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Paper short abstract

Liminal health activism reveals how trans individuals and allies transform institutional exclusion into dispersed practices of knowledge circulation and care, operating across healthcare's edges to enable trans-inclusive primary care beyond formal biomedical channels.

Paper long abstract

This paper develops the concept of liminal health activism to describe how marginalized communities transform exclusion from institutional healthcare into adaptive practices of knowledge making and change. Focusing on trans-inclusive primary care in Israel, the study examines how trans individuals and allies from within the healthcare system navigate asymmetries in medical authority while creating alternative spaces for learning, care, and collaboration. Operating at the edges of formal institutions, liminal health activism captures dispersed and pragmatic forms of engagement that circulate experiential knowledge across bureaucratic, educational, and technological boundaries within healthcare infrastructures.

Drawing on semi structured interviews with 39 healthcare professionals, trans community members, and activists, along with textual analysis and ethnographic observations, the paper traces how informal initiatives performed outside medical curricula facilitate new exchanges about trans health and expertise. These small scale interventions expose both the porousness and resilience of biomedical systems, revealing how dominant epistemologies selectively absorb activist knowledge while retaining core hierarchies of credibility.

By situating these practices within broader debates on knowledge infrastructures and institutional transformation, the paper highlights the contingent and non linear ways in which marginalized patient communities carve out spaces of participation from within healthcare's margins.