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Despite multiple and persuasive arguments against the validity of doing so, many basic writers continue to be identified by what Brian V. Street calls the "autonomous model of literacy," a model that research tells us is as artificial and inappropriate as it is ubiquitous. This article describes a curricular response to the political, material, and ideological constraints placed on basic writing via this autonomous model and instead treats literacy as a social practice. After a brief description of the local conditions from which our program emerged, I articulate what I call a "pedagogy of rhetorical dexterity," the new model upon which our curriculum is based. Informed by both the New Literacy Studies and activity theory, rhetorical dexterity teaches writers to effectively read, understand, manipulate, and negotiate the cultural and linguistic codes of a new community of practice based on a relatively accurate assessment of another, more familiar one. The final sections of the article describe the assignments included in a recent version of our curriculum, as well as selected student responses to these assignments and readings. Accepting that a curricular solution to the institutionalized oppression implicit in much literacy learning is necessarily partial and temporary, I argue that fostering students' awareness of the ways in which an autonomous model deconstructs itself when applied to real-life literacy contexts empowers them to work against this system. (Contains 8 notes.)

Purpose: Transgender and nonbinary (TGNB) patients experience many barriers when seeking quality healthcare services, including ineffective communication and negative relationships with their providers as well as a lack of provider competence (including knowledge, training, and experience) and humility (engagement in the process of self‐reflection and self‐critique) in treating TGNB individuals. The purpose of this qualitative study was to identify factors associated with cultural competence and humility that facilitate and impede effective relationships between TGNB young adults and their healthcare providers. Methods: Data came from individual interviews with 60 young adults aged 18 to 24 from Florida who self‐identified as transgender or nonbinary. We analyzed the data using inductive thematic approaches, and a feminist perspective, to identify themes associated with patient‐provider relationships. Conclusions: We identified 4 themes related to patient‐provider relationships: (1) Participants indicated effective patient‐provider communication and relationships are facilitated by providers requesting and utilizing TGNB patients' correct names and personal pronouns. (2) Participant narratives conveyed their preferences that providers "follow their lead" in terms of how they described their own anatomy, reinforcing the utility of cultural humility as an approach for interactions with TGNB patients (3) Participants discussed the detrimental effects of TGNB patients having to educate their own providers about their identities and needs, suggesting clinicians' competence regarding gender diversity is paramount to fostering and maintaining patient comfort. (4) Finally, participants' responses indicated concerns regarding the confidentiality and privacy of the information they provided to their providers, suggesting a lack of trust detrimental to the process of building rapport between patients and their providers. Clinical Relevance: Our findings indicate balancing the use of cultural humility and cultural competence during clinical encounters with TGNB young adults can enhance patients' experiences seeking healthcare. Nursing education is often devoid of focus on caring for transgender and nonbinary persons. Additional provider training and education on approaching clinical encounters with TGNB patients with cultural humility and competence should improve patient‐provider communication and relationships, leading to a higher quality of patient care. [ABSTRACT FROM AUTHOR]