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    Stigma, social and structural vulnerability, and mental health among transgender women: A partial least square path modeling analysis
    Journal of Nursing Scholarship (2023)
    Athena D. F. ShermanMelinda HigginsMonique S. BalthazarMiranda HillMeredith KlepperJason S. SchneiderDee AdamsAsa RadixKenneth H. MayerErin E. CooneyTonia PoteatAndrea L. WirtzSari L. Reisner
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    Abstract:
    Abstract Introduction Existing literature suggests that transgender women (TW) may be at high risk for adverse mental health due to stress attributed to combined experiences of stigma and complex social and structural vulnerabilities. Little research has examined how these co‐occurring experiences relate to mental health. We aimed to test a theoretically driven conceptual model of relationships between stigma, social and structural vulnerabilities, and mental health to inform future intervention tailoring. Design/Methods Partial least square path modeling followed by response‐based unit segmentation was used to identify homogenous clusters in a diverse community sample of United States (US)‐based TW ( N = 1418; 46.2% White non‐Hispanic). This approach examined associations between latent constructs of stigma (polyvictimization and discrimination), social and structural vulnerabilities (housing and food insecurity, unemployment, sex work, social support, and substance use), and mental health (post‐traumatic stress and psychological distress). Results The final conceptual model defined the structural relationship between the variables of interest within stigma, vulnerability, and mental health. Six clusters were identified within this structural framework which suggests that racism, ethnicism, and geography may be related to mental health inequities among TW. Conclusion Our findings around the impact of racism, ethnicism, and geography reflect the existing literature, which unfortunately shows us that little change has occurred in the last decade for TW of color in the Southern US; however, the strength of our evidence (related to sampling structure and sample size) and type of analyses (accounting for co‐occurring predictors of health, i.e., stigma and complex vulnerabilities, reflecting that of real‐world patients) is a novel and necessary addition to the literature. Findings suggest that health interventions designed to offset the negative effects of stigma must include anti‐racist approaches with components to reduce or eliminate barriers to resources that contribute to social and structural vulnerabilities among TW. Herein we provide detailed recommendations to guide primary, secondary, and tertiary prevention efforts. Clinical Relevance This study demonstrated the importance of considering stigma and complex social and structural vulnerabilities during clinical care and design of mental health interventions for transgender women who are experiencing post‐traumatic stress disorder and psychological distress. Specifically, interventions should take an anti‐racist approach and would benefit from incorporating social support‐building activities.
    Keywords:
    Stigma
    Topics:
    LGBTQ Health, Identity, and Policy
    Racial and Ethnic Identity Research
    African Sexualities and LGBTQ+ Issues
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    The Stickiness of Weight Stigma: An Examination of Residual Weight Stigma, Stigma Targets, and Willingness to Date
    Social Behavior Research and Practice - Open Journal (2017)
    Mary Beth AsburyJessica M. W. KratzerThomas M. Brinthaupt
    This research examined the stickiness of stigma related to being overweight and dating.Three studies explored whether residual weight stigma exists by comparing being overweight to other stigmatized conditions.The first study showed little evidence that overweight was a stigmatizing condition, with participants showing similarities in willingness to date someone who is overweight compared to other physical or medical conditions.There was partial support in the second study for the prediction that overweight was a stigmatizing condition in comparison to conditions related to physical appearance.The third study indicated that there was a tendency for participants to attribute greater personal responsibility for the overweight condition compared to other stigmatized conditions.Taken together, the results provided little evidence for residual stigma associated with the overweight condition and dating preferences.
    Stigma
    Weight stigma
    Citations (1)
    “This is an illness. No one is supposed to be treated badly”: Community-based stigma assessments in South Africa to inform TB stigma intervention design
    Research Square (Research Square) (2023)
    Isabel FosterAmanda BiewerNosivuyile VanqaGoodman MakandaPhumeza Tisile
    Abstract Background Though TB-related stigma is a recognized barrier to care, interventions are lacking and gaps remain in understanding the drivers and experiences of TB-related stigma. We undertook community-based mixed methods stigma assessments to inform stigma intervention design. Methods We adapted the Stop TB Partnership stigma assessment tool, and trained three peer research associates (PRAs; two TB survivors, one community health worker) to conduct surveys with people with TB (PWTB, n=93) and caregivers of children with TB (n=24) at peri-urban and rural clinic sites in Khayelitsha, Western Cape, and Hammanskraal, Gauteng Province, South Africa. We descriptively analyzed responses for each stigma experience (anticipated, internal, and enacted), calculated stigma scores, and undertook generalized linear regression analysis. We further conducted 25 in-depth interviews with PWTB (n=22) and caregivers TB (n=3). Using inductive thematic analysis, we performed open coding to identify emergent themes, and selective coding to identify relevant quotes. Themes were organised using the CARD (Constraints, Actions, Risks and Desires) framework. Results Surveys revealed at least one-third of PWTB and one-quarter of caregivers report experiences of anticipated, internal, and/or enacted stigma, which affected engagement throughout the care cascade. Participants in rural locations (compared to peri-urban) reported higher anticipated, internal, and enacted stigma (β-coefficient 0.72, 0.71, and 0.74). Interview participants described how stigma experiences, including HIV intersectional stigma, act individually and in concert as key constraints to impede care, and underpins failure to disclose a TB diagnosis, isolation, and exclusion. Stigma resilience arose through understanding that TB can affect anyone and should not diminish self-worth. Risks of stigma, driven by fears related to disease severity and infectiousness, led to care disengagement and impaired psychological wellbeing. Participants desired counselling, identifying a specific role for TB survivors as peer counsellors, and community education. Conclusions Stigma is highly prevalent and negatively impacts TB care and the well-being of PWTB, warranting its assessment as a primary outcome indicator rather than intermediary contributor to poor cascade outcomes. Multicomponent stigma interventions are needed, including counselling for PWTB and education for health workers and communities. Such interventions must incorporate contextual differences based on gender or setting, and use survivor-guided messaging to foster stigma resilience.
    Stigma
    Social stigma
    Citations (1)
    Social Support of Organ Donor Families in China: A Quantitative and Qualitative Study
    Frontiers in Public Health (2021)
    Aijing LuoHaiyan HeZehua XuXuantong DengWenzhao Xie
    Background: Donor families experienced a difficult time during and after the process of organ donation. There is a necessity to understand the support they received and what they need to help them get through a painful time. This study aimed to investigate the social support level and social support needs of the donor families in China. Methods: A cross-sectional study was conducted among 102 donor families using a questionnaire to investigate their demographics and social support level. To further understand their social support needs, in-depth interviews were conducted among 9 donor families. Results: Findings of the study showed that (1) Most of the family members (74, 72.6%) lacked social support, and only a small number of families (28, 27.5%) received sufficient social support (2). The coping style had an impact on the overall social support level ( P = 0.014) (3). There was a lack of emotional support, information support and material support toward the donor's family members. Both emotional support and material support are significantly needed. Conclusions: The overall social support level remained insufficient and the utilization degree of social support was low. Organ donor families are in desperate need of material and emotional support. The level of social support is largely influenced by the donor familie's coping style. Compared with a negative coping style, donor families who adopted a positive coping style acquire more social support.
    Emotional support
    Family Support
    Demographics
    Citations (5)
    “This is an illness. No one is supposed to be treated badly”: community-based stigma assessments in South Africa to inform tuberculosis stigma intervention design
    BMC Global and Public Health (2024)
    Isabel FosterAmanda BiewerNosivuyile VanqaGoodman MakandaPhumeza Tisile
    Though tuberculosis (TB)-related stigma is a recognized barrier to care, interventions are lacking, and gaps remain in understanding the drivers and experiences of TB-related stigma. We undertook community-based mixed methods stigma assessments to inform stigma intervention design.
    Stigma
    Social stigma
    Citations (4)
    Guides on Stigma and Mental Wellbeing. Guide 3. How to reduce sources of stigma.
    H BroekkampS DhondgeMelissa DuckBassey EbensoD Gbolahan
    Stigma
    Citations (0)
    Longitudinal Impact of Public Stigma on Self-Stigma: Is Societal Stigma Internalized?
    PsycEXTRA Dataset (2012)
    Rachel L. BitmanDavid L. VogelJoseph H. Hammer
    Stigma
    Longitudinal Study
    Citations (0)
    A Review Of The Literature And Media Reports Of Patterns Of Mental Health Stigma And Addressing Stigma In Slovenia Until 2010 / Pregled Literature In Medijskih Poročil O Stigmatizaciji Ljudi Z Duševnimi Motnajmi In O Ukrepih Proti Stigmi V Sloveniji Do Leta 2010
    Slovenian Journal of Public Health (2013)
    Maja ValićLee KniftonVesna Švab
    Abstract As part of the ASPEN (Anti-Stigma Programme - European Network) project’s Work Package 4 (‘Anti-stigma’ best practice), Aspen sites were to conduct a literature review on stigma in their country. In Slovenia, besides the peer review publications and reports, we also included all media reports on stigma in the last five years to illustrate the impact of various professional and public initiatives to reduce stigma and discrimination against depression. The Slovenian report includes several areas of mental health stigma defined through peer reviewed literature and other professional publications.
    Stigma
    Health Professionals
    Citations (0)
    Understanding and Measuring Stigma
    Patrick W. CorriganDavid RoeHector W. H. Tsang
    This chapter contains sections titled: The scope of the problem Concepts for understanding stigma Where do we learn stigma? Signals that lead to stigma Putting it all together Suggestions for challenging mental health stigma Stigma and world diversity Assessing stigma Summary
    Stigma
    Scope (computer science)
    Citations (0)
    Overcoming Stigma II
    Oxford University Press eBooks (2011)
    Stephen P. Hinshaw
    Abstract The focus of Chapter 10 is public media, as well as attitudes and practices in the mental health professions, in the reduction of stigma and discrimination of mental illness.
    Stigma
    Citations (0)