Anticipating, experiencing, and responding to disenfranchising talk: The experiences of people with type 1 diabetes

This interpretive study applies the theory of communicative (dis)enfranchisement to analyze 290 narratives authored by people diagnosed with type 1 diabetes (T1D). Using thematic co-occurrence analysis, we identified interrelationships both among and across types of anticipated and experienced (dis)enfranchising talk (DT) and participants’ responses to DT. Specifically, participants anticipated a lack of understanding and being accused of seeking pity or being incompetent in managing T1D. Participants experienced pressure from healthcare providers, unwanted intrusions, financial barriers, and negative self-talk. Participants responded to DT via denial, learning from others, and creating enfranchising messages. Utilizing a data matrix tool, we identify two theoretical relationships across types of DT and types of responses – a relationship between inability to manage T1D and experiencing unwanted intrusions from others, and between financial barriers and creating enfranchising messages. We offer theoretical implications and practical suggestions for people with T1D and their families, healthcare providers, and public health officials.