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Perry C, Goldenberg S, Deering K, Patrick L, Braschel M, Shannon K, Bingham B. Structural racism and violence: Routine healthcare access in a cohort of marginalized Indigenous women and Two-Spirit Peoples during the COVID-19 Pandemic. RESEARCH SQUARE 2023:rs.3.rs-3450143. [PMID: 37961370 PMCID: PMC10635380 DOI: 10.21203/rs.3.rs-3450143/v1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/15/2023]
Abstract
Objectives Historical and ongoing colonial violence, racism, discrimination, criminalization, and intergenerational trauma continues to impact the health of Indigenous women (cisgender and transgender) and Two-Spirit Peoples. Previous and ongoing work clearly articulate the deeply harmful roles of colonialism and racism in continuing to systemically exclude Indigenous Peoples from accessing equitable and culturally safe healthcare. While the COVID-19 pandemic has amplified structural inequities, little attention has been paid to how the pandemic impacts healthcare access for Indigenous women and Two-Spirit Peoples living in urban settings. The aim of this study was to evaluate factors associated with experiencing difficulty accessing routine healthcare in a cohort of marginalized urban Indigenous women and Two-Spirit Peoples on the ancestral, occupied territories of the Musqueam, Squamish and Tsleil-Waututh Nations in what is now referred to as Metro Vancouver, Canada during the COVID-19 pandemic. Methods Data were drawn from AMPLIFY, a study of Indigenous cis and trans women and Two-Spirit Peoples in Metro Vancouver. Analyses drew on baseline and semi-annual questionnaire data collected with sex workers and women living with HIV from October 2020-August 2021. We used bivariate and multivariable logistic regression with generalized estimating equations (GEE) to model correlates of experiencing difficulty accessing a family doctor, nurse, or clinic for routine healthcare during the COVID-19 pandemic in the last 6-months. Results Amongst 142 marginalized Indigenous women and Two-Spirit Peoples (199 observations), 27.5% reported difficulty accessing routine healthcare. In multivariable GEE logistic regression, participants who had ever been pregnant (AOR:4.71, 95% CI:1.33-16.66) experienced negative changes in psychological and emotional well-being (AOR: 3.99, 95% CI: 1.33-11.98), lacked access to culturally safe health services (AOR:4.67, 95% CI:1.43-15.25), and had concerns regarding safety or violence in their community (AOR:2.72, 95% CI:1.06-6.94) had higher odds of experiencing recent difficulty accessing routine healthcare. Discussion Findings are in line with the BC Commissioned In Plain Sight report which recommends the need for accessible, culturally safe, anti-racist, and trauma-informed routine healthcare for marginalized Indigenous cisgender and transgender women and Two-Spirit Peoples during the current and future pandemics. More community-based research is needed to understand access needs for culturally safe routine healthcare amongst marginalized Indigenous cisgender and transgender women and Two-Spirit Peoples.
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Williams CC, Gibson MF, Mooney E, Forbes JR, Curling D, green DC, Ross LE. A Structural Analysis of Gender-Based Violence and Depression in the Lives of Sexual Minority Women and Trans People. AFFILIA 2023; 38:350-366. [PMID: 37538836 PMCID: PMC10394395 DOI: 10.1177/08861099231155887] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 08/05/2023]
Abstract
This article explores structural mechanisms that are the context for violence and depression in the lives of sexual minority women and trans people in Ontario, Canada. The article draws on interviews with 14 people who reported experiences of depression in the previous year, foregrounding three representative narratives. Narrative and case study analysis reveal that violence is a repeated and cumulative experience over lifetimes, occurring across different interpersonal contexts and institutional encounters. A common theme across the narratives is that experiences of violence are connected to a broader context in which structural arrangements, cultural norms, and institutional processes create conditions where marginalized people are put in harm's way, perpetrators are empowered, and justice and access to help are elusive. As the violence experienced by these sexual minority women and trans people is rooted in structural and cultural oppression represented in poverty, racism, misogyny, homophobia, and transphobia, the prevention of violence and its consequences for these and other marginalized populations requires systemic transformation of the structures and systems that currently allow and perpetuate harm.
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Affiliation(s)
- Charmaine C. Williams
- Factor-Inwentash Faculty of Social Work, University of Toronto, Toronto, Ontario, Canada
| | - Margaret F. Gibson
- School of Social Work, Renison University College, University of Waterloo, Waterloo, Ontario, Canada
| | - Emily Mooney
- Factor-Inwentash Faculty of Social Work, University of Toronto, Toronto, Ontario, Canada
| | - Joellean R. Forbes
- Factor-Inwentash Faculty of Social Work, University of Toronto, Toronto, Ontario, Canada
| | | | | | - Lori E. Ross
- Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
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3
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Behler AC, George N, Collibee C, Hamilton L, Oleson EB, Thamotharan S. A conceptual framework for queer, black womxn sexual assault survivors: an adaptation of the minoritised stress model. CULTURE, HEALTH & SEXUALITY 2023; 25:791-802. [PMID: 35900895 DOI: 10.1080/13691058.2022.2089734] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/02/2021] [Accepted: 06/10/2022] [Indexed: 06/02/2023]
Abstract
Queer, Black womxn experience sexual assault at an alarming rate in the USA leading to adverse mental and physical health outcomes in survivors. A synthesis of the literature was conducted to understand their unique lived experiences and needs. This article proposes an adapted Meyer's Minoritised Stress framework to understand salient clinical factors impacting Queer, Black womxn sexual assault survivors, including those associated with multiple minoritised identities: Queer-based trauma, race-based trauma, cultural betrayal trauma, and misogynoir. Given the high rates of victimisation, marginalisation and discrimination, psychologists and others working with members of this population should engage with and address these factors to provide culturally responsive, sexually affirming and effective mental health treatment and care.
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Affiliation(s)
| | - Nevita George
- Department of Psychology, University of Colorado Denver, Denver, CO, USA
| | - Charlene Collibee
- Department of Psychology, University of Colorado Denver, Denver, CO, USA
| | - Lindsey Hamilton
- Department of Psychology, University of Colorado Denver, Denver, CO, USA
| | - Erik B Oleson
- Department of Psychology, University of Colorado Denver, Denver, CO, USA
| | - Sneha Thamotharan
- Department of Psychology, University of Colorado Denver, Denver, CO, USA
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Bedera N, Nordmeyer K, Holland KJ. "I Could Never Tell My Parents": Barriers to Queer Women's College Sexual Assault Disclosure to Family Members. Violence Against Women 2023; 29:800-816. [PMID: 35938472 DOI: 10.1177/10778012221101920] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Queer women are at high risk of college sexual victimization, but they face barriers to formal support services. As a result, informal support is critical. This study uses data from 40 open-ended interviews to explore family members' reactions to queer women's disclosures and examine whether their family is a reliable source of informal support. Findings indicate that family reactions are often more harmful than helpful. In comparison to research focused on heterosexual survivors, we find family reactions to be more extreme and disparaging of queer survivors' sexual identities. In fact, family members' negative reactions may pose barriers to accessing formal services.
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Canan SN, Kaplan AM, Jozkowski KN. Comparing Rates of Sexual Assault Between Panel Quota and Social Media Samples: Findings Across Sexual Orientation Categories. JOURNAL OF INTERPERSONAL VIOLENCE 2022; 37:NP21386-NP21399. [PMID: 34821509 DOI: 10.1177/08862605211056027] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
Sexual assault is prevalent and may be even more prevalent among sexual minorities. However, prevalence rates vary, in part, due to discrepancies in sampling methods. Given this, we assessed whether two popular non-probability sampling types (panel quota vs. social media recruitment) produced different sexual assault prevalence rates when holding all other methodological choices (definitions, measures, scoring) constant in a sample of lesbian, bisexual, queer, and heterosexual adults, excluding cisgender men. Two phases of data collection occurred-a panel quota sample (n = 1366), recruited from an online sample aggregator, and social media sample (n = 1102), recruited through lesbian, gay, bisexual, transgender, and queer (LGBTQ) social media sites. Participants were asked about sexual assault and rape experiences in both childhood and adulthood using a modified form of the Sexual Experiences Scale-Short Form Victimization. Both phases used the same definitions of sexual assault, prevalence measures, and prevalence scoring. Overall, the sample recruited via LGBTQ social media yielded statistically higher sexual assault prevalence rates for all four types of victimization experiences measured: lifetime sexual assault (LSA), rape-specific LSA, childhood sexual assault (CSA), and adulthood sexual assault. However, when parsing out subgroups, this finding only held for heterosexual participants who had rates > 30% higher in the social media sample compared with the panel quota sample. These findings suggest that researchers studying sexual assault in lesbian, bisexual, or queer adults may be able to use social media sampling techniques, which require less resources, without concern that the sampling technique is inflating prevalence when compared to panels.
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Affiliation(s)
- Sasha N Canan
- 14621Public Health Program at University of North Carolina Wilmington, Wilmington, NC, USA
| | | | - Kristen N Jozkowski
- 1772School of Public Health at Indiana University, Bloomington, IN, USA
- 1772The Kinsey Institute for Research in Sex, Gender, and Reproduction at Indiana University, Bloomington, IN, USA
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Carmody MD, Cruz TH, Soto Mas F, Qeadan F, Handal AJ. Violence and the Academic Lives of College Students at the Intersection of Race/Ethnicity and Sexual Orientation/Gender Identity. JOURNAL OF INTERPERSONAL VIOLENCE 2022; 37:NP4487-NP4509. [PMID: 32954934 DOI: 10.1177/0886260520958654] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
To ascertain whether sexual and/or gender minority (SGM) students at a Hispanic-serving institution who experience violence are more likely to experience interference with their academic lives when compared to heterosexual, cisgender students, and how this relationship differs by race/ethnicity. Data came from 736 undergraduate students at a university in the Southwestern United States responding to a 2017 Campus Climate Survey. Multivariable logistic regression was conducted on self-identified SGM students and reported interference with their academic lives. The model was also tested for effect modification by race/ethnicity. Two-thirds (67.65%) of SGM students reported four or more incidences of violence. Nearly one-fifth (18.83%) of SGM students reported being harassed, insulted, threatened, or intimidated, and 2.63% reported being physically hurt (including forced sex), because the perpetrator thought the individual might have been gay, lesbian, bisexual, or transgender. SGM students had 2.44 (95% CI: 1.29, 4.61) increased odds of interference with academic life as a result of violence victimization compared with non-SGM students. When the model was evaluated for effect modification by race/ethnicity, large effect sizes were observed, although the results were not significant. SGM undergraduate students are at significantly increased risk of violence and interference with their academic lives. This research emphasizes the need for institutions of higher education to ensure that their policies and practices support equal access to education by SGM students. Additionally, this study contributes insights into a potential protective effect of Hispanic ethnicity that warrants further research.
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Affiliation(s)
- Mary D Carmody
- The University of New Mexico, Albuquerque, New Mexico, USA
| | | | | | | | - Alexis J Handal
- University of Michigan School of Public Health, Ann Arbor, Michigan, USA
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Bedera N, Nordmeyer K. An Inherently Masculine Practice: Understanding the Sexual Victimization of Queer Women. JOURNAL OF INTERPERSONAL VIOLENCE 2021; 36:11188-11211. [PMID: 31916490 DOI: 10.1177/0886260519898439] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
Sexual violence is a widespread social issue, and sexual victimization is especially prevalent among queer-identified women. Still, there is little research on queer women's experiences of sexual violence or explanations for the high rate of victimization. This study uses data from 40 open-ended interviews to investigate queer women's experiences with sexual violence and those who perpetrate it. Respondents answered questions about the characteristics of their sexual assaults and perpetrators, as well as connections the survivors perceive between their sexual assaults and sexual identities. Findings indicate that the perpetrators of such sexual assaults invoke an expression of masculinity, regardless of the perpetrator's gender identity at the time of violence. To understand the nuanced role of masculinity in queer assailant's assaults, we develop the concept of "righteous masculinity," which refers to a traditional (and, in this case, violent) masculinity invoked by marginalized people in an attempt to reclaim power. We find that sexual violence against queer women is an especially powerful way to enact masculinity through drawing upon misogyny and homophobia simultaneously, providing an explanation for the high rates of sexual victimization among queer women. We argue that centering masculinity can help scholars and activists better challenge the sexual victimization of queer women and deepen understanding of the links between gender-based violence and masculinity.
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Wei TH, Jervis LL, Jiang Y, Reinschmidt KM, Stephens LD, Zhang Y, Teasdale TA. Cultural Unintelligibility and Marital Pressure: A Grounded Theory of Minority Stigma Against Women with Same-Sex Attraction in Mainland China. ARCHIVES OF SEXUAL BEHAVIOR 2021; 50:3137-3154. [PMID: 34642837 DOI: 10.1007/s10508-021-02050-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/18/2020] [Revised: 04/28/2021] [Accepted: 05/15/2021] [Indexed: 06/13/2023]
Abstract
Minority stigma against sexual minority women and its contributions to these women's health disparities have been widely investigated in Western countries. By contrast, little has been known about minority stigma against women with same-sex attraction (WSSA) in mainland China. This study aimed at exploring the nature, genesis, and pathways of minority stigma among this rarely studied minority group in terms of China's unique social and cultural organization of gender and sexuality. A grounded theory approach was applied to 28 participants of Chinese WSSA through in-depth telephone interviews to elicit their views and perspectives anchored in their daily experiences with gender hierarchy and normative heterosexuality. Findings of this study identified marital pressure and cultural unintelligibility as two principal components of minority stigma against Chinese WSSA. A conceptual framework was developed to illustrate how minority stigma relies on the mutually reinforcing loop of martial pressure and culturally unintelligible status of female same-sex attraction to oppress Chinese WSSA within and across intrapersonal, interpersonal, and structural levels. The parent-daughter relationship, laden with the Confucian value of filial piety, was highlighted as the major pathway of minority stigma to force Chinese women with same-sex attraction into heterosexual marriage and make female same-sex attraction culturally unintelligible. These findings lay a foundation for conceptualizing and measuring minority stigma of Chinese WSSA caused by the stigmatization of their same-sex attraction. Moreover, these findings would contribute greatly to understanding how cultural particularities critically affect the local process of stigmatization through which power relations and social control are practiced.
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Affiliation(s)
- Tao H Wei
- College of Public Health, University of Oklahoma Health Sciences Center, Oklahoma City, OK, 73104, USA.
| | - Lori L Jervis
- College of Arts and Sciences, University of Oklahoma, Norman, OK, USA
| | - Yun Jiang
- School of Nursing, University of Michigan, Ann Arbor, MI, USA
| | - Kerstin M Reinschmidt
- College of Public Health, University of Oklahoma Health Sciences Center, Oklahoma City, OK, 73104, USA
| | - Lancer D Stephens
- College of Public Health, University of Oklahoma Health Sciences Center, Oklahoma City, OK, 73104, USA
| | - Ying Zhang
- College of Public Health, University of Oklahoma Health Sciences Center, Oklahoma City, OK, 73104, USA
| | - Thomas A Teasdale
- College of Public Health, University of Oklahoma Health Sciences Center, Oklahoma City, OK, 73104, USA
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Dale SK, Reid R, Safren SA. Factors associated with resilience among Black women living with HIV and histories of trauma. J Health Psychol 2021; 26:758-766. [PMID: 30957560 PMCID: PMC6783333 DOI: 10.1177/1359105319840690] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
In the United States, Black women living with HIV face various individual (e.g. trauma) and structural (e.g. racism) adversities. However, resilience is understudied among Black women living with HIV. A total of 100 Black women living with HIV in the United States completed measures of resilience, general self-efficacy, self-esteem, post-traumatic growth, trauma symptoms, trauma-related cognitions, and depressive symptoms. Regressions controlling for age and education indicated that higher resilience was associated with higher general self-efficacy (β = .39, p < .001), higher self-esteem (β = .48, p < .001), higher post-traumatic growth (β = .34, p < .01), lower post-traumatic cognitions (β = -.36, p < .001), lower trauma symptoms (β = -.29, p < .01), and lower depressive symptoms (β = -.38, p < .001). Our findings suggest potential targets for interventions.
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Affiliation(s)
- Sannisha K Dale
- University of Miami, USA
- Massachusetts General Hospital, USA
- Harvard Medical School, USA
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10
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Morrison MA, Parker KM, Sadika B, Sameen DE, Morrison TG. ‘Newsworthy enough?’: media framing of Canadian LGBTQ persons’ sexual violence experiences. PSYCHOLOGY & SEXUALITY 2021. [DOI: 10.1080/19419899.2020.1729845] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Affiliation(s)
| | - Kandice M. Parker
- Department of Psychology, University of Saskatchewan, Saskatoon, Canada
| | - Bidushy Sadika
- Department of Psychology, University of Saskatchewan, Saskatoon, Canada
| | - Durr-E Sameen
- Department of Psychology, University of Saskatchewan, Saskatoon, Canada
| | - Todd G. Morrison
- Department of Psychology, University of Saskatchewan, Saskatoon, Canada
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Flanders CE, Anderson RE, Tarasoff LA. Young Bisexual People's Experiences of Sexual Violence: A Mixed-Methods Study. JOURNAL OF BISEXUALITY 2020; 20:202-232. [PMID: 36213598 PMCID: PMC9536248 DOI: 10.1080/15299716.2020.1791300] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/28/2023]
Abstract
Bisexual people are at an increased vulnerability for sexual victimization in comparison to heterosexual people, as well as gay and lesbian people. As the majority of first sexual violence experiences happen prior to age 25 for bisexual women, young bisexual people are particularly vulnerable. Despite consistent evidence of this health disparity, little is known about what factors might increase young bisexual people's risk for sexual victimization, or how they access support post-victimization. The current study addresses this gap through a mixed-method investigation of young bisexual people's experiences of sexual violence with a sample of 245 bisexual people age 18-25. Quantitative results indicate that bisexual stigma significantly predicts a greater likelihood of reporting an experience of sexual violence. Qualitative findings support that while not all participants felt bisexual stigma related to their experience of sexual violence, some felt negative bisexual stereotypes were substantial factors. Interview participants found connecting with other survivors, particularly LGBTQ+ and bisexual survivors, to be beneficial. Some participants encountered barriers to accessing support, such as discrimination in schools. Sexual violence researchers should consider bisexual stigma as an important factor, and support services the potential positive impact of bisexual-specific survivor support.
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Affiliation(s)
- Corey E. Flanders
- Department of Psychology and Education, Mount Holyoke College, South Hadley, MA, USA
| | - RaeAnn E. Anderson
- Department of Psychology, University of North Dakota, Grand Forks, ND, USA
| | - Lesley A. Tarasoff
- Interdisciplinary Centre for Health & Society, University of Toronto Scarborough, Scarborough, ON, Canada
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Hughes TL, Veldhuis CB, Drabble LA, Wilsnack SC. Research on alcohol and other drug (AOD) use among sexual minority women: A global scoping review. PLoS One 2020; 15:e0229869. [PMID: 32187200 PMCID: PMC7080264 DOI: 10.1371/journal.pone.0229869] [Citation(s) in RCA: 69] [Impact Index Per Article: 17.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2019] [Accepted: 02/15/2020] [Indexed: 12/31/2022] Open
Abstract
Until the 1980s, the limited research on alcohol and other drug (AOD) use among sexual minority women (SMW) focused on alcohol and used samples recruited from gay bars, resulting in inflated estimates of hazardous drinking. Over the past several decades the number of AOD studies with SMW has increased dramatically. To characterize this literature, we conducted a scoping review to answer the following questions: What do we know, and what are the gaps in research about AOD use among SMW? We searched multiple electronic databases (Medline [PubMed], CINAHL, PsycInfo, and Web of Science) for peer-reviewed research articles about AOD use among adult SMW published between January 1, 2000 and May 31, 2017. After duplicates were removed the search identified 4,204 articles. We reviewed the titles and abstracts and removed articles that did not meet inclusion criteria. We used full-text review of the remaining 229 articles to make a final determination regarding inclusion and we retained 181 articles for review. Although the quantity of AOD research with SMW has grown substantially, the great majority of studies have been conducted in the United States (US) and most focus on hazardous drinking; relatively little research has focused on other drugs. In addition, although there has been marked improvement in theories and methods used in this research, many gaps and limitations remain. Examples are the lack of longitudinal research; reliance on samples that tend to over-represent white, well-educated, and relatively young women; sparse attention to mechanisms underlying the disproportionately high rates of AOD use among SMW; and the absence of intervention research. In general, more high-quality research on SMW's use of AODs is needed, but gaps and limitations are particularly large in non-western countries. Addressing these research gaps and limitations is essential for providing information that can be used to develop more effective prevention and early intervention strategies, as well as for informing policies that can help to reduce risky drinking and drug misuse among SMW.
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Affiliation(s)
- Tonda L. Hughes
- School of Nursing, Columbia University, New York, New York, United States of America
| | - Cindy B. Veldhuis
- School of Nursing, Columbia University, New York, New York, United States of America
| | - Laurie A. Drabble
- San Jose State University, San Jose, California, United States of America
| | - Sharon C. Wilsnack
- University of North Dakota, Grand Forks, North Dakota, United States of America
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Flanders CE, Anderson RE, Tarasoff LA, Robinson M. Bisexual Stigma, Sexual Violence, and Sexual Health Among Bisexual and Other Plurisexual Women: A Cross-Sectional Survey Study. JOURNAL OF SEX RESEARCH 2019; 56:1115-1127. [PMID: 30632801 DOI: 10.1080/00224499.2018.1563042] [Citation(s) in RCA: 28] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/18/2023]
Abstract
Bisexual women experience higher rates of sexual victimization relative to heterosexual and lesbian women, and worse sexual health outcomes. Though these health disparities are well documented in the literature, few empirical data have been published on what factors are driving these disparities. Further, research documenting sexual victimization and health of plurisexual (i.e., attracted to more than one gender) women group all participants as bisexual. We do not know whether these experiences are similar across subgroups of plurisexual women. The current study reports on data from a cross-sectional survey, analyzing the relationships between bisexual-specific stigma and sexual violence, as well as other sexual health outcomes, across a sexually diverse group of plurisexual participants. Findings indicate that bisexual stigma is a significant predictor of lifetime sexual violence (odds ratio [OR] = 1.99, p = .015) and verbal coercion (OR = 2.60, p = .004), but not other outcomes. There are differences across sexual identity categories, with bisexual participants being less likely to report sexual violence and verbal coercion, and less likely to access sexually transmitted infection/human immunodeficiency syndrome testing, compared to other plurisexual groups. Our findings support that bisexual stigma is an important factor to consider in understanding sexual violence disparities experienced by bisexual and other plurisexual women.
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Affiliation(s)
| | | | | | - Margaret Robinson
- Department of Sociology and Social Anthropology, Dalhousie University
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Dale SK, Safren SA. Resilience takes a village: black women utilize support from their community to foster resilience against multiple adversities. AIDS Care 2019; 30:S18-S26. [PMID: 30628458 DOI: 10.1080/09540121.2018.1503225] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
Black women living with HIV (BWLWH) represent the highest percentage of women with HIV in the U.S. and experience worse health outcomes than other women living with HIV, in part due to experiences of trauma, racism, HIV-stigma, and stressors they face as women. However, their own stories of resilience in the face of multiple adversities and insights of community stakeholders may inform our field on how to best empower this population to strive despite adversities. Thirty BWLWH in the U.S. and fifteen community stakeholders were interviewed about women's experiences and adaptive coping strategies used to cope with trauma, racism, HIV-stigma, and gender-related stressors. Interviews were coded using thematic content analysis. A major theme that spanned across interviews with BWLWH and community stakeholders was that resilience was fostered by members of their "village". In the midst of or following adverse experiences BWLWH used social support from their children, grandchildren, other family members, friends/peers, and caring providers in order to overcome their adversities and focus on their health and well-being. Promoting resilience among BWLWH requires an understanding of the most adaptive strategies utilized to "bounce back" following or in the face of adversities. Our findings highlight that both BWLWH and community stakeholders recognize social support from their "village" as an importance resilience resource. Research and applied efforts need to be geared at strengthening both BWLWH and their "village" in order to promote resilience and reduce health disparities.
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Affiliation(s)
- Sannisha K Dale
- a Department of Psychology , University of Miami , Miami , FL , USA.,b Department of Psychiatry , Massachusetts General Hospital , Boston , MA , USA.,c Harvard Medical School , Boston , MA , USA
| | - Steven A Safren
- a Department of Psychology , University of Miami , Miami , FL , USA
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Beckman K, Shipherd J, Simpson T, Lehavot K. Military Sexual Assault in Transgender Veterans: Results From a Nationwide Survey. J Trauma Stress 2018; 31:181-190. [PMID: 29603392 PMCID: PMC6709681 DOI: 10.1002/jts.22280] [Citation(s) in RCA: 33] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/22/2017] [Revised: 01/14/2018] [Accepted: 01/19/2018] [Indexed: 11/11/2022]
Abstract
There is limited understanding about the frequency of military sexual assault (MSA) in transgender veterans, characteristics associated with MSA, or subsequent mental and behavioral health problems. To address this gap, we used an online national survey of 221 transgender veterans to identify prevalence of MSA and to assess its association with demographic characteristics, past history of sexual victimization, and stigma-related factors. We also evaluated the association between MSA and several mental and behavioral health problems. Overall, 17.2% of transgender veterans experienced MSA, but rates differed significantly between transgender women (15.2%) and transgender men (30.0%). Using adjusted regression models, MSA was associated with adult sexual assault prior to military service, odds ratio (OR) = 4.05, 95% CI [1.62, 10.08], and distal minority stress during military service, OR = 2.98, 95% CI [1.28, 6.91]. With respect to health outcomes, MSA was associated with past-month posttraumatic stress disorder (PTSD) symptom severity, B = 10.18, 95% CI [3.45, 16.91]; current depression symptom severity, B = 3.71, 95% CI [1.11, 6.30]; and past-year drug use, OR = 3.17, 95% CI [1.36, 7.40]. Results highlight the vulnerability of transgender veterans to MSA, and the need for military prevention programs that acknowledge transgender individuals' heightened risk. Furthermore, clinicians should consider clinical screening for PTSD, depression, and drug use in transgender veterans who have a history of MSA.
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Affiliation(s)
- Kerry Beckman
- Department of Health Services Research, University of Washington, Seattle, Washington, USA
| | - Jillian Shipherd
- Lesbian, Gay, Bisexual, and Transgender Health Program, Department of Veterans Affairs, Washington, District of Columbia, USA,VA Boston Healthcare System, Boston, Massachusetts, USA,National Center for PTSD, Women’s Health Sciences Division, Boston, Massachusetts, USA,Boston University School of Medicine, Boston, Massachusetts, USA
| | - Tracy Simpson
- Center of Excellence in Substance Abuse and Treatment (CESATE), VA Puget Sound Health Care System, Seattle, Washington, USA,Department of Psychiatry and Behavioral Sciences, University of Washington, Seattle, Washington, USA
| | - Keren Lehavot
- Department of Health Services Research, University of Washington, Seattle, Washington, USA,Department of Psychiatry and Behavioral Sciences, University of Washington, Seattle, Washington, USA,Health Services Research and Development Center of Innovation (COIN), VA Puget Sound Health Care System, Seattle, Washington, USA
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Dworkin ER, Menon SV, Bystrynski J, Allen NE. Sexual assault victimization and psychopathology: A review and meta-analysis. Clin Psychol Rev 2017; 56:65-81. [PMID: 28689071 PMCID: PMC5576571 DOI: 10.1016/j.cpr.2017.06.002] [Citation(s) in RCA: 343] [Impact Index Per Article: 49.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2017] [Revised: 05/22/2017] [Accepted: 06/18/2017] [Indexed: 01/18/2023]
Abstract
Sexual assault (SA) is a common and deleterious form of trauma. Over 40years of research on its impact has suggested that SA has particularly severe effects on a variety of forms of psychopathology, and has highlighted unique aspects of SA as a form of trauma that contribute to these outcomes. The goal of this meta-analytic review was to synthesize the empirical literature from 1970 to 2014 (reflecting 497 effect sizes) to understand the degree to which (a) SA confers general risk for psychological dysfunction rather than specific risk for posttraumatic stress, and (b) differences in studies and samples account for variation in observed effects. Results indicate that people who have been sexually assaulted report significantly worse psychopathology than unassaulted comparisons (average Hedges' g=0.61). SA was associated with increased risk for all forms of psychopathology assessed, and relatively stronger associations were observed for posttraumatic stress and suicidality. Effects endured across differences in sample demographics. The use of broader SA operationalizations (e.g., including incapacitated, coerced, or nonpenetrative SA) was not associated with differences in effects, although including attempted SA in operationalizations resulted in lower effects. Larger effects were observed in samples with more assaults involving stranger perpetrators, weapons, or physical injury. In the context of the broader literature, our findings provide evidence that experiencing SA is major risk factor for multiple forms of psychological dysfunction across populations and assault types.
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Flanders CE, Pragg L, Dobinson C, Logie C. Young sexual minority women's use of the internet and other digital technologies for sexual health information seeking. CANADIAN JOURNAL OF HUMAN SEXUALITY 2017. [DOI: 10.3138/cjhs.261-a2] [Citation(s) in RCA: 30] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
We know little about the online sexual health information seeking practices and needs specific to young sexual minority women. This is problematic as young sexual minority women report heightened negative sexual health outcomes in contrast to their heterosexual peers, which could be partially addressed through being able to access effective, relevant online sexual health information sources. This exploratory qualitative study employed a series of focus groups to understand more about what types of online resources young sexual minority women access, their motivations for using those resources, and what types of sexual health information they need. The focus group data were analyzed from a thematic analysis approach. Results indicate that participants used a wide range of online resources, such as apps, websites, blogs, and YouTube. The type of resource accessed often depended upon the information needed. Participants reported preferring online resources due to experiences or expectations of heteronormativity from their sexual health service providers, convenience and accessibility, the capacity to remain anonymous, and the lack of relevant sexual health information offline. These findings help begin to fill the gap on knowledge of young sexual minority women's sexual health information seeking practices, which can be used for the development of effective online sexual health information resources targeting young sexual minority women.
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Affiliation(s)
- Corey E. Flanders
- Department of Psychology and Education, Mount Holyoke College, South Hadley, MA
| | - Lauren Pragg
- Department of Social and Political Thought, York University, Toronto, ON
| | | | - Carmen Logie
- Factor-Inwentash Faculty of Social Work, University of Toronto, Toronto, ON
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Flanders CE, Ross LE, Dobinson C, Logie CH. Sexual health among young bisexual women: a qualitative, community-based study. PSYCHOLOGY & SEXUALITY 2017. [DOI: 10.1080/19419899.2017.1296486] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Affiliation(s)
- Corey E. Flanders
- Department of Psychology and Education, Mount Holyoke College, South Hadley, MA, USA
| | - Lori E. Ross
- Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada
| | - Cheryl Dobinson
- Director of Community Programming and Research, Planned Parenthood Toronto, Toronto, ON, Canada
| | - Carmen H. Logie
- Factor-Inwentash Faculty of Social Work, University of Toronto, Toronto, ON, Canada
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Lacombe-Duncan A, Logie CH. Correlates of clinical breast examination among lesbian, gay, bisexual, and queer women. CANADIAN JOURNAL OF PUBLIC HEALTH = REVUE CANADIENNE DE SANTE PUBLIQUE 2016; 107:e467-e472. [PMID: 28026715 PMCID: PMC6972324 DOI: 10.17269/cjph.107.5351] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/27/2015] [Revised: 08/03/2016] [Accepted: 08/08/2016] [Indexed: 01/21/2023]
Abstract
OBJECTIVES Lesbian, gay, bisexual, and queer (LGBQ) women have increased risk of breast cancer yet lower use of early detection screening than heterosexual women. This lower use may be due in part to sexual stigma. The study purpose was to explore correlates of past two-year clinical breast examination (CBE) among LGBQ women to better understand screening disparities, particularly among gender non-conforming LGBQ women. METHODS A cross-sectional Internet-based survey was conducted with LGBQ women in 2011-2012. We conducted multivariate logistic regression to assess the associations between individual, social/structural and health care factors and past two-year CBE among LGBQ women (n = 414), including a subsample of gender non-conforming LGBQ women (n = 148). RESULTS In multivariate analyses, significant correlates of past two-year CBE among the full sample included sexually transmitted infection knowledge (OR: 1.12, 95% CI: 1.05, 1.19), sexual risk practices (OR: 0.92, 95% CI: 0.87, 0.98), past two-year Papanicolaou test (OR: 8.36, 95% CI: 4.24, 16.45), having a regular source of health care (OR: 4.84, 95% CI: 2.60, 9.01), and health care provider knowing one's sexual orientation (OR: 3.60, 95% CI: 2.29, 5.81). Among gender non-conforming LGBQ women, perceived gender non-conformity stigma (OR: 0.85, 95% CI: 0.74, 0.99) and belief that one's health care provider is uncomfortable with one's sexual orientation (OR: 0.33, 95% CI: 0.11, 1.00) were also associated with lower screening. CONCLUSION These findings enhance understanding of individual, social/structural, and health care factors correlated with CBE among LGBQ women. More research is needed to understand the complex interplay of these factors to inform multi-level interventions to address screening disparities for diverse LGBQ women.
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Flanders CE, Tarasoff LA, Legge MM, Robinson M, Gos G. Positive Identity Experiences of Young Bisexual and Other Nonmonosexual People: A Qualitative Inquiry. JOURNAL OF HOMOSEXUALITY 2016; 64:1014-1032. [PMID: 27797650 DOI: 10.1080/00918369.2016.1236592] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
The majority of LGBTQ psychological research focuses on dysfunction. The exclusion of strengths-based perspectives in LGBTQ psychology limits the understanding of LGBTQ mental health. In this article we report experiences that young bisexual and other nonmonosexual people perceive as affirming of their sexual identity. A 28-day, daily diary study was used to investigate whether bisexual-identified participants encountered positive experiences related to their sexual identity, and which type of experiences they perceived to be positive. Using a constructivist grounded theory approach, participants' experiences were organized according to a social ecological model. Experiences were reported at the intrapersonal, interpersonal, and institutional levels, but most positive sexual identity experiences occurred at the interpersonal level. Implications for positive health outcome research and the integration of positive psychology with LGBTQ psychology are discussed, as well as study limitations.
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Affiliation(s)
- Corey E Flanders
- a Social Epidemiological Research, Centre for Addiction and Mental Health , Toronto , Ontario , Canada
| | - Lesley A Tarasoff
- b Dalla Lana School of Public Health, University of Toronto , Toronto , Ontario , Canada
| | | | | | - Giselle Gos
- b Dalla Lana School of Public Health, University of Toronto , Toronto , Ontario , Canada
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Aggleton P, de Wit J, Myers T, Du Mont J. New outcomes for sexual health promotion. HEALTH EDUCATION RESEARCH 2014; 29:547-553. [PMID: 24924828 DOI: 10.1093/her/cyu033] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Affiliation(s)
- Peter Aggleton
- Centre for Social Research in Health, UNSW Australia, Sydney, NSW 2052, Australia, Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, M5T 3M7, Canada and Women's College Research Institute, Women's College Hospital, Toronto, Ontario, M5G 1N8, Canada
| | - John de Wit
- Centre for Social Research in Health, UNSW Australia, Sydney, NSW 2052, Australia, Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, M5T 3M7, Canada and Women's College Research Institute, Women's College Hospital, Toronto, Ontario, M5G 1N8, Canada
| | - Ted Myers
- Centre for Social Research in Health, UNSW Australia, Sydney, NSW 2052, Australia, Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, M5T 3M7, Canada and Women's College Research Institute, Women's College Hospital, Toronto, Ontario, M5G 1N8, Canada
| | - Janice Du Mont
- Centre for Social Research in Health, UNSW Australia, Sydney, NSW 2052, Australia, Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, M5T 3M7, Canada and Women's College Research Institute, Women's College Hospital, Toronto, Ontario, M5G 1N8, CanadaCentre for Social Research in Health, UNSW Australia, Sydney, NSW 2052, Australia, Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, M5T 3M7, Canada and Women's College Research Institute, Women's College Hospital, Toronto, Ontario, M5G 1N8, Canada
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