Transgressing gender norms in addiction treatment: Transgender rights to access within gender segregated facilities.

Despite having disproportionately high rates of substance use disorder and co-occurring health and mental health issues compared to the general population, transgender individuals experience significant barriers to accessing and engaging in addiction treatment programs. Inpatient addiction treatment centers were originally designed to treat substance-dependent heterosexual cisgender populations and, as such, feature gender-segregated housing, bathrooms, and treatment sessions. The heteronormative structural and programmatic barriers, combined with exposures to stigmatic and prejudicial attitudes, may dissuade transgender populations from benefiting from the addiction treatment they so direly need. The purpose of this article is to examine the current policy debate surrounding the rights of transgender individuals in public accommodations in the context of inpatient addiction treatment centers

Alcoholics Anonymous is a fellowship of people: A qualitative study.

This New York City-based qualitative study rooted in minority stress and grounded theories explores the experiences of 11 transgender and gender nonconforming (TGNC) adults in Alcoholics Anonymous (AA). Three themes emerged in the study: (1) AA as a foundation for sobriety and gender transition; (2) experiences with gender minority-based stigma in AA; and (3) use of adaptive strategies to negotiate survival in AA. This paper concludes with recommendations for AA members, substance abuse treatment professionals, social workers, and other healthcare providers to enhance TGNC experiences within substance abuse treatment and recovery communities

Anti-racism and substance use treatment: Addiction doesn’t discriminate, but, do we?

Contemporary racism in the United States contributes to health, mental health, and substance use disorder (SUD) disparities among People of Color (POC) compared with White individuals. Despite entering into substance use treatment with a greater severity of SUD and related consequences, POC experience more barriers to treatment engagement, completion, and satisfaction than their White counterparts. As substance use treatment counselors are socialized within institutions of systemic racism, it is important to examine their positioning on racism in relation to their capacity for culturally competent care. This article articulates a need to implement an antiracist framework for substance use treatment

Trans feminine sexual violence experiences: The intersection of transphobia and misogyny.

Trans feminine individuals are at a higher risk of sexual victimization than any other subset of the U.S. population. This New York City (NYC)-based study employed an intersectional framework with a phenomenological interview format to explore the experiences of trans feminine adult study participants with sexual victimization. A total of 10 in-depth interviews with a diverse sample of trans feminine individuals were conducted. Analysis revealed themes specific to (1) the diversity of experiences within sexual victimization, (2) transmisogynistic sexual victimization, (3) internalized transmisogyny and cissexism, and (4) the health consequences of sexual victimization. Recommendations for policy and programmatic enhancements, future research directions, and implications for social workers are provided

Operationalizing intersectionality in social work research: Approaches and limitations

Despite intersectionality’s relevance to social work, scholars have raised concerns that its misguided applications place it “in danger of being co-opted, depoliticized, and diluted.” This scoping review examined the use of intersectionality in empirical social work research, specific to the extent, contexts, and degree of responsibility with which it has been applied. Using the search term convention [“social work” OR “social services”] AND [“intersectional” OR “intersectionality”], 22 databases were searched for peer-reviewed research published between 2009 and 2019, yielding 153 articles. The 33 studies meeting inclusion criteria were examined according to two frameworks: (1) typologies for intersectional conceptual approach and (2) intersectionality responsible use guidelines (RUG). Most studies used an intracategorical approach (n ¼ 24), while fewer used an intercategorical (n ¼ 7) or a mixed intra- and intercategorical approach (n ¼ 2). On average, studies met approximately half of the RUG. Studies most frequently (n ¼ 29) aligned with the guideline “Recommend ways to promote positive social transformation and justice through research, teaching, and practice.” Studies least frequently (n ¼ 3) conformed to the guideline “Credits Black feminist activist roots of intersectionality.” Responsible stewardship is recommended to address power in knowledge production, researcher positionalities, and social justice action

Intersectional anti racist advocacy practice in healthcare organizations

Health care organizations, like individuals, can evolve to become antiracist and promote racial equity within and beyond the organization. In this brief article, we introduce an intersectional antiracist advocacy practice framework applicable to health care organizations that seek restorative and transformative change, as well as participation in social and economic justice action. Becoming an antiracist organization requires an acknowledgment that no organization is impervious to racist and other oppressive ideologies. Organizations can then begin to interrogate, interrupt, and address how racism permeates agency policies, procedures, and culture. The implementation of an intersectional antiracist advocacy practice framework within organizations involves a multifaceted approach, including both internal and external practices. Internally facing practices include providing mandatory antiracist trainings to all employees; promoting a representative and equitable workplace; and developing an organizational power structure based on inclusion, transparency, and accountability. Externally facing practices include fostering nonexploitative, reciprocal community partnerships; contributing to social and economic justice movements; and demonstrating transparency and accountability for the negative impact of operations in Black, Indigenous, and People of Color (BIPOC) communities and lands. We conclude with key questions for health care organizations to consider in regard to their racial equity efforts, specifically around organizational readiness, risk tolerance, and long-term commitment

“Render a service worthy of me”: A qualitative study of factors influencing access to LGBTQ-specific health services

For a half-century, LGBTQ-specific health services have sought to address the unmet health care needs of LGBTQ people in the U.S. However, there is a dearth of research examining factors that influence LGBTQ care-seekers’ reasons for choosing LGBTQ-specific services and their experiences accessing care. This interview-based study explored factors that facilitate and inhibit access to LGBTQ-specific health services among a sample of 40 LGBTQ adults in a major U.S. city. Using framework analysis, emergent themes were organized into supply- and demand side factors, guided by Levesque et al.’s (2013) framework for patient-centered health care access. Supply-side factors included provider empathy and affirmation, provider knowledge, comprehensive care, and provider based stigma. Demand-side factors included care-seeker\u27s willingness for self-disclosure, care-seeker beliefs placing primacy on health needs over LGBTQ identities, contentment with general providers, a lack of knowledge for service identification, and perceptions of ability to pay. Social aspects of care seeking were also identified, including desires for social belonging, collective self-esteem, and community solidarity. Findings suggest opportunities to enhance the fit between health care policy, LGBTQ-specific provider characteristics, and care-seeker needs, particularly for multiply marginalized LGBTQ communitie

Online victimization, womanism, and body esteem among young Black women.: A structural equation modeling approach

Digital media use represents a central part of young adults’ daily life, within which social interactions increasingly center on visual content. While visual content, such as representations of self, may facilitate positive social interactivity, it may also increase susceptibility to harmful social interactions, such as appearance-related online victimization. Black women’s bodies are often the target of gendered racial microaggressions and sexual victimization which can contribute to body image concerns. Still, the online victimization–body esteem link among Black women remains unexamined. This study used structural equation modeling to examine the associations between four categories of online victimization (i.e., general online victimization, online individual racial victimization, online vicarious racial victimization, online sexual victimization) and body esteem. We further examined whether womanism, an identity-based factor, moderated the relationship between online victimization and body esteem. A sample of 1,595 young Black women completed an online survey. Results showed that online sexual victimization was significantly negatively associated with body esteem and that high levels of womanism buffered the harmful impact of general online victimization on body esteem. Future research is needed to examine Black women’s and gender expansive people’s experiences with online gendered racial victimization along with other forms of online intersectional oppressio

Black women’s experiences of gendered racial sexual objectification, body image, and depressive symptoms

Black women navigate unique sexual objectification experiences and concerns about their bodies as a consequence of the race- and gender-based marginalization that they face. However, less is known about the influence of gendered racial sexual objectification experiences on Black women’s mental health (i.e., depressive symptoms) or the contributions of key body image indicators (i.e., body surveillance and current-ideal body image discrepancy) that reflect Black women’s engagement in monitoring and managing their bodies. We surveyed 1595 Black women to test our hypotheses that experiences of gendered racial sexual objectification (i.e., frequency and stress appraisal) would be positively associated with depressive symptoms and that body surveillance and current-ideal body image discrepancy would moderate this association. Analyses showed that more frequent experiences of gendered racial sexual objectification and higher stress appraisal of these experiences were significantly associated with more depressive symptoms. Furthermore, body surveillance and current-ideal body image discrepancy moderated the relation between gendered racial sexual objectification and depressive symptoms. Findings highlight how Black women’s objectification and increased engagement in body monitoring and management practices are associated with their experiences of depressive symptoms, and thus, may negatively influence their mental health

Gendered racial microaggressions scale: Measurement invariance across sexual orientation

Gendered racial microaggressions are often assessed using the Gendered Racial Microaggressions Scale. Despite its use with mixed samples of heterosexual and sexual minority Black women, this instrument has yet to be evaluated for its measurement invariance across sexual orientation. This study evaluated the measurement invariance of the Gendered Racial Microaggressions Scale across sexual orientation (heterosexual [n=1,147] versus lesbian, gay, or bisexual [LGB], n=359) in a sample of 1,506 Black cisgender women ages 18–30 years old. The Gendered Racial Microaggressions Scale’s four-factor structure, including Beauty and Sexual Objectification, Silenced and Marginalized, Strong Black Woman, and Angry Black Woman, was replicated with our sample. Results from the multigroup confirmatory factor analysis indicated the Gendered Racial Microaggressions Scale had configural, metric, and scalar invariance across sexual orientation groups. Strict invariance was not established. Multi-group comparison of latent factor mean scores revealed Black LGB women as having higher Beauty and Sexual Objectification scores than Black heterosexual women on the Gendered Racial Microaggressions stress appraisal scale. The Gendered Racial Microaggressions Scale can be recommended in meaningfully assessing differences in latent factor mean scores among Black heterosexual and LGB women. Practitioners, researchers, and policy makers should seek to address the role of intersectional microaggressions in the lived experiences of sexual and gender minorities of color, including as it relates to systemic disadvantage and health, mental health, and social disparitie