A Best Practices Guide to Intersectional Approaches in Psychological Research

The coping strategies of individuals in multiple jeopardy settings: the case of unemployed older women

This research investigates the harmful consequences of discrimination on self-esteem and examines the coping options of individuals belonging to several stigmatized groups (i.e., unemployed older women) within the multiple jeopardy perspective. Our sample comprised 420 individuals selected by age, gender and professional status. We tested whether the positive and negative links between discrimination and psychological distress induced by discrimination, would vary according to the number of disadvantaged categories individuals belong to. An analysis of the mediating role of some coping options was also conducted. Overall, the results support most of our hypotheses and suggest that the assumed impact of perceived discrimination on psychological outcome increase with the cumulation of discriminations. We also found that, among the various coping options used by individuals in our sample, commitment, but not age-group identification, mediated the links between the cumulated discrimination and self-esteem. The discussion addresses issues related to workplace discrimination in light of the multiple jeopardy perspective.

A systematic review of the impact of post-harvest aquatic food processing technology on gender equality and social justice

Post-harvest practices and technologies are key to reducing global aquatic harvest loss. The lives of post-harvest fisheries workers, over half of them women, are deeply affected by these technologies, but their equity and equality outcomes are poorly understood. This systematic review synthesizes evidence of post-harvest aquatic food processing technology outcomes, showing that persistent inequalities in social structure and norms disadvantage women across a range of technologies, both traditional and improved, especially regarding control over resources. We found that improved technologies bring enhanced productivity and possibly income for workers, yet contracts are often precarious due to pre-existing social inequities. While power and control of resources is more unequal in factory settings, it is not necessarily equal in traditional contexts either, despite offering greater flexibility. More rigorous comparative research, including voices of diverse actors, is key to understanding the impacts of different technologies on gender equality and social justice and inform policymaking.

Categorization of continuous covariates and complex regression models-friends or foes in intersectionality research

OBJECTIVES

To reduce health inequities, it is important to identify intersections in characteristics of individuals subject to privilege or disadvantage. Different proposals for that have recently been published. One approach (1) considers models specified with first- and all second-order effects and another (2) the stratification based on multiple covariates; both categorize continuous covariates. A simulation study was conducted in order to review both methods with regard to identification of intersections showing true differences, rate of false-positive results, and generalizability to independent data compared to an established approach (3) of backward variable elimination according to Bayesian information criterion (BE-BIC) combined with splines.

STUDY DESIGN AND SETTING

R software has been used to simulate the covariates age, sex, body mass index, education, and diabetes to examine their association with a continuous frailty score for osteoporosis using multiple linear regression. In setting 1, none of the covariates was associated with the frailty score, that is, only noise is present in the data. In setting 2, the covariates age, sex, and their interaction were associated with the frailty score, such that only females above 55 years formed an intersection associated with an increased frailty score. All approaches were compared under varying sample sizes (N = 200-3000) and signal-to-noise ratios (SNRs, 0.5-4) in 1000 replications. For model evaluation, bootstrap resampling was used. The models were fitted in internal learning data and then used to predict outcomes in the internal validation data. The mean squared error (MSE) was used for comparison and the frequency of false-positive findings calculated.

RESULTS

In setting 1, approaches 1 and 2 generated spurious effects in more than 90% of simulations across all sample sizes. In a smaller sample size, approach 3 (BE-BIC) selected 36.5% of the correct model, in larger sample size in 89.8% and always had a lower number of spurious effects. MSE in independent data was generally higher for approaches 1 and 2 when compared to 3. In setting 2, approach 1 selected most frequently the correct interaction but frequently showed spurious effects (>75%). Across all sample sizes and SNR, approach 3 generated least often spurious results and had lowest MSE in independent data.

CONCLUSION

Categorization of continuous covariates is detrimental to studies on intersectionality. Due to high and unrestricted model complexity, such approaches are prone to spurious effects and often lack interpretability. Approach 3 (BE-BIC) is considerably more robust against spurious findings, showed better generalizability to independent data, and can be used with most statistical software. For intersectionality research, we consider it most important to describe relevant differences between intersections and to avoid nonreproducible and spurious findings.

Dress is a Fundamental Component of Person Perception

ACADEMIC ABSTRACT

Clothing, hairstyle, makeup, and accessories influence first impressions. However, target dress is notably absent from current theories and models of person perception. We discuss three reasons for this minimal attention to dress in person perception: high theoretical complexity, incompatibility with traditional methodology, and underappreciation by the groups who have historically guided research in person perception. We propose a working model of person perception that incorporates target dress alongside target face, target body, context, and perceiver characteristics. Then, we identify four types of inferences for which perceivers rely on target dress: social categories, cognitive states, status, and aesthetics. For each of these, we review relevant work in social cognition, integrate this work with existing dress research, and propose future directions. Finally, we identify and offer solutions to the theoretical and methodological challenges accompanying the psychological study of dress.

PUBLIC ABSTRACT

Why is it that people often agonize over what to wear for a job interview, a first date, or a party? The answer is simple: They understand that others' first impressions of them rely on their clothing, hairstyle, makeup, and accessories. Many people might be surprised, then, to learn that psychologists' theories about how people form first impressions of others have little to say about how people dress. This is true in part because the meaning of clothing is so complex and culturally dependent. We propose a working model of first impressions that identifies four types of information that people infer from dress: people's social identities, mental states, status, and aesthetic tastes. For each of these, we review existing research on clothing, integrate this research with related work from social psychology more broadly, and propose future directions for research.

Utilizing Latent Class Analysis to Assess the Association of Intersectional Stigma on Mental Health Outcomes Among Young Adult Black, Indigenous, and Sexual Minority Women of Color

Purpose: Discrimination has detrimental effects on mental health, particularly among Black, Indigenous, and people of color who are also sexual minority women (BIPOC SMW); however, measurement of multiple intersecting forms of discrimination (e.g., race, gender, and sexual identity discrimination among BIPOC SMW) poses methodological challenges. This analysis uses latent class analysis (LCA) to examine the influences of discrimination on mental health in a convenience sample of BIPOC SMW. Methods: Online survey data from BIPOC SMW aged 18-29 years (n = 324) were used to estimate latent classes for discrimination type (race, gender, and sexual identity). Data for this study were collected from July to October 2018. Adjusted linear regressions examined the influences of discrimination profiles on perceived stress and depressive symptoms. Results: Utilizing LCA, the following four classes emerged: (1) low discrimination; (2) mid-level discrimination; (3) high racial, medium gender, and low sexual identity discrimination; (4) high discrimination. Classes 3 and 4 were positively associated with perceived stress and depressive symptoms relative to Class 1 in adjusted models. Conclusion: This analysis highlights the importance of intersectionality and the adverse impact of multiple forms of discrimination on mental health outcomes for BIPOC SMW. Respondents reporting higher levels of racial or multiple forms of discrimination had poorer mental health outcomes. LCA is a promising analytical tool for investigating intersectional stigma and discrimination. There is an urgent need to develop tailored, culturally appropriate intersectional mental health interventions to address the multiple identities and oppressions faced by BIPOC SMW.

Intersectional Person Perception: A Scoping Review of Studies Investigating the Roles of Category Relationships and Cognitive Processes

This review considered experimental studies that used an intersectional framework in order to examine (1) how perceived relationship between the categories in a given intersection impacts the perception of its members and (2) how intersectional person perception has been studied through different cognitive processes. A systematic search in databases identified 5,393 records, and a screening processes resulted in 43 articles reporting 110 studies. The way intersectional targets were cognitively processed depended on contextual factors as well as on the perceived relationship between intersected identities (e.g., perceived [in-]congruence between identities). Less prototypical intersectional targets (e.g., Black gay men) sometimes experienced intersectional invisibility, facing both relative advantages (e.g., being less associated with certain negative stereotypes), and disadvantages (e.g., being overlooked, less recognized) compared to more prototypical members of their constituent ingroups (e.g., Black people, gay men). Future work should incorporate observed exceptions to these patterns and expand the cultural context of analysis.

Exploring the Application of Intersectionality as a Path toward Equity in Perinatal Health: A Scoping Review

OBJECTIVE

To conduct a scoping review to determine how past studies have applied the theory of intersectionality, a critical feminist research paradigm, to understand the physical health and mental health outcomes of perinatal people as a step toward addressing maternal health disparities and injustice. The study includes a review of existing research on maternal physical and mental health outcomes, presents the strengths and limitations of existing studies, and provides recommendations on best practices in applying intersectionality in research to address systemic issues and improve outcomes for the perinatal population.

METHODS

We conducted an extensive literature search across four search engines, yielding 28 publications using the intersectionality framework that focused on the outcomes of perinatal people, with a total sample of 9,856,042 participants. We examined how these studies applied intersectionality and evaluated them based on three areas: conceptualization, research method, and interpretation/findings.

RESULTS

Our findings indicate that maternal health researchers have provided good descriptions of the interaction of systemic inequalities and have used analysis that allows for the examination of interlocking and mutually reinforcing social positions or systems. We find that improvement is needed in the areas of conceptualization, reflexivity, and understanding of power structure. Recommendations are provided in the form of a checklist to guide future research toward an impactful approach to addressing perinatal health disparities.

RELEVANCE

Our scoping review has implications for improving applied health research to address perinatal health disparities, mortality, and morbidity. Recommendations are given along with references to other tools, and a guidance checklist is provided to support scholars in creating an impactful approach to applying intersectionality in the goal of addressing maternal health disparities.

Disordered eating symptoms as a function of perceived weight status and race: An intersectional examination

Disordered eating (DE) exhibited by individuals with intersecting marginalized identities may be less likely to be perceived as pathological compared to DE exhibited by individuals with non-marginalized identities. The present experiment tested the intersectional impact of weight status and race stimuli on responses to DE in a college sample. Undergraduate students (N = 193, M_age = 18.57, SD = 1.88, 71 % female) read a fictional account from a female target with DE who was described as "underweight," "average weight," or "overweight," and "White" or "Black." Participants completed an in-lab survey assessing detection of and responses to DE. Three 2 (race: Black, White) x 3 (weight status: underweight, average weight, overweight) ANCOVAs revealed a main effect of weight status. DE was more likely to be detected in "underweight" than "average" and "overweight" targets (p < .001). Participants encouraged weight loss for "average" and "overweight" targets compared to "underweight" targets (p < .001) and encouraged weight restoration for "underweight" targets compared to "average weight" and "overweight" targets (p < .001). No significant effects for target race or interaction between weight status and race emerged. These findings underscore the salience of weight status in shaping perceptions of DE.

LGBTQI cancer patients' quality of life and distress: A comparison by gender, sexuality, age, cancer type and geographical remoteness

Background

There is growing acknowledgement of the psycho-social vulnerability of lesbian, gay, bisexual, transgender, queer and/or intersex (LGBTQI) people with cancer. The majority of research to date has focused on cisgender adults with breast or prostate cancer.

Study Aim

This study examined psycho-social factors associated with distress and quality of life for LGBTQI cancer patients and survivors, across a range of sexualities and gender identities, intersex status, tumor types, ages and urban/rural/remote location using an intersectional theoretical framework.

Method

430 LGBTQI people with cancer completed an online survey, measuring distress, quality of life (QOL), and a range of psycho-social variables. Participants included 216 (50.2%) cisgender women, 145 (33.7%) cisgender men, and 63 (14.7%) transgender and gender diverse (TGD) people. Thirty-one (7.2%) participants reported intersex variation and 90 (20%) were adolescents or young adults (AYA), aged 15-39. The majority lived in urban areas (54.4%) and identified as lesbian, gay or bisexual (73.7%), with 10.9% identifying as bisexual, and 10.5% as queer, including reproductive (32.4%) and non-reproductive (67.6%) cancers.

Results

Forty-one percent of participants reported high or very high distress levels, 3-6 times higher than previous non-LGBTQI cancer studies. Higher rates of distress and lower QOL were identified in TGD compared to cisgender people, AYAs compared to older people, those who identify as bisexual or queer, compared to those who identify as lesbian, gay or homosexual, and those who live in rural or regional areas, compared to urban areas. Elevated distress and lower QOL was associated with greater minority stress (discrimination in life and in cancer care, discomfort being LGBTQI, lower outness) and lower social support, in these subgroups. There were no differences between reproductive and non-reproductive cancers. For the whole sample, distress and poor QOL were associated with physical and sexual concerns, the impact of cancer on gender and LGBTQI identities, minority stress, and lack of social support.

Conclusion

LGBTQI people with cancer are at high risk of distress and impaired QOL. Research and oncology healthcare practice needs to recognize the diversity of LGBTQI communities, and the ways in which minority stress and lack of social support may affect wellbeing.

An Examination of the Psychology of Working Theory with Employed Asian American Women

Guided by the psychology of working theory (PWT) and an intersectional approach, the present study investigated how social class and gendered racial microaggression were associated with decent work through experiences of work volition in a sample of 262 self-identified employed Asian American women. Overall, most of the hypothesized direct paths were significant, with social class positively relating to work volition, gendered racial microaggression negatively related to decent work, and work volition positively related to decent work. Support for indirect effects was mixed. Work volition was found to significantly mediate the relation between social class to decent work, but not significantly mediate between gendered racial microaggression to decent work. Overall, results suggest the need for further investigation and refinement of the PWT to gain a better understanding of Asian American women's experience regarding accessibility to decent work. Practical implications and future research directions are discussed.

Violence perpetration prevalence among Colorado (United States) high school students across gender, racial/ethnic, and sexual identities

Adolescent violence, including sexual violence, homophobic name-calling, and teen dating violence, are public health problems that cause harm to many adolescents in the United States. Although research on the perpetration of these forms of adolescent violence has increased in recent years, little is known about perpetration rates across gender, race/ethnicity, and sexual orientation. To address this gap, the current study descriptively examined perpetration rates between and across different identities, including self-identified race/ethnicity, sexual identity, and gender identity. In Fall 2017, 9th - 11th grade students (N = 4782) at 20 high schools in Colorado (United States) completed a survey that assessed demographics (e.g., race/ethnicity, sexual identity, and gender identity) and various forms of violence perpetration. Compared to female adolescents, male adolescents reported significantly higher perpetration rates for: any sexual violence (27% vs. 17%); sexual harassment (26% vs. 15%); unwanted sexual contact (8% vs. 4%); and homophobic name-calling (61% vs. 38%). Differences in perpetration rates were also observed among various racial/ethnic, sexual, and gender minority students compared to non-minority students. This emphasizes a need for more research on how minority stress that results from the dynamics of intersecting identities and societal systems of power-including racism, sexism, homophobia, and transphobia-contributes to violence perpetration. Evidence-based violence prevention approaches, particularly strategies targeted at changing social norms about violence, gender, and sexuality, need to be tailored and evaluated for students with diverse cultural and social identities to ensure safe school climates for all students.

"Surviving Discrimination by Pulling Together": LGBTQI Cancer Patient and Carer Experiences of Minority Stress and Social Support

Background

Lesbian, gay, bisexual, transgender, queer and/or intersex (LGBTQI) people with cancer and their carers report poorer psychological outcomes than the general non-LGBTQI cancer population. There is growing acknowledgement that these health inequities can be explained by minority stress, which can be buffered by social support.

Study Aim

To examine subjective experiences of minority stress and social support for LGBTQI people with cancer and their carers, drawing on qualitative findings from the Out with Cancer study.

Method

An online survey including open ended items was completed by 430 LGBTQI cancer patients and 132 partners and other carers, representing a range of tumor types, sexual and gender identities, age and intersex status. A sub-sample of 104 patients and 31 carers completed an interview, with a follow-up photovoice activity and second interview completed by 45 patients and 10 carers. Data was thematically analysed using an intersectional theoretical framework.

Results

Historical and present-day experiences of discrimination, violence, family rejection and exclusion created a legacy of distress and fear. This impacted on trust of healthcare professionals and contributed to distress and unmet needs in cancer survivorship and care. Social support, often provided by partners and other chosen family, including intimate partners and other LGBTQI people, buffered the negative impacts of minority stress, helping LGBTQI patients deal with cancer. However, some participants lacked support due to not having a partner, rejection from family of origin and lack of support within LGBTQI communities, increasing vulnerability to poor psychological wellbeing. Despite the chronic, cumulative impacts of minority stress, LGBTQI patients and carers were not passive recipients of discriminatory and exclusion in cancer care, demonstrating agency and resistance through collective action and advocacy.

Conclusion

LGBTQI people have unique socio-political histories and present-day psycho-social experiences that contribute to distress during cancer. Social support serves to buffer and ameliorate this distress. There is a need for cancer healthcare professionals and support services to be aware of and responsive to these potential vulnerabilities, including the intersectional differences in experiences of minority stress and social support. There is also a need for recognition and facilitation of social support among LGBTQI people with cancer and their carers.

Missing perspective: Marginalized groups in the social psychological study of social disparities

Drawing on interdisciplinary, feminist insights, we encourage social psychologists to embrace the active participation of marginalized groups in social disparities research. We explain (1) how the absence of marginalized groups' perspectives in research presents a serious challenge to understanding intergroup dynamics and concomitant disparities, and (2) how their inclusion could assuage some of social psychology's "fatal flaws."

"It's impossible for them to understand me 'cause I haven't said a word": how women baby boomers shape social participation spaces in old age

The baby boom generation's retirement will change the conceptualization of participation in old age due to their particularities from having experienced a specific socio-historical context. Likewise, the feminization of old age underscores the importance of developing research from the perspectives of gender and critical feminist gerontology. The objective of the present study is to identify and analyze women baby-boomers' conceptualizations about social participation regarding the configuration of social participation spaces. Five discussion groups and five individual interviews were conducted with 56 baby boomers residing in Andalusia (Spain). Here we focus on a separate analysis of the 27 women participating in these settings. The results were organized around four factors: desirability of social participation spaces, adaptation of spaces to preferences, facilitators and barriers in the adaptation of spaces, and the importance of agency in the social participation spaces. Through the analyzed discourse it was observed that participants in this study gave special importance to promoting spaces that involve social contribution, self-management, and self-determination of the spaces, adaptation of access, as well as exercising agency.

Bridging Across the Digital Divide: Identifying the Extent to Which LGBTIQ+ Health Service Websites Engage Culturally and Linguistically Diverse (CALD) Users

eHealth is promoted as a viable platform for health service provision, as it can deliver relevant information instantaneously and anonymously, whilst circumventing geographical and discriminatory barriers that can occur in face-to-face settings. Lesbian, gay, bisexual, transgender, intersex and queer (LGBTIQ+) communities stand to benefit greatly from eHealth services, however, the way in which culturally and linguistically diverse (CALD) LGBTIQ+ users are included within eHealth service provision is currently unknown. The current study observed the way in which Australian LGBTIQ+ health service websites are inclusive of CALD users. Quantitative content analysis was performed on 19 Australian LGBTIQ+ health service websites, with a focus on translation of services and materials, English and digital literacy, and CALD specific resources. Results showed limited translated information across all websites, an absence of translation tools embedded in the home page, as well as moderate to high levels of digital and English literacy required, and largely absent CALD specific resources. These results suggest that Australian LGBTIQ+ health service websites are not currently meeting the unique needs of their CALD constituents. Increased availability of translation services, navigation tools, and CALD LGBTIQ+ stakeholder inclusion during website development is recommended to ensure more equitable access for CALD LGBTIQ+ communities.

A Comparison of Health-Related Quality of Life Among Transgender Adults in the United States

Few studies exist that examine within-group differences of the transgender population. This paper aims to assess differences in sociodemographic characteristics and health-related quality of life (HRQoL) among transgender men (TM), transgender women (TW), and transgender gender nonconforming (TGNC) individuals in the United States. Data were pooled from the 2014-2017 Behavioral Risk Factor Surveillance System. Chi-square tests and weighted multivariable logistic regression models investigated differences in HRQoL by gender identity and separately identified predictors of HRQoL in these groups. Overall, TGNC individuals self-reported worse general health than TW or TM. TW and TGNC individuals who also identified as lesbian, gay, or bisexual (LGB) had higher odds of reporting frequent mental distress compared to their heterosexual counterparts. Race/ethnicity, education, and employment also emerged as predictors of HRQoL. Findings support the need to disaggregate these subpopulations of transgender individuals to address the unique needs of each subgroup.

Women, race and place in US Agriculture

Research on women in U.S. agriculture highlights how, despite real challenges, women have made and continue to make spaces for themselves in this male-dominated profession. We argue that, partly due to data accessibility limitations, this work has tended to use white women's experiences in agriculture as universal. Analyzing micro-data from the 2017 Census of Agriculture, this paper offers descriptive statistics about women and race in U.S. agriculture. We examine numerous characteristics of U.S. farms, including their spatial distribution, the average number of acres farmed, predominant crop types, and other characteristics to describe how white, Black, Indigenous, and Pacific Islander/Asian women farmers are faring. Our findings suggest significant differences in women's farms by race. We argue that these are related to the history of forced and voluntary migration within the U.S. Our results indicate that understanding women's experiences in farming requires understanding the impact of race and these broader historical patterns. Finally, because of these differences across races, we suggest that supporting "women in agriculture" may require tailored responses from agricultural policy and programming that addresses unique needs in specific communities.

Humanizing racialization: Social psychology in a time of unexpected transformational conjunctions

The unexpected transformations produced by the conjunction of COVID-19, the murder of George Floyd and the resurgence of Black Lives Matter highlight the importance of social psychological understandings and the need for a step change in theorization of the social. This paper focuses on racialization. It considers issues that social psychology needs to address in order to reduce inequalities and promote social justice. It draws on theoretical resources of intersectionality and hauntology to illuminate the ways in which social psychological research frequently makes black people visible in ways that exclude them from normative constructions. The final main part of the paper presents an analysis of an interview with the racing driver Lewis Hamilton to illustrate possible ways of humanizing racialization by giving recognition to the multiplicity and historical location of racialized positioning. The paper argues that, while social psychology has made vital contributions to the understanding of group processes and of racisms, there remains a need to humanize racialization by conducting holistic analyses of black people's (and others') intersectional identities.

Socioeconomic Classes among Oldest-Old Women in South Korea: A Latent Class Analysis

Oldest-old women are known to live at the intersection of multiple socioeconomic disadvantages in South Korean society. This study classified oldest-old Korean women into several socioeconomically homogeneous classes based on various socioeconomic status (SES) risks and compared health characteristics among the identified classes. This cross-sectional study utilized the 2019 Korean Community Health Survey, including data from 11,053 women (≥80 years). Latent class analysis determined the number of underlying socioeconomic classes based on nine selected SES variables. Four distinct socioeconomic classes were identified: “Urban, living alone, recipient of NBLSS, moderate education, leisure activity” (Class 1), “Rural, traditional house, living with others, not financially deprived, low education, employed” (Class 2), “Urban, living with family, financially affluent, not employed, no barriers to healthcare” (Class 3), “Rural, traditional house, living alone, financially deprived, uneducated, employed, barriers to healthcare” (Class 4). Depressive symptoms, subjective stress, and the prevalence of sleep disorder and diabetes were higher in Class 1 compared to other classes. Health-related quality of life, perceived health, and self-rated oral health were the poorest in Class 4. Class 3 reported the best health status. Understanding the intersecting SES risk factors in this group can aid in developing targeted interventions.

How Adolescents, Mothers, and Fathers Qualitatively Describe Their Experiences of Co-Occurrent Problems: Intimate Partner Violence, Mental Health, and Substance Use

This qualitative study examines the perceptions of mothers, fathers, and adolescents on the relations they see between intimate partner violence, mental health and substances use parental problems that co-occur in their family, and the mothers' and fathers' associated parenting challenges. The sample was composed of 43 people (15 mothers, 16 fathers, and 12 adolescents) who were directly affected by the co-occurrence of intimate partner violence and mental health or substances use parental problems. The participants were recruited with the collaboration of public and community organizations in the Province of Québec (Canada). The data were collected through semi-structured interviews and combined with a table detailing the specific problems identified by the participants. A thematic content analysis method was employed to do the coding, and a summary of the results was returned to some participants who agreed to collaborate with the validation of the results. The analysis revealed numerous and diverse relations between the interviewees' co-occurring problems, but two principal patterns emerged. The first one was chiefly observed in the comments made by mothers and adolescents who saw the co-occurring problems as being the consequence of the intimate partner violence on the mother. The second pattern was largely observed in the fathers' comments, who explained that the substance use problems came before the intimate partner violence and acted as an aggravating factor. The co-occurrence of intimate partner violence with other parental problems strongly affected the mothers' and fathers' parenting, making it more difficult to meet the children's needs. Considering the complexity and diversity of the experiences and needs of the mothers, fathers, and children in co-occurring situations, future studies should evaluate the services provided to these families and the coordination between the different concerned organizations.

FOREST protocol: a qualitative study exploring health and sexuality of transmasculine individuals in France

INTRODUCTION

While current research on sexuality and health often explores sexual behaviours among heterosexual and gay cisgender individuals, little is known about the sexualities of transgender people, especially transmasculine people. When data are available, sexual health is often reduced to risk exposure, not considering in detail social context and determinants that could contribute to a more comprehensive approach, such as general health, class, race, exposure to violence or social representations. Recognising this gap, identified in both national (French) and international scientific literature, this study aims to explore the sexual health of transmasculine people, employing an intersectional approach and considering both positive and negative health determinants.

METHODS

This 2-year research based in the disciplinary field of social psychology, with a gender perspective, and will apply qualitative methods. We adopt a community-based research approach, integrating one university and one community-based organisation in the coordination of the study. In a triangulation perspective, two rounds of semistructured interviews will be performed with key informants (medical practitioners, community-based support services workers, etc) and with people self-identifying as transmasculine. Focus groups will complement data collection.

ETHICS AND DISSEMINATION

FOREST protocol was approved by the Comité d'Évaluation Éthique (CEEI) de l'Institut National de la Santé Et de la Recherche Médicale (CEEI/International Review Board 00003888). The research adopts the principles of open science, and findings will be published assuring participants' confidentiality. Informative flyers and videos will be elaborated to communicate study findings to participants, stakeholders and the transcommunities at large, and data will be stored in lasting archives.

Sexual Orientation Identity Development Milestones Among Lesbian, Gay, Bisexual, and Queer People: A Systematic Review and Meta-Analysis

This paper is a systematic review and meta-analysis on sexual orientation identity development milestones among people who are lesbian, gay, bisexual, or another sexual minority identity (LGB+). Common milestones measured in the 30 studies reviewed were becoming aware of queer attractions, questioning one's sexual orientation, self-identifying as LGB+, coming out to others, engaging in sexual activity, and initiating a romantic relationship. Milestones occurred in different sequences, although attraction was almost always first, often followed by self-identification and/or sexual activity; coming out and initiating a romantic relationship often followed these milestones. Meta-analysis results showed that the mean effect sizes and 95% confidence intervals varied by milestone: attraction [M _age=12.7 (10.1, 15.3)], questioning one's orientation [M _age=13.2 [12.8, 13.6]), self-identifying [M _age=17.8 (11.6, 24.0)], sexual activity [M _age=18.1 (17.6, 18.6)], coming out [M _age=19.6 (17.2, 22.0)], and romantic relationship [M _age=20.9 (13.2, 28.6)]. Nonetheless, results also showed substantial heterogeneity in the mean effect sizes. Additional meta-analyses showed that milestone timing varied by sex, sexual orientation, race/ethnicity, and birth cohort. Although patterns were found in LGB+ identity development, there was considerable diversity in milestone trajectories.

Reflections on Neurofeminism and Intersectionality Using Insights From Psychology

Intersectionality contends that sex/gender is constituted of and with other social categories, and that the social structures giving rise to inequality should be addressed in research. This is a powerful and important perspective from which to investigate the processes and consequences of social group memberships, one which has been overlooked by most neuroscientific research. In particular, neurofeminism, a field of critical neuroscience that challenges neuroscientific assumptions, methods and interpretations of data that reinforce sexism, has ignored intersectionality to date. In contrast, research in the field of psychology has been engaging with intersectionality for more than a decade. In reflecting on how intersectionality has advanced feminist research in psychology, this paper provides a critical analysis of potential novel research avenues for neurofeminism. We identify three main research themes guided by intersectionality. The first theme involves research centered on understanding the socio-structural causes of health inequalities experienced by individuals with intersecting marginalized social identities; the second concerns research addressing the psychological processing of social group memberships that underlies the enactment of systemic discriminatory practices; and the third theme comprises intersectionality research that aims to challenge psychological epistemology. Drawing parallels between the fields of psychology and neuroscience, we explore the potential benefits and risks of advancing an intersectionality-informed neurofeminism.

Population heterogeneity in associations between hormonal contraception and antidepressant use in Sweden: a prospective cohort study applying intersectional multilevel analysis of individual heterogeneity and discriminatory accuracy (MAIHDA)

OBJECTIVES

From a reproductive justice framework, we aimed to investigate how a possible association between hormonal contraceptive (HC) and antidepressants use (as a proxy for depression) is distributed across intersectional strata in the population. We aimed to visualise how intersecting power dynamics may operate in combination with HC use to increase or decrease subsequent use of antidepressants. Our main hypothesis was that the previously observed association between HC and antidepressants use would vary between strata, being more pronounced in more oppressed intersectional contexts. For this purpose, we applied an intersectional multilevel analysis of individual heterogeneity and discriminatory accuracy approach.

DESIGN

Observational prospective cohort study using record linkage of national Swedish registers.

SETTING

The population of Sweden.

PARTICIPANTS

All 915 954 women aged 12-30 residing in Sweden 2010, without a recent pregnancy and alive during the individual 1-year follow-up.

PRIMARY OUTCOME MEASURE

Use of any antidepressant, meaning being dispensed at least one antidepressant (ATC: N06A) during follow-up.

RESULTS

Previously mentally healthy HC users had an OR of 1.79 for use of antidepressants compared with non-users, whereas this number was 1.28 for women with previous mental health issues. The highest antidepressant use were uniformly found in strata with previous mental health issues, with highest usage in women aged 24-30 with no immigrant background, low income and HC use (51.4%). The largest difference in antidepressant use between HC users and non-users was found in teenagers, and in adult women of immigrant background with low income. Of the total individual variance in the latent propensity of using antidepressant 9.01% (healthy) and 8.16% (with previous mental health issues) was found at the intersectional stratum level.

CONCLUSIONS

Our study suggests teenagers and women with immigrant background and low income could be more sensitive to mood effects of HC, a heterogeneity important to consider moving forward.

Gender affirmation and social exclusion amongst trans women of color in Australia

INTRODUCTION

Transgender (trans) women of color navigate the intersected identity frames of gender, race, social class and sexuality, whilst facing multiple layers of stigma, discrimination and violence during and following gender affirmation. However, little is known about the ways in which trans women of color negotiate gender affirmation, in the context of the risk of social exclusion and violence.

AIM

This article discusses the experience and construction of gender transitioning and gender affirmation for trans women of color living in Australia, associated with the risk of social exclusion or violence.

METHOD

In-depth interviews and photovoice were conducted with 31 trans women of color, analyzed through theoretical thematic analysis informed by intersectionality theory.

RESULTS

The following themes were identifed: 1) 'Gender affirmation: A bittersweet experience', with three subthemes: 'Self-empowerment is tempered by family rejection', 'Migration facilitates gender affirmation' and 'Gender affirmation and social support'; 2) 'Being a trans woman of color', subthemes: 'Bodily agency and passing', 'Femininity as pleasure and cultural self-expression', and 'Resisting archetypal White hetero-femininity'; 3) 'Hormones, surgical intervention and navigating the health system'.

CONCLUSION

Gender transitioning and gender affirmation involved the intersection of gender, cultural, social class and sexual identities, accomplished through personal agency and with the support of significant others. To ensure that policy and support services meet the needs of trans women of color, it is critical that the voices of such multiply-marginalized women are at the center of leadership, program and policy development.

Bringing an Intersectional Lens to “Open” Science: An Analysis of Representation in the Reproducibility Project

Feminist psychologists have called for researchers to consider the social and historical context and the multidimensionality of participants in research studies. The Reproducibility Project documents the degree to which the findings from mainstream psychological studies are reproduced. Drawing on intersectionality theory, we question the value of reproducing findings while ignoring who is represented, intersecting social and group identities, sociohistorical context, and the power and privilege that likely influence participants’ responses in psychology experiments. To critically examine the Reproducibility Project in psychology, we analyzed the 100 replication reports produced between 2011 and 2014 (Open Science Collaboration, 2015). We developed an intersectional analytic framework to investigate (a) representation, (b) whether demographic and identity factors were considered through a multidimensional or intersectional lens, (c) explanations of non-replication, and (d) whether socio-cultural context was considered. Results show that reports predominantly include WEIRD samples (people from Western, educated, industrialized, rich, and democratic countries). Context and identity were rarely considered, even when study design relied on these factors, and intersectional identities and structures (considering power, structural issues, discrimination, and historical context) were absent from nearly all reports. Online slides for instructors who want to use this article for teaching are available on PWQ's website at http://journals.sagepub.com/doi/suppl/10.1177/03616843211035678

Bridging Feminist Psychology and Open Science: Feminist Tools and Shared Values Inform Best Practices for Science Reform

Feminist researchers have long embraced the challenging, dismantling, and reimagining of psychology, though their contributions to transforming psychological science remain largely overlooked in the mainstream open science movement. In this article, we reconcile feminist psychology and open science. We propose that feminist theory can be leveraged to address central questions of the open science movement, and the potential for methodological synergy is promising. We signal the availability of feminist scholarship that can augment aspects of open science discourse. We also review the most compelling strategies for open science that can be harnessed by academic feminist psychologists. Drawing upon best practices in feminist psychology and open science, we address the following: generalizability (what are the contextual boundaries of results?), representation (who is included in research?), reflexivity (how can researchers reflect on who they are?), collaboration (are collaborative goals met within feminist psychology?), and dissemination (how should we give science away?). Throughout each section, we recommend using feminist tools when engaging with open science, and we recommend some open science practices for conducting research with feminist goals.

Intersectionality in quantitative research: A systematic review of its emergence and applications of theory and methods

BACKGROUND

Intersectionality is a theoretical framework rooted in the premise that human experience is jointly shaped by multiple social positions (e.g. race, gender), and cannot be adequately understood by considering social positions independently. Used widely in qualitative studies, its uptake in quantitative research has been more recent.

OBJECTIVES

To characterize quantitative research applications of intersectionality from 1989 to mid-2020, to evaluate basic integration of theoretical frameworks, and to identify innovative methods that could be applied to health research.

METHODS

Adhering to PRISMA guidelines, we conducted a systematic review of peer-reviewed articles indexed within Scopus, Medline, ProQuest Political Science and Public Administration, and PsycINFO. Original English-language quantitative or mixed-methods research or methods papers that explicitly applied intersectionality theoretical frameworks were included. Experimental studies on perception/stereotyping and measures development or validation studies were excluded. We extracted data related to publication, study design, quantitative methods, and application of intersectionality.

RESULTS

707 articles (671 applied studies, 25 methods-only papers, 11 methods plus application) met inclusion criteria. Articles were published in journals across a range of disciplines, most commonly psychology, sociology, and medical/life sciences; 40.8% studied a health-related outcome. Results supported concerns among intersectionality scholars that core theoretical tenets are often lost or misinterpreted in quantitative research; about one in four applied articles (26.9%) failed to define intersectionality, while one in six (17.5%) included intersectional position components not reflective of social power. Quantitative methods were simplistic (most often regression with interactions, cross-classified variables, or stratification) and were often misapplied or misinterpreted. Several novel methods were identified.

CONCLUSIONS

Intersectionality is frequently misunderstood when bridging theory into quantitative methodology. Further work is required to (1) ensure researchers understand key features that define quantitative intersectionality analyses, (2) improve reporting practices for intersectional analyses, and (3) develop and adapt quantitative methods.

Intersecting internalized stigmas and HIV self-care among men who have sex with men and who use substances

RATIONALE

Men who have sex with men (MSM) are disproportionately affected by HIV, substance use, and stigma related to co-existing or intersecting identities that are stigmatized or devalued by society (e.g., being a sexual minority male, a person living with HIV, or a person who uses substances). Evidence indicates that when stigma is internalized it may act as a barrier to engagement in self-care behaviors.

OBJECTIVE

Gaining a better understanding of how intersecting internalized stigmas affect HIV self-care among MSM who use substances.

METHODS

To investigate these relationships, we conducted semi-structured qualitative interviews until we reached thematic saturation (n = 33) with HIV + MSM who use substances and were sub-optimally engaged in HIV care. Interviews inquired about identity, internalized stigmas, substance use, HIV self-care behaviors, and interrelationships between concepts.

RESULTS

Our sample was 61% African American and 76% reported annual incomes of ≤$20,000. Approximately half of the participants explicitly described how intersecting internalized stigmas impacted their sense of self and their behavior. The overwhelming majority conveyed that internalized stigma related to substance use was the most burdensome and was considered a barrier to HIV self-care behaviors. Participants also described internalized stigmas related to HIV and sexual orientation, as well as race, effeminateness, poverty, and housing instability, which together impacted their psychological wellbeing and HIV self-care.

CONCLUSIONS

Our results indicate a need for clinicians to consider and address intersecting internalized stigmas, particularly internalized stigma related to substance use, to both reduce substance use and improve HIV self-care among MSM who use substances and are sub-optimally engaged in HIV care.

Intersectionality on the go: The diffusion of Black feminist knowledge across disciplinary and geographical borders

Kimberlé Crenshaw coined the term "intersectionality" in 1989 as a critique of feminist and critical race scholarship's neglect of-respectively-race and gender. Since then, the concept has been interpreted and reinterpreted to appeal to new disciplinary, geographical, and sociocultural audiences, generating heated debates over its appropriation and continued political significance. Drawing on all 3,807 publications in Scopus that contain the word "intersectionality" in the title, abstract, or keywords, we map the spread of intersectionality in academia through its citations. Network analysis reveals the contours of its diffusion among the 6,098 scholars in our data set, while automated text analysis, manual coding, and the close reading of publications reveal how the application and interpretation of intersectional thinking has evolved over time and space. We find that the diffusion network exhibits communities that are not well demarcated by either discipline or geography. Communities form around one or a few highly referenced scholars who introduce intersectionality to new audiences while reinterpreting it in a way that speaks to their research interests. By examining the microscopic interactions of publications and citations, our complex systems approach is able to identify the macroscopic patterns of a controversial concept's diffusion.

Favorable Evaluations of Black and White Women's Workplace Anger During the Era of #MeToo

Researchers investigating gender and anger have consistently found that White women, but not White men, are evaluated unfavorably when experiencing anger in the workplace. Our project originally aimed to extend findings on White women's, Black women's, and White men's workplace anger by examining whether evaluations are exacerbated or buffered by invalidating or affirming comments from others. In stark contrast to previous research on gender stereotyping and anger evaluations, however, results across four studies (N = 1,095) showed that both Black and White women portrayed as experiencing anger in the workplace were evaluated more favorably than White men doing so. After Study 1's initial failure to conceptually replicate, we investigated whether perceivers' evaluations of women's workplace anger could have been affected by the contemporaneous cultural event of #MeToo. Supporting this possibility, we found evaluations were moderated by news engagement and beliefs that workplace opportunities are gendered. Additionally, we found invalidating comments rarely affected evaluations of a protagonist yet affirming comments tended to favorably affect evaluations. Overall, findings suggest the need for psychologists to consider the temporary, or perhaps lasting, effects of cultural events on research outcomes.

Intersectionality and Smoking Cessation: Exploring Various Approaches for Understanding Health Inequities

OBJECTIVE

Many marginalized groups smoke at higher rates and have greater difficulty quitting than less marginalized groups. Most research on smoking cessation inequities has focused on a single sociodemographic attribute (eg, race or socioeconomic status), yet individuals possess multiple attributes that may increase risk. The current study used an intersectionality framework to examine how the interplay between multiple marginalized attributes may impact smoking cessation outcomes.

METHODS

A diverse sample of 344 adults enrolled in a smoking cessation program and reported on sociodemographic attributes (eg, race/ethnicity, gender, income) and continuous smoking abstinence on their quit date and at 1, 2, and 4 weeks postquit date. A Cox proportional hazard regression model was used to estimate whether intersectional links among race/ethnicity, gender, and income were related to smoking cessation outcomes.

RESULTS

Lower household income may be related to higher risk of smoking cessation failure. There were no significant interactions among race/ethnicity, gender, and income in predicting relapse. Pairwise intersectional group differences suggested some groups may be at higher risk of relapse. Number of marginalized sociodemographic attributes did not predict relapse.

CONCLUSIONS

Intersectionality may be a promising framework for addressing health inequities, and may help elucidate how to best design and target intervention efforts for individuals characterized by sociodemographic intersections that concur particularly high risk for poor tobacco cessation outcomes.

IMPLICATIONS

Despite an overall decline in smoking rates, socioeconomic inequities in smoking prevalence and cancer mortality are widening. Efforts targeting tobacco cessation should incorporate new theory to capture the complex set of factors that may account for tobacco cessation inequities (eg, multiple aspects of identity that may influence access to tobacco cessation treatment and exposure to certain stressors that impede cessation efforts). Intersectionality may be a promising framework for addressing health inequities in tobacco use and cessation and may help elucidate how to best design and target intervention efforts for individuals that concur particularly high risk for poor tobacco cessation outcomes.

Social Determinants of Discrimination and Access to Health Care Among Transgender Women in Oregon

Purpose: Transgender women in the United States experience health disparities and limited access to gender-affirming health services. This study describes the social determinants of health that shape access to health services for transgender women in Oregon, a state with a high tally of gender-affirming policies.

Methods: We conducted qualitative interviews with 25 transgender women between 18 and 39 years of age. Interviews explored the social, economic, cultural, and legal factors that shape access to health. A Qualtrics survey captured sociodemographic characteristics. We identified facilitators and barriers to accessing gender-affirming services using thematic analysis of qualitative data.

Results: Our participants perceived gender-affirming health services in Oregon to be relatively trans-friendly, compared to other parts of the United States. This perception drew several transgender women in our sample to migrate to Oregon from other “more conservative” states. Facilitators included ease with legal name change (60% had completed), inclusiveness of hormone therapy in the Oregon Health Plan, and availability of informed consent hormone therapy. However, for our participants, economic and social discrimination were major limiting factors to accessing and navigating health services. Social factors exacerbated difficulties navigating and understanding health systems to achieve coverage; 20% had insurance that did not cover hormone therapy. Specialized surgeons were located in urban/suburban centers; electrolysis coverage was limited; and 10% had gender-affirming surgery.

Conclusion: This study indicates that services are necessary to assist with navigating access to gender-affirming health care, even in affirming policy contexts like Oregon.

Hate Crimes Against Trans People: Assessing Emotions, Behaviors, and Attitudes Toward Criminal Justice Agencies

Based on a survey of 593 lesbian, gay, bisexual, and transgender (LGBT) people in the United Kingdom, this study shows that direct anti-LGBT hate crimes (measured by direct experiences of victimization) and indirect anti-LGBT hate crimes (measured by personally knowing other victims of hate crime) are highly prolific and frequent experiences for LGBT people. Our findings show that trans people are particularly susceptible to hate crimes, both in terms of prevalence and frequency. This article additionally highlights the negative emotional and (intended) behavioral reactions that were correlated with an imagined hate crime scenario, showing that trans people are more likely to experience heightened levels of threat, vulnerability, and anxiety compared with non-trans LGB people. The study found that trans people are also more likely to feel unsupported by family, friends, and society for being LGBT, which was correlated with the frequency of direct (verbal) abuse they had previously endured. The final part of this study explores trans people's confidence levels in the Government, the police, and the Crown Prosecution Service (CPS) in relation to addressing hate crime. In general, trans people felt that the police are not effective at policing anti-LGBT hate crime, and they are not respectful toward them as victims; this was especially true where individuals had previous contact with the police. Respondents were also less confident in the CPS to prosecute anti-LGBT hate crimes, though the level of confidence was slightly higher when respondents had direct experience with the CPS. The empirical evidence presented here supports the assertion that all LGBT people, but particularly trans individuals, continue to be denied equal participation in society due to individual, social, and structural experiences of prejudice. The article concludes by arguing for a renewed policy focus that must address this issue as a public health problem.

How Intersectional Are Mental Health Interventions for Sexual Minority People? A Systematic Review

Purpose: Complex and widespread stigma exposes sexual minority people to disproportionate risks for adverse mental health. Intersectionality theory calls for consideration of the unique experiences of living with multiple forms of inequality. Yet, concerns remain regarding the extent to which intersectionality theory has been integrated into mental health interventions for sexual minority populations. This systematic review aims to assess the degree to which available mental health interventions account for intersecting forms of marginalization and to identify methods that facilitate the application of intersectionality. Methods: A search for peer-reviewed English language journal articles was conducted using PsycINFO and PubMed to locate reports of mental health interventions for sexual minority groups. A coding framework was designed to evaluate how interventions incorporated intersectionality theory. Results: Of 1877 potentially eligible articles, forty-three were included in the analysis. They were each classified as low, medium, or high with regard to intersectionality. Thirteen (30.2%) were rated as low on intersectionality for only recruiting a homogeneous group of participants in the interventions; 23 (53.4%) were classified as medium for including additional identities in recruitment without responding to possible intersectional disadvantages; 7 (16.3%) were rated as high with adequate consideration of the complex effects of intersecting positions. In addition, the review identified community-based participatory research as a common and instrumental method to ensure intersectionality. Conclusions: This review highlights the limitations of interventions for sexual minority people in addressing intersectionality. Guidelines are needed for clinical practice and evaluation to adequately incorporate intersectionality theory.

A deviation too many? Healthcare professionals' knowledge and attitudes concerning patients with intellectual disability disrupting norms regarding sexual orientation and/or gender identity

BACKGROUND

People with intellectual disability (ID) have few role models for sexual expression and behaviour, and those who identify as LGBTQ experience dual marginalization. The aim of this study is to explore knowledge and attitudes concerning patients with both ID and norm-breaking sexuality and/or gender identity among healthcare professionals in habilitation centres.

METHOD

Data were collected from four focus group interviews that included 19 healthcare professionals from child and adult teams at two Swedish habilitation centres. Data were analysed using thematic analysis.

RESULTS

Three themes were identified as follows: heteronormative treatment in health care, barriers for inclusion and possibilities for inclusion.

CONCLUSIONS

Norm-breaking sexuality and gender identity are still relatively invisible in habilitation centres. People with ID are still predominately desexualized and perceptions regarding their sexuality are lagging behind the rest of society. Conditions that allow for more LGBTQ-affirmative practice were described by the teams that have undergone LGBTQ training.

Gendered racism and the sexual and reproductive health of Black and Latina Women

Objective: To understand health disparities, it is important to use an intersectional framework that examines unique experiences of oppression faced by particular groups due to their intersecting identities and social positions linked to societal structures. We focus on Black and Latina women and their experiences with 'gendered racism' - unique forms of oppression due to the intersection of race/ethnicity and gender - to foster understanding of disparities between Black and Latina versus White women in sexual and reproductive health outcomes in the U.S. Specifically, we focus on stereotype-related gendered racism (ongoing discrimination and stereotype threat based on historically-rooted stereotypes about Black and Latina women's sexuality and motherhood) and birth control-related mistrust (ongoing mistrust of the government and medical system related to birth control due to historical and current abuses).Design: We analyzed data from two survey studies with adult women in New York (Study 1: paper-and-pencil community data collection, N = 135, M_age= 43.35) and across the U.S. (Study 2: online data collection, N = 343, M_age= 29.49) who were currently pregnant or had at least one child and identified as Black, Latina, or White.Results: Black and Latina women reported greater frequency of and concern over stereotype-related gendered racism (F(3,131) = 17.90, p < .001 Study 1; F(3,339) = 22.23, p < .001 Study 2) and greater birth control-related mistrust (F(3,131) = 7.55, p < .001 Study 1; F(3,339) = 17.32, p < .001 Study 2) than White women did. In turn, stereotype-related gendered racism was positively associated with pregnancy-specific stress (ß = .40, p < .001 Study 1; ß = .33, p < .001 Study 2), and birth control-related mistrust was negatively associated with sexual relationship power (ß = -.19, p = .002 Study 2), which are factors known to contribute to birth outcomes and sexual risk, respectively.Conclusion: Findings suggest that gendered racism may play an important role in existing racial/ethnic disparities in women's sexual and reproductive health outcomes, and interventions addressing gendered racism at multiple levels are needed to promote health equity.

Reconceptualising precision public health

As currently conceived, precision public health is at risk of becoming precision medicine at a population level. This paper outlines a framework for precision public health that, in contrast to its current operationalisation, is consistent with public health principles because it integrates factors at all levels, while illuminating social position as a fundamental determinant of health and health inequities. We review conceptual foundations of public health, outline a proposed framework for precision public health and describe its operationalisation within research and practice. Social position shapes individuals' unequal experiences of the social determinants of health. Thus, in our formulation, precision public health investigates how multiple dimensions of social position interact to confer health risk differently for precisely defined population subgroups according to the social contexts in which they are embedded, while considering relevant biological and behavioural factors. It leverages this information to uncover the precise and intersecting social structures that pattern health outcomes, and to identify actionable interventions within the social contexts of affected groups. We contend that studies informed by this framework offer greater potential to improve health than current conceptualisations of precision public health that do not address root causes. Moreover, expanding beyond master categories of social position and operationalising these categories in more precise ways across time and place can enrich public health research through greater attention to the heterogeneity of social positions, their causes and health effects, leading to the identification of points of intervention that are specific enough to be useful in reducing health inequities. Failure to attend to this level of particularity may mask the true nature of health risk, the causal mechanisms at play and appropriate interventions. Conceptualised thus, precision public health is a research endeavour with much to offer by way of understanding and intervening on the causes of poor health and health inequities.As currently conceived, precision public health is at risk of becoming precision medicine at a population level. This paper outlines a framework for precision public health that, in contrast to its current operationalization, is consistent with public health principles because it integrates factors at all levels, while illuminating social position as a fundamental determinant of health and health inequities. We review conceptual foundations of public health, outline a proposed framework for precision public health and describe its operationalization within research and practice. Social position shapes individuals' unequal experiences of the social determinants of health. Thus, in our formulation, precision public health investigates how multiple dimensions of social position interact to confer health risk differently for precisely defined population subgroups according to the social contexts in which they are embedded, while considering relevant biological and behavioural factors. It leverages this information to uncover the precise and intersecting social structures that pattern health outcomes, and to identify actionable interventions within the social contexts of affected groups. We contend that studies informed by this framework offer greater potential to improve health than current conceptualizations of precision public health that do not address root causes. Moreover, expanding beyond master categories of social position and operationalizing these categories in more precise ways across time and place can enrich public health research through greater attention to the heterogeneity of social positions, their causes and health effects, leading to identification of points of intervention that are specific enough to be useful in reducing health inequities. Failure to attend to this level of particularity may mask the true nature of health risk, the causal mechanisms at play and appropriate interventions. Conceptualized thus, precision public health is a research endeavour with much to offer by way of understanding and intervening on the causes of poor health and health inequities.

What If Psychology Took Intersectionality Seriously? Changing How Psychologists Think About Participants

Using intersectionality to change how psychologists think about the demographic profile of their participants is one readily available change that psychologists across the discipline can implement to improve psychological science. In this article, we aim to provide a guide for psychologists who are not already engaged with feminist practices and/or are unsure of how an intersectional approach to participants applies to their research. We argue that by engaging with four perspective shifts of intersectional thinking: multidimensionality, dynamic construction, structural power, and outcomes of systemic disadvantage and advantage, psychologists can more accurately represent the “person” that psychology, as a discipline, seeks to understand. We suggest changes at the researcher, journal, and grant-making agency levels to support an intersectional reconceptualization of participants. As psychology continues to change, in order to foster reproducible science practices and research with relevance to real-world problems, there is opportunity to promote discipline-level change that would take intersectionality seriously.

Currently married women's present experiences of male intimate partner physical violence in Bangladesh: An intercategorical intersectional approach

In Bangladesh, one in five currently married women (CMW) presently experience male intimate partner physical violence (MIPPV). While previous studies analysed women's individual-level multiple locations-younger age, lower education, income, and poverty in an additive manner, we took an intersectional approach to look at the effects of their multiple intersectional locations on MIPPV. Using McCall's intercategorical intersectional approach, we examine how women's intersectional locations are associated with their odds of experiencing MIPPV. Our sample from a 2015 nationally representative survey comprised 14,557 CMW living with their spouses. Thirty-four percent of CMW are young, 49% below primary educated, 19% income earning, 23% poor, and 25% experience MIPPV. We found that CMW in their dual disadvantaged younger age-lower education and single disadvantaged higher education-poor locations have 13.57% (95% CI, 9.25, 17.89) and 12.02% (95% CI, 6.87, 17.17) (respectively) higher probabilities of experiencing MIPPV than their counterparts in the corresponding dual privileged older age-higher education and higher education-nonpoor locations. Consistent with intersectionality theory, instead of prioritising a few groups over others (i.e. Oppression Olympics), we recommend building intersectional solidarity with women, men and communities to disrupt the underlying socio-economic-educational-legal-political structures and processes that have sustained these marginalised locations.