Agency in endometriosis pain communication in English and Spanish


  • Stella Bullo Manchester Metropolitan University
  • Mariana Pascual Pontificia Universidad Católica de Santiago
  • Dalia Magaña University of California, Merced



endometriosis, transitivity, social actors, agency, health communication, pain


This article interrogates the linguistic construction of agency in accounts of endometriosis pain in English and Spanish. Endometriosis is a reproductive condition causing incapacitating pain which is often dismissed or normalised, leading to delayed diagnosis. We take a patient-centred qualitative approach and analyse data gathered from 10 semi-structured interviews with women with endometriosis in British English and Argentine Spanish, using the transitivity and social actor representation frameworks. The findings indicate that the women across the two settings represent pain as an agentive overpowering actor and themselves with varying degrees of decreased agency. However, pain is more closely related to mental representations of the patients’ experiences in Spanish than in English, where it is construed as an actor performing physical actions. The findings of the study have implications for pain communication practices and cross-language healthcare communication and should inform local pain assessment measures.

Author Biographies

Stella Bullo, Manchester Metropolitan University

Stella Bullo is a Senior Lecturer in Linguistics at Manchester Metropolitan University. Her research is in health communication, investigating discourses of women’s health and in particular endometriosis, pain communication and cross-cultural discourses of health.

Mariana Pascual, Pontificia Universidad Católica de Santiago

Mariana Pascual is an Associate Professor in the Language Sciences Department, Pontificia Universidad Católica de Chile. She has conducted research in the language of evaluation in discourse, with a focus on the linguistic construction of social memory and pain. Her research also includes inter-personal relations in academic discourse. 

Dalia Magaña, University of California, Merced

Dalia Magaña is an Assistant Professor of Spanish Linguistics at the University of California, Merced. Her research raises awareness about the role of interpersonal language in improving healthcare communication with Spanish speakers and developing intentional pedagogy for teaching Spanish to serve Latinxs in high-stakes situations such as in healthcare. 


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How to Cite

Bullo, S., Pascual, M., & Magaña, D. (2022). Agency in endometriosis pain communication in English and Spanish. Communication and Medicine, 18(1), 22–36.