Neighborhood Safety and Neighborhood Police Violence Are Associated with Psychological Distress among English- and Spanish-Speaking Transgender Women of Color in New York City: Finding from the TURNNT Cohort Study.

Transgender women of color (TWOC) experience high rates of police violence and victimization compared to other sexual and gender minority groups, as well as compared to other White transgender and cisgender women. While past studies have demonstrated how frequent police harassment is associated with higher psychological distress, the effect of neighborhood safety and neighborhood police violence on TWOC's mental health is rarely studied. In this study, we examine the association between neighborhood safety and neighborhood police violence with psychological distress among TWOC. Baseline self-reported data are from the TURNNT ("Trying to Understand Relationships, Networks and Neighborhoods among Transgender Woman of Color") Cohort Study (analytic n = 303). Recruitment for the study began September 2020 and ended November 2022. Eligibility criteria included being a TWOC, age 18-55, English- or Spanish-speaking, and planning to reside in the New York City metropolitan area for at least 1 year. In multivariable analyses, neighborhood safety and neighborhood police violence were associated with psychological distress. For example, individuals who reported medium levels of neighborhood police violence had 1.15 [1.03, 1.28] times the odds of experiencing psychological distress compared to those who experienced low levels of neighborhood police violence. Our data suggest that neighborhood safety and neighborhood police violence were associated with increased psychological distress among TWOC. Policies and programs to address neighborhood police violence (such as body cameras and legal consequences for abusive officers) may improve mental health among TWOC.

I am Lifted Above the World: utilizing VR for stress reduction among perinatal women of color.

Background: Perinatal mental health conditions affect 800,000 individuals annually in the United States and are a leading cause of complications in pregnancy and childbirth. However, the impact of these conditions varies across racial and ethnic groups. Portable digital solutions, such as mobile apps, have been developed for maternal mental health, but they often do not adequately cater to the needs of women of color. To ensure the effectiveness and equity of these interventions, it is crucial to consider the unique experiences of perinatal women from diverse racial backgrounds. This qualitative study aims to explore the complex aspects of motherhood, maternal mental well-being, and resilience among perinatal women of color. It also investigates the factors that either hinder or facilitate the use of Virtual Reality (VR) for stress management in this specific demographic. Methods: This research involves two focus groups comprising perinatal women, primarily identifying as Black or Latina, enrolled in the ongoing Nurturing Moms study at the University of Miami Miller School of Medicine. Additionally, feedback is collected from five different participants. The study assesses Nurture VR™, a VR-based program integrating mindfulness techniques, relaxation exercises, and guided imagery for pregnancy and postpartum. Results: Qualitative analysis uncovers five primary themes and 19 sub-themes, addressing the complexities of motherhood, maternal mental health, attitudes towards VR therapy, postpartum care, and the perception of resilience. Participants share challenges related to household management, caregiving, financial stress, breastfeeding, relaxation, sleep, and the significance of social support. Their preferences and reservations regarding VR therapy are also expressed. Conclusion: This study sheds light on the diverse struggles and obstacles faced by women of color during and after pregnancy, with potential repercussions for their mental and sleep health. It underscores the need for mental health screening and analysis of maternal stress-related sleep issues, in addition to the facilitation of social support in maternal health programs. Additionally, it highlights the promise of culturally responsive behavioral treatments, including VR interventions, in offering timely and tailored mental health support to perinatal women, taking into account their intersectional identities.

Racial Microaggressions Mediate the Association Between Posttraumatic Stress and Alcohol Use Among Women of Color Experiencing Intimate Partner Violence.

Objective: Women of Color (WoC) experiencing intimate partner violence (IPV) have elevated rates of posttraumatic stress disorder (PTSD) and alcohol use and related harm (e.g., increased alcohol use and negative consequences). This secondary data analysis assessed the role of racial microaggressions in the association between PTSD and alcohol use and related harm among WoC experiencing IPV. Methods: Participants were 103 WoC currently experiencing IPV and using substances (Mage=40.39, 51.5% Black) who were recruited from the community and completed assessments of PTSD, racial microaggressions, and alcohol use and related harm. Results: Assumptions of Inferiority (e.g., intelligence; B = 1.44, SE = 0.90, 95% CI [0.10, 3.54]) and Environmental Microaggressions (e.g., portrayal in media; B = 1.88, SE = 1.03, 95% CI [0.28, 4.30]) explained the association between PTSD and alcohol use and related harm. Conclusions: Findings underscore the influence of specific microaggressions in the relation between PTSD and alcohol use and related harm among WoC experiencing IPV.

Mental Health and Treatment Engagement among Low-Income Women of Color Living with HIV.

Low-income women of color are disproportionately more likely to contract HIV, struggle with treatment adherence, and have compromised health as a result of HIV infections in comparison to White and more affluent women. The current study is a secondary analysis aimed at examining the association between stress, symptoms of depression, trauma exposure, healthcare engagement, and adherence self-efficacy, among low-income women of color with human immunodeficiency virus (HIV)/acquired immune deficiency syndrome (AIDS). Structural equation modeling is used to identify latent mental health symptoms that may influence one another, as well as outcomes involving treatment engagement. Participants contributing to this dataset (n = 134) were low income, women of color (primarily African American) living with HIV or AIDS, receiving care at a major medical center in the northeastern United States. Findings indicate significant indirect associations between perceived stress and the outcome of medical appointment attendance. Significant mediators of this indirect relationship include depressive symptoms, parenting stress, and adherence self-efficacy. Implications for health and behavioral health practice and policy interventions are drawn. Areas in need of future research are identified.

Women of Color in the Health Professions: A Scoping Review of the Literature.

Women of color (WoC) in the health professions encounter challenges in advancement to higher positions, disparities in wages, discrimination, lack of expectation to achieve leadership positions, and absence of extensive support networks. Articles in the literature have addressed race and/or gender in the context of professional development. However, applying an intersectional lens or framework to better understand the contextual issues of professional development for WoC remains to be addressed. Thus, this scoping review aimed to (i) identify health professions literature that addresses disparities affecting WoC, and (ii) describe strategies and approaches to support WoC in the health professions. Methods: The literature searches were conducted in multiple databases, including PubMed and MEDLINE (Ovid); and Google and Google Scholar were used to "hand search" further articles including gray literature. Three independent reviewers reviewed and screened articles for inclusion in accordance with a guide. Search included articles on pharmacy or healthcare professions, published in English, and which met three content criteria: racial disparities/inequities, professional development/career advancement, and women or gender disparities Results: A total of 31 articles were included-medicine (17), nursing (1), pharmacy (7), other (4), and multiple health professions (2). Key findings included underrepresentation of women and minority groups, inequities in professional advancement and leadership positions for WoC, and greater dissatisfaction and attrition among minority and women professionals. Conclusion: WoC face unique and distinct challenges and barriers in their professional careers resulting from the intersectionality of not only race and gender, but also lived experiences and opportunities. Strategies to improve diversity and representation should include an intersectional framework or lens and be critically evaluated.

Pelvic Floor Disorders in Black Women: Prevalence, Clinical Care, and a Strategic Agenda to Prioritize Care.

Pelvic floor disorders are a group of common conditions affecting women of all racial and ethnic groups. These disorders are undertreated in all women, but this is especially magnified in Black people who have been historically marginalized in the United States. This article seeks to highlight the prevalence of pelvic floor disorders in Black women, evaluate the clinical care they receive, examine barriers they face to equitable care, and present a strategic agenda to prioritize the care of Black women with pelvic floor disorders.

Reproductive justice for Black, Indigenous, Women of Color: Uprooting race and colonialism.

Historically, atrocities against Black, Indigenous, and Women of Color's (BIWoC) reproductive rights have been committed and continue to take place in contemporary society. The atrocities against BIWoC have been fueled by White supremacy ideology of the "desirable race" and colonial views toward controlling poverty and population growth, particularly that of "undesirable" races and ethnicities. Grounded in Critical Race Theory, this paper aims to provide a critical analysis of historical and contemporary violations of BIWoC reproductive rights; discuss interventions based on empowerment and advocacy principles designed to promote women's reproductive justice; and discuss implications for future research, action, and policy from the lenses of Critical Race Theory and Community Psychology. This paper contributes to the special issue by critically analyzing historical and contemporary racism and colonialism against BIWoC, discussing implications for future research and practice, and making policy recommendations.

Representative Survivorship: A Look Into the Race-Evasiveness of Title IX and Understanding the Barriers to Reporting for Women of Color.

While there are many cultural norms that serve as barriers to Women of Color reporting sexual assault on college campuses, there are also several institutional and systemic barriers. This paper explores some of these barriers and argues for Title IX, a policy that addresses issues of sexual assault on college campuses, to encompass and protect more than a person's sex alone. In addition to the legal system, institutions of higher education have a long-standing history of discrimination against racial and ethnic minority groups, in particular with addressing sexual assault crimes. This paper argues that specific measures need to be outlined in Title IX that acknowledge and redress the effects of institutional harms on the BIPOC community. This paper also discusses how adopting a restorative justice and intersectional approach to policy reform will aid in building a supportive relationship between survivors and their educational institutions.

Health Experiences of Women University Students of Color and Women International Students in the United States During the First Year of the COVID-19 Pandemic: Findings From a Transnational, Virtual Photovoice Study.

Women university students in the United States who are students of color and international students consistently experience health disparities. These were exacerbated due to the COVID-19 pandemic and racial upheaval following the murder of George Floyd. Within that context, this study aimed to explore the health and well-being experiences of women students of color and international women students at a university in the Midwestern United States in 2020-2021. This participatory, transnational study utilized a virtual adaptation of Photovoice with 14 participants who joined the study from five different countries. Participatory elements included participant co-researchers co-leading development of the photo "mission," icebreakers, naming of the project, design of the project logo, choosing photos for discussion and exhibits, initial analysis of emergent themes, and approval and editing of photos for exhibit. Inductive thematic analysis revealed three themes: (1) grief and loss, (2) barriers and facilitators to social health, and (3) fear and stress from simultaneous social stressors. Data was not mutually exclusive with some photos and narratives illustrating more than one theme. The women experienced grief and loss while negotiating effects of social isolation and adapting to maintain social health. Negative mental and emotional health experiences were amplified as the social context of police brutality and anti-immigrant sentiments overlaid the stress of the pandemic. Study results demonstrate need for increased and tailored health and social service support for women students of color and international women university students.

Epistemologies of love and desire: Chicana Lesbians: The Girls Our Mothers Warned Us About.

This article provides a context for the publication of Chicana Lesbians: The Girls Our Mothers Warned Us About (1991). As Chicana literature and feminism flourished, the visibility of Chicanas increased dramatically, and at the same it became noticeable that Chicana lesbian representations lacked considerably. During this time roughly from the 1980s through 2000, the focus on Chicana lesbian representation reached a new level of awareness which ultimately led to an increase in demand for publications by and about Chicana lesbians. However, this new visibility did not materialize so easily and there were still resistances in the academy and at national conferences that led to major, well-documented confrontations. This was a dramatic and momentous period for the establishment of a public discourse about Chicana lesbians within Chicana/o studies that still continues today. Arguably, contributions by Chicana lesbians provided many foundational theories critical to the development of Chicana feminist thought and Chicana Studies that merits recognition. Published by Third Woman Press in 1991 and edited by Carla Trujillo, this book collection signaled a turn in perceptions of Chicana/o gays and lesbians across communities and in academic circles. This article argues that the publication of Chicana Lesbians: The Girls Our Mother Warned Us About was made possible by a confluence of social, cultural, and literary engagements with other publications that arose from a politics of love and desire. As a result, love and desire are epistemic expressions that shape the collective voices in Chicana Lesbians.

Women of color and the hidden curriculum of school psychology doctoral programs.

Doctoral training programs educate future practitioners, scholars, and researchers. They therefore are an important site of inquiry for critical school psychologists interested in interrogating and confronting the inequities that exist within the field. We conducted four focus groups with 15 Black, Indigenous, and Women of Color (BIWOC) students in various APA-accredited school psychology Ph.D. programs to understand how they experienced their programs. We argue that the programs delivered a hidden curriculum to the participants through various socializing, vicarious, and disciplinary events, in addition to the official curriculum delivered to all students. Data analysis indicated that the hidden curriculum was delivered in four settings and consisted of six lessons, including (a) you do not belong here, (b) you cannot be trusted, (c) you are on your own, (d) you are not safe here, (e) you are a token, and (f) you will only get performative allyship from us. We discuss each of these lessons and contemplate on ways in which programs and faculty can combat their deleterious impact on the students.

Flames of transformation: Igniting better mental and physical health for racialized and gendered North Americans.

COVID-19 is catalyzing both crises and opportunities for communities of color. The crisis of high mental and physical morbidities and mortalities exposes persistent inequities while providing opportunities to celebrate the power of rejuvenated anti-racism movements, fueled partly in response to the extremism of ultra-conservative governments, the circumstances to reflect deeply on racism because of forced stay-at-home-orders, and digital technologies primarily driven by youth. In marking this historical moment of longstanding anti-racism and decolonial struggles, I assert the importance of foregrounding women's needs. In analyzing racism, rooted in colonialism and white supremacy, and its impacts on mental and physical health status, I focus on improving racialized women's lives within the larger context, concentrating on the determinants of health. I contend that fanning the flames to scathe the racist and sexist foundations of North American society will break new ground for sharing wealth, bolstering solidarity and sisterhood, and ultimately improving Black, Indigenous, and Women of Color (BIWOC) health. Canadian BIWOC earn approximately 59 cents to the dollar earned by non-racialized men, creating vulnerabilities to economic downturns, such as the one Canada is currently in. BIWOC care aides, at the bottom of the healthcare hierarchy, are emblematic of other Black, Indigenous, and People of Color (BIPOC), who face risks of frontline work, low wages, poor job security, unpaid sick days and so forth. To that end, policy recommendations include employment equity initiatives that hire groups of racialized women who consciously express solidarity with each other. Cultural shifts within institutions will be key to providing safe environments. Improving food security, internet access and BIWOC-related data collection linked to community-based programming while prioritizing research on BIWOC will go a long way toward improving BIWOC health. Addressing racism and sexism within the healthcare system, aiming for equitable diagnostic and treatment foci, will require transformative efforts including determined leadership and buy-in from all levels of staff, long-term training and evaluation programs, audited by BIPOC communities.

Challenges to Help-Seeking Among Women of Color Exposed to Intimate Partner Violence.

Women exposed to intimate partner violence (IPV) often rely on support from their informal support networks to obtain resources that may mitigate IPV. This study explored the challenges women of color encounter in seeking advice and information from their informal support networks (i.e., family, friends, neighbors, community members) regarding IPV support services. In-depth interviews were conducted with 29 IPV survivors who self-identified as Black or Hispanic. Data were analyzed using grounded theory methodology. Results showed that participants lacked informational support, both in their communities and in their interpersonal relationships with family and friends. Communities treated IPV as normal and propagated the belief that women's responsibilities were to men and family. Family and friends discouraged IPV information seeking and advised that IPV should be kept private to avoid community shaming. The community environments also lacked information about resources for women experiencing IPV. The lack of information from their informal support networks appeared to delay participants' help-seeking. As the frequency and severity of violence escalated, some participants engaged in independent information searching, using social media and online information sources as well as conventional media like radio and newspapers. Others received information from first responders in the wake of a violent emergency. Participants described the information they received online or from first responders as empowering, encouraging them to engage in support services. Similarly, they felt empowered by the information they received from social workers, counselors, and victims' advocates, and they wished to use what they learned to help other women in similar circumstances. Women experiencing IPV and their communities need more information regarding IPV support services. Successful interventions for IPV survivors and their support networks may necessitate community-level education and altering biased perceptions of gender-appropriate behaviors.

Comfort in seeking support from sexual violence prevention education health services among college women.

Objective: Explores racial differences of sexual violence-(SV) health service-(HS) outcomes among college women: (1) seeking support from a confidential-resource-(CR) and (2) reporting SV to the Title IX office. Participants: Data was collected from all ages of women (N = 583) and grade levels from one-large university on the Pacific-coast. Methods: Logistic-regression of HS outcomes were performed using the Fall 2016 American College Health Association-NCHA-II-survey. Results: The following variables increased the likelihood of women seeking support from the two health-services: (#1CR) relationship-status, race, and experiencing sexual-violence. WOC were 7x more likely to seek support if physically-assaulted, and WW were 3.9x more likely to seek support if a graduate student. (#2Title IX) year in school, physical-assault, and receiving prevention-education after the first-year in college. Overall, there were significant differences by race in the variables that influenced WW and WOC's comfort or likelihood to seek support. Conclusion: Colleges need to consider the disproportionate impact of SV on WOC.

Assessing the Preliminary Efficacy of a Nonrandomized, Clinic-Based HIV Risk Reduction Pilot Intervention for PrEP-Initiated, Alcohol- and Other Drug-Using Women of Color in Miami, FL.

In this paper, we assessed the preliminary efficacy and acceptability of a quasi-experimental, clinic-based sexual risk reduction pilot intervention for pre-exposure prophylaxis (PrEP)-initiated, alcohol- and other drug-using women of color and explored their self-reported barriers to, and facilitators of, PrEP use. Using a mixed methods design, analyses incorporated pre- and post-intervention study assessment data from 38 women and semi-structured process evaluations using a subsample of 25. The intervention administered over an 8-week period consisted of 4 one-on-one in person educational sessions, a process evaluation, and study assessments conducted at baseline and 3 and 6 months. Post intervention, statistically significant changes in sexual risk scores were not observed; however, we found significant decreases in alcohol use (Z = - 3.02, p = .003, η2 = .41). Process evaluation data revealed interpersonal relationships as a key motivator for PrEP initiation as well as a prominent barrier to PrEP use; these relationships rarely facilitated adherence. Overall, women found the intervention to be acceptable and reported a wide range of benefits of participation-most notably its therapeutic benefits. Findings from this study provide preliminary evidence of the potential for the Talking PrEP with Women of Color intervention to improve risky behaviors, knowledge, and attitudes related to sexual risk taking. Furthermore, findings suggest that interventions to increase PrEP uptake and adherence in at-risk women may benefit from supporting them in accurately estimating their risk for HIV and increasing their sense of social support.

Internalized HIV-related stigma in women of color obtaining care at an HIV specialty center in Los Angeles County, California.

The current study examined the role of internalized HIV-related stigma in antiretroviral therapy adherence, viral load, and retention in care among women of color living with HIV in Los Angeles County, California. African American and Hispanic/Latino women 18 years of age and older completed a one-time brief survey between September 2017 and February 2018. Descriptive statistics, and univariable and multivariable logistic regressions were used to analyze the data. Seventy-six participants enrolled in the study and 74 completed the entire survey. Seventy-six percent of respondents were Hispanic/Latino, 24% were African American, 71% were unemployed, and 54% had less than a high school education. Thirty-five percent were defined as having "high" stigma with a score in the upper quartile of the scale. Being unemployed, having a high school education or less, and not meeting the Health Resources and Services Administration's annual retention in care measure were associated with "high" stigma. When controlling for education and employment status, those reporting "high" stigma vs. "low" stigma were 18.8 times more likely to not meet the criteria for annual retention in care (OR = 18.8, 95% CI = 1.9-189.2, p = 0.013). Stigma-reduction interventions targeting healthcare settings may be necessary to improve patient retention and engagement in care.

Pragmatic, Persistent, and Precarious: The Pathways of Three Minority Ethnic Women in STEM Higher Education.

Minority ethnic women are underrepresented in Science, Technology, Engineering, and Mathematics (STEM) higher education. Whilst existing studies, mostly in the US context, have provided valuable insights into racial and gender inequalities, there appears to be limited research in the UK. Through the lens of science identity, this article draws on qualitative data which was collected over three years, to appreciate how minority ethnic women develop their identity and belonging in STEM higher education, from the start to the end of their degrees. We present three case studies: (1) Nancy, a British East Asian Computer Science student, who appears pragmatic as she understands the extrinsic value of her degree, despite negative feelings and experiences; (2) Carol, a Black British Biomedical student, who can be seen as persistent, as supported by her intrinsic commitment to work in healthcare; and (3) Mawiya, a British Middle Eastern Mathematics student, whose experiences are somewhat precarious, because she must continuously negotiate her mathematics identity, which is often in question by herself and others. We discuss and compare the similarities and differences in the higher education pathways of these students. We also highlight the nuances of identity development and identity management, and consider multiple social inequalities for minority ethnic women. We conclude with a discussion of the implications of the findings for policy and practice.

Susan Stryker on solidarity: An interview for the Journal of Lesbian Studies.

For a special issue on Solidarity within the LGBTQ + community edited by Finn Mackay and Nikki Hayfield, Ella Ben Hagai, the editor of the Journal of Lesbian Studies interviewed Susan Stryker. Susan Stryker is a lesbian historian whose research, books, and films were pathbreaking in creating the field of trans* studies. I interviewed Susan to better understand the connections between queer cultures and the emergence of trans scholarship. I was also interested in her perspectives on the sort of solidarities that played a role in the trans revolution today. In the last part of the interview, I discuss with Stryker the political obstacles facing trans people and forms of solidarity necessary to face the current backlash in the U.S. against LGBTQ + people in general. In her interview, Stryker highlights the connection between BDSM subcultures, women of color feminism, and the emergence of trans* scholarship. She discusses the historical galvanization of trans and queer resistance around police violence and carceral logics, drawing lessons for overcoming current divisions in the queer community. Speaking about contemporary politics in the United States, Stryker illuminates the backlash against feminism and transgender rights and provides inspiration toward a strategy of united front politics.

Creating an inclusive community for BIPOC faculty: women of color in academia.

Institutions of higher education are increasingly diverse with more women and people of color hired, but there remains much work to be done to ensure that underrepresented faculty feel supported in their careers, evaluated fairly for tenure and/or promotion, and made to feel appreciated and valued in their institutions. This perspective paper will review how interpersonal and institutional prejudice disadvantage women of color in academia in aspects of their professional responsibilities including teaching, mentoring students, research, and service. The combination of these challenges explains why women of color are not rewarded in the same way and do not advance as quickly in their academic careers compared to white men. After considering the subtle and direct ways that biases cause harm to women of color, we present recommendations to better support women of color in faculty roles with the goal of combating prejudice pertaining to both racial/ethnic and gender biases.

Navigating Pregnancy and the Healthcare System during COVID-19: A Qualitative Study with Perinatal Women of Color.

OBJECTIVE: To address health disparities in the perinatal period (i.e., during pregnancy and through one year after birth) by exploring the intersectional experiences of perinatal Black, Indigenous, and other People of Color (BIPOC) women during the COVID-19 pandemic. In this study, participants were asked if and how COVID-19 had impacted their experiences of receiving healthcare, whether they had faced any challenges during this time, how they had navigated these challenges, and what recommendations they had for improving perinatal healthcare. METHODS: Between November 2021 and March 2022 our team conducted eight virtual focus groups comprising perinatal BIPOC women. A semi-structured interview protocol was used, and interviews were voice recorded and transcribed verbatim. The data were analyzed using reflexive thematic analysis. RESULTS: Three major themes common in BIPOC perinatal healthcare experiences during COVID-19 were generated through engaging in reflexive thematic analysis: (1) an overwhelming lack of support from providers, (2) experiences of blame and shame, and (3) difficulties navigating institutional policies that were unclear or ever-changing during the COVID-19 pandemic. Recommendations from participants included greater empathic communication from providers in the face of uncertainty during COVID-19, greater access to information and guidance for caring for themselves and their babies, and an overall request for greater compassion while navigating an exciting and busy time. RELEVANCE: These findings have implications for trauma-informed and inclusive perinatal care that can reduce the impacts of systemic inequalities for perinatal BIPOC women. This study offers a discussion of implications for future training for maternal health providers and implications for community-based programs.