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Paper short abstract

This paper examines how intersecting generational, territorial, and health system polarization fragments care infrastructures for young women with breast cancer in Chile, generating both structural exclusions and solidaristic resistance practices.

Paper long abstract

This paper examines how sociopolitical polarization fragments care infrastructures for young women with breast cancer in Chile, focusing on intersecting generational, territorial, and health system exclusions within a deeply segmented public/private structure. Drawing on interviews with women diagnosed before age 40 and health professionals in urban and rural contexts of the Metropolitan Region, we analyze how this polarization operates across multiple dimensions: (1) generational polarization, where age-based protocols dismiss young women's bodily knowledge, producing diagnostic delays and advanced-stage diagnoses; (2) territorial polarization, where rural women face compounded exclusions through distance, resource scarcity, and metropolitan concentration of oncological infrastructure; and (3) public/private polarization, embodying class-based inequalities and structural extraction through mechanisms that transfer resources from the overstretched public system to private providers. From a Global South epistemological standpoint, we theorize these fractures as expressions of epistemic, territorial, and economic injustice rooted in neoliberal restructuring. Yet amid these structural violences, we document emergent solidaristic practices: community-based care webs and collective navigation strategies. These reparative practices from below reveal how more cohesive, democratic healthcare imaginaries are enacted daily by those systematically excluded, offering critical insights into decolonial health futures.