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Care in Transit examines the transnational emergence of transgender health care as an institutionalizing field and public entitlement. Clinical care for trans people has been classically framed as a pitched struggle between providers and patients, but coordination and negotiation increasingly characterize this relation. Care in Transit thus turns to examine sites of local and transnational collaboration (in addition to conflict), specifically in trans health’s public provision and regulation. Looking ethnographically to activists and health care providers in Buenos Aires and New York City, the project seeks to explain how these groups work together to assemble, intervene on, and refigure the infrastructures through which trans health care takes shape. While such cooperation may seem to signal an increased standardization and stabilization, I propose that it instead signals the protraction of a period of ambiguity within which a multitude of care practices and political claims can proliferate. I call this set of dynamics and practices “transmutable care,” and explore it analytically through classification, racialized citizenship, statistical politics, and feminist politics of care.

Formerly a critical diagnosis, in the U.S. HIV is now classified as a chronic disease that can be survived and managed. From the early days of the AIDS crisis in the 1980s through the HAART (Highly Active Antiretroviral Treatments) era, HIV has remained an expensive illness. Many of the costs have been born by the public health systems of U.S. cities and states as well as the federal HIV program named for pioneering AIDS icon, Ryan White. In the mid-1990s, expensive but effective pharmaceutical HIV treatments called HAART became widely available through public and private health insurance in the U.S. Over the same time, cost containment strategies restructured US healthcare, and today inequalities remain entrenched in HIV health systems across the US and beyond. In this dissertation, I ask how and for whom HIV becomes “potentially chronic” and definitely expensive in the midst of US healthcare reforms. The biomedical and bureaucratic re-classifications of HIV as a chronic illness provide a case for examining how the problem of healthcare costs becomes linked to the bodies and lives of people and particular populations: What are the embodied and institutional consequences of HIV becoming a “life-long” disease? I ask what it means for HIV to be defined, managed and experienced as a chronic illness in U.S. healthcare and policy and what is at stake in this re-classification. In the context of managing costs and chronic conditions simultaneously, who has access to experiencing HIV as a chronic condition? How, why, and through what processes is this chronicity achievable for some people? Based at a San Francisco HIV clinic, an early epicenter of the HIV/AIDS epidemic that later became a hub of biomedical research and global model for HIV care, I ethnographically traced how patients and staff are navigating biomedical bureaucracies and health insurance markets as they attempt to obtain and provide healthcare. With an historical and ethnographic account of recent U.S. heal

Human milk is being exchanged today in ways that are increasingly fraught and contentious. Non-profit milk banks are working hard to keep up with increasing demand from neonatal intensive care units (NICUs) for banked donor milk (BDM); informal exchanges have exploded through the use of Facebook platforms designed for milk sharing and other websites designed for milk selling; and for-profit entities are competing for donated human milk and for hospital-customers of banked donor milk. In this contested space, issues of safety, and the ethical procurement and distribution of human milk are ubiquitous.This dissertation follows a multi-cited ethnography of non-profit human milk banking, informal milk sharing and the use of human milk in biomedical innovation both in for-profit and academic settings. Drawing on both feminist science and technology studies and situational analysis, I argue that there are two key issues that make contemporary forms of human milk exchange particularly contentious, what I call “the two donor dynamic” and “the problem of commodification”. I argue that the ways value is constructed in the different forms of exchange under consideration negotiate these issues in unique ways that set out moral/ontological understandings about human milk. Non-profit banking establishes value through logics of surplus, scarcity, safety and care where (for example) donors are cared for and understood as breastfeeding mothers first and donors second and recipients are prioritized according to medical need because of the scarcity of BDM. Informal sharing networks are establishing themselves as forms of biosocial affective economies where a mother’s too much or too little milk can be experienced as breastfeeding problems and informal exchange as a form of relief. I argue that corporate entities and academic centers developing products from human milk employ promissory understandings of breast milk as that which is both best for a baby and possibly offering biomedical

In the United States, diagnosed cases of autism have increased more than ten fold over the past four decades. This dramatic change has become the source of considerable controversy, raising questions about what lies behind these rising numbers. These debates have spurred new directions in research on the causes of autism, including epidemiologic studies focused on environmental factors and gene-environment interactions.This dissertation provides a sociological study of the emergence, practices, and consequences of autism gene-environment interaction research. Using participant observation, document analysis, and interviews with scientists, advocates and mothers of children diagnosed with autism, I argue that autism gene-environment interaction research is situated within a larger social and scientific process I call anticipating autism. Building on scholarship in medical sociology, science and technology studies and social theory, this process captures how autism is increasingly being produced as a possible future that should be preemptively considered, acted upon and engaged in the present.My findings detail how this process is taking place across sites of knowledge production, scientific practice, autism diagnosis and family life. In particular, I describe how advocacy efforts, science, and family experiences of autism facilitated new approaches to the study of the condition. Following a prospective epidemiologic study focused on autism risk factors during fetal development and early childhood, I show how gene-environment interaction research is shifting understandings of autism both spatially and temporally. Finally, I describe how, for mothers of children diagnosed with autism who are expecting another child, research participation becomes a practice in caring for specific children, being a "good mother," and preparing for the future. These findings reflect changing relationships between science, uncertainty and care in the post-genomic era. This dissertation co