Intimate Partner Violence in Transgender and Nonbinary Relationships: Actor-Partner Associations with Relationship Satisfaction, Dyadic Coping, and Partner Support.

Purpose: Transgender and nonbinary (TNB) adults experience disproportionate levels of intimate partner violence (IPV) compared with cisgender populations. Most research with TNB samples has focused on individual and demographic risk factors associated with IPV. Scarce research with TNB samples has evaluated how relational factors correlate with IPV victimization, which would be more consistent with dyadic models of IPV. The current study assessed associations between relational factors and psychological and physical victimization among TNB adults and their significant others. Methods: The sample included 112 dyads (total N = 224; mean [M] relationship length = 8.2 years; M age = 35) comprising a TNB adult and their significant other. Given our dyadic sample, we used actor-partner interdependence models to assess actor (i.e., intrapersonal) and partner (i.e., cross-partner) associations between relational factors (e.g., relationship satisfaction, dyadic coping, and partner social support) and IPV victimization among TNB individuals and their partners. Results: We identified numerous actor-partner effects across dyadic coping subscales and measures of partner support on TNB adult reports of IPV victimization. Actor effects were also significant for relationship satisfaction on both TNB and their partner's reports of IPV victimization. Conclusion: Results provide some of the first evidence of relational factors in association with IPV victimization among TNB adults and their intimate partners. These findings have clinical implications for identifying TNB individuals at risk for IPV in their relationships.

A mixed-methods study of race-based stress and trauma affecting Asian Americans during COVID.

COVID-19 propelled anti-Asian racism around the world; empirical research has yet to examine the phenomenology of racial trauma affecting Asian communities. Our mixed methods study of 215 Asian participants of 15 ethnicities examined experiences of racism during COVID and resulting psychological sequelae. Through qualitative content analysis, themes emerged of emotional, cognitive, and behavioral changes resulting from these racialized perpetrations, including: internalizing emotions of fear, sadness, and shame; negative alterations in cognitions such as reduced trust and self worth; and behavioral isolation, avoidance, and hypervigilance, in addition to positive coping actions of commitment to racial equity initiatives. We engaged in data triangulation with quantitative Mann-Whitney U tests, finding that those who experienced COVID discrimination had significantly higher racial trauma and PTSD scores compared to those who did not. Our convergent findings provide clinicians with novel ways to assess the ongoing impact of racial trauma and implement appropriate interventions for clients.

Sexual Minority Women and Discriminatory Health Care Experiences: An Intersectional Evaluation Across Race and Ethnicity.

OBJECTIVE: Health care discrimination contributes to medical mistrust among marginalized communities. Sexual minority women of color (SM-WOC) are marginalized because of the intersection of their sexual orientation, gender, and race/ethnicity and regularly report poor health care experiences at the intersection of these identities. However, research has yet to quantify differences in the prevalence of reported health care discrimination across SM women of various racial/ethnic backgrounds. As such, this study compared the rates of discriminatory treatment during the most recent medical appointment between SM-WOC (Black, Hispanic, Asian American, Native American) and White SM women. METHODS: We used nationally representative data from the Association of American Medical Colleges survey of health care services. Data were collected from 2010 to 2019 from N = 1,499 SM women (n = 458 SM-WOC). Binary logistic regressions compared frequencies of reported identity-based discrimination between each minoritized racial/ethnic group to White SM women. RESULTS: Across the sample, 33% of SM-WOC reported discrimination during their last medical appointment compared with 19% of White SM women. Discriminatory treatment was more common among every minoritized racial/ethnic group of SM women compared with White SM women, with variability in frequency of specific forms of identity-based discrimination across minoritized racial/ethnic groups. CONCLUSIONS: Although discriminatory treatment during the last medical appointment was common for all SM women, prevalence was higher for SM-WOC compared with White SM women. Findings have important implications for policy and practice to reduce health disparities, such as targeted interventions for SM-WOC and provider trainings in cultural humility, implicit bias, and common microaggressions.

Sexual Minority Women, Health Care Discrimination, and Poor Health Outcomes: A Mediation Model Through Delayed Care.

Purpose: Sexual minority (SM) women are a heterogeneous group who commonly report negative health care experiences at the intersection of their diverse sexual orientations and racial/ethnic identities. However, scarce research has evaluated how negative health care experiences may affect health outcomes among this population. Informed by the Health Equity Promotion Model for SM health, this study evaluated mediation models in which delayed care mediated the association between provider discrimination and poor health outcomes in SM women. Sexual orientation (plurisexual or monosexual) and race/ethnicity (women of color or White) were evaluated as moderators of the direct and indirect pathways. Methods: The sample included SM women (N = 1530) from the nationally representative Association of American Medical Colleges biannual Consumer Survey of Healthcare Access (2010-2020). Mediation models were conducted with lavaan structural equation modeling software. Results: Reported discrimination from a health care provider was associated with higher physical and emotional impairment, and these associations were partially mediated through delayed care. Sexual orientation and race/ethnicity also moderated several indirect and direct pathways. Conclusion: Results provide evidence of delayed care as a possible mediation pathway between provider discrimination and worse health in SM women and that the strength of these associations may vary by sexual orientation and race/ethnicity. Results indicate a need for policy change and clinical trainings to reduce the harm of provider discrimination on SM women.

Centering Asian American Women's Health: Prevalence of Health Care Discrimination and Associated Health Outcomes.

Asian American women routinely face multiple and intersectional forms of discrimination based on their marginalized social identities, including during their interactions within the US health care system. However, most research on discrimination against Asian American women is limited by its exclusive focus on race-, gender-, or language-based forms of discrimination; and research has yet to assess if their discriminatory health care experiences are associated with poor health outcomes. To address this gap, we centered the experiences of Asian American women (N = 905) from the Association of American Medical Colleges Biannual Consumer Survey of Health Care Access, a national survey of health care consumers conducted from 2011 to 2020. Prevalence rates were established for unfair treatment due to race, gender, culture, language, age, health insurance, and sexual orientation. Multiple regression models were used to assess how these discriminatory experiences were associated with health and functioning outcomes. Findings demonstrate a high prevalence (32.0%) and wide range of discriminatory experiences in health care settings among Asian American women. The majority of these discriminatory experiences were significantly associated with poorer health and functioning outcomes, even after controlling for demographic influences. Results highlight the need for further development of culturally sensitive medical practices and policies to improve the delivery of health care for Asian American women.

Intimate partner violence in female same-gender couples: An investigation of actor-partner correlates within the past year.

Objective: Female same-gender couples experience higher rates of intimate partner violence (IPV) as compared to other couples, yet research on IPV in this population is limited and almost exclusively focused on individual-level correlates. Given the interdependent nature of IPV, the current study examined actor and partner associations of recent IPV use in female same-gender couples. Method: Data were collected from 103 adult female same-gender couples (N = 206) and analyzed using actor-partner interdependence models. Results: The odds of engaging in physical assault in the last year were positively associated with partner (but not actor) discrimination, alcohol use, and anxiety symptoms and negatively associated with both actor and partner relationship adjustment, emotional intimacy, and partner (but not actor) dedication and social support. The odds of engaging in high levels of psychological aggression in the last year were positively associated with actor and partner depressive and anxiety symptoms, actor (but not partner) negative communication, and partner (but not actor) discrimination and negatively associated with both actor and partner emotional intimacy, actor (but not partner) relationship adjustment, dedication, and social support. Conclusion: These findings demonstrate the interdependent nature of IPV-associated factors in female same-gender couples. Clinical implications include evaluating factors associated with recent IPV use that take into account dyadic associations between partners. (PsycInfo Database Record (c) 2022 APA, all rights reserved).