PCOS Discourses, Symbolic Impacts, and Feminist Rhetorical Disruptions of Institutional Hegemonies. Marissa C. McKinley, Lanham, MD: Lexington Books, 2023. 162 pages, $95.00 hardback, $45.00 ebook.
Publisher’s webpage: https://rowman.com/ISBN/9781666905519/PCOS-Discourses-Symbolic-Impacts-and-Feminist-Rhetorical-Disruptions-of-Institutional-Hegemonies.
Reviewed by Leslie R. Anglesey (she/her), PhD, St. Mary’s College of California
Date posted: April 2025
Recommended citation: Anglesey, Leslie R. (2025) “Book review: PCOS Discourses, Symbolic Impacts, and Feminist Rhetorical Disruptions of Institutional Hegemonies.” Rhetoric of Health & Medicine: Vol. 8: Iss. 3.
Read below or download here.
In PCOS Discourses, Symbolic Impacts, and Feminist Rhetorical Disruptions of Institutional Hegemonies (2023), Marissa C. McKinley takes up an investigation of representations of bodies marked by a diagnosis of Polycystic Ovary Syndrome (commonly referred to as PCOS) in mass media, and how individuals (whether they identify as having PCOS or not) engage in discourse around bodies and people with PCOS.[1] Throughout the book, McKinley utilizes a variety of rhetorical and qualitative methods to demonstrate that, in mass media sites, people with PCOS are afforded little agency in their identity formation and often represent the PCOS body as deviant—even disgusting—because it denies Western notions of feminine beauty standards. However, in virtual health communities, people with PCOS create spaces to resist these restrictions and to enact greater agency, where complex identities and embodied experiences can lead to action-based health recommendations by people with PCOS for the larger PCOS community.
McKinley mobilizes a traditional organization of the book. Chapters 1 through 3 introduce her project and key operationalized terminology, a thorough review of the literature in the field, and a detailed discussion of McKinley’s methods and methodology. She outlines the nexus of multiple scholarly traditions to understand how the PCOS body is rendered and regulated through media representations, including body scholarship (such as Bordo, Herzig, and Rhode), rhetorical inquiry (Burke and Foucault), and discourse theory (by way of van Dijk). To reveal how PCOS is represented in mass media and how agency is framed in both public discourse around mass media and within virtual health communities, McKinley analyzes three rhetorical artifacts. First, McKinley analyzes an episode of TLC’s series Strange Love, which features a woman with PCOS whose hirsutism (excessive facial hair growth) becomes the object of “strange love” between the subject of the episode and her spouse. McKinley’s second rhetorical artifact is a forum about the episode of Strange Love on the People magazine’s website, where people react to how the PCOS subject, Annalissa Hackleman, chooses to allow her facial hair to grow into a beard rather than enact the feminine hairless beauty norm by shaving. Finally, McKinley turns to the virtual health community myPCOSteam.com to document how people with PCOS communicate their experiences with PCOS and support other participants’ journeys toward diagnosis, treatment, and acceptance of living with PCOS. Within these artifacts, McKinley outlines how she selected posts from People magazine’s online forum and the myPCOSteam online forum, highlighting the need to create reasonably sized data sets and to control for researcher bias.
In the second half of the book, chapters 4 through 6, McKinley offers readers a close reading of the Strange Love episode and thematic coding and rhetorical analysis of randomly selected posts from the People.com and myPCOSteam.com forums. These analyses reveal several key findings related to the framing of PCOS bodies in mass media. Strange Love situates interviews with Annalisa Hackleman, and those of her husband, David Hackleman, around a theme McKinley calls “unpacking.” The interviews with Annalisa and David, as well as voiceovers recorded by the show provided background to Annalisa’s facial hair history, grooming practices, and her anticipated grooming plans, such as her consideration of possibly shaving her beard for an upcoming wedding anniversary. McKinley highlights themes of emotions, focusing on Annalisa’s sense of support from her husband, friends, and family. McKinley concludes that Strange Love both enforces the hairless norm and presents alternatives to it. McKinley argues that “privately organized media companies will often employ unique storytelling techniques” such as polarization and simplification “to grow viewership and maximize profits” (p. 78). Throughout Strange Love’s exploitation of the deviance of hirsutism and their validation of Hackleman’s rejection of the hairless norm, TLC and Strange Love enable polarized responses from people with PCOS and general audiences: either they feel affirmed for conforming to the hairless norm or they identify with the alternative Hackleman offers.
McKinley next turns to myPCOSteam.com to understand how people with PCOS engage in various discourse practices within the context of a virtual health community. Building on her previous findings, McKinley seeks to understand how people with PCOS might enact different forms of agency, identity, and existence compared to their portrayals in mass media. McKinley argues that myPCOSteam.com is an example of a virtual health community: a virtual space where people share their illness stories and exchange ideas about suspected or diagnosed health conditions in public or private internet spaces. McKinley’s analysis reveals two dominant themes. First, in myPCOSteam.com, participants engage in “unpacking facets of health,” which highlights moments where users chart their PCOS journey, discuss symptoms, and discuss experiences with providers. The second theme, “taking self-action,” emerges when users solicit health narratives from other participants that can be operationalized in the user’s health advocacy and wellbeing. For McKinley, these themes reveal a significant difference between people with PCOS’ agency in identity formation and discourse practices and the agency afforded to them through mass media. First, they can control the narrative of their bodies, their identities, and their experiences. Second, they can act as a source of support, encouragement, and knowledge, a positionality not afforded through biomedical discourse and institutions.
In the concluding chapter, McKinley synthesizes the previous chapters and restates her research findings. She offers readers recommendations for future research, including key texts on the methods, methodology, and rationales for when McKinley’s research design choices might be appropriate for readers’ future research. The book concludes by returning to McKinley’s experiences with PCOS. In the preface of her book, McKinley delves into her personal experiences with PCOS, highlighting the challenges she faced in navigating the medical system to obtain a diagnosis and manage her symptoms. In the conclusion, she offers vivid descriptions of a new kind of PCOS pain that comes from the physical and mental toll of the writing process. For rhetoric of health and medicine scholars researching health topics that they are personally invested in, McKinley’s reflection on the “fatigue of writing about a personal health topic” provides a sobering insight into the challenges of researching deeply personal subjects (p. 120). McKinley’s conclusion also offers a hopeful perspective on how RHM scholarship can advocate for the wellbeing of women who have been silenced and marginalized by a male-dominated healthcare system.
PCOS Discourses highlights how mass media misrepresents PCOS bodies, giving those with PCOS little control over their identities. Symptoms like weight gain, hirsutism, and cystic acne are routinely depicted as unacceptable deviations from Western feminine beauty standards. In contrast, McKinley explores how people with PCOS create alternative spaces to advocate for themselves and envision new identities, countering the limitations imposed by mass media. The book thoroughly examines rhetorical artifacts and links them to broader media and online health community representations. Further, PCOS Discourses contributes to feminist rhetorical inquiry and the RHM field by combining personal narrative with academic critique. This book underscores the importance of advocacy for individuals with chronic health conditions like PCOS. McKinley’s work excels when integrating personal experiences with academic analysis, as highlighted in her preface where she shares her own journey with PCOS symptoms and diagnosis. There, she makes it clear that PCOS is more than just “a chronic disease characterized by interrelated and overlapping symptoms and problematized by the overproduction of insulin, testosterone, and androgens” (p. 21). She centers her own experiences with PCOS to render it a constellation of chronic embodied experiences rather than a one-dimensional diagnosis that should be controlled and disciplined until people with PCOS’ embodiment becomes submissive to hegemonic values.
McKinley’s goal of health advocacy is infused on every page of PCOS Discourses. Notably, McKinley offers readers an expansive advocacy framework through which they can enact PCOS health advocacy through their research, participation, sharing, and volunteering. McKinley models an ethos of health advocacy both through her research in PCOS Discourses as well as by offering readers a free personal health file that readers can use to advocate for themselves and share with others. As a reader, I was immediately excited by this resource, but, upon navigating to the press’s website, was disappointed to not find the file (this, however, is more likely to be a concern for the publisher, not McKinley). McKinley’s work elevates RHM’s commitment to health advocacy across personal, public, medical, and other spaces, especially since McKinley’s subject is a condition that often eludes diagnosis and treatment despite its pervasiveness. PCOS Discourses includes an appendix that provides a comprehensive advocacy framework for RHM scholars. This appendix outlines various ways to advocate for PCOS, such as through research, participation, sharing, and volunteering. As such, McKinley models an ethos of health advocacy both through her research in PCOS Discourses as well as by offering readers a free personal health file that readers can use to advocate for themselves and share with others.
Readers with various backgrounds and goals will find PCOS Discourses a valuable resource. Graduate students and scholars new to RHM will find McKinley’s clear organization, detailed descriptions of methods useful for starting their own RHM projects. More experienced RHM scholars will benefit from a thoughtful exploration of a health condition that has not yet been extensively researched. Future scholarship on PCOS representation and health advocacy might build on McKinley’s work to create stronger engagement with issues of gender and PCOS. As a reader, I was struck at the many opportunities to consider PCOS alongside other gender identities—be they androgynous, trans, non-binary, queer, or other gender non-conforming identities. PCOS Discourses has the potential to strengthen and extend the dwelling places of RHM scholarship.
[1] ,’ though many members of the PCOS community use the identity-first construction ‘PCOS-er(s).’
Author Bio
Leslie R. Anglesey (she/her/hers) is an assistant professor and program coordinator in the Writing Studies Program at Saint Mary’s College of California. Her research interests focus on accessible composition pedagogy, mentorship, and rhetorics of health and medicine.