Trauma Recovery in the Transgender and Gender Diverse Community: Extensions of the Minority Stress Model for Treatment Planning

Transgender and gender diverse (TGD) populations, including those that do not identify with gender binary constructs (man or woman) are increasingly presenting for treatment of posttrauma sequelae. Providers who offer services for trauma survivors including posttraumatic stress disorder (PTSD) treatment should be knowledgeable about evidence-based care and have some cultural familiarity with TGD experiences. Indeed, the Minority Stress Model suggests that the combination of distal and proximal minority stressors can combine to produce increased mental health symptoms as compared with cisgender peers, though this model has yet to be fully tested. Clients often present with a complicated picture of experiences, which include a variety of minority stressors, microaggressions, discrimination, and traumatic events that can all be related to their identity. However, conceptualizations of trauma treatment in the context of extensive minority stress are lacking. This paper summarizes the existing literature and offers guidance to mental health providers who are well positioned to address stigma, discrimination, violence, and related symptoms that arise from micro-, mezzo- and macro-level spheres of TGD individuals’ experience.     

I loved him and he scared me: Migrant women,partner visas and domestic violence

This study considers the experience of migrant women engaging with the Australian Department of Immigration through the Family Violence Provisions (Migration Regulations, 1994). These provisions allow women applying for partner visas to remain in the country after separation, if they can prove they experienced domestic violence. Forty semi-structured interviews were conducted with twenty migrant women from diverse backgrounds, focusing on their experiences of intimacy and violence and their emotions regarding the relationship. Using the Listening Guide methodology, data was analysed focusing on women's voices and the emotions concerning this subject. This paper considers Australian Immigration Law's requirement of a ‘genuine and continuing relationship’ and how it engages with women's emotions. The study argues that there is a distance between women's emotional responses to their relationships and immigration demands for proof and emotional consistency. The result is that women's emotions are dismissed by the same immigration system that has been historically shaped by emotions towards immigrants. The article ends by proposing that women's stories and emotions are valuable sources of information for visa processes and indicates countries where, in some cases, immigration laws already engage with women's emotions as reliable sources of information.     

Waist-to-Hip Ratio and Unhealthy Body Change in Women

The role of waist-to-hip ratio (WHR) in unhealthy body change was examined in a sample of 143 women university students. They completed the Eating Disorder Examination-Questionnaire (EDE-Q), reported their level of concern with weight and with WHR, and used unmarked measuring tapes to record their subjective (self-perceived), ideal, and objective (measured) waist and hip circumference. Although body shape was reported as important, and concern with WHR correlated significantly with symptoms of disordered eating, the relationships involving WHR were not independent of those involving body weight. Thus, there appears to be little behavioural and/or clinical significance in the aesthetic evaluations made by women of their WHR. Reasons for this are considered in light of evidence that women regard WHR as more difficult to control and less amenable to change than their overall body weight.     

Women Living with Traumatic Brain Injury

Abstract

Women living with Traumatic Brain Injury (TBI) typically experience social and emotional sequelae that can be effectively addressed in the context of a psychotherapeutic relationship. Traumatic Brain Injuries can affect the full range of human functioning, from activities of daily living to experiencing a coherent sense of self. In this article, we focus on two issues, social isolation and emotional functioning, that encompass a number of key challenges facing women with TBI and are common and fruitful foci of psychotherapy. Social isolation includes marginalization in multiple communities, the invisibility of cognitive disabilities, difficulties in interpersonal relationships, and difficulties in employment and access to transportation. Emotional functioning includes posttraumatic stress symptoms, loss of self-esteem, anxiety, depression, anger, and shame. Two exemplary cases are used to illustrate the themes and underscore the complexities and realities of adjusting to TBI. Recommendations for therapists and consumers are woven throughout the paper.     

The impact of thin idealized media images on body satisfaction: Does body appreciation protect women from negative effects?

This article examines whether positive body image can protect women from negative media exposure effects. University women (N = 112) were randomly allocated to view advertisements featuring ultra-thin models or control images. Women who reported high levels of body appreciation did not report negative media exposure effects. Furthermore, the protective role of body appreciation was also evident among women known to be vulnerable to media exposure. Women high on thin-ideal internalization and low on body appreciation reported appearance-discrepancies that were more salient and larger when they viewed models compared to the control group. However, women high on thin-ideal internalization and also high on body appreciation rated appearance-discrepancies as less important and no difference in size than the control group. The results support the notion that positive body image protects women from negative environmental appearance messages and suggests that promoting positive body image may be an effective intervention strategy.     

A Social Ecological Model of Syndemic Risk affecting Women with and At-Risk for HIV in Impoverished Urban Communities

Syndemic risk is an ecological construct, defined by co‐occurring interdependent socio‐environmental, interpersonal and intrapersonal determinants. We posited syndemic risk to be a function of violence, substance use, perceived financial hardship, emotional distress and self‐worth among women with and at‐risk for HIV in an impoverished urban community. In order to better understand these interrelationships, we developed and validated a system dynamics (SD) model based upon peer‐reviewed literature; secondary data analyses of a cohort dataset including women living with and at‐risk of HIV in Bronx, NY (N = 620); and input from a Bronx‐based community advisory board. Simulated model output revealed divergent levels and patterns of syndemic risk over time across different sample profiles. Outputs generated new insights about how to effectively explore multicomponent multi‐level programs in order to strategically develop more effective services for this population. Specifically, the model indicated that effective multi‐level interventions might bolster women’s resilience by increasing self‐worth, which may result in decreased perceived financial hardship and risk of violence. Overall, our stakeholder‐informed model depicts how self‐worth may be a major driver of vulnerability and a meaningful addition to syndemic theory affecting this population.     

Resilience in Community: A Social Ecological Development Model for Young Adult Sexual Minority Women

Family support and rejection are associated with health outcomes among sexual minority women (SMW). We examined a social ecological development model among young adult SMW, testing whether identity risk factors or outness to family interacted with family rejection to predict community connectedness and collective self‐esteem. Lesbian and bisexual women (N = 843; 57 % bisexual) between the ages of 18–25 (M = 21.4; SD = 2.1) completed baseline and 12‐month online surveys. The sample identified as White (54.2 %), multiple racial backgrounds (16.6 %), African American (9.6 %) and Asian/Asian American (3.1 %); 10.2 % endorsed a Hispanic/Latina ethnicity. Rejection ranged from 18 to 41 % across family relationships. Longitudinal regression indicated that when outness to family increased, SMW in highly rejecting families demonstrated resilience by finding connections and esteem in sexual minority communities to a greater extent than did non‐rejected peers. But, when stigma concerns, concealment motivation, and other identity risk factors increased over the year, high family rejection did not impact community connectedness and SMW reported lower collective self‐esteem. Racial minority SMW reported lower community connectedness, but not lower collective self‐esteem. Families likely buffer or exacerbate societal risks for ill health. Findings highlight the protective role of LGBTQ communities and normative resilience among SMW and their families.     

The impact of the amount of social evaluation on psychobiological responses to a body image threat

The present study examined the impact of amount of social-evaluative body image threat on psychobiological responses. Women (N = 123) were randomized into an individual-threat, group-threat or no-threat condition. Participants completed a measure of state body shame and provided a sample of saliva (to assess cortisol) at baseline and following their condition. Both threat conditions had higher baseline-adjusted body shame following the threat compared to the no-threat condition; however, no difference on baseline-adjusted body shame between the threat conditions was found. The same pattern of results was found for cortisol – both threat conditions had higher baseline-adjusted response cortisol than the no-threat condition, with no significant differences between the threat groups. Findings suggest that the magnitude of psychobiological responses to a social-evaluative body image threat does not differ with the amount of social-evaluative threat (individual- versus group-threat). These findings provide insight into the context of body image threats of women.