Public health, pluralism, and the telos of political virtue.

In the ethics of public health, questions of virtue, that is, of what it means for public health to act excellently, have received little attention. This omission needs remedy first because achieving improvements in population-wide health can be in tension with goals like respect for the liberty, self-determination, or non-oppression of various individuals or groups. A virtue-ethics approach is flexible and well-suited for the kind of deliberation required to resolve or mitigate such tension. Public health requires practically wise and careful thinking, which virtue ethics brings with it. Furthermore, too tight a focus on delivering outcomes in determining how public health should act has, in some cases, actually undermined its ability to achieve those consequences. However, the main concern about incorporating virtue into public health in a pluralistic society is likely to be that virtue is generally teleological, and we would surely need some widely agreed upon idea of something like flourishing or the common good for this to work. In this paper, I propose that for public health to express virtue in its work, it must express a commitment to justice as it goes about its business promoting and protecting the health of the population. Justice is both a contributor toward better health for groups in society, and a worthwhile goal in its own right. I will sketch an argument that justice as non-oppression - not merely health equity - is the right telos toward which excellent public health should aim in a pluralist society.

"When you live in a colony every act counts": Exploring engagement in and perceptions of diverse anti-colonial resistance strategies in Puerto Rico.

While social psychology has contributed much to our understanding of collective action, other forms of resistance are understudied. However, in contexts of long-standing oppression-such as ongoing colonialism-and past repression of liberation struggles, other resistance strategies are important considering the constraints on overt, collective action in such contexts. This paper reports findings from an interview study in Puerto Rico (N = 22) exploring anti-colonial resistance. We analysed participants' own resistance, future preferred strategies, and descriptive norms of other ingroup members' resistance. Through thematic analysis, we identified six distinct forms of anti-colonial resistance. Notably, none of the participants reported participating in collective action. Instead, participants engaged in different forms of symbolic everyday resistance to preserve a positive, distinct cultural identity, and raise critical consciousness of the group's oppression. Additionally, more tangible resistance strategies included staying on the land and building independent economies. Overall, this study illustrates the importance of considering a more comprehensive set of resistance strategies in contexts of long-standing colonial oppression to recognize oppressed groups' agency and provide a better understanding of how people undermine destructive power.

Mobilizing Critical Occupational Therapy Praxis to Promote Structural Justice, Equity, and Rights[Formula: see text].

BACKGROUND: Societal structures and systems compel occupational therapists, at times, to behave in ways that perpetuate injustices. Justice theorists have described how Global North social structures have created the conditions for oppression of some groups while enabling additional groups to have unearned privileges. Mobilizing critical occupational therapy praxis is an essential response. PURPOSE: This lecture addresses three questions: why should occupational therapists integrate structural justice, equity, and rights into their everyday practices?; what gives occupational therapy the potential to be a structural justice-, equity-, and rights-oriented profession?; and, how can occupational therapy mobilize critical praxis that will promote structural justice, equity, and rights? KEY ISSUES: Occupational therapy's embeddedness in structures of injustice and therapists' obligations to integrate justice, equity, and rights into their everyday practices are increasingly evident. A focus on occupational participation, growing critical consciousness, socially transformative practices, and capacity for collective action position occupational therapy to be a structural justice-oriented profession. Critical reflexivity and reflection; justice-, equity-, and rights-based lenses; and acts of resistance and disobedience to oppressive systems can help mobilize critical praxis. IMPLICATIONS: Occupational therapists have individual and collective opportunities for exercising the moral imagination and moral courage to mobilize critical occupational therapy praxis.

Vicarious heterosexism-based stress induces alcohol, nicotine, and cannabis craving and negative affect among sexual minority young adults: An experimental study.

Purpose: Sexual minority young adults are at increased risk for hazardous drinking and alcohol use disorder compared to heterosexual adults. Heterosexism-based stressors contribute and often explain inequities in alcohol outcomes. However, the extant research primarily relies on correlational designs, and often neglects the importance of alcohol craving, despite its foundational role in addiction. Leveraging a novel experimental mood induction paradigm, this study examined the effects of exposure to vicarious heterosexism-based stress on alcohol craving and negative affect among sexual minority young adults who drink heavily. We also examined its effects on cannabis and nicotine craving among participants who used cannabis and nicotine, respectively. Lastly, we examined moderating factors that could influence the impact of exposure to heterosexism-based stress on alcohol craving. Methods: Participants were 101 heavy drinking sexual minority young adults, ages 20-35 (M = 26.46 years old; SD = 3.49), recruited from the community (51.5% female sex assigned at birth; 76.3% cisgender; 51.5% plurisexual; and 42.6% racial and ethnic minorities). They completed three mood induction trials counterbalanced over three visits on different days: heterosexism stress, general stress, and neutral. Structured interviews assessed criteria for DSM-5 alcohol use disorder (AUD) and substance use, and self-report measures assessed lifetime traumatic stressors. Results: Most participants met criteria for past-year AUD (74.7%). Exposure to heterosexism stress produced more negative affect and substance craving than the neutral mood induction, even while controlling for demographic variables and lifetime exposure to traumatic and heterosexism stressors. Exposure to heterosexism-based stress had large effects on alcohol craving among participants who had greater drinking to cope motives and heterosexism-specific rejection sensitivity, whereas the effects were small for those who had lower drinking to cope motives and heterosexism-specific rejection sensitivity. Demographic, lifetime stress, prior alcohol use, and AUD symptom severity variables were not significant moderators. Greater substance craving induced by heterosexism-based stress in the laboratory was associated with greater recent and current substance use. Conclusions: This study findings show that vicarious exposure to heterosexism elicits negative mood and alcohol, cannabis, and nicotine craving among sexual minority young adults who engaged in heavy drinking. The effects for alcohol craving were largest among those who endorse high levels of drinking to cope motives and heterosexism-based rejection sensitivity. These findings have implications for oppression-based stress and motivational models of addiction.

Oppression-Based Stress and Alcohol Inequities Among Sexual and Gender Minority People: An Intersectional Multilevel Framework.

PURPOSE: Sexual and gender minority (SGM) people are at heightened risk for alcohol use, hazardous drinking, and alcohol use disorder compared to heterosexual and cisgender individuals. This paper: (a) presents an oppression framework that integrates intersectionality, stress, stigma, and addiction-based theories to examine the complex and nuanced ways oppression-based stress (e.g., minority stress) leads to sexual orientation and gender identity inequities in alcohol use; (b) conducts a narrative review that summarizes recent and novel advancements in the literature on the impact of oppression-based stressors on alcohol use outcomes across structural, interpersonal, and intrapersonal domains among SGM people; and (c) provides future research and intervention directions for the alcohol field. SEARCH METHODS: A select review of the literature was conducted on July 10, 2023, using multiple electronic databases (i.e., PsycInfo, PubMed, Web of Science) and focusing on studies that had examined the associations between oppression-based stressors and alcohol use outcomes across structural, interpersonal, and intrapersonal levels. Search terms focused on alcohol consumption; SGM people, particularly SGM people of color; and oppression-based stress. Cross-sectional studies that focused on heterosexism-based and anti-bisexual oppression-based stressors at the interpersonal or intrapersonal levels and alcohol use outcomes were excluded as they have been included in prior reviews of the literature. SEARCH RESULTS: The initial and combined search across the databases resulted in 3,205 articles. Of those, the narrative review included 50 peer-reviewed articles that focused on the following four areas of the literature on the associations between oppression-based stressors and alcohol use outcomes: (1) experimental, longitudinal, and experience sampling studies of heterosexism- and anti-bisexual oppression-based stressors (22 articles); (2) any studies of cissexism-based stressors (12 articles); (3) any studies of intersectional oppression among SGM people of color (seven articles, one article overlapped with the first category and another overlapped with the fourth category); and (4) any studies of structural oppression (11 articles). DISCUSSION AND CONCLUSIONS: Results of this narrative review indicate that mounting evidence implicates oppression-based stress in inequities in alcohol use, hazardous drinking, and alcohol use disorder in SGM populations. This reflects SGM people's embodiment of oppression and injustice at the structural, interpersonal, and intrapersonal levels. Given some inconsistent and mixed patterns of findings, future research needs greater specificity in drinking inclusion criteria, robust and well-validated measures, more attention to culturally and developmentally relevant moderating and mediating mechanisms across the lifespan, application of sophisticated methodologies, and integration of intersectional and addiction frameworks.

Barriers to Formal Help-Seeking Among Black American Young Adults: Exploring the Roles of Sexual Violence Victimization, Intersectional Oppression, and Perceived Burdensomeness.

Though sexual violence can impact people across genders, sexual orientations, ages, and incomes, societal inequities can increase the risk of experiencing sexual violence. Such inequities are often intersectional in nature (e.g., racism and sexism) and may impact a person's ability to engage in help-seeking for experiences of sexual violence, especially among those who perceive themselves to be a burden on others or society as a whole. Therefore, the purpose of the current study was to examine the association between experiencing sexual violence, intersectional oppression, and perceived burdensomeness on barriers to help-seeking among Black American young adults. Participants (n = 289) completed an online questionnaire assessing constructs of interest. We found that half of our sample experienced any sexual violence and nearly three-fourths experienced more than one form of intersectional oppression (e.g., racism, sexism, and homophobia). Ultimately, we found that sexual violence and perceived burdensomeness - but not intersectional oppression - were correlates of experiencing barriers to help-seeking. Through incorporating multiple marginalized identities beyond Black race, our findings can expand our understanding of barriers to help-seeking among diverse Black sexual violence survivors, while revealing a new area for practitioners, healthcare providers, social workers, and related professionals to focus intervention strategies on: perceived burdensomeness. These findings are relevant to all who care for the health and well-being of those who have experienced sexual violence, chronic stress (due to singular and multiple forms of discrimination), and/or other traumas.

Deconstructing the Trauma-Altered Identity of Black Men.

Multiple and continuous traumatic events experienced by Black men impose altering effects on their identities, and their mentalization and presentation of themselves in society. However, the unique dynamics of the impact of trauma in shaping Black men's identities are not well understood, because their experiences with trauma are not well documented. This paper is a secondary analysis of the qualitative component of a mixed method study that explored trauma, social support, and resilience among 103 racialized youth survivors of gun violence in Toronto, Canada. The analysis for this paper specifically focused on young Black male participants in the study to understand their disproportional experiences with gun violent trauma. Thematic analysis of their narrative demonstrated three themes: 1) trapped by the trauma of systemic oppression; 2) identity marred by the trauma of systemic oppression; and 3) masculinity shifted by the trauma of systemic oppression. The thematic mapping of themes and subthemes yielded the trauma-altered identity (TAI), a concept coined to represent the intersections of trauma, systemic oppression, masculinity, and the identity of Black male survivors. Using a metaphoric artwork to conceptualise the TAI, we explore its psychosocial impacts and set strategies for deconstructing its influence on Black men. While we acknowledge that trauma experiences may vary among Black males, we recognise that understanding intersections of risks associated with trauma among young Black males presents opportunities for policy discussions, advocacy, and social justice reforms.

Anti-oppression as praxis in the research field: Implementing emancipatory approaches for researchers and community partners.

Equity, diversity, and inclusion (EDI) and anti-oppression (AO) policies are implemented in research to address intersecting systemic barriers for marginalized populations. Grant applications now include questions about EDI to ensure researchers have considered how research designs perpetuate discriminatory practices. However, complying with these measures may not mean that researchers have engaged with AO as praxis. Three central points emerged from our work as a women's research collective committed to embedding AO practices within the research methodology of our community-based study. First, research ideas must be connected to larger pursuits of AO in and across marginalized communities. Secondly, AO as praxis in the research design is an exercise in centering cultural knowledge and pragmatic research preparation and response that honours the collective. Lastly, AO approaches are not prescriptive. They must shift, adapt, and change based on the research project and team, creating space for transformative resistance and emancipation of racialized researchers and community workers.

"These Conversations Shouldn't be Easy You're Going to Have to Shift. It Means Reflection It Means Change": Moving Anti-Oppression Beyond Incremental Changes in the GBV Sector.

Little is known about racialized women's work experiences in EDI/AO policy-led Canadian women's organizations in the gender-based violence (GBV) sector. Twenty-three racialized and white GBV workers participated in a critical qualitative study. Five themes emerged illustrating that racialized women workers are experiencing systemic violence through acts of racism and discrimination. The two themes examined in this paper: a culture of silence and shifting the needle forward reveal that the GBV sector is primarily an affirmative space. Creating greater safety for racialized women workers means moving toward transformative approaches that challenge the system's responsibility in creating and supporting anti-oppressive efforts in the elimination of violence.

Informing inclusive and affirmative hospital pharmacy services for 2SLGBTQ+ patients.

DISCLAIMER: In an effort to expedite the publication of articles, AJHP is posting manuscripts online as soon as possible after acceptance. Accepted manuscripts have been peer-reviewed and copyedited, but are posted online before technical formatting and author proofing. These manuscripts are not the final version of record and will be replaced with the final article (formatted per AJHP style and proofed by the authors) at a later time. PURPOSE: Two-spirit, lesbian, gay, bisexual, transgender, and queer (2SLGBTQ+) people disproportionally experience health disparities, and hospital pharmacists, given their accessibility and expertise in medication management, are ideally positioned to provide care to this vulnerable population. This study investigated the barriers and facilitators faced by hospital pharmacists when providing care to 2SLGBTQ+ patients, with the goal of informing enhancement of quality care provided to these patients. METHODS: A mixed-methods triangulation design was utilized, comprising an online survey and qualitative interviews with Canadian hospital pharmacists. The survey used the lens of systemic oppression as a framework and assessed pharmacists' perceptions and knowledge. Survey data were analyzed using descriptive statistics, and interviews were analyzed using thematic analysis. RESULTS: A total of 129 individuals participated in the survey, and 15 participants were interviewed. Eleven themes were identified, and findings revealed a complex web of individual, interpersonal, and systemic barriers and facilitators. Pharmacists expressed a lack of proficiency and confidence in discussing 2SLGBTQ+ health topics, further compounded by an apprehension to engage and a fear of causing harm. Pharmacists desired support from their leadership teams and organizations in the form of access to resources, time to engage in training, and workplace environments that encourage discussions about 2SLGBTQ+ health. CONCLUSION: Hospital pharmacists in Canada are willing to provide inclusive care to 2SLGBTQ+ patients but face significant barriers. These findings highlight the need for comprehensive education, supportive workplace cultures, and accessible resources to address health disparities and improve care for 2SLGBTQ+ individuals.

Through the Lens of Societal Norms and Experiences: Students' Conceptualization of Patient Case Data When Diversity is Apparent.

OBJECTIVE: There are increasing calls to improve the representation of diversity within case-based learning materials, yet it is unclear how students interpret the inclusion of diversity data when synthesizing case information. The objective of this study was to determine factors that influence students' interpretation of written case data for visualization of a patient case. METHODS: This was a qualitative study using interviews. Entry-to-practice pharmacy students from Dalhousie University in Canada were recruited to review 6 cases, each with varying representations of diversity (eg, race, sexual orientation, gender, relationship status, disability, or none). Students were prompted to state how they visualized the case patient and what factors influenced their perceptions. Interviews were audio-recorded and transcribed verbatim. A reflexive thematic analysis was conducted to interpret themes. RESULTS: Interviews were conducted with 18 students. Students relied on 5 factors when interpreting case data in the presence of diversity. In addition to the case data itself, these included personal experience (relating to themselves or personal relationships), professional experience (through work or school), population stereotypes, and perceived societal norms. CONCLUSION: This study found that students rely on their personal and professional experiences, perceptions, and social conditioning when interpreting the presence of diversity within learning materials. Findings support the notion that educators should deliberately and conscientiously expose students to a broad representation of diverse populations to increase students' knowledge and understanding of populations, and to create intentional time and space to challenge existing stereotypes that contribute to the inequities in health care.

Intersectional Oppression-Based Stress, Drinking to Cope Motives, and Alcohol Use and Hazardous Drinking Among Sexual and Gender Minority Adolescents Who Are Black, Indigenous, and People of Color.

Purpose: This study examined the associations between intersectional oppression-based stress and recent alcohol use and hazardous drinking among sexual and gender minority (SGM; e.g., queer or transgender) adolescents who were Black, Indigenous, and People of Color (BIPOC), also known as queer and transgender BIPOC (QTBIPOC) adolescents, and the mediating role of coping motives (i.e., drinking to cope) on these associations. Methods: Data were from a subsample of QTBIPOC adolescents who used alcohol in the past year (n = 1365) from a national U.S. sample of SGM adolescents aged 13-18 years. Results: Intersectional oppression-based stressors were associated with greater odds of recent alcohol use and hazardous drinking, as well as greater coping motives. Coping motives mediated the associations between intersectional-based stressors and both recent alcohol use and hazardous drinking among the aggregate sample of QTBIPOC adolescents, as well as among some subgroups of BIPOC adolescents. Conclusions: The results of this study highlight that intersectional oppression-based stressors are prevalent among QTBIPOC adolescents and serve as a risk factor for alcohol use and hazardous drinking. Multilevel interventions are needed to target and dismantle intersectional oppressions to address alcohol inequities impacting QTBIPOC adolescents. Drinking to cope motives mediated the associations between intersectional oppression-based stress and drinking outcomes, underscoring another important mechanism to target within a context of oppression in drinking interventions.

The influence of personal and economic oppression on a country's corruption levels worldwide.

This empirical research study endeavors to analyze the indirect association between oppression and corruption in 147 nations around the globe to answer one question: "Why does oppression drive corruption in many nations?" The author used secondary data from two different resources. The first source is the Corruption Perception Index (CPI), created by Transparency International (TI) in 2020, and the Human Freedom Index (HFI), co-published by the Cato Institute. In addition, the second source is the Political Stability Index in 2020 to test the three research hypotheses using the R-square, and Anova shows that the model is personal and economic oppression explains 53.5 percent of the variance. In addition, the Weighted Least Squares Regression Analyses imply that there is a positive and meaningful connection between personal oppression (ß = 3.028, p < 0.000) and corruption and economic oppression and corruption (5.203, p < 0.000). This study's findings confirmed the theoretical and conceptual relationship between oppression and bribery and identified personal and economic oppression factors as the leading causes of corruption in many countries. The study findings also contribute to the literature and the industry as well. Theoretically, the study results help researchers to understand why oppression causes corruption at the country level. Practically, the study results help policymakers, educators, and international business planners to consider roots when making successful strategic decisions in the era of the globalized world. The author also discussed the research limitations and practical and theoretical implications.

Dismantling the colonial mindset and becoming "Gender AWAke": From gendered complicity to embodied praxis.

The purpose of this article is to delineate the nature of the colonial mindset, which perpetuates gendered settler colonial structures of historical oppression in research and practice. By connecting a critical consciousness and living in alignment with agility (AWA), this work explicates pathways from gendered complicity to embodying praxis-or becoming gender AWAke. This article begins by describing the nature of the colonial mindset. Second, I critically examine the dominant discourse institutionalized by Western psychology. Third, I introduce the FHORT and critically analyze how the colonial mindset has affected and driven violence against Indigenous women. Examining how settler colonial structural sexism in its heteropatriarchal and heteropaternalistic forms has become imposed upon the lives of Indigenous women and gender-expansive peoples exposes subjugated knowledges; it provides an empirical scaffolding for people to become critically conscious of dominant gender norms that apply to people, institutions, and society more broadly. Finally, I propose living AWAke for personal and collective liberation.

Opportunities for incorporating intersectionality into biomedical informatics.

Many approaches in biomedical informatics (BMI) rely on the ability to define, gather, and manipulate biomedical data to support health through a cyclical research-practice lifecycle. Researchers within this field are often fortunate to work closely with healthcare and public health systems to influence data generation and capture and have access to a vast amount of biomedical data. Many informaticists also have the expertise to engage with stakeholders, develop new methods and applications, and influence policy. However, research and policy that explicitly seeks to address the systemic drivers of health would more effectively support health. Intersectionality is a theoretical framework that can facilitate such research. It holds that individual human experiences reflect larger socio-structural level systems of privilege and oppression, and cannot be truly understood if these systems are examined in isolation. Intersectionality explicitly accounts for the interrelated nature of systems of privilege and oppression, providing a lens through which to examine and challenge inequities. In this paper, we propose intersectionality as an intervention into how we conduct BMI research. We begin by discussing intersectionality's history and core principles as they apply to BMI. We then elaborate on the potential for intersectionality to stimulate BMI research. Specifically, we posit that our efforts in BMI to improve health should address intersectionality's five key considerations: (1) systems of privilege and oppression that shape health; (2) the interrelated nature of upstream health drivers; (3) the nuances of health outcomes within groups; (4) the problematic and power-laden nature of categories that we assign to people in research and in society; and (5) research to inform and support social change.

Anti-oppression pedagogy in health professions: a scoping review.

Health professional learners are increasingly called to learn about health inequity to reduce inequities and improve patient care and health outcomes. Anti-oppression pedagogy (AOP) addresses the need for health professional learners to understand multiple health inequities and the structures and systems that produce inequities. However, the inclusion of AOP in health professions education varies and there is a lack of clarity in its conceptualization and integration. A scoping review was conducted to address this gap and to understand how AOP is conceptualized and integrated in health professions education. Thirty-six articles met the inclusion criteria. The articles demonstrated that AOP is not commonly utilized terminology within health professions education. When AOP is integrated, it is not consistently conceptualized but is generally viewed as a broad concept that focuses on antiracism; decoloniality; intersectionality; and supporting learners to understand, critically reflect on, and act against structural and systemic forms of oppressions. In addition, there is variation in the integration of AOP in health professions education with the most common methods consisting of discussions, cases, reflection, learning through lived experiences, and the incorporation of humanities within a longitudinal curriculum. The results of this scoping review highlight the need for health professions education to develop one clear concept that educators use when teaching about anti-oppression, which may reduce working in silos and allow educators to better collaborate with each other in advancing this work. In addition, this review suggests that health professional programs should consider incorporating AOP in curricula with a broad and longitudinal approach utilizing the common methods of delivery. To better support programs in including AOP in curricula, further research is required to emphasize the benefits, provide clarity on its conceptualization, and determine the most effective methods of integration.

Epistemic appropriation and the ethics of engaging with trans community knowledge in the context of mental healthcare research.

Mental healthcare research increasingly focuses the needs of trans people and, in doing so, acknowledges knowledge and epistemic resources developed in trans communities. In this article, we aim to raise awareness of an ethical issue described by Emmalon Davis that may arise in the context of engaging with community knowledge and epistemic resources: the risk of epistemic appropriation. It is composed of two harms (1) a detachment of epistemic resources developed in the originating community and (2) a misdirection of these epistemic resources for epistemic goals of a dominant community. In this article, we map and discuss the ethical concerns in using knowledge originating in trans communities in terms of epistemic appropriation in the context of mental healthcare research. We first argue that misgendering, failing to reference non-academic sources and a lack of attribution in community authorship are forms of epistemic detachment. Second, we problematize cases of epistemic misdirection of trans epistemic resources, focusing on the examples of detransition and transition regret. We discuss harms related to epistemic appropriation in relationship to risks to safety. The article aims to raise awareness about the risk of epistemic appropriation both in researchers engaging with trans knowledge as well as in mental healthcare workers who seek information on trans.

Decolonizing nursing education: Reflecting on Paulo Freire's pedagogy of the oppressed.

Historically, nursing education's foundation has been framed by colonial practices of whiteness, which serves as a fulcrum for oppression, Western epistemic ideology, racial injustice, and health inequity. As a microcosm of the broader academy, nursing education must pivot to dismantle practices impeding the advancement of the profession and move to decolonize processes of professional edification. Decolonization is not a metaphor; it requires unlearning the deep socialization of Eurocentric perspectives embedded in nursing education and relearning in a new, inclusive manner that embraces historically marginalized knowledge systems and experiences. This paper aims to operationalize what this decolonization process would look like for nursing education while reflecting on Paula Freire's Pedagogy of the Oppressed. The authors will highlight the interrelationship of the main concepts of Paulo Freire's critical pedagogy, including liberation, critical consciousness, dialog, humanization, dehumanization, problem posing, and banking education.

The mental health benefits and costs of critical consciousness: A longitudinal investigation of the co-occurring positive and negative effects of critical consciousness among sexual minorities.

Critical consciousness is a powerful tool for individuals from marginalized groups to transcend their oppressive conditions through engagement in critical reflection, motivation, and action. Nonetheless, the mental health benefits and costs of critical consciousness have received limited research attention. The present study utilized a longitudinal research design to explore the positive and negative relationships between critical consciousness and mental health among sexual minority individuals in different developmental stages. A total of 636 sexual minority individuals were involved in the baseline study and were asked to complete a follow-up questionnaire after one year. The results demonstrated a co-occurrence of positive and negative effects of critical consciousness on mental health among sexual minority individuals across time. On the one hand, critical consciousness was associated with better mental health outcomes through the mediation of internalized oppression and community connectedness. Specifically, critical consciousness was associated with reduced internalized oppression, which in turn was linked to lower levels of emotional distress. Critical consciousness was also associated with heightened levels of community connectedness, which in turn was associated with improved well-being. On the other hand, the results revealed a positive direct effect of critical consciousness on emotional distress, after controlling for internalized oppression and community connectedness. Notably, developmental stage moderated the relationship between critical consciousness and well-being. A negative association between critical consciousness and well-being was observed among sexual minority youth, whereas no such association was found among sexual minority adults. While the study highlights that critical consciousness can be a pedagogical and therapeutic tool for the liberation and empowerment of sexual minority individuals, it is equally important to acknowledge the potential risks associated with critical consciousness. Striking a balance between critical consciousness and self-care is crucial for sustaining meaningful engagement in the pursuit of social change.

"Caught in the crossfire" - women veterans' testimonies regarding excessively violent acts committed in combat zones.

As women in the Israeli Defense Forces (IDF) are increasingly placed in supportive and combat roles in active war zones, they routinely encounter and participate in violent acts. This study focusses on the centrality of gendered inequality and oppression as a factor that shapes not only women's experience in the military but also their responses in cases of excessive violence. The goal of this study was to explore the ways women veterans of combat or combat-support units conceptualize their stance regarding violent acts which they either committed or witnessed in war zones. Using a qualitative approach, we analyzed the retrospective testimonies of 58 Israeli women veterans from the archives of an NGO that documents veteran combatants exposure to excessive violence. Most women explained their violent acts as inherent to the military system and culture, which in our analysis was categorized as examples of either internalized gender oppression or as identification with the aggressor. A smaller number of women described their attempts to protest, as they took a moral stance rooted in a feminine perspective. The three explanations revealed through the analysis of the testimonies reflect the inner tension experienced by many women in the military, as they navigate between two extreme positions, either as victims of male dominance, or as aggressors that are part of a powerful military system. In this study, gendered inequality provides a framework for analyzing the data. Thus, this study contributes to the theoretical knowledge and methodological approaches concerning violent situations in combat areas, focusing on the various ways in which women veterans subjectively and retroactively conceptualize their participation in and responses to violent acts.