The effects of (pseudo-)medical menopause discourse on YouTube

The abundance of online medical misinformation pertaining to the treatment of menopause symptoms can create significant confusion for afflicted individuals seeking answers while browsing the Internet. This study investigates oral online menopause discourse employed by ‘health influencers’ and medical professionals in terms of its pragmatic impact. Two distinct sets of YouTube videos were selected for analysis. The first corpus consists of 20 videos (89,046 words) uploaded between 2010-2022 by individuals promoting natural hormone balancing and compounded Bioidentical Hormone Therapy (cBHT) as a treatment for menopause symptoms. The second dataset includes 16 videos (66,333 words) and was added between 2013-2022 by institutions and medical professionals advocating for Menopausal Hormone Therapy (MHT). To investigate the effects of the discourse, the study focuses on the speakers’ use of subjective mental verb projections and reporting verbs. As engagement resources, these constructions allow for an exploration of the speakers’ dialogistic positioning and commitment to the validity of the shared information. Based on part-of-speech (POS) categories and the Appraisal framework, a contrastive appraisal analysis was conducted on both corpora, examining the system of Engagement and quantifying the appraisals. Further analysis focused on the lexicogrammatical realisations of subjective epistemic and evidential formulations beyond the sentence level, including the speakers’ deployment of attitude and graduation resources. The comprehensive computer-assisted appraisal analysis shows how the interplay of deliberate objectification and affectivity may render online media content more persuasive and increase the likelihood of false information. It shows that health influencers employ a higher number of non-congruent mental verb projections in pronounce moves, in an attempt to align the audience with their own stance, even though the constructions are described as entertain resources in Appraisal theory. In entertain moves, the YouTube creators primarily select metaphorical formulations to influence the viewers’ perception of the shared information, promoting cBHT. The health influencers predominantly attributed the shared information to human sources and hearsay evidence through the amplified use of lower-value reporting verbs and lexical graduation. In contrast, the medical professionals mainly opted for mental verb projections in pronounce moves to share specific views of reality grounded in scientific consensus. As members of the scholarly community, they attributed the communicated knowledge to research evidence, employing reporting verbs that indicated a high commitment to factual information and endorsing sources. The study offers valuable insight into the rhetorical effects of pseudo-medical discourse related to the online debate on appropriate menopause treatment. As a critical discourse analysis, it underscores the need for awareness of the increasing prevalence of medical disinformation in the digital sphere, especially in the light of repeated menopause medication shortages.

All tables and figures are my own.