as it functions via online platforms (often called e-health literacy) to argue for a capacious definition of health literacy that encompasses the community work of people talking about their sexual health online. Put simply, I used these documents to show how, by its very nature, public health is limited in key ways, and now, I use health literacy as a tool for rectifying its shortcomings. This move precedes my full discussion of my results in the next chapter, through which I build a new, community-based health literacy framework. Rupturing Epistemic Hubris: Reframing the Cultural Politics of Health Literacy The Network of the National Library of Medicine (NNLM), which functions as an outreach sector for the National Institutes of Health, offers perhaps the most comprehensive 97 definition of health literacy. According to the NNLM’s website on initiatives for improving the public’s health, “health literacy requires a complex group of reading, listening, analytical, and decision-making skills, as well as the ability to apply these skills to health situations” (para. 2). Andrew Wawrzyniak et al. (2013), who notably form their definition amid HIV outreach efforts which resonates with my work here, state that health literacy might be best understood as “a complex phenomenon involving access to and skillful use of health-related information to inform and improve health decision-making, behaviors, and outcomes” (p. 295). Similarly, the NNLM states that health literacy “includes the ability to understand instructions on prescription drug bottles, appointment slips, medical education brochures, doctor’s directions and consent forms, and the ability to negotiate complex health care systems” (para. 2). At the risk of flattening what is undoubtedly a complex array of research models, tools, and frameworks, I argue that what occurs too often within these definitions is a limited notion of literacy itself, relegating the meaning of “health-related information” to merely numeracy and alphabetic literacy. What also troubles me is the relationship between the person with a risky identity and their health literacy levels, which serve only to augur an eventual HIV infection (via epistemic hubris). Put another way, though public health scholars have increasingly attended to how varying aspects of a risky person’s life manifest within their health literacy levels, the overarching definition of health literacy itself precludes any sort of substantive change. One can never have a high-enough levels of health literacy. Community health literacy scholars Jessica Nalani Lee and Amy Hickman (2018), in their synthesis of multiple health literacy frameworks within public health, argue that these popularly used health literacy definitions fail to account for the affective, experiential dimensions of patients’ lives. Indeed, Lee and Hickman (2018) point out that “researchers and 98 clinicians must account for the fact that [health literacy] is not isolatable to reading and numeracy skills. It then follows that [health literacy] assessments should reflect the understanding of literacy as a socially situated practice” (p. 78). They approach health literacy in the plural, arguing that “community literacy scholarship advances a complex and socially situated understanding of [health literacy] across functional, communicative, and critical domains” (Lee & Hickman, 2018, p. 80). These domains complicate the traditional approach to those cultural dimensions of health literacy extant within current outreach efforts. However, though public health as an enterprise in safeguarding and improving community health has precluded such work by its very definitions, investing energy into expanding the “literacy” component of health literacy through community literacy scholars offers an avenue for intervention. The entrypoint I spotlight here for doing this work works from the somewhat weak definitions surrounding the cultural approaches to HIV-specific public health outreach that stand to benefit from community literacy perspectives. The Centers for Disease Control and Prevention’s (CDC) (2019) training for healthcare professionals, for example, outlines the following regarding culture’s importance within understanding health literacy and how it might be factored into outreach: “As part of a cultural group, people learn communication rules, such as who communicates with whom, when and where something may be communicated, and what to communicate about” (para. 3). This approach is muddied by the baseline definition of culture the CDC (2019) provides, which it says “can be defined by group membership, such as racial, ethnic, linguistic or geographical groups, or as a collection of beliefs, values, customs, ways of thinking, communicating, and behaving specific to a group” (para. 2). Though not inherently problematic, the CDC’s definitional regime—an act of division typical of the biomedical model 99 (Clark et al., 2003)—relegates outreach to each facet of an identity without accounting for each in relation to each other. Wawrzyniak et al. (2013), in their discussion of the cultural implications of HIV/AIDS rates, state that health literacy levels are “closely related to socioeconomic status and education, thereby increasing risk for low health literacy among those who are most vulnerable. HIV/AIDS disproportionately impacts these high-risk groups (e.g., the poor and members of racial and ethnic minorities)” (p. 295). Elsewhere, the NNLM has a similarly limited focus on culture related to health literacy: “health literacy is affected by belief systems, communication styles, and understanding and response to health information. Even though culture is only one part of health literacy, it is a very important piece of the complicated topic of health literacy” (para. 4). Another worrisome example comes from HIV.gov (2020), the U.S. Department of Health & Human Services’ primary HIV/AIDS information outlet: “Some population groups have higher rates of HIV . . . thus raising the risk of new infections with each sexual or injection drug use encounter. Additionally, . . . stigma, discrimination, income, education, and geographic region affect people’s risk for HIV” (para. 1). Such phrasing is dangerous, binding culture to specific practices that cut across different groups of people. For example, a gay Black man that uses needles for drug injection, within this reasoning, is at higher risk that a white gay man who does so solely because of the former’s Blackness, an identity derived from embodied experiences that have been co-opted by colonial forces (i.e., biomedicine). In other words, too often, cultural approaches to health literacy reinforce the risky identities that come about from biomedicalization (here, the processes by which health citizenship is established according to the particularities of individual and group identity). That said, though troublesome in its simplicity, the cultural dimension of health literacy as it is 100 defined in this manner affords the definitional expansion for which I argue. In essence, much like the affordances of using a risky identity as a means of engaging with the healthcare system at large—which in turn legitimates and limits a patient’s agency—the cultural aspect of health literacy offers the capacity for hotwiring the concept of health literacy via an attention to community literacies, particularly how cultural community members work together to craft their literate selves in relation to health and wellness. Lee and Hickman (2018) say well my intentions here: “There is room for an individual’s personal knowledge, inclusive of social and cultural ways of knowing and being, to help inform and supplement the more commonly authorized ways of knowing typically embodied in biomedical approaches to healthcare” (p. 77). To sum up the majority of my argumentation in this article, the biomedicalization process (as part of the project of settler colonialism) has shaped contemporary public health and has similarly limited health literacy as a framework for community outreach. Moreover, popular definitions surrounding health literacy from public health officials and organizations have also extensively ignored the work of literacy studies—due in part to the delegitimization of community knowledges and an adherence to scientific theory as doctrine—leading to a limited definition of health literacy that, by its very conditions, cannot account for how communities share knowledge amongst themselves. Thus, in the following chapter, I offer ways that rhetoricians of health and medicine, as well as technical communicators can lend their critical repertoires to the definitional expansion of health literacy. In so doing, I draw from Lee and Hickman’s (2018) framework for understanding health literacy as a social practice, primarily whether health literacy assessments “measure or otherwise account for the personal, emotional, social, and cultural resources the healthcare recipient brings to the literacy event” (p. 81). 101 Conclusion: Talking about Sexual Health Online is a Community Health Literacy I spend much of Chapter 3 of this dissertation outlining the cultural import of the internet, and here I spotlight the internet as it serves as both the functional and communicative domain of situated community knowledge. Along the pace of technological innovation and adoption, public health outreach focusing on health literacy has also attuned itself to how cultural communities come together in cyberspace. For example, Sonja Erikainen et al. (2019) argued that “patient- generated content and (patient) data such as self-reporting of symptoms and recovery that is shared through social media platforms is increasingly used for medical research in ways that disrupt traditional research modes” (p. 4). This rhetorical work on the part of online cultural communities serves as the baseline for how I approach redefining health literacy in terms of online sexual health discussions. In the following chapter, I extend the evolution of health literacy into the proliferation of online platforms that function as sites for medical knowledge to circulate within and for a cultural community. I review these facets of community health literacy specific to the ongoing engagement with sexual health via Truvada and PrEP. In so doing, I work to flesh out more fully the rhetorical framework that undergirds the concept of community health literacy. I also show how public health officials might use this framework to reinvigorate their outreach efforts to include community both community knowledges and strategies for navigating the complex domain of sexual health while also combatting the settler colonial logics at play within public health itself. In that sense, I spotlight community health literacy as a means by which officials might operationalize the maxim I have learned so well throughout my community engagement work that I recounted in Chapter 1: community knows best for community. 102 CHAPTER 5: BLOOD CELLS, DRAG QUEENS, AND DIGITAL FAGGOTRY: THREE CASE STUDIES (OR TOWARD A COMMUNITY FRAMEWORK OF VIRULENT LITERACY) Care work is essential, though historically and contemporaneously either unremunerated or very poorly remunerated. Care work is work, but a form of work that is consistently denied and disavowed. Whatever the economic form of social organization we happen to inhabit, whatever the locale, whatever the historical moment, care work is necessary for survival and flourishing. . . . The work we do to keep each other alive exceeds mensuration. How could we ever actually quantify the daily acts of care that circulate in the interspecies milieu we inhabit? — Hil Malatino, Trans Care (2020, p. 44). Toward a Virulent Community Literacy Community persists despite settler colonialism and its violent strains of white supremacist, cisheteropatriarchy— in spite of the colonial intimacies of health and medicine with ongoing marginalization. Via the clinic or the club-wall flyer, the slow creep of epistemic hubris (Valles, 2018) has thus far foreclosed the moves toward community thrivance centered on health and well-being that proceed from the height of the HIV/AIDS crisis in the 1980s and 90s. Essentially, pharmaceutical companies, well-funded public health institutions, and conglomerate medical establishments have superseded the grassroots work through which many queer and trans Black, Indigenous, and People of Color (QTBIPOC) communities thrive; forced out of 103 agency, we are prescribed what to do rather than deliberate over what will be best for us.55 This foreclosure stems, as I argued in the prior chapter, from the epistemic limits of what care can be in relation to HIV/AIDS, what health literacy can be defined as against the epistemic apparatus at the core of public health, and how the meaning-making practices of QTBIPOC are misaligned with the colonial machinations of medicine and public health. Indeed, the epistemic architecture of public health often structurates itself in contradistinction to the lifeways and cultural practices that comprise how QTBIPOC often flow through the world across varying contextual domains. The hubristic crawl can be fraught, too, with the rhetorical pull of risky identities, as I have outlined in the prior chapter. Often, the manner by which public health attenuates itself to HIV/AIDS outreach for QTBIPOC measures identity against its risky potency, what Julian Gil-Peterson (2013) called the “technology of risk,” the virulent logic of “you can (and will) get it too and here is why” (p. 287). This especially insidious, totalizing purview collapses bodily autonomy, our agency becoming bound up in the question of, “Do you want an HIV test?” when we go to the doctor with a sprained ankle (Spieldenner, 2017). Moreover, since the introduction of pre-exposure prophylaxis (PrEP) to the general public—and especially within QTBIPOC communities—the interface between medicine/health and such communities has become especially fraught with risky rhetoric (Teston et al., 2019). And so, as HIV scholar and activist Andrew Spieldenner notes, this rhetorical inscription inflects agential limitations within the largesse of health 55 As one salient example, early on during Queering Medicine’s life, myself and other organizers were approached by representatives by Gilead, which wanted us to partner with the company and use their branded materials with our work in the Greater Capital Region. Along with that offer, they offered us financial support, which would admittedly have aided us greatly in the last 4 years of work as everything we’ve done thus far has been volunteer-based. That said, what would have happened if we agreed was every deliberation we had regarding our projects would have needed direct input from an agent of the company—a straight white man who, admittedly, was nice and friendly enough. But still, the point here is that queer health and wellness should be forged by and through queer action. We know best for ourselves. 104 outreach. Sexual health becomes synonymous with condoms only, wherein the particularities of bodily affect are subsumed regardless of the cultural norms that have developed in concert with Truvada and other medications; the virus presents through this logical code, materially and/or rhetorically. Contextualizing this claim within the purview of my project, this foreclosure appears in the form of what Adrian Guta, Stuart Murray, and Alex Mcclelland (2011) call “biofascism,” or how neoliberal policy at the state and international level (via the United Nations) combine with the increasingly decentralized power of queer communities to have a say over their own health, lives, and community practices. Guta et al. (2011) locate their theory of biofacism, though, within both the pharmaceutical concourse of medial deliberation, product testing and development, and neoliberal policy that relegates those affected by the virus to the sidelines. Here, though, as I outlined in Chapters 3 and 4, I claim a foothold within the epistemic domain wherein using social media counts, too, as a valid and necessary site of interrogation in relation to sexual health. All the adaptive ways we form community and keep each other safe—we cannot let them slip away into the episteme of the biomedicalizing concourse made possible by ongoing colonization. In this vein, then, I advance virulency, which prompts us to look for the ingenuity in the mundane digital rhetorical practices amongst marginalized communities affected most by HIV/AIDS—not by their identities that have been co-opted into risky discursive regimes, but by the colonial machinations that lend to a lower quality of life. As I argued in Chapter 4, we might limn the moves toward a just horizon that can be enacted by accounting for different health literacy practices and, perhaps more importantly, upcycling that knowledge in profound ways. To preface the discussion of the results below, I explicate my notion of a virulent literacy, a meaning-making act that upcycles Spieldenner (2016) and Rick Lee’s (2013) concept of an 105 AIDS literacy, or how the literate practices of queer and trans people across varying media indexes the virus’s presence in our lives, material and otherwise. In this case, I advance virulent literacy as an AIDS literacy infused with the creative affordance of queer of color thinking and sensibility within the domain of digital cultural rhetorics: the use of a drag queen meme to communicate complex science information, the likening of one’s anus to a black hole, and the transmission of bedroom-born technical practices around medication usage. By combining the concept of an AIDS literacy with digital and health literacy perspectives, I foreground virulent literacy practices within the core of what Jessica Nalani Lee and Amy Hickman (2018) outline as a community-centered health literacy framework to use a revised sexual health literacy framework that accounts for the varied meaning-making practices that emerged within the case studies I established within the data set core to this dissertation. Specifically, as I note in the prior chapter, Lee and Hickman (2018) contend that the apparatus of health literacy as an assessment framework within health and medical contexts too often relies on alphanumeracy, foreclosing what might otherwise be dynamic literacy practices across a variety of multimodal texts. Moreover, the critical perspectives found within literacy studies, rhetoric and composition, and technical communication have foregone serious inclusion in how public health officials derive assessment frameworks. Thus, before getting into the thick of virulent literacy, I build off Lee and Hickman’s (2018) rubric for health literacy tools that can function outside of clinical settings: • Does the HL assessment only measure healthcare recipients’ performance of a skill, or does the assessment provide a range of situations where HL might be assessed? • Does the HL assessment measure or otherwise account for the personal, emotional, social, and cultural resources the healthcare recipient brings to the literacy event? 106 • Does the HL assessment identify and evaluate critical literacy skills that may help inform appropriate health-related decisions and build upon prior knowledge? (p. 80–81) I extend these parameters within my conception of virulent literacy, scaffolding each into the contexts of the three case studies I established using the data gathered (described in Chapter 2). Within this upcycling, I foreground, too, the notion that literacy comprises the meaning-making practices by which we understand our sexuality and sexual practices (Alexander, 2008). More to the point, “sexuality—or the varied ways in which narratives of intimacy, pleasure, the body, gender, and identity become constructed and disseminated personally, socially, and politically— is itself a complex literacy event” (Alexander, 2008, p. 1). Virulent literacy, then, hinges on the fact that the meaning-making practices of QTBIPOC regarding HIV/AIDS inherently entail the complexity of queer identity and the various ways they are mediated. For my presentation of the results below and how virulent literacy (as a framework of community health literacy specifically for QTBIPOC communities) allows for the uptake of community practices as actions rife with health literate practices, I also append this concept with the practical potential of so-called tactical technical communication (J.-J. Alexander & Edenfield, 2021; Edenfield, Colton, et al., 2019; Edenfield et al., 2019; Kimball, 2017). Specifically, virulent literacy in this framing constitutes the manner by which 1) “radical sharing uses the Internet as a lever that can dramatically magnify the impact of an individual utterance” (Kimball, 2017, p. 4), while also 2) demonstrating how “increasingly digitized communication landscapes . . . [reveal] ulterior rhetorical practices [that] allow for more effective and socially just design scenarios to emerge” (Green, 2020, p. 12). As Spieldenner (2017) noted of his coming-of-age in the time of HIV/AIDS, “Public service announcements, community education sessions, stultifying school classes, gossip, and pornography taught me about gay sex [and sexual 107 health]” (p. 121). As such, virulent literacy as concept advances these literacy events into the digital domain, wherein the internet user becomes an active member of meaning making within their context—intaking knowledge about their sexual health, gestating it within their life’s purview, and circulating it by sharing new knowledge across other users in a given domain (in this case, Twitter), who then likewise sequence it amongst their own followers and contexts. So, to situate the results below as a virulent literacy, I infuse Lee and Hickman’s (2018) community health literacy framework with the dynamic analytics of an AIDS literacy contextualized within the digital realm, a move that Pamela Takayoshi (2016) says “captures these many ways of being in the world with written language [and multimedia], as well as [captures] what it is people actually do in the moment of composing the products of literate interaction” (p. 16). In this manner, and through the presentation of the case studies below, I reveal “alternative ways of understanding what bodies are for, of what they are capable, of how we can live with and through them, and of how we can reimagine agency over them” (Alexander, 2021, p. xxii). As such, virulent literacy—a health literacy practice attuned to both community and the affective dimensions of being queer, trans, and BIPOC—constitutes the following: • Virulent literacy occurs in settings beyond health and medical contexts, such as a bathhouse, an online hook-up app, or social media platforms, and forum-based websites, and these domains should be accounted for in assessing a user’s health literacy in relation to HIV/AIDS. • Virulent literacy accounts for the personal, emotional, social, and cultural resources present with the media landscape of QTBIPOC, as well as how other unrelated media are appropriated and fashioned into communicative instances suffused with queer of color sensibilities and practices. 108 • Virulent literacy serves as a mean of identifying and evaluating appropriate health-related information that then is circulated into other users’ timelines and social media settings, building on prior utterances and appending it as needed, which then sequences into other such literacy events. Combined, these three parameters convene to showcase how multifaceted health literacy can be when configured within the practical epistemology of being queer/trans and of color. In what follows, then, I showcase how virulent literacy as a community health literacy framework can help health and medicine limn the manner by which they might configure their outreach, centralizing the agency of QTBIPOC to move through the world in the way they always have— on their own terms and in community. Finally, before entrenching myself within analysis results that demonstrate the operative parameters of virulent literacy, I restate here what I set out to do with this project. After creating a self-populating Twitter archive in fall 2018 that gathered tweets using the keywords “Truvada,” PrEP,” and “HIV,” I accrued 15,000 discrete tweets as of June 2020 (though the archive now nears 30,000).56 Using thematic detection software, I then created and conducted a two-round coding schema on the archive, deriving datasets comprising general utterances from queer and trans users of color, public health officials using social media for outreach, and organizations using the social media platform to share research findings. Focusing on the data subset comprising 300 discrete users of color and relevant media (i.e., news articles, public health advertisements, other emergent artifacts from the data), I created three case studies focusing on: the rollout of HIV prevention advertisements within queer-centered media; the resurgence of 56 Thank you to Dr. Dawn Opel for affording me space to practice methodologizing in a way that made sense for me. Many thanks, too, for coming to the soft launch of this project at ATTW 2018 (shout-out, as well, to McKinley Green and Ryan Murphy for infusing in this project their valuable input). 109 body-centered discussions about the medication in relation to broader developments surrounding Gilead Sciences Inc. and its patents; and the use of social media to take to task bad actors and misinformed healthcare providers. Below, I detail each of these case studies within the boundaries I outlined in the methodology presented in Chapter 2. Or, put another way, here are stories that emerged from the data. Case Study 1: “What? Straight white people don’t get AIDS?” QTBIPOC experience quite a different internet in terms of the images that circulate within our culturally distinct online spaces. As I mentioned in Chapters 1, 3, and 4, QTBIPOC navigate numerous platforms in ways that make sense to them, attuning cultural knowledge and lifeways to the algorithmic architecture of the internet (Parham, 2019) and carving space, as it were, for themselves across varying platforms. Approaches to understanding the bevvy of internet-based platforms that comprise online life have tended to examine the distinct cultural remediation of cultural practice within digital environments (Arola, 2017; Brock, 2020; Brown, 2019; Lockett, 2021; Noble, 2019), as well as the manner by which the so-called objective computational nature of the internet tends toward increasing marginalization and oppression (Noble, 2018). Within this latter approach, many users in the data noted this tendency within social media sites (i.e., Facebook and Instagram, which are owned by parent company Meta), streaming services (e.g., Hulu) and YouTube commercials, and Google-based advertisements (via the company’s AdSense program). Indeed, what quickly emerged in the data were frequent discussions of a commercial and larger advertisement campaign meant to foster adoption of PrEP and Truvada, as well as other safe-sex practices as demarcated by public health officials (i.e., taking the medication and using condoms). In short users were upset about this campaign—and understandably so—which corresponded to numerous tweets that were posted within the 110 duration outlined in Chapter 2 (June 2018 – December 2019). Created in 2017 and circulated into the present by ION Marketing Group—originally for Truvada, though the commercial has since been updated to feature Descovy—the Healthysexual advertisement campaign was a first in centering QTBIPOC in an advertisement for a medication arguably created specifically for those communities (“Case Study: Gilead,” 2018). Comprising the print-based media of the campaign are flyers, each showcasing Black and Latinx people in varying activities.57 For example, in one flyer, two brown men—presumably Latinx—are shown in bed together with luchador masks on, signifying the physical intimacy that will commence, wherein safety is factored into that equation via the presence of masks. In another flyer, two Black men are shown hugging each other from the side, one’s arm extended to take a selfie of the two in what appears to be a bustling nightlife scene. Finally, one other flyer shows two Black trans women out shopping in a store, smiling toward the camera. Notably, out of all the advertisements created, only one features a light-skin (presumably white) man, who is accompanied by another white gay man, reinforcing through this visual rhetorical work the desire politics often at play within queer and trans circles as delimited by racism and prejudice. Accompanying the visuals are numerous statements such as “Healthysexuals connect,” and “Healthysexuals don’t rush.” These flyers circulated amongst various print and online magazines, newspapers, as well as popular queer-focused blogs and websites. Perhaps most notable among all of the publications Gilead selected was Rolling Stone. Additionally, a commercial was circulated by Gilead specifically focused on Truvada for PrEP, airing across a variety of streaming services such as YouTube and Twitch, as well as Hulu, 57 Unfortunately, because of copyright issues, I cannot include images of the campaign in this dissertation, though I am able to include a screenshot of a YouTube video. For a complete overview of the campaign and its visuals, please see Mike Wilke’s (2017) opinion piece in Queerty*, an online gay magazine. 111 which has a paid tier for members to watch commercials within their media of choice for a lower price. The video ad, which is titled “I’m on The Pill,” is about 1 minute and 30 seconds long, and it likens Truvada as a once-a-day medication to the birth control, which is popularly referred to as just “the pill.”58 The ad began airing in June 2018 and features primarily QTBIPOC, as well as who is presented as a straight Black woman (likely included in the visual rhetorical design of the advertisement given extant rates). Throughout the commercial, the people presented run through daily activities, including dancing at a studio, going on what appears to be a movie date, and holding a picnic with family members. During each of the events, the actors turn to the camera and talk about why they are on “the pill,” discussing the benefits of regularly taking Truvada for PrEP, condom usage, consulting with doctors about sexual health and practices, and other related matters. Much like the flyers created, during the commercial, one white gay man is presented as going to a movie theater to apparently meet up with another white gay man on a date, again reinscribing the desirability politics of QTBIPIC among white queer and trans people. And so, across both the flyers and the commercial, many users were, for the lack of a better word, pissed. Indeed, viewers across a variety of identities noted several problematics with the commercial, including the politics of sexual desirability abound in the how white gay man was presented apart from the actors of color, the overwhelming majority of the actors being Black and Latinx, and the somewhat unrealistic activities taking place while actors discussed their sexual health practices—goings-on that had no bearing, for the most part, on the lives of the viewers. Central to what emerged in the discussions online, however, was the nature of the actors’ identities, and many users were particularly incensed at what they were shown, in full living color, within the advertisement: public health advances the notion that only QTBIPOC 58 For readers, you can find the video here at this link: https://www.youtube.com/watch?v=6GEOB9aplh0. 112 contract HIV, reifying through the visual rhetorical work—the self-fulfilling prophecy I touched on in Chapters 1 and 4. Twitter thus became the space for QTBIPOC to air their grievances, but beyond Twitter, viewers took to Reddit, Instagram, and eventually to the YouTube comments of the video to discuss the problematics of the video (though such spaces also abound with racist, homophobic comments, which can be said, sadly, about much of the internet). As such, the problem presented here is that public health outreach meant to reduce infection rates among particular groups of people that are more prone to infection also conscript their identities into the rhetoricity of the virus as I touched on in Chapters 1 and 4. I am concerned with this operationalization of risk within public health in how much of the visual rhetorical work of stemming the crisis tide (i.e., advertisement visuals) hinges on showcasing QTBIPOC as either on the precipice of seroconversion or pushed past that edge. Put simply, risk is too often centralized within all aspects of HIV prevention and especially within its communication design. Indeed, Twitter User A (Gay, Black, Cis), in posting the link to the commercial, noted the following: “this TRUVADA hiv prep commercial is messed up man. I know its statistics, but damn why EVERYBODY in it gotta be black and/or gay.” In addition to his tweet, Twitter User B commented: “The #truvada commercial is absolutely offensive. Portraying a world in which only gay, trans, or POC can acquire HIV is unacceptable. Moreover the last thing our world needs right now is another misrepresentation that could cause harm our minority communities.” To this tweet, a respondent (a white, straight man) stated that the commercial was crafted as such likely because of the extant rates of new infections among the targeted groups—the epistemic regime of risk at play again within the rhetorical deliberation core to the question of “Who is at risk?” in the first place. To that response, Twitter User A noted that, though the rates might of course be higher for some cultural and racial communities than others, focusing solely on such 113 groups of people is not necessarily the correct approach. The presentation, he argued, engenders nothing more than a myth that only certain people can and will get HIV/AIDS—“everybody can get AIDS.” This comment—that anyone can be infected with the virus and that specific groups of people being highlighted is problematic—was circulated in various ways across 62 users total, in addition to the Twitter users mentioned here. Figure 2: A screenshot of a YouTube video for a Truvada commercial. This screenshot of the commercial titled “I’m on The Pill” paid for and distributed by Gilead portrays primarily people of color looking at the camera. They are standing in an empty dance studio. This point of contention—the actors in the commercial, as well as the models used for the flyers primarily being non-white—constitutes the primary takeaway from this case study. Indeed, Twitter User I (gay, Black, cis) posted a screenshot of the ad he had come across on his Instagram account, stating: “So Truvada for prep is for black people, gay people and trans people. why is it not for straight white people? What? White people don't get AIDS?” The final question he posed unfolds the many problematics that underpin the practice of public health and governmental agencies seeking to stem the rising rates of new HIV infections—the use of particular bodies as a rhetorical strategy misses the mark, in this case, as the messaging gets 114 confounded within rhetorical decisions made. These implications are readily present throughout the varying the social lives of QTBIPOC. For example, Spieldenner and Christian Castro (2010), in their examination of Black communities and the manner by which they are targeted by public health agencies, found that “they decontextualize African American men by portraying them as single individuals within a predominantly European American group. This limits the range of African American men portrayed and places them firmly away from possible links to [their] community” (p. 279). In much the same way, the various identities portrayed—Black and Latinx, primarily—are excised from the cultural particularities of their lives; they are sanitized and presented within the void of the advertisement’s setting. As a queer Chicano who has sex with other men, I have begun to intuit that this over- prioritization lends to the rhetorical conscription of QTBIPOC lives (as I touched on in Chapter 1), which mostly appear in much of the communication design of public health. With my particular online life, I get, on average, one ad a day across the social media platforms that I use, and through the algorithmic attunement to my body, identity, and sexual history, these ads assume I am either already HIV positive—I am not—or that I am not intelligent enough or have adequate traditional health literacy levels to know how to parse through the information circulating around the medication, sexual health practices, and other aspects of living as a queer person in the 21st century (in a settler colony, at least, such as the United States). As Kristina Gupta (2011) argues, the “focus on sex as a potentially ‘unhealthy’ activity continues to this day. Particularly after the rise of HIV/AIDS, we have witnessed an explosion of public health interventions focused on ‘risky’ or ‘unsafe’ sexual behavior” (p. 129). In this way, HIV is rhetorically linked to specific groups of people beyond actual contact with the virus, tying their lives and healthy potential to an inevitable infection. 115 With regards to the actual advertisements used for HIV/AIDS medications, typically, as Spieldenner and Castro (2010) say, these approaches integrate most of these risky rhetorics: they use an ad to educate, or they try to scare people into safer sex, perhaps using controversial images or messaging, and mostly, they try to use inspiration—usually in the form of a person living with HIV having a successful life or images of people who have no seroconverted, or tested positive for HIV, with full control over their sexual healthy lives. What occurs within this formulation, then, is the relationship between the person with a risky identity and their health literacy levels, which serve only to augur an eventual HIV infection. Put another way, though public health officials attend to how varying aspects of a risky person’s life manifest within their health literacy levels, the overarching definition of health literacy itself precludes any sort of substantive change because all it allows for in the rhetorical construction of a message is the centrality of QTBIPOC; an Oroborus comes alive as QTBIPOC can never have a high-enough levels of health literacy and as such they will always be heavily featured in the advertisement. However, as the case study above reveals, QTBIPOC have begun to take note of how the algorithmic architecture both surveils them and instills the narrative that either they’re about to become HIV positive or have already seroconverted. Within each of the domains the message is clear: using risk to inform outreach does not work, and QTBIPOC have developed an attunement—via virulent literacy practices—as a result, serving as a means by which we might reconfigure current approaches. Case Study 2: “Big pharm doesn't give a fuck.” The prior case study expands on the cultural idiosyncrasies of specific communities and the manner by which they circulate in online spaces—how they flourish into other timelines and compound with rhetorical velocity. However, the increasing corporatization of public health 116 activism, including the sexual health experiences and practices of QTBIPOC, sets the backdrop for the how activism, outreach, and engagement are framed within the scope of sexual health. As Guta, Murray, and McClelland (2011) have argued, the gradual takeover of queer sexual health on the part of the global medical industrial complex, colloquially known as Big Pharma in many queer health organizing circles, including Gilead, has also led to the expulsion of queer and allied activists from medical spaces. Relatedly, many users in the data also commented on the material and social conditions by which their access to PrEP and Truvada was made possible, including preclusions that occur at the clinical and pharmacy interface, as well as the broader social forces that often lend to a lower quality of life for QTBIPOC. As such, though the expressed goal of many public health agencies and of Gilead Science Inc. is to foster adoption amongst many of the targeted communities, one common refrain that frequently emerges is that communities of color don’t trust medical professionals—often rightfully so—and this so-called mistrust leads to lesser uptake with drugs such as Truvada. but what quickly emerged within the data were a host of other reasons, many of which implicate the confluence of white supremacy and cisheteropatriarchy, which are endemic to medicine and public health, as the backdrop for why QTBIPOC might forgo PrEP or Truvada. Returning briefly to the broader contextual factors at play, in 2018 and later in 2019, the Gilead’s patent over Truvada faced contestation in both the United Kingdom and in the US. Of course, these developments occurred in large part because of handwringing over which entity should receive the most money from the medication based on what owned what. In the UK, thanks in large part to grassroots organizers around #BreakThePatent and different laws surrounding the agency of pharmaceutical companies in relation to the public good, Gilead’s patent on Truvada was broken, allowing for affordable generics, thereby expanding access to the 117 medication to users who otherwise would not be able to afford it. That said, in 2019, the Donald Trump administration sued Gilead for using data patented by the US to create Truvada, meaning that at the core of the patent-breaking in the US was capital—more of a concern for the coffers of the US government than the well-being of the people most affected by the HIV/AIDS. That said, Gilead soon developed Descovy, what the company touts as the newer, safer version of Truvada (though the differences between the two medications are relatively minor and depend on specific bodies and reactions). Put simply, the company created Descovy primarily to make money given that generic and affordable versions of Truvada exist. More importantly, across the duration of this case study (September 2018 –December 2018, November 2019 –May 2020), numerous users noted these developments and shared as much across different networks on Twitter. They also shared stories of how they sought to get on PrEP: speaking with doctors, navigating insurance networks, and delimiting the broader machinations that preclude uptake of the medication. Take for example, Twitter User J (Non-binary, Queer, Latinx), who stated that “PrEP is not getting to the hands it’s supposed to. After going thru the process of getting truvada, its no wonder why so many PoC would rather not go through all the hoops and pay all that money to get a pill. And if you dont have insurance....” In this instance, many responded to Twitter User J, noting that many QTBIPOC have lower access to the monetary and cultural capital needed to both have a regular medical provider, medical insurance, or the funds required to pay for the medication long enough to shore up the resistance to HIV that Truvada/PrEP affords. On a similar note, Twitter User K (Black, Gay, Cis) posted about his trepidation at the cost of PrEP/Truvada, spotlighting the fact that the price of the medication was still exorbitant even with financial assistance: “Anyone use #truvada and always run into problems with @GileadSciences #copay card? Lol. It’s INSANE that a drug that helps prevent HIV is $500 to me a month 118 AFTER my insurance. #prep #gay #BS #GileadCoPayCard.” However, what occurred within the responses to this post, which was bolstered by Twitter User K’s strategic use of the hashtags, were breakdowns of how other users navigated other co-pay options and how to appropriate vouchers, coupons, and other discounts from specific national-level providers such as CVS and Walgreens. In this way virulent literacy as a health literacy framework beyond health and medical contexts was shown in how users shared knowledge about navigating provider and insurance networks to get access to a Truvada prescription. That said, one user noted that, despite the excellent knowledge circulating amongst the users, this work should not have to take place at all: “Let me remind y'all that Gilead is a terrible fucking company, and it's been hurting the LGBTQ community for years. They sell Truvada for PrEP, and they've jacked up the prices of this potentially lifesaving drug and refuse to let it go generic.” Indeed, outside of this thread, Twitter User L (Gay, Latinx, Cis) expressed deep frustration at the amount he and many other QTBIPOC have to contend with just to maintain regular access to PrEP and to safeguard their serostatus: “I've been on PReP for 3+ years which is Truvada/Descovy and my medication is over $1000 a bottle for a single 30 day supply after Martin [Shkreli] raised the price of the drug over 1000%. Big Pharm doesn't give a fuck.” Across these and many other discrete tweets, users noted a disconnect between the amount of money needed to produce the medication—down to the cost per pill—and the amount Gilead charges for the medication for both insured and uninsured people, the latter of which comprises primarily QTBIPOC because of systemic racism and homophobia. As Twitter User M stated, “the fact that PrEP is so exorbitantly expensive is wild bc there are common vaccines that are less effective than PrEP. if HIV/AIDS wasn’t most common among queer people and POC you bet your ass Truvada would be $5 a bottle.” Other users noted this throughline between the types of people 119 more susceptible to a new HIV infection and the cost of the medication precluding them from taking it regularly, which is the overall point of PrEP—a consistent regimen. Of note was Twitter User N (Black, Queer, Cis), who stated that “As a Black woman, in [large metropolitan city in the South], who took #PrEP for a year. The cost is not discussed enough. I paid for Truvada because I was working on a campaign promoting PrEP. With my insurance and HSA, I still paid over $600 for a 3-month supply with the coupon.” In this case, even as Twitter User M worked on a campaign promoting the medication in a city, she was still aware of the material barriers for QTBIPOC to regularly take PrEP—this preclusion abounds across various locations because, frankly, anti-Blackness ad racism underpin the world in which QTBIPOC live. What is perhaps most interesting, however, is that QTBIPOC face such a seemingly totalizing barrier to accessing PrEP (because having and not having money is often a matter of life and death for QTBIPOC) despite being overwhelmingly targeted by Gilead and many public health agencies. That said, numerous users across the data also discussed difficulties even speaking with medical providers about the medication. This issue ranged across various contact points within the clinic interface, as users pointed out that receptionists would not know what QTBIPOC patients were specifically requesting, or pharmacy techs not knowing what specific medication users were requesting (despite Truvada having existed since 2012). As such, Twitter User O (Black, Cis, Bisexual) remarked “I’ve got to find a queer (or queer friendly) Doctor. Preferably a PoC. I just tried to talk to my GP about starting PrEP and the new drug options and they had no clue of any other than Truvada.” Many users noted the difficulty of finding providers who could match with QTBIPOC’s specific cultural needs, such as Twitter User P (Black, Gay, Cis), who used queer-specific language to vent to his followers: “The tea? My last physician refused to prescribe me Truvada(PrEP) and instead 120 gave me a referral to a dude 45 minutes away because she disagreed with my sex life. My new physician? She instantly prescribed it to me. We need more doctors who truly care about their patients.” This refrain—that QTBIPOC need more providers who care about their patients— reverberates out, too, with the refrain of sexual liberation. However, public health agencies and agents are trained so often to foreground the use of condoms or abstinence, and providers are often unaware of or in opposition to the specific health and medical needs of QTBIPOC. Twitter User Q (Latinx, Non-binary, Queer), who resided in a large, metropolitan setting, responded to another thread about this same topic, stating: “The flip side is when you go to a random suburban or small town PCP clinic and tell them you are on Truvada they assume you are HIV+, or otherwise just don’t grasp the concept of PrEP in general.” Through all of these tweets, users demonstrate an attunement to a world that misaligns with their particular needs as QTBIPOC; they recognize what is preventing them from living full, healthy lives—and they now use social media as a method of tactical technical communication to share knowledge about how to navigate the hostile environments we circulate through. This approach is not solely limited to issues surrounding access to Truvada and PrEP, however. Case Study 3: “My Blood cells when I take my Truvada” In a viral tweet, Twitter User Q (Queer, Latinx, Cis) simply states, “My blood cells when I take my Truvada” with an attached GIF of popular drag queen Shangela walking in a snow globe costume on the runway of RuPauls’ Drag Race All Stars (see Image 1). Otherwise known as DJ Pierce, a gay Black man from Paris, Texas, Shangela has solidified her presence as one of the most recognizable Black queer performers in the U.S. thanks in part to her multiple appearances on the show. In the clip, Shangela wears an all-white catsuit with red 121 embellishment, a nod to the holiday theme for the runway challenge in that episode. Most notably, Shangela walks down the runway in a giant plastic bubble to give the illusion of being in a snow globe, which the judges in the show point out did well in conveying the holiday sensibilities needed for her particular challenge. What she does provide, moreover, is a visual rife with rhetoricity for Twitter User A to smartly make the connection to his serostatus and his adherence to Truvada and the overall regiment of pre-exposure prophylaxis (PrEP). In Twitter User Q’s reconfiguration, the bubble surrounding Shangela serves as a forcefield of sorts, with the drag queen herself recast as a healthy red blood cell (vis-à-vis the visual mingling of the red embellishment and the white catsuit). In this sense, what Twitter User A meant when he tweeted the image with the caption was that he has a working understanding of how Truvada “works by blocking an enzyme called HIV reverse transcriptase. By blocking this enzyme, it prevents HIV from making more copies of itself in the body” (para. 6). Though Truvada does not necessarily surround the blood cell as a forcefield, as it were, the medication does block HIV infections through complex biological processes occurring at the cellular level, meaning that Twitter User Q’s joke about Shangela being a red blood cell holds true. Additionally, as is typical for drag queens walking down the runway on RuPaul’s Drag Race, Shangela exudes confidence and elegance in her walk while also giving humor and camp with her visuals and body language, though the clip featured in the GIF is relatively short. Attuning his humor-as-science-communication to his identity, Twitter User Q thus casts the act of taking Truvada—a sexual health practice that has seen particular debate among queer men of color—as one that might be joyful through Shangela’s Black queer aesthetics. In other words, Twitter User A draws on the queer aesthetics of Shangela’s costume and runway walk to parse through the complex workings of Truvada and convey his own meaning of the medication’s workings. 122 Figure 3: An image of drag queen Shangela Laquifa Wadley. Drag queen Shangela Laquifa Wadley is shown walking down the runway of RuPaul’s Drag Race. She is wearing white catsuit with red ornaments attached to the fabric while enclosed in a plastic ball to emulate being in a snow globe. Joëlle Kivits (2004) called such rhetorical work the construction of the “informed patient.” As she argues, much if not all health information seeking occurs online, leading to a reconceptualized relationship between patients and their providers. Kivits (2004) stated that non- medically trained people mitigate numerous information streams via the internet: “information- seeking activity connects the contemporary imperative of the information society of being informed about health and other life areas and the reflexive project of an informed self” (Kivits, 2004, p. 525). Kivits (2009) also argued that “lay knowledge perspectives indeed demonstrate how health and illness understandings are also formed outside medical settings” (p. 675). In essence, medical contexts—those settings and ephemera encountered throughout life that represent a communicative instance between a person and the medical-industrial complex—no longer serve as the circulative space for medical information.59 59 To be clear, I follow Judy Segal (2009) when she says that “what we typically think of as getting health information is, in any case, not wholly a unidirectional process, in which the Web informs the patient, well or badly, and the patient takes the next step” (p. 359). In that sense, health literacy serves to rhetorically steer the decision- making process, influencing whether patients choose to seek care and, if so, what kind of care they seek. Segal (2009) argues that understanding health knowledge on the internet means seeing it as “a bidirectional process: the Web makes the user and the user makes the Web too” (p. 359). In this manner, Segal (2009) argues that health literacy can be construed as “a rhetorical transaction . . . [which] involves text and trajectories of influence. Internet- health users read about, and then adjudicate on, matters of health and illness (Shall I take this medication? Shall I get myself to an emergency room?)” (p. 352). For my argumentation here, we might think of the term “medical information” as anything produced by internet users that lends to the rhetoricity of health literacy as a decisive 123 Twitter User Q’s message resonated well with his audience of primarily Black and Latinx queer men and trans women as evidenced by both the more than 3,000 engagements with his tweet and the metadata of those profiles interacting with Twitter User Q. Take, for instance, how another Twitter User R (Black, Cis, Gay) identifies with the tweet, using the phrase “I’m so weak,” a typical response to a queer of color-coded joke, and then saying how he too adheres to the regimen, taking his medication every day at 9:30 AM. To that thread, Twitter User S (Black, Queer, Trans Woman) simply states that Twitter User A speaks “nothing but facts,” confirming the medical knowledge that Twitter User Q communicates via Shangela’s runway walk. In sum, Twitter User Q draws on culturally relevant popular media to convey 1) that he takes Truvada as part of his PrEP regimen and 2) that he understood the basics of how Truvada was affecting his body, and 3) that he is countering the oftentimes stigmatized act of being on PrEP by normalizing it through the utterance. This particular utterance is iterated in a variety of expressions across the data, all of which constituting what I termed in Chapter 2 as the case study of the everyday, wherein users locate the complex machinations that shape their lives in their common communicative acts. With this naming convention, I foreground the importance of mundanity—the everyday—while tying it to the desire of putting out information for the so-called “imagined audience” (Marwick & boyd, 2011). With these particular expressions, the motive tug of practice. That said, in using the word “rhetoricity” in relation to health literacy, I mean to say that health literacy invokes a complex rhetorical situation, as Segal (2009) says, through a cultural rhetorics understanding of practice. Following that train of thinking, how sexual health is discussed online contributes to a certain rhetorical situation that casts interlocutors as knowledge sharers of matters pertaining to their bodies, sex acts, lives, and identities. Moreover, as Segal (2009) writes, “The Web makes the user in part by immersing her in information that is simultaneously remote and immediate, pertinent and impertinent; it keeps its distance and casts an unimaginably wide net” (p. 359). Thus, the rhetorical situation of a health literacy—such as seeking sexual health information— becomes ambiguous given the numerous platforms available to users, including those not specific to health knowledge. As I argue in this section, Twitter and its communality serve as a useful entrypoint to understanding how community health literacies might flourish in cyberspace. 124 tweeting about one’s body in relation to medication, HIV/AIDS, condom usage, and other aspects of sexual health sequence unto others the discursive dispelling of stigma—a powerful determiner in how QTBIPOC communicate about their sex acts, sexual health, and other personal matters. Indeed, stigma surrounding both taking the medication and discussing one’s serostatus forecloses much of the sexual imaginary public health holds for QTBIPOC communities. As such, much of what I gathered from the data centered on Twitter User Q’s tweet (in part, of course, because of its virality), though many other instances indicate similar moves in relating details about one’s sexual health in mimetic forms in relation to goings-on with contextually relative events. Within these kairotic moments, virulent literacy plays out for users as they engage in popular culture via different media while attending to events that backdrop both the communicative instance of their tweets and the broader shifts of pharmaceutical companies and governmental agencies. As I relate in Chapter 2, specifically with Truvada, the patent breaking occurring within the UK and subsequently the US incurred various reactions that prompted likewise responses across social media. Specifically, in late 2019, as the then administration moved to break the patent over Truvada, R&B singer Frank Ocean, a queer Black man, responded to efforts on the part of Gilead to retain its patent by thematizing a party around PrEP (titled PrEP+) to also celebrate the re-release of his first two albums. That said, attendees noted the sanitized nature of the event— which included a bevy of white social media influencers and DJs—much to the chagrin of Ocean’s predominately queer Black and Latinx listener base. Moreover, despite the sexual undertones of the event’s naming convention (which was meant to signal a return to the sexual revolution that was taking place leading up to the advent of the HIV/AIDS crisis), the event featured high-profile celebrities who were primarily straight and white. To enter into the event, 125 attendees were told that they could not bring in any medications—including Truvada—and they were unable to partake in sex acts as is customary for nightly parties in queer New York City spaces—ones that Ocean stated his party would be a return to in style (though it was in name only). Thus, despite Ocean’s identive similarities with those whose lives are most shaped by PrEP and the outreach efforts on the part of companies like Gilead, the event he held misaligned with the cultural needs of his fans—many of whom took to Twitter to discuss their displeasure at the event and its cultural design. Take, for example, Twitter User S (Latinx, Non-Binary, Queer) who tweeted out, “I’m gonna throw my own PrEP+ party but it’s literally me putting out Truvada in candy dishes and playing ‘Into You’ on repeat.” The song in question is a rather popular single from noted vocalist and pop music star Ariana Grande, who herself has amassed a large contingent of QTBIPOC fans, though what is more intriguing is the image Twitter User S used with their tweet, which is a meme comprising Ariana Grande’s cover for her then-current album Sweetener, with the singer’s eye’s visually manipulated to be bloodshot while she holds two bottles of poppers to both her nostrils. Poppers are chemical psychoactive drugs called alkyl nitrites, and in particular, the inhalant drug amyl nitrite, and they are often used amongst queer and trans communities in what is termed chem-sex, or the use of mood- and mind-altering stimulants to enhance pleasure or to loosen orifices for easier sexual penetration (often anal sex). Notably, the image showcases two bottles of poppers, an act that would induce severe side effects and likely lead to hospitalization. However, given the sexually sparse context of the party, and Twitter User S’s obvious camp flair infused into the image, the point here is that other users would recognize such uses of poppers as dangerous and unfeasible. 126 Figure 4: A meme of singer Ariana Grande inhaling poppers. A meme of R&B and pop star Ariana Grande is shown, with the singer’s eye’s manipulated to be bloodshot while her hands are made to be holding two bottles of poppers up to her nostrils. Indeed, Twitter User T (Gay, Latinx, Cis) responds to Twitter User S by saying, “As long as there's a punch bowl filled with lube, we good.” In this example, Twitter User S signals an understanding of both how poppers allow for enhanced sexual pleasure—thereby providing the need for lubricant—and the social parameters wherein poppers are an appropriate addendum to a queer nightlife part in NYC. Moreover, Twitter User T signals a response to the broader rhetorical implications of PrEP and Truvada as the medication and regimen allowed for revised sexual mores among younger queer and trans users of color, who now find unprotected sex as, for the most part, a safe option. In tweeting this response, Twitter User T also demonstrates to his nearly 10,000 followers that sex enhanced with poppers is a culturally appropriate correction to Ocean’s tame party, lending his ethoic weight to Twitter User S’s message as an attendee of the party. The response generated numerous other threads of QTBIPOC 1) sharing knowledge about safely using poppers in recognizing the campiness of the Ariana Grande meme while also 2) demonstrating an understanding of what kind of sexual proclivities are made possible through regular use of Truvada for PrEP (i.e., unprotected anal, chem-sex). In this schema of what I call 127 digital cultural faggotry, the party allowed for a virulent literacy to flesh out for many internet users a means by which they could better understand the contextual elements surrounding popular tweets while also circulating such knowledge to other users. In this way, virulent literacy abounds as users generate and share content that is contextually specific to their sexual health. Of note with Twitter User S’s tweet was a response that garnered much input from users. Specifically, Twitter User F (Black, Gay, Cis) prompted a question of Twitter User S, asking, “Are the girls mixing PrEP and poppers now? Im sure they use poppers at the same time ... so yes?” In this utterance, Twitter User F uses the term girls to signal his membership in the broader community of Black queer men (and to an extent other queer men of color; Davis, 2022). As such, numerous other users who are part of the girls responded to the tweet, clarifying for Twitter User U the interactions between popular brands of poppers and Truvada, much of which was fact-checked by other users chiming in and clarifying other talking points. For my overall argumentation within this dissertation, the work that these Twitter users performed (in addition to the 142 other Twitter users communicating within these threads and circulating similar media to their followers as encountered in the data) constitutes a form of community-based health literacy that is virulent literacy, a literacy event that follows along the rhetorical engagement generated within online cultural communities. Indeed, Twitter User Q’s example stands as one of many occurring on Twitter, and the plethora of other similar tweets show that many users conduct similar work, often through the same rhetorical modes (i.e., popular media use in the form of memes and in-group language). Together, these conversations serve as a community health literacy shared among those with risky identities who are most affected by both HIV and the public health efforts that correspond to the virus. Virulent literacy as a community-based health literacy framework allows outsiders of a 128 cultural community to understand how insiders circulate health knowledge derived from their bodies, risky identities, locations, and histories, followings Lee and Hickman’s (2018) definitional expansion of health literacy to encompass “social and cultural values . . .[and] individual and social histories. Socially situated and complex understandings of [health literacy] engage issues of power at play in the dissemination, uptake, and use of health information” (p. 77). Thus, virulent literacies serve as the means by which people use social media platforms—in this case, Twitter—and speak to those members of their shared cultural communities and others who share similar oppressions in relation to their health and well-being. Community health literacies also function via community knowledge ways much like how Twitter User Q communicated with other queer men of color about his sexual health via Shangela’s costume, Black queer humor, and sensibilities. Through an attention to the genealogy of standard health literacy, community health literacy runs counter to the top-down approach to health literacy because rhetorically deciphering the communicative instances comprising a literacy event often requires being a member of those communities. That said, the examples above are notable for their virality and the engagement occurring across users in the threads. However, beyond the high-engagement tweets that emerged within the data, numerous other examples demonstrated the parameters of virulent literacy outlined above. Indeed, users posted about their bodies in relation to Truvada and PrEP, including some noting bodily reactions, strategies for managing the medication in addition to other pharmaceuticals, and posing general questions about the medication to which other users responded. In one notable instance, Twitter User V (Gay, Cis, Mixed/Latinx) posted: “Ok, Sexual Health Twitter: are there any downsides to (or side effects from) being on #Truvada? Aside from the obvious? #PrEP.” This user does not have many followers, but notably, the tweet 129 garnered numerous responses from users who did not follow Twitter User V—including verified accounts with thousands of followers and noted public health officials. In these responses, users clarified some of the opaque details about the medication and its side effects, and some users shared their own experiences with the medication. This algorithmic work of users tuning into so- called sexual health Twitter—a phrase meant to signal a contingent of users communicating around a similar topic or theme—occurred frequently, comprising 82 people total. For example, Twitter User W (Latinx, Non-binary, Queer) tweeted: “I’ve been taking Prep (truvada) for about 3 weeks now and I have been having the most weird, random & disturbing dreams. Like Wtf?” To that response, many users noted similar side effects, and some noted how they would speak to their medical providers about this aspect of taking the medication. Additionally, Twitter User X (Latinx, Gay, Cis), upon switching to a newer medication, asked “I switched from Truvada to Descovy (the new PrEP) last night and am wondering if I need to build it up in my system before it’s effective, like I did w/ Truvada. The pharmacist didn’t know. Anyone know?” To this tweet, numerous users spoke about their experiences switching to a newer medication (a point of interest in a case study below), sharing the science of the medication and clarifying for Twitter User X the nature of the newer medication and the manner by which it builds a resistance to HIV in a body. Even beyond the actual pharmacoscience of the medication itself, users also shared knowledge about how to tell if others were adhering to the regimen (though some utterances invoked carcerality that has been ingrained in the policing of people living with HIV through state-targeted criminalization and stigma). Take, for example, Twitter User Y (Filipino, Gay, Cis), who shared a how-to regarding determining if someone’s sex partner has been taking their Truvada regularly: “If someone tells you to do bareback because he's on Prep, don't believe easily 130 unless he shows you a concrete proof like the actual meds in a canister (brand name Truvada or any other brand which contains two medicines - tenofovir and emtricitabine). Stay safe.” Following that tweet, this user also posted: “Check to see when the prescription was filled, and shake the bottle or open it to see how many pills have actually been taken.” In this way, everyday users both shared knowledge about their bodies in relation to the medication and prompted information about Truvada and other particularities of PrEP, constituting ad-hoc moments of health and risk communication surrounding both how HIV transmits and how Truvada functions to prevent new infections. Another salient example occurred when Twitter User Z (Gay, Black, Cis) who, in response to a large event in a Southern metropolitan city, tweeted: “So for the people that’s out here sucking, licking, and fucking if your doc recommended truvada for prep would you take it?” To that, many attendees of the event responded with information pertinent in engaging in so- called risky behavior as afforded by regularly taking Truvada and adhering to PrEP, corresponding both to the rhetoricity of sexual politics and hook-up culture among queer men of color. Indeed, Twitter User A1 (Bisexual, Trans, Black) also tweeted out: “It’s gonna be so much raw sex in #Atlanta this weekend and I’m here for it. #ATLPride. Hopefully everyone is up to date on their #truvada for prep.” In this and other instances, many users demonstrated a deep understanding of the deliberative processes surrounding unprotected anal sex and other so-called unsafe sex acts. sharing strategies for discussing their sexual health and adherence to PrEP, Truvada, and Descovy, signaling that they already had discussed with their doctors the medication (not without problems as I touch on below) and developed a plan of action, as it were, for having anonymous sex at the event. Within a normative schema of health literacy, such 131 rhetorical action would present as superfluous at best and misinformed at worst. That said, what surfaces consistently within these utterances is an astute understanding of sexual health, bodies, medications, and the value of upcycling such knowledge when appropriate. Conclusion: Community Knows Best for Community The major takeaways from these case studies reveal an urgency for something new: better, more adaptive definitions of health literacy, as I have advanced in this chapter, and new approaches to public health outreach. As such, the dataset I worked with in this chapter was relatively small compared to traditional Twitter data-based studies (an intentional move as I outlined in Chapter 2). But still, one can only wonder what was not gathered by the system I used to collect the data. What stories do not circulate on Twitter and other social media platforms? How are QTBIPOC responding to the messaging, the homophobia, the racism they experience out in the world writ large? These topics, of course, have energized the community-specific practices through which numerous communities have sustained themselves; indeed, community persists, and trans and queer networks of care have existed in some form or another so that we can keep each other healthy and safe when healthcare won’t (Edenfield et al., 2019). With the latter aspect, in the following chapter, I hotwire (paperson, 2017) the applied fields I highlight above to make a move toward building a better, healthier world for QTBIPOC. For my specific disciplinary and practical purview, this work stems from the communication design we encounter in our everyday lives. For example, what might an HIV prevention ad look like that acknowledges the systemic racism and homophobia that converge to preclude access to vital medication? I believe we can build such experiences for QTBIPOC, and in doing so, build a better world—hope has driven me to this project and, now, to the end of this dissertation. 132 CHAPTER 6: CONCLUSION: HOTWIRING TECHNICAL COMMUNICATION IN THE THIRD UNIVERSITY (NOTES ON RELATIONAL DESIGN) If we think of the university as a machine that is the composite of many other machines, these machines are never perfect loyalists to colonialism—in fact, they are quite disloyal. They break down and produce and travel in unexpected lines of flight. Your witch’s flight pulls bits of the assemblage with you and sprays technology throughout its path. — la paperson, A Third University Is Possible (20167, p. 55) Building a Better World: Plans for the Future To speak a field’s name is to invoke a series of political conditions from which emerge university, discipline, practice, and people. Indeed, a field arises as a conglomerate of people trained under a particular purview—a repertoire of practice that at once instantiates and extends the lexical domain of a field and its possibilities within the broader world. So, when I say technical and professional communication, I speak to a series of political conditions by which we might understand the field. And so, to end this dissertation, I touch on the possibilities and conditions that underpin the field’s ethics, programmatic structurings, methodologies for research, and considerations for work in a settler colonial backdrop—our ordinary lives in an extraordinary time. Although the history of technical communication in the United States can be mapped out with a centuries-long genealogy, the general consensus is that the field began about 60 years ago during the 1950s (Johnson-Eilola & Selber, 2004). As a field, technical communication 133 has a complex history interwoven with scientific work and engineering (Longo, 2001), endeavors found at the root of modernism and settler colonial conquest and expansion. I do not make an outlandish claim, then, when I say technical and professional communicators are too often the discursive agents of empire in the varying places wherein we work, which also precludes much of the good that might do out in the world. Homing in on the Society for Technical Communication (STC) and the ethical standards for the field as one example, we can examine the six parameters that allow for the ethical possibilities for technical communication: legality, honesty, confidentiality, quality, fairness, and professionalism (“Ethical Principles,” 1998). Of course, each find their grounding within settler colonialism, a series of conditions that set the stage for the concept of legality, ethics, and professionalism in the first place. On its website, STC gives each of these ethical areas about a paragraph’s length of an explanation. Moreover, the portion pertaining to fairness discusses the value of “cultural variety and other aspects of diversity,” stating that technical communicators must align themselves with their employers to an extent that seems ethically correct according to the public definition of good. Interestingly, no substantive explanation is given as to what this good entails or what types of diversity STC values (e.g. race, ethnicity, gender, sexuality, disability, etc.). Despite the lack of specificity, one can assume that STC’s “Ethical Principles” should be followed in addition to the ethical codes of the company for whom a technical communicator works. Within the verbiage of STC's “Fairness” principle, the organization recommends that, should ethical dilemmas occur, the technical communicator “disclose it to those concerned and obtain their approval before proceeding” (“Ethical Principles”). This recourse presents some difficulties because, should the technical or professional communicator refer to the offended party within the ethical dilemma, they are confronted with 134 the prospect of performing duties or, upon receiving less-than-favorable feedback from the offended party, refusing work and facing consequent action (i.e. being let go from a company, losing work opportunities, receiving unfavorable evaluation). If the technical or professional communicator receives negative feedback from the offended party, he or she has the option of overlooking the feedback and continuing with the work (which certainly is the technical communicator's prerogative). And thirdly—and perhaps most importantly—if the technical communicator receives and agrees with the negative feedback from the offended party, the ethical principles of the company or organization—which are predicated on overarching societal ethics—might subsume whatever recourse is available to the technical communicator and the offended party. This example is one of undoubtedly many examples that problematize the call for social justice work in a field founded at the core of modernity (Powell, 2012). We seemingly have no way out of the schema—but perhaps we might hotwire one from what is available to us. At the outset of planning this dissertation, I sought to queer the genre of a dissertation grounded in technical and professional communication—as well as several interrelated fields—in some incredible manner that at once captures my maneuvering through disciplines, methods, and theories (and life) while also presenting something real—substantive work that does incredible action out in the world. From the start, I also avoided falling into the trap of what Barbara Smith (2019) rightly highlights as the definitional voiding of the word “queer”—of radical politics, knowledge making, community. You might read the infinitive “to queer” in the above sentence as “to fuck with”: to play amid categories of knowledge that expand to others in constellations that 135 are visible only to those who are critically imaginative (Royster, 2005). What this playfulness means in terms of my disciplinary adaptivity is that I operate within a through-line between rhetoric, composition, literacy, and technical and professional communication—pretending that each are not connected is a colonial trick as historiography rightly highlights the interconnectedness of these disciplines (Powell, 2002). But I also move beyond—I am mobile in my excursions, moving in and out of numerous other academic worlds. In this dissertation, I enacted a sustained engagement with broad swathes of disciplinary traditions and fields: the humanities, social sciences, rhetoric and writing studies, communication studies, Black studies, Critical Race Theory, American Indian and Indigenous Studies, science, technology, and medicine studies, technofeminism, disability studies, literary criticism, and others. By orienting my research paradigm via cultural rhetorics (Riley-Mukavetz, 2014), I also zeroed in on the genre of a dissertation and played with it—queered it—in a manner befitting my own queer worldmaking via academic practice. Adela Licona and Karma Chávez (2015) define this frenetic movement as a relational literacy, which involves “a [remixing] practice that disarticulates and delegitimates normative logics and affirms/creates new, alternative shared knowledges” (p. 104). I have created this dissertation with experiential and embodied theory, or those aspects of my life—my theory in the flesh (Moraga, 1983)—that constellate across a night sky—a figure looms overhead, pointing to a new world. As demonstrated in how I force the adjective “critically” into the infinitive “to imagine” in the second sentence of this conclusion (disrupting grammar through a split infinitive), I am working against the limiting logics of constraint that might dictate the disciplinary scape of my project therein, my analytical possibilities, and perhaps even my audience. I am, after all, a writing and rhetoric scholar, and this document is meant to signal that I am a member of this 136 disciplinary community through citations in a literature review and attention to a particular disciplinary lineage. But my intellectual genealogy—beginning in a small classroom at the University of Texas at San Antonio, wherein I read Gloria Anzaldúa, Chela Sandoval, Alice Walker, and Aurora Levins Morales—misaligns with such academic stricture. I rely on the “shared theory and method of oppositional consciousness and social movement . . . [or] the strategy of articulation necessary to resolve the problematics of the disciplinization and apartheid of academic knowledges” (Sandoval, 2000, p. 77). Put another way, I have adopted Sara Ahmed’s (2017) toolkit for living a feminist life, minimizing my citations of white scholars building white worlds. I want to build something else instead. With this project, I am also hoping to reach across space and time and compel another graduate student (in rhetoric and writing or beyond) to throw a wrench in the system in either a similar or other fantastic manner—tenured white professors who do the intellectual work of propagating the cognitive work of European empires and who have elided the knowledges of people of color do not need my or anyone else’s citation (Powell, 1999; Mignolo, 2011; paperson, 2017). This constellative approach to hotwiring this dissertation stems from my own entry points to the research questions underpinning my project, and I have created this project not through invention but rather through constellative dimensionality. I have woven together strands from worldmaking projects that, when brought together, delimit the kind of world I would like to live in. I take seriously the presumption that “there is plenty of room in knowledge-making enterprises to celebrate what we know while still extending those parameters in dynamic and generative ways” (Royster, 2005, p. 9). In other words, I have used my queer relational literacy to critically imagine disciplinary 137 connections that offer theories and methodologies for doing the practical work of my dissertation. In that vein, I end this dissertation by advancing what I term relational design, a method by which we might use the “university for decolonizing work [using] these machines of decolonial desire, the desire for a third university” (paperson, 2017, p. 32). With the notion of hotwiring, I follow la paperson (2017) and his cyborgian parameters for recognizing the technologies of settler colonialism as they machinate the contemporary university. I take close to heart the notion that we can do meaningful, decolonial work using these technologies. In this case, when I say relational design, I mean to hotwire the standard practices within technical and professional communication that are core to user advocacy, which “is at the core of usability, UX, user-centered design, participatory design, human-centered design, and value- sensitive design” (Jones et al., 2016, p. 218). In this sense, what I propose here is not necessarily new but rather an epistemologically infused method by which we take standard practices and use them as scyborgs—decolonial workers using settler colonial technologies to disrupt its projects (paperson, 2017). Given the specific purview of my work in this project, I primarily advance the notion of relational design within the context of health and medical contexts, specifically focusing on one case study in the prior chapter as a means of moving forward now that that project nears its terminus. Put another way, I offer relational design as both 1) a corrective for the problem of risk-informed communication design endemic to much of the communicative strategies that public health agencies use and 2) a means by which we can build a better world for queer and trans Black, Indigenous, and People of Color (QTBIPOC) by attuning the work we do as technical and professional communicators to virulent literacy practices. Relational design as a method of user advocacy (Jones et al., 2016) upcycles Maria Novotny’s (2021) notion of relational advocacy, which comprises four components: “(1) actively listen to the constituents 138 represented in research and/or advocacy, (2) work to identify any slippages where tensions may emerge, (3) bring such slippages to the attention of advocacy campaign directors/organizations, and (4) continue to mediate tensions.” Returning briefly to the example of ethics from STC above, the approaches to public health outreach outlined throughout this dissertation simply just do not match with what QTBIPOC need or want. And because the federal government and large, seemingly all-encompassing pharmaceutical companies often set the guidelines for such engagements, technical communicators working within these domains (such as myself) find our work and well-being in a precarious place. However, through relational design, I envision renewed approaches to the communication design central to how QTBIPOC interface health and medicine as broader endeavors. What might an advertisement for Truvada or Descovy look like, for example, if they acknowledged the structural issues at play wherein QTBIPOC are materially and socially disafforded access to the medication? What might an advertisement look like that did not heavily feature the bodies of racialized peoples? These questions are ones I have spent this dissertation leading up to, and now, they drive my work forward. I plan to continue this line of inquiry and develop further the means by which we might design in relational ways to build a better world for QTBIPOC. Indeed, Jennifer Sano-Franchini (2015) says well how digital cultural rhetoricians have modeled this rhetorical move: “Some of the key goals of cultural rhetorics scholarship include exposing and disrupting dominant narratives, playing with the notion of academic discourse . . . and doing the intellectual work of renaming, reconceptualizing, and continually resituating the kind of work that rhetoricians can and should do” (p. 53). 139 As such, every move in this project was intentional, and practiced via my theorizing, methodologizing, researching, writing. My constellative invigorations of rhetoric and writing studies requires a thorough engagement with texts across the confluence of disciplines beyond rhetoric and writing—and so to future readers, know much work is needed. This work is the project of understanding how worlds are made through the rhetorical-relational processes of meaning making itself. And so, in this way, I hope that I have used the digital material conventions of writing to delve deeper into argumentation, to explain myself further, and to do the due diligence of constellating. Consider my hotwiring a rhetorical techne, then, an invention born of the work required of using the settler technologies that give us the tools we use—even down to this word processor—as a means of fucking with the regiments of a settler colonial world. Layers upon layers have led me to the end: the introduction storying the project, the methodology, the theory chapter making sense of the socio-material digital world, the interrogative chapter looking how documents shape health and wellness, and the results showing what flourishes in the world despite white supremacist cisheteropatriarchy, and this conclusion. Each chapter affected the next, and I hope that this reading has affected you well. 140 REFERENCES 141 REFERENCES Absolon, K. (2011). Kaandossiwin: How we come to know. Fernwood Publishing. Ahmed, S. (2006). Queer phenomenology: Orientations, objects, others. Duke University Press ---. (2017). Living a feminist life. Duke University Press. Alexander, J. (2008). Literacy, Sexuality, Pedagogy: Theory and Practice for Composition Studies. Utah State University Press. ---. (2021). Stroke Book: The Diary of a Blindspot. Fordham University Press. https://about.jstor.org/terms Alexander, J.-J., & Edenfield, A. C. (2021). Health and Wellness as Resistance: Tactical Folk Medicine. Technical Communication Quarterly, 1–16. https://doi.org/10.1080/10572252.2021.1930181 Alexander, J., & Rhodes, J. (2018). Introduction: What do we talk about when we talk about digital writing and rhetoric?. In J. Alexander & J. Rhodes (Eds.), The Routledge Handbook of Digital Writing and Rhetoric (pp. 1–6). Routledge. Amrute, S. (2020, February 25). Tech colonialism today. Points, Data & Society. https://points.datasociety.net/tech-colonialism-today-9633a9cb00ad Anand, N., Gupta, A., & Appel, H. (Eds.). (2018). The promise of infrastructure. Duke University Press. Angus, D. (2017). Theme detection in social media. In L. Sloan & A. Quan-Haase (Eds.), The SAGE handbook of social media research methods (pp. 530–544). SAGE Publications. Arola, K. (2017). Indigenous interfaces. In D. Walls & S. Vie (Eds.), Social writing/social media: Publics, presentations, and pedagogies (pp. 209–224). University Press of Colorado. ---. (2018). A land-based digital design rhetoric. In J. Rhodes & J. Alexander (Eds.), The Routledge handbook of digital writing and rhetoric (pp. 199–213). Routledge. Association of Internet Researchers. (2019). Internet Research: Ethical Guidelines (3.0). https://aoir.org/reports/ethics3.pdf Bailey, M., & Peoples, W. (2017). Towards a Black feminist health science studies. Catalyst: Feminism, Theory, Technoscience, 3(2), 1–27. 142 Batza, K. (2018). Sickness and wellness. In D. Romesburg (Ed.), The Routledge history of queer America (pp. 287–299). Routledge. Beck, E. & Hutchinson Campos, L. (2021). Privacy matters: Conversations about surveillance within and beyond the classroom. Utah State University Press. Beer, D. (2009). Power through the algorithm? Participatory web cultures and the technological unconscious. New Media & Society, 11(6), 985–1002. Benard, A. A. F. (2016). Colonizing Black female bodies within patriarchal capitalism. Sexualization, Media, & Society, 2(4), 1–11. Benjamin, R. (2019). Introduction: Discriminatory design, liberating imagination. In R. Benjamin (Ed.), Captivating technology: Race, carceral technoscience, and liberatory imagination in everyday life (pp. 1–22). Duke University Press. Bratta, P. & Powell, M. (2016). Introduction to the special issue: Entering the cultural rhetorics conversation. Enculturation: A Journal of Rhetoric, Writing, and Culture, 21(1). http://enculturation.net/entering-the-cultural-rhetorics-conversations. Braveman, P., & Gottlieb, L. (2014). The social determinants of health: It’s time to consider the causes of the causes. Public Health Reports, 129(2), 19–31. https://doi.org/10.1177/00333549141291s206 Brock Jr., A. (2011). Beyond the pale: The Blackbird web browser’s critical reception. New Media and Society, 13(7), 1085–1103. https://doi.org/10.1177/1461444810397031 --- . (2020). Black technoculture and/as afrofuturism. Extrapolation, 6(1–2), (pp. 7–28). ---. (2020a). Distributed Blackness: African American cybercultures. New York University Press. Brown, N. M. (2019). Methodological cyborg as Black Feminist technology: Constructing the social self using computational digital autoethnography and social media. Cultural Studies ↔ Critical Methodologies, 19(1), 55–67. Burgess, M. (2018, February 16). What is the Internet of Things? WIRED explains. WIRED. https://www.wired.co.uk/article/internet-of-things-what-is-explained-iot Carbado, D. W., Crenshaw, K. W., Mays, V. M., & Tomlinson, B. (2013). Intersectionality: Mapping the movements of a theory. Du Bois Review, 10(2), 303–312. Centers for Disease Control and Prevention. (2019, October 19). Culture and Language. Health Literacy. https://www.cdc.gov/healthliteracy/culture.html ---. (2020). HIV Surveillance Report, 2018 (Updated). U.S. Department of Health and Human 143 Services. https://www.cdc.gov/hiv/pdf/library/reports/surveillance/cdc-hiv-surveillance- report-2018-updated-vol-31.pdf ---. (2021). International Classification of Diseases, Tenth Revision, Clinical Modification (ICD- 10-CM). National Center for Health Statistics. https://www.cdc.gov/nchs/icd/icd10cm.htm Césaire, A. (2000). Discourse on colonialism. Monthly Review Press. Charmaz, K. (2014). Reconstructing grounded theory (2nd ed.). SAGE Publications. Chun, W.H.K. (2013). Programmed Visions: Software and Memory. The MIT Press. Clare, E. (2017). Brilliant imperfection: Grappling with cure. Duke University Press. Clarke, A. E., Mamo, L., Fishman, J. R., Shim, J. K., & Fosket, J. R. (2003). Biomedicalization: Technoscientific transformations of health, illness, and U.S. biomedicine. American Sociological Review, 68(2), 161–194. Cobos, C., Raquel Ríos, G., Johnson Sackey, D., Sano-Franchini, J., & Haas, A. (2018). Interfacing cultural rhetorics: A history and a call. Rhetoric Review, 37(2), 139–154. https://doi.org/10.1080/07350198.2018.1424470 Coleman, E. (2010). From sexology to sexual health. In P. Aggleton & R. Parker (Eds.), Routledge Handbook of Sexuality, Health and Rights (pp. 135–144). Routledge. Collins, P. H. (2000). Black Feminist Thought: Knowledge, conciousness, and the politics of empowerment (2nd ed.). Routledge. Combahee River Collective. (1977). The Combahee River Collective statement. BlackPast.org. https://www.blackpast.org/african-american-history/combahee-river-collective-statement- 1977/ Cottom, T. M. (2017). Black cyberfeminism: Ways forward for intersectionality and digital sociology. In J. Daniels, K. Gregory, & T.M. Cottom (Eds.), Digital Sociologies (pp. 211–231). Policy Press. Cultural Rhetorics Theory Lab. (n.d.). Doing cultural rhetorics. https://crtheorylab.wordpress.com/how-do-you-do-cultural-rhetorics/ Cushman, E., Jackson, R., Nichols, L., Rivard, C., Moulder, A., Murdock, C., Grant, D., & Adams, H. (2019). Decolonizing projects: Creating pluriversal possibilities in rhetoric. Rhetoric Review, 38(1), 1–22. Davis, S. E. (2019). Shade: Literacy narratives at Black Gay Pride. Literacy in Composition Studies, 7(2), 56–89. 144 ---. (2022). Trade: Sexual identity, ambiguity, and literacy normativity. Literacy in Composition Studies, 9(2), 48–66. de Sousa Santos, B. (2018). The end of the cognitive empire: The coming of age of epistemologies of the south. Duke University Press. Dhamoon, R. (2015). A feminist approach to decolonizing anti-racism: Rethinking transnationalism, intersectionality, and settler colonialism. Feral Feminisms, 4, 20–37. Dotson, K. (2018). On the way to decolonization in a settler colony: Re-introducing Black Feminist identity politics. AlterNative, 14(3), 190–199. Duarte, M. (2017). Network sovereignty: Building the internet across Indian Country. University of Washington Press duCille, A. (1994). The Occult of true Black womanhood: Critical demeanor and Black feminist studies. Signs: Journal of Women in Culture and Society, 19(3), 591–629. Edwards, D. (2020). Digital rhetoric on a damaged planet: Storying digital damage as inventive response to the Anthropocene. Rhetoric Review, 39(1), 59–72. Edwards, D. & Gelms, B. (2018). The rhetorics of platforms: Definitions, approaches, futures. Present Tense, 6(3), http://www.presenttensejournal.org/editorial/vol-6-3-special-issue- on-the-rhetoric-of-platforms Edenfield, A. C., Holmes, S., & Colton, J. S. (2019). Queering tactical technical communication: DIY HRT. Technical Communication Quarterly, 28(3), 177–191. Edenfield, A. C., Colton, J. S., & Holmes, S. (2019). Always already geopolitical: Trans health care and global tactical technical communication. Journal of Technical Writing and Communication, 49(4), 433–457. https://doi.org/10.1177/0047281619871211 Eng, D. L., & Puar, J. K. (2020). Introduction: Left of queer. Social Text, 38(4), 1–24. Erikainen, S., Pickersgill, M., Cunningham-Burley, S., & Chan, S. (2019). Patienthood and participation in the digital era. Digital Health, 5, 1–10. Fanon, F. (1994). A dying colonialism. Grove Press. ---. (2008). Black skin, white masks. Pluto Press. Faris, M. (2018). How to be gay with locative media: The rhetorical work of Grindr as a platform. Present Tense: A Journal of Rhetoric in Society, 3(6). https://www.presenttensejournal.org/volume-6/how-to-be-gay-with-locative-media-the- rhetorical-work-of-grindr-as-a-platform/ 145 Flexner, A. (1910). Medical education in the United States and Canada: A report to the Carnegie Foundation for the Advancement of Teaching. The Carnegie Foundation for the Advancement of Teaching. Fussel, S. (2017, Aug 17). Why can’t this soap dispenser identify dark skin? Gizmodo, https://gizmodo.com/why-cant-this-soap-dispenser-identify-dark-skin-1797931773 Frith, J. (2020). Pushing back on the rhetoric of “real” life. Present Tense: A Journal of Rhetoric in Society, 8(2). https://www.presenttensejournal.org/volume-8/pushing-back-on-the- rhetoric-of-real-life/ Frohlich, K. L., & Potvin, L. (2008). Transcending the known in public health practice: The inequality paradox: The population approach and vulnerable populations. American Journal of Public Health, 98(2), 216–221. Garza, Alicia. (2014, Oct 7). A herstory of the #BlackLivesMatter movement. TheFeministWire.com. https://www.thefeministwire.com/2014/10/blacklivesmatter-2/ Gaspar de Alba, A. (2014). Introduction: Activist scholarship and the historical vortex of the “bad woman.” In [Un]framing the “bad woman”: Sor Juana, Malinche, Coyolxauhqui, and other rebels with a cause (pp. 1–38). University of Texas Press. Gaudry, A. J. P. (2011). Insurgent research. Wicazo Sa Review, 26(1), 113–136. Gelms, B. & Edwards, D. (2019). A technofeminist approach to platform rhetorics. Computers and Composition Online. http://cconlinejournal.org/techfem_si/02_Gelms_Edwards/ Gill-Peterson, J. (2013). Haunting the queer spaces of AIDS: Remembering ACT UP/New York and an ethics for an endemic. GLQ, 19(3), 279–300. https://doi.org/10.1215/10642684- 2074512 Gilmore, R. W. (2007). Golden gulag: Prisons, surplus, crisis, and opposition in globalizing California. University of California Press. Glouberman, S., & Millar, J. (2003). Evolution of the determinants of health, health policy, and health information systems in Canada. American Journal of Public Health, 93(3), 388– 392. Gould, J. (1988). The problem of being “Indian”: One mixed-blood’s dilemma. In S. Smith & J. Watson (Eds.), De/colonizing the subject: The politics of gender in women’s autobiography (pp. 81–88). University of Minnesota Press. Green, M. (2020). Resistance as participation: Queer theory's applications for HIV health technology design. Technical Communication Quarterly, 1–14. Greene, J., Basilico, M. T., Kim, H., & Farmer, P. (2013). Colonial medicine and its legacies. In 146 P. Farmer, J. Y. Kim, A. Kleinman, & M. Basilico (Eds.), Reimagining global health: An introduction (pp. 33–73). University of California Press. Gupta, K. (2011). “Screw health”: Representations of sex as a health-promoting activity in medical and popular literature. Journal of Medical Humanities, 32(2), 127–140. Guta, A., Murray, S., & McClelland, A. (2011). Global AIDS governance, Biofascism, and the difficult freedom of expression. Aporia: The Nursing Journal, 3(4), 15–29. Haas, A. M. (2007). Wampum as hypertext: An American Indian intellectual tradition of multimedia theory and practice. Studies in American Indian Literatures, 19(4), 77–100. ---. (2018). Toward a digital cultural rhetoric. In J. Alexander & J. Rhodes (Eds.), The Routledge handbook of digital writing and rhetoric (pp. 412–422). Routledge. Hancock, T. (1986). Lalonde and beyond: Looking back at “A new perspective on the health of Canadians.” Health Promotion International, 1(1), 93–100. Harvey, A., & Luka, M. E. (2019). Space, place, and the materiality of Internet Studies: An introduction to the #AoIR18 special issue. Information Communication and Society, 22(6), 767–773. Hesford, W., Licona, A., & Teston, C. (2018). Precarious Publics. The Ohio State University Press. Hicks, M. (2021). When did the fire start?. In T. S. Mullaney, B. Peters, M. Hicks, & K. Philip (Eds.), Your computer is on fire (pp. 13–26). The MIT Press. HIV.gov. (2020, May 14). What Is the Impact of HIV on Racial and Ethnic Minorities in the U.S.? Impact on Racial and Ethnic Minorities. https://www.hiv.gov/hiv- basics/overview/data-and-trends/impact-on-racial-and-ethnic-minorities Hoberman, J. (2012). Black and blue: The origins and consequences of medical racism. University of California Press. Hogan, M. (2018). Data is airborne; data is inborn: The labor of the body in technoecologies. First Monday, 23(3). https://doi.org/10.5210/fm.v23i3.8285 Hu, T.-H. (2015). A prehistory of the cloud. The MIT Press. ---. (2017). Black boxes and green lights: Media, infrastructure, and the future at any cost. English Language Notes, 55(1–2), 81–88.s Humphreys, L., Gill, P., & Krishnamurthy, B. (2014). Twitter: A content analysis of personal information. Information Communication and Society, 17(7), 843–857. 147 ION Marketing Group. (2018). Case Study: Gilead Sciences Healthysexual Tour. ION Marketing Group Case Studies. https://ionmktggroup.com/case-study/stigma-pop-up/ Jackson, Z. I. (2020). Becoming human: Matter and meaning in an antiblack world. New York University Press. Johnson, A. H. (2019). Rejecting, reframing, and reintroducing: Trans people’s strategic engagement with the medicalisation of gender dysphoria. Sociology of Health and Illness, 41(3), 517–532. Johnson-Eilola, J. & Selber, S.A. (2004). Central works in technical communication. Oxford University Press. Johnson, E. P. (2001). “Quare” studies, or (almost) everything I know about queer studies I learned from my grandmother. Text and Performance Quarterly, 21(1), 1–25. Kim, J. B. (2017). Toward a crip-of-color critique: Thinking with Minich’s “Enabling Whom?” Lateral: Journal of the Cultural Studies Association, 6(1). https://csalateral.org/issue/6- 1/forum-alt-humanities-critical-disability-studies-crip-of-color-critique-kim Kimball, M. A. (2017). Tactical technical communication. Technical Communication Quarterly, 26(1), 1–7. https://doi.org/10.1080/10572252.2017.1259428 King, T. L. (2019). The black shoals: Offshore formations of Black and Native studies. Duke University Press. Kivits, J. (2004). Researching the “informed patient.” Information, Communication & Society, 7(4), 510–530. ---. (2009). Everyday health and the internet: A mediated health perspective on health information seeking. Sociology of Health and Illness, 31(5), 673–687. Krieger, N. (2011). Epidemiology and the people’s health: Theory and context. Oxford University Press. Kynard, C. (2020). “All I Need Is One Mic”: A Black feminist community meditation on the work, the job, and the hustle (& why so many of yall confuse this stuff). Community Literacy Journal, 14(2), 5–24. Lalonde, M. (1974). A new perspective on the health of Canadians: A working document. Government of Canada la paperson. (2017). A third university is possible. University of Minnesota Press. Lee, J. N., & Hickman, A. C. (2018). Keyword essay: Health literacy. Community Literacy Journal, 12(2), 73–83. https://doi.org/https://doi.org/10.1353/clj.2018.0007 148 Lee, R. H. (2013). Reading and AIDS literacy in Allen Barnett’s short fiction. Literature and Medicine, 31(1), 142–173. https://doi.org/10.1353/lm.2013.0002 Lenape Nation of Pennsylvania. (2018). About the Lenape Nation of Pennsylvania. Lenape Nation. https://www.lenape-nation.org Licona, A. C., & Chávez, K. R. (2015). Relational literacies and their coalitional possibilities. Peitho, 18(1), 96–107. Lisicky, P. (2020). Later: My life at the edge of the world. Graywolf Press. Littauer, A. H. (2018). Sexual minorities at the apex of heteronormativity (1940s-1965). In D. Romesburg (Ed.), The Routledge history of queer America (pp. 67–81). Routledge. Lloyd, K. C. (2017). Centering “being undetectable” as the new face of HIV: Transforming subjectivities via the discursive practices of HIV treatment as prevention. BioSocieties, 13(2), 470–493. Lockett, A. (2021). What is Black Twitter? A rhetorical criticism of race, dis/information, and social media. In A. L. Lockett, I. D. Ruiz, J. C. Sanchez, & C. Carter (Eds.), Race, rhetoric, and research methods (pp. 165–213). The WAC Clearinghouse/University Press of Colorado. Longo, Bernadette. (2000). Spurious coin: A history of science, management, and technical writing. SUNY Press. Marwick, A. E., & boyd, d. (2011). I tweet honestly, I tweet passionately: Twitter users, context collapse, and the imagined audience. New Media and Society, 13(1), 114–133. McBride, D. (2005). Why I hate Abercrombie & Fitch: Essays on race and sexuality. New York University Press. McKee, H. & Porter, J. (2009). The ethics of internet research: A rhetorical, case-based approach. Peter Lang Publishing. McKenzie, M., & Tuck, E. (2015). Place in research: Theory, methodology, and methods. Routledge. McKittrick, K. (2014). Mathematics Black life. The Black Scholar, 44(2), 16–28. ---. (2021). Dear science and other stories. Duke University Press. Medina-López, K. (2018). Rasquache rhetorics: A cultural rhetorics sensibility. Constellations, 1(1), 1–20. Mejia, R. (2016). The epidemiology of digital infrastructure. In S. U. Noble & B. M. Tynes 149 (Eds.), The intersectional internet: Race, sex, class, and culture Online (pp. 229–241). Peter Lang Publishing. Mignolo, W. D. (2011). The darker side of Western modernity: Global futures, decolonial options. Duke University Press. Mikdashi, M. (2013). What is settler colonialism? American Indian Culture and Research Journal, 2(37), 23–34. Miller, C. (1984). Genre as social action. Quarterly Journal of Speech, 709(2), 151–167. https://doi.org/10.1080/00335638409383686 Miner, D. A. (2015). Makataimeshekiakiak, settler colonialism, and the specter of Indigenous liberation. In N. Brown & S. Kanouse (Eds.), Re-collecting Black Hawk: Landscape, memory, and power in the American Midwest (pp. 219–235). University of Pittsburgh Press. Minich, J. A. (2016). Enabling whom? Critical disability studies now. Lateral: Journal of the Cultural Studies Association, 5(1). https://csalateral.org/issue/5-1/forum-alt-humanities- critical-disability-studies-now-minich/ Moraga, C. (1983). Entering the lives of others: Theory in the flesh. In C. Moraga & G. Anzaldúa (Eds.), This bridge called my back: Writings by radical women of color (2nd ed., pp. 22–23). Kitchen Table: Women of Color Press. Moreton-Robinson, A. (2015). The white possessive: Property, power, and Indigenous sovereignty. The University of Minnesota Press. Morgensen, S. L. (2010). Settler homonationalism: Theorizing settler colonialism within queer modernities. GLQ, 16(1–2), 105–131. ---. (2015). A politics not yet known: Imagining relationality within solidarity. American Quarterly, 67(2), 309–315. Mukavetz, A. M. R. (2014). Towards a cultural rhetorics methodology : Making research matter with multi-generational women from the Little Traverse Bay Band. Rhetoric, Professional Communication and Globalization, 5(1), 108–125. Muñoz, J. E. (2020). The sense of brown. Duke University Press. Murphy, M. (2017a). Alterlife and decolonial chemical relations. Cultural Anthropology, 32(4), 494–503. ---. (2017b). Commentary: What can’t a body do? Catalyst: Feminism, Theory, Technoscience, 3(1), 1–15. 150 Murthy, D. (2017). The ontology of tweets: Mixed-method approaches to the study of Twitter. In L. Sloan & A. Quan-Haase (Eds.), The SAGE handbook of social media research methods (pp. 559–572). SAGE Publications. Network of the National Library of Medicine. (n.d.). Health Literacy. Initiatives. https://nnlm.gov/initiatives/topics/health-literacy Noble, S.U. (2016). A future for intersectional Black Feminist Technology Studies. Scholar & Feminist Online, 13(3), https://sfonline.barnard.edu/traversing-technologies/safiya- umoja-noble-a-future-for-intersectional-black-feminist-technology- studies/0/?print=true#identifier_7_2621 ---. (2018). Algorithms of oppression: How search engines reinforce racism. New York University Press. ---. (2019). Toward a critical black digital humanities. In M. Gold & L. Klein (Eds.), Debates in the digital humanities 2019 (pp. 27–35). University of Minnesota Press. Noble, S.U. & Tynes, B.M. (2016). The intersectional internet: Race, sex, class, and culture online. Peter Lang Publishing. Novotny, M. (2021). Intervening in #Access2Care: Towards a rhetorical framework for relational advocacy. Present Tense, 9(1), https://www.presenttensejournal.org/category/volume-9/issue-1-volume-9/ Opel, Dawn S. (2018). Ethical research in “Health 2.0.” In L. Meloncon & J. B. Scott (Eds.), Methodologies for the rhetoric of health & medicine (pp. 176–94). Routledge. Paré, A., Starke-Meyerring, D., & McAlpine, L. (2009). The dissertation as multi-genre: Many Readers, Many Readings. In C. B. Bazerman, A. Adair Bonini, & D. Figueiredo (Eds.), Genre in a Changing World (pp. 183–197). The WAC Clearinghouse; Parlor Press. Parham, M. (2019). Sample | signal | strobe: Haunting, social media, and Black digitality. In M. Gold & L. Klein (Eds.), Debates in the digital humanities 2019 (pp. 101–122). University of Minnesota Press. Paulson, S. (2016, July 29). Critical intimacy: An interview with Gayatri Chakravorty Spivak. Los Angeles Review of Books. https://lareviewofbooks.org/article/critical-intimacy- interview-gayatri-chakravorty-spivak Piepzna-Samarasinha, L. L. (2018). Care work: Dreaming disability justice. Arsenal Pulp Press. Powell, M. (1999). Blood and scholarship: One mixed-blood’s story. In Keith Gilyard (Ed.), Race, rhetoric, and composition (pp. 1–16). Heinemann. ---. (2002). Listening to ghosts: An alternative (non)argument. In P. Bizzell, C. Schroeder, & H. 151 Fox (Eds.), ALT DIS: Alternative discourses and the academy (pp. 11–22). Boynton/Cook-Heinemann. ---. (2012). 2012 CCCC chair’s address: Stories take place: A performance in one act. College Composition and Communication, 64(2), 383–406. Pendergrast, K. (2019, November 29). The next big cheap. Real Life Magazine. https://reallifemag.com/the-next-big-cheap/ Puar, J. (2007). Terrorist assemblages: Homonationalism in queer times. Duke University Press. ---. (2017). The right to maim: Debility, capacity, disability. Duke University Press. Ramos, S. (2014). Digital is dead: Techno-seduction at the colonial difference, from Zapatismo to Occupy Wall Street. In D. Hicky & J. Essid (Eds.), Identity and leadership in virtual communities: Establishing credibility and influence (pp. 220–236). IGI Publishing. ---. (2017). Building a culture of solidarity: Racial discourse, Black Lives Matter, and Indigenous social justice. enculturation: A Journal of Rhetoric, Writing, and Culture, 21(1). http://enculturation.net/building-a-culture-of-solidarity Rheault, D. (1999). Anishinaabe Mino-Bimaadiziwin - The Way of a Good Life. Debwewin Press. Riley Mukavetz, A. (2014). Towards a cultural rhetorics methodology: Making research matter with multi-generational women from the Little Traverse Bay Band. Rhetoric, Professional Communication and Globalization, 5(1), 108–125. Ríos, G. (2015). Cultivating land-based literacies and rhetorics. Literacy in Composition Studies, 3(1), 60–70. Ross, L. J. (2017). Reproductive justice as intersectional feminist activism. Souls: A Critical Journal of Black Politics, Culture, and Society, 19(3), 286–314. Rowe, A. C., & Tuck, E. (2017). Settler colonialism and cultural studies: Ongoing settlement, cultural production, and resistance. Cultural Studies ↔ Critical Methodologies, 17(1), 3– 13. Royster, J. J. (2005). Introduction: Marking trails in studies of race, gender, and culture. In J. J. Jones & A. M. Mann Simpkins (Eds.), Calling cards: Theory and practice in the study of race, gender, and culture (pp. 1–14). SUNY Press. Rusert, B. (2019). Naturalizing coercion: The Tuskegee Experiments And the laboratory life of the plantation. In R. Benjamin (Ed.), Captivating technology: Race, carceral technoscience, and liberatory imagination in everyday life (pp. 25–49). Duke University Press. 152 Sackey, D. J., Boyle, C., Xiong, M. N., Ríos, G. R., Arola, K. L., & Barnett, S. (2019). Perspectives on cultural and posthumanist rhetorics. Rhetoric Review, 38(4), 375–401. San Francisco AIDS Foundation. (2019). Side-by-side comparison: Truvada and Descovy for PrEP. PrEP. https://www.sfaf.org/resource-library/side-by-side-comparison-truvada-and- descovy-for-prep/ ---. (2020). 1. The Basics. PrEPFacts.org. https://prepfacts.org/prep/the-basics Sandoval, C. (2000). Methodology of the oppressed. University of Minnesota Press. Sano-Franchini, J. (2015). Cultural rhetorics and the digital humanities: Toward cultural reflexivity in digital making. In J. Ridolfo & W. Hart-Davidson (Eds.), Rhetoric and the digital humanities (pp. 49–64). The University of Chicago Press. Saldaña, J. (2009). The coding manual for qualitative researchers. SAGE Publications. Schalk, S. (2017). Critical disability studies as methodology. Lateral: Journal of the Cultural Studies Association, 6(1). https://csalateral.org/issue/6-1/forum-alt-humanities-critical- disability-studies-methodology-schalk Scott, J. B. (2016). Sexual counterpublics, disciplinary rhetorics, and Truvada. In J. Alexander & J. Rhodes (Eds.), Sexual rhetorics: Methods, identities, publics (pp. 217–229). Routledge. Segal, J. Z. (2009). Internet health and the 21st-century patient: A rhetorical view. Written Communication, 26(4), 351–369. Shahani, N. (2016). How to survive the whitewashing of AIDS: Global pasts, transnational futures. In QED: A Journal in GLBTQ Worldmaking (Vol. 3, Issue 1). https://muse.jhu.edu/article/614679 Simmons, A. (2015, September). Technology colonialism. Model View Culture, 27. Retrieved from https://modelviewculture.com/pieces/technology-colonialism Sjoding, M., Dickson, R. P., Iwashyna, T. J., Gay, S. E., & Valley, T. S. (2020). Racial bias in pulse oximetry measurement. The New England Journal of Medicine, 383, 2477-2478. DOI: 10.1056/NEJMc2029240 Smith, B. (2019 June 19). Barbara Smith: Why I left the mainstream queer rights movement. The New York Times. https://www.nytimes.com/2019/06/19/us/barbara-smith-black-queer- rights.html Spieldenner, A. (2016). PrEP whores and HIV prevention: The queer communication of HIV pre-exposure prophylaxis (PrEP). Journal of Homosexuality, 63(12), 1685–1697. ---. (2017). Infectious Sex? An autoethno-graphic exploration of HIV prevention. QED: A 153 Journal in GLBTQ Worldmaking, 4(1), 121–129. http://scholarlypublishingcollective.org/msup/qed/article- pdf/4/1/121/941040/qed.4.1.0121.pdf Spieldenner, A., & Castro, C. (2010). Education and fear: Black and gay in the public sphere of HIV prevention. Communication Education, 59(3), 274–281. Starosielski, N. (2015). The undersea network. Duke University Press. Sylvestre, P., Castleden, H., Denis, J., Martin, D., & Bombay, A. (2019). The tools at their fingertips: How settler colonial geographies shape medical educators’ strategies for grappling with anti-Indigenous racism. Social Science and Medicine, 237(December 2018), 1–9. Takayoshi, P. (2016). Methodological challenges to researching composing processes in a new literacy context. Literacy in Composition Studies, 4(1), 1–23. TallBear, K. (2011, Nov. 18). Why interspecies thinking needs Indigenous standpoints. Society for Cultural Anthropology. https://culanth.org/fieldsights/why-interspecies-thinking- needs-indigenous-standpoints Terranova, T. (2000). Free labor: Producing culture for the digital economy. Social Text, 18(2), 33-58. Teston, C., Gonzales, L., Bivens, K., & Whitney, K. (2019). Surveying precarious publics. Rhetoric of Health & Medicine, 2(3), 321–351. Thobani, S. (2014). Prologue. In (Eds.). Queer necropolitics (pp. xv–xvii). Routledge. Todd, L. (1996). Aboriginal narratives in cyberspace. In M. A. Moser & D. MacLeod (Eds.), Immersed in technology: Art and virtual environments (pp. 179–194). The MIT Press. Todd, Z. (2015). Indigenizing the Anthropocene. In H. Davis & E. Turpin (Eds.), Art in the Anthropocene: Encounters among aesthetics, politics, environments and epistemologies (pp. 241–254). Open Humanities Press. ---. (2016). An Indigenous feminist’s take on the ontological turn: “Ontology” is just another word for colonialism. Journal of Historical Sociology, 29(1), 4–22. Tuck, E., Smith, M., Guess, A. M., Benjamin, T., & Jones, B. K. (2014). Geotheorizing Black/Land: Contestations and contingent collaborations. Departures in Critical Qualitative Research, 3(1), 52–74. Tuck, E, & Yang, K. W. (2012). Decolonization is not a metaphor. Decolonization: Indigeneity, Education & Society, 1(1), 1–40. 154 ---. (2013). R-words: Refusing research. In D. Paris & M. T. Winn (Eds.), Humanizig research: Decolonizing qualitative inquiry with youth and communities (1st ed., pp. 223–247). SAGE Publication. Tynes, B., Schuschke, J., & Noble, S. U. (2016). Digital intersectionality theory and the #BlackLivesMatter movement. In B. Tynes & S. U. Noble (Eds.), The intersectional internet: Race, sex, class, and culture online (pp. 21 – 40). Peter Lang Publishing. Valles, S. A. (2018). Philosophy of population health: Philosophy for a new public health era. Routledge. Walton, R., Moore, K. R., & Jones, N. N. (2019). Technical communication after the social justice turn. Routledge. Watts, V. (2013). Indigenous place-thought & agency amongst humans and non-humans (First Woman and Sky Woman go on a European world tour!). Decolonization: Indigeneity, Education & Society, 2(1), 20–34. Wawrzyniak, A. J., Ownby, R. L., McCoy, K., & Waldrop-Valverde, D. (2013). Health literacy: Impact on the health of HIV-infected individuals. Current HIV/AIDS Reports, 10(4), 295–304. Weheliye, A. G. (2014). Habeas viscus: Racializing assemblages, biopolitics, and black feminist theories of the human. Duke University Press. Wilke, M. (2017, April 8). PHOTOS: PrEP marketing campaigns get homoerotic. It’s about time. Queerty*. https://www.queerty.com/photos-prep-marketing-campaigns-get- homoerotic-heres-20170408 Wilson, S. (2008). Research is ceremony: Indigenous research methods. Fernwood Publishing. Wolfe, P. (2006). Settler colonialism and the elimination of the Native. Journal of Genocide Research, 8(4), 387–409. Wynter, S. (2003). Unsettling the coloniality of being/power/truth/freedom: Towards the Human, after Man, its overrepresentation—An argument. New Centennial Review, 3(3), 257–337. Wynter, S. (2006). On how we mistook the map for the territory, and reimprisoned ourselves in our unbearable wrongness of being, of Desêtre: Black studies toward the human project. In L. R. Gordon & J. A. Gordon (Eds.), A Companion to African-American studies (pp. 107–118). Blackwell Publishing. 155