Pained Subjects: Self-harm, Sexual Health, and US Citizenship

Date of Award


Degree Type


Degree Name

Doctor of Philosophy (PhD)




Carol Fadda


This dissertation analyzes how discourses surrounding self-harm have circulated and evolved from the postwar period to the present in the United States. Combining the connotations of sexual self-abuse and psychiatric self-injury, it argues that the pathologizing claim that people are harming themselves has been an especially flexible and persistent means of positioning people as both threatening and disposable to the US citizenry and health of the nation-state, working in tandem with distinct racialized, classed, and gendered processes of devaluation. Simultaneously, it argues that people categorized as self-harming directly engage with and reframe the pathologizing meanings that medical, cultural, and national institutions affix to their bodyminds. I analyze how this has occurred in four arenas in which national crises arose about how subjects with sexualities, illnesses, and embodiments deemed self-inflicted would relate to the imagined community of the US citizenry. The anxieties arising from these crises gathered meaning around several cultural figures: BD(SM) and the sexual masochist, abortion and the self-inducing woman, AIDS and the self-inflicting homosexual and drug addict, and transness and the self-mutilating transgender adolescent. I analyze these constructions in a range of archival materials like legislation, pornography, medical texts, and newspaper accounts. Alongside these cultural discourses, I analyze how the life-writing of people who have experienced illegal abortion, HIV/AIDS diagnoses, and trans embodiment theorizes the dense relationship between choice and coercion that have structured their bodyminds, leaving the moral nature of self-harm productively unsettled. These texts, which include fictionalized autobiographies, memoirs, and collaborative narrative projects, theorize an interlinked schema of choosing pain, choosing death, and choosing not to inhabit a coherent self, which together critique the norms analyzed here and provide models of relation across difference.


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