Identity Stigma Research Articles

Government Policy and NGO Intervention for People Living With HIV (PLHIV) in the Philippines: The Case of PLHIV in an Urban Community in Southern Philippines

Alarmed with the rapid increase of HIV cases in the Philippines, the government has instituted Republic Act 8504 known as Philippine AIDS Prevention and Control Act of 1998. Down south, an ordinance on policies and measures to prevent and control STI, HIV/AIDS infections was promulgated in Iligan City. A non-government organization, known as Northern Mindanao AIDS Advocates (NorMAA) was organized to extend assistance to People Living with HIV (PLHIV) in the area. With a very scarce if not nil local literature on PLHIV, it necessitates the conduct of this study. Conducted in Iligan city, Southern the study aims to find out social stigma and coping mechanisms among PLHIV members of the NorMAA. Using a qualitative design of key informant interview which entails in-depth interview, the study conducted a personal and individual interview with seven informants who were identified purposively using a snowball or referential sampling method. Research ethics of informed consent and confidentiality are strictly observed by the researchers in the conduct of data gathering and data presentation. Findings were analyzed using social stigma of Erving Goffman (1963) and social identity of Tajfel (979). Labeled as Person Living with HIV (PLHIV) and having joined the NorMAA, the key interview informants acquired the social identity as PLHIV. With such identity which implies a dreaded health condition, two courses of actions are found among the informants: disclosure and concealment of their social identity and health status as PLHIV. Those who disclosed their identity to their significant others had negative experiences which to them are a stigma. Those who preferred to conceal their identity as PLHIV attributed this to imagined stigma – forms of stigma which they imagined to experience once their health status is known by others. NorMAA’s collaborative works with the local government agencies pave the way to recover and boost self-confidence of the PLHIVs. The continuous sustainable interventions that targeted not just on the individual level of the PLHIV but also the family members are significantly an evident. Despite their stigmatized social identity, most PLHIV maintained a positive outlook in life with better perceived life-chances.

Welfare Stigma of Social Assistance on Women Recipients in Urban China

In urban China, the study of the welfare stigma of poor females receiving social assistance is neglected. An in-depth interview method was used with 16 urban female assistance recipients aged 16–70 years old in the city of Chengdu to examine the forms and the consequences of welfare stigma on them. The purpose of the study is to examine the issue of welfare stigma of female assistance recipients in urban China by means of empirical evidence. The findings suggest that female assistance recipients suffer from welfare stigma in three forms: identity stigma, treatment stigma, and procedure stigma. The three kinds of stigmas mingled with each other are imposed on the female assistance recipients and make them victims of constructed welfare stigma. Welfare stigma does not affect the decision to apply for assistance to meet basic living expenses. Suffering from welfare stigma positions female recipients in a state of isolation and exclusion. The study’s results suggest that efforts should be made to reduce and eliminate welfare stigma of social assistance on female assistance recipients in urban China. Future study should be broadened to consider the comparison of the stigma on female recipients with that on male recipients.

Mentally ill, HIV-positive, or sexual predator? Determining myths perceived as representative of transgender people

The present study explored possible stereotypical beliefs, or myths, related to prejudice and discrimination toward transgender individuals in the US. In a 5 x 2 x 3 mixed factorial design, Amazon Mechanical Turk workers ( N = 1,450) read a description of a target depicted as a sexual predator, HIV-positive, having a mental illness, an ally of transgender people, or unfair to others. They then completed an intuitive judgment task regarding the target’s gender (male or female) and identity stigma detail (transgender, sexual minority, or no stigmatized detail), and provided feeling thermometer ratings for various groups. Results indicated that participants perceived mental illness as relatively representative of transgender people, but not HIV-status or sexual predation. Feeling thermometer ratings for transgender people were significantly lower than those for other gender/stigma categories and were negatively correlated with participant religiosity and conservatism. We discuss these findings in terms of gendered assumptions and present implications for gender-related stigma and the role of perceived mental illness in antitransgender prejudice.

Loving More Than One Color: Bisexuals of Color in Italy Between Stigma and Resilience

The present research explored the narratives of Bi + people of Color living in northern Italy and the strategies they used to deal with multiple identity negotiations, stigma, and discrimination. As previous research suggests, Bi + people of Color face a double stigma due to the intersection between a nonmonosexual orientation and a nonwhite skin tone. Following an interdisciplinary approach between social psychology and cultural anthropology, we conducted qualitative interviews with bisexual men of Color with different migratory backgrounds (e.g. Sub-Saharan Africa and South America). Narratives of stigma and resilience emerged by focusing on the intersections between the axes of sexual orientation and skin tone. Findings illustrate how the double stigma that Bi + people of Color experience affects their personal and political lives through their relationships with relevant social actors and networks.

Young People's Reasons for FeelingSuicidal.

Background: While considerable attention has been given to explanations for youth suicide, less is known about the reasons that young people themselves give for suicidality. Research on online communications gives an opportunity to investigate the real-time reasons young people give for feeling suicidal. Aims: This study aimed to identify the reasons that young people provide for feeling suicidal in posts published on a suicide prevention forum, hosted on the social media platform Tumblr. Method: We filtered 2 months' worth of posts to identify those that related specifically to suicide. In total, 210 posts were thematically analyzed to identify the reasons given for suicidality and the meanings associated with these. Results: Six main reasons for suicidality were identified in the analysis: feeling lonely and socially disconnected, experiencing identity stigma, failing to meet expectations, being helpless, feeling worthless, and experiences of mental ill-health. Limitations: There are advantages as well as limitations associated with relying on Internet-based data. Limitations include the inability to establish participant demographics and the lack of context for posts. Conclusion: Suicide prevention efforts should target the reasons that young people give for feeling suicidal in the moment of crisis in order to engage this population more effectively.

Sexual behavior stigma and depression among transgender women and cisgender men who have sex with men in Côte d'Ivoire

PurposeTransgender women (TGW) and cisgender men who have sex with men (cisMSM) across sub-Saharan Africa experience health inequalities relative to other adults. Recent research has also revealed health inequalities between these often-conflated groups. Among TGW and cisMSM in Côte d’Ivoire, we sought to determine whether transgender female identity was associated with probable depression, and whether sexual behavior stigma mediated this association. MethodsIn 2015–2016, a cross-sectional respondent-driven sampling survey of adult TGW and cisMSM was conducted across five cities. We conducted a three-way decomposition of mediation and interaction of gender identity and sexual behavior stigma. Depression was measured by the nine-item Patient Health Questionnaire (PHQ-9). ResultsOf 1301 participants, 339 (26.1%) were TGW. The prevalence of probable depression was 22.7% among TGW and 12.2% among cisMSM (P < .001). After confounder adjustment, the relative risk of depression attributable to transgender female gender identity was 1.68 (95% CI = 1.36, 2.00) with 69.9% (95% CI = 42.6, 97.1) of this effect mediated by sexual behavior stigma. The effect of stigma on depression did not differ significantly by gender. ConclusionsThese data suggest that stigma mitigation interventions specifically addressing the stigma affecting transgender women may also address mental health inequalities between transgender women and cisMSM in Côte d’Ivoire.

Double Jeopardy? Stigma of Identity and Affirmative Action

This article seeks to understand stigma faced by students from groups who enter higher educational institutions on the basis of affirmative action. The article uses the theoretical insights from the “stereotype content model” which disentangles the social-psychological mechanisms of “externalization” and “internalization.” The data are from a primary survey administered to university students in India to understand the channel of stigma associated with caste-based affirmative action (AA). The article finds that despite a significant gap in entry scores at admission, there are no significant differences in the effort and academic attitudes between AA and non-AA students. Yet, there are clear and significant differences between caste groups that reveal the presence of stigma through the “externalization” mechanism, that is, upper caste peers tend to evaluate beneficiary performance prejudicially, indicating the prevalence of discriminatory attitudes toward students who are admitted through AA. However, there is no compelling evidence of “internalization”: that is, students from beneficiary groups do not necessarily internalize their peers’ low evaluation of their own competence. These findings suggest the need for establishing an antidiscriminatory apparatus inside higher educational institutions to counter stigmatizing attitudes and microaggressions against AA admits.

Syndemic Classes, Stigma, and Sexual Risk Among Transgender Women in India.

Syndemic theory could explain the elevated HIV risk among transgender women (TGW) in India. Using cross-sectional data of 300 TGW in India, we aimed to: identify latent classes of four syndemic conditions (Depression-D, Alcohol use-A, Violence victimization-V, HIV-positive status), test whether syndemic classes mediate the association between stigma and sexual risk, and test whether social support and resilient coping moderate the association between syndemic classes and sexual risk. Four distinct classes emerged: (1) DAV Syndemic, (2) AV Syndemic, (3) DV Syndemic, and (4) No Syndemic. TGW in the DAV Syndemic (OR 9.80, 95% CI 3.45, 27.85, p < 0.001) and AV Syndemic classes (OR 2.74, 95% CI 1.19, 6.32, p < 0.01) had higher odds of inconsistent condom use in the past month than the No Syndemic class. Social support significantly moderated the effect of DAV Syndemic class on inconsistent condom use. DAV Syndemic was found to be a significant mediator of the effect of transgender identity stigma on sexual risk. HIV prevention programs among TGW need to: (a) incorporate multi-level multi-component interventions to address syndemic conditions, tailored to the nature of syndemic classes; (b) reduce societal stigma against TGW; and (c) improve social support to buffer the impact of syndemics on sexual risk.

Collaboration between key populations in a global partnership for health and human rights: Lessons learned from ‘Bridging the Gaps’

ABSTRACTBecause HIV and AIDS key populations share common social-cultural factors challenging their sexual health and rights (e.g. stigma, criminalisation), there is an assumed benefit of collaborative programmes where various key populations work in solidarity. In this paper, we reflect on how partners collaborated in a complex alliance of over 100 different NGOs, representing and supporting three key populations – lesbian, gay, bisexual and transgender (LGBT) people, sex workers and people who use drugs – working across 16 countries. We used a multiple-method approach of participant observation, qualitative interviews, and a survey to explore the benefits, facilitators and challenges of collaboration. Results show that motivators for collaboration included being part of the larger funding structure with applied impacts, a repressive human rights context, and intersectionality. Barriers for collaboration included identity politics, stigma, and constraints regarding the appropriate timing of new collaborations. Finally, facilitators include practical support for engagement, the framing of human rights in a medical agenda, and recognition of implicit differences. We conclude that for building the capacity for collaboration among socially marginalised groups it is important to develop trust and the ability to recognise strength in difference beyond the initial identification of shared norms and common goals.

Gender Socialization Practices Among Bisexual and Other Nonmonosexual Mothers: A Longitudinal Qualitative Examination

ABSTRACTThough social scientists have researched sexual-minority parenting practices regarding the gender socialization of children, to date this research has focused exclusively on sexual-minority parents in same-gender relationships, and almost exclusively on the experiences of gay and lesbian parents. This article addresses the gender socialization parenting practices of 25 nonmonosexual sexual-minority women who are in different-gender relationships through analysis of qualitative in-depth interviews that took place over the course of 1 year. Our findings indicate that the experiences of these participants differ from both those reported in previous literature on sexual-minority parents in same-gender relationships, as well as heterosexual parents in different-gender relationships. Specifically, participants do not report sexual identity stigma as restricting the degree of cross-gender socialization in which they engage, nor do they report a gender normative influence from their male partners. Findings are discussed in the context of a socioecological framework.

Multivariate analysis of covariates of adherence among HIV-positive mothers with low viral suppression

BackgroundAs part of efforts to improve the prevention of mother-to-child transmission in Northern Uganda, we explored reasons for poor viral suppression among 122 pregnant and lactating women who were in care, received viral load tests, but had not achieved viral suppression and had more than 1000 copies/mL. Understanding the patient factors associated with low viral suppression was of interest to the Ministry of Health to guide the development of tools and interventions to achieve viral suppression for pregnant and lactating women newly initiating on ART as well as those on ART with unsuppressed viral load.MethodsA facility-based cross-sectional and mixed methods study design was used, with retrospective medical record review. We assessed 122 HIV-positive mothers with known low viral suppression across 31 health facilities in Northern Uganda. Adjusted odds ratios were used to determine the covariates of adherence among HIV positive mothers using logistic regression. A study among health care providers shed further light on predictors of low viral suppression and a history of low early retention. This study was part of a larger national evaluation of the performance of integrated care services for mothers.ResultsAdherence defined as taking antiretroviral medications correctly everyday was low at 67.2%. The covariates of low adherence are: taking other medications in addition to ART, missed appointments in the past 6 months, experienced violence in the past 6 months, and faces obstacles to treatment. Mothers who were experiencing each of these covariates were less likely to adhere to treatment. These covariates were triangulated with perspectives of health providers as covariates of low adherence and included: long distances to health facility, missed appointments, running out of pills, sharing antiretroviral drugs, violence, and social lifestyles such as multiple sexual partners coupled with non-disclosure to partners. Inadequate counseling, stigma, and lack of client identity are the frontline factors accounting for the early loss of mothers from care.ConclusionsAdherence of 67% was low for reliable viral suppression and accounts for the low viral suppression among HIV-positive mothers studied, in absence of any other factors. This study provided insights into the covariates for low adherence to ART and low viral load suppression; these covariates included taking other medications in addition to ART, missed appointments in the past 6 months, feels like giving up, doesn’t have someone with whom to share private concerns, experienced violence in the past 6 months, and faces obstacles to treatment and confirmed by health providers. To improve adherence, we recommend use of a screening tool to identify mothers with any of these covariates so that more intensive adherence support can be provided to these mothers.

‘Never call me a mercenary’: Identity work, stigma management and the private security contractor

Organisation studies has paid little attention to the contemporary private security industry, despite its enormous recent growth as a supplement to or replacement for state military services in theatres of conflict. To address this neglect, we investigate the workers at the heart of the industry: private security employees or contractors. Amidst widespread and extremely critical media coverage of their activities, we consider the individual contractor as a central agent of contemporary conflict, identifying three main objections to their deployment: a lack of just cause, virtue and professional legitimacy. Using scholarship on identity work and stigma management more specifically, we analyse contractors’ accounts of their employment to identify the communicative strategies they employ to challenge the stigma attributed to their occupation and/or to them as incumbents. Our data set is memoirs written by five British contractors, published between 2006 and 2011. We also suggest that data such as these are under-utilised in organisation studies’ treatment of identity work, because they represent a distinctive form of this work which we label identity writing.

IM as a Goal-Oriented Response to Stigma Communication at Work: A Self-regulation Perspective

In responding to stigma communication at work, people are often under the influence of environmental constraints that may significantly curtail the availability of different identity management strategies. This paper highlights that identity management in workplace settings should be seen as a goal-driven, motivated, and norm-guided response. We present a conceptual model that opens up the black box of why people choose to accept or challenge stigma communication at work by integrating identity management and stigma literatures with self-regulation literature. Our model and associated propositions present how organizational norms and contextual features, individual difference variables such as identity centrality and self-efficacy, and multiple goals such as self- enhancement, self-verification, and belonging, together drive an individual’s choices of identity management strategies. We also discuss how individuals engage in multiple goal pursuit under stigma threat and how that may impact their self-regulatory reserves. We raise novel research questions to spur future research and present practical recommendations to help practitioners harness the value of diversity in organizations.

Transitions in Polyamorous Identity and Intercultural Communication: An Application of Identity Management Theory

ABSTRACTThis study examines the communicative strategies and nonmonogamous identity formation of individuals who are polyamorous. We investigate the identity management tactics that individuals who are polyamorous utilize to navigate a society in which monogamy and monosexuality are the norm. Interactions of individuals who are polyamorous within a mononormative society are treated as a type of intercultural communication due to the contrasting cultural identities and communication rules. E-interviews with 38 individuals who are polyamorous provided basis for phone and Skype interviews. Twenty-two interviews produced the phases of identity management, including trial and error, enmeshment (mixing up), and renegotiation. Analyzing interviewees’ communication also produced the themes of managing stigma and impressions of the relationship identity. Implications of the study include a richer understanding of polyamorous identity management, polyamory as a relationship orientation, and a new perspective in applying identity management theory.

Coping with Sexual Identity Stigma in the U.S. Military: An Examination of Identity Management Practices Prior to and After the Repeal of “Don’t Ask, Don’t Tell”

ABSTRACTThis study assesses the identity management strategies employed by gays, lesbians, and bisexuals in the U.S. military prior to and after the repeal of “Don’t Ask, Don’t Tell.” In-depth interviews were conducted with gay, lesbian, and bisexual service members and veterans. Data were analyzed using constant comparative analysis. Findings revealed that these service members made thoughtful and deliberate decisions about whether or not, and to whom, they would reveal their sexual identities. Identity concealment was practiced most often, even after the repeal, which was found to incite feelings of self-reproach, isolation, and stress. However, several new identity management strategies emerged after the repeal of “Don’t Ask, Don’t Tell” (i.e., strategies of openness) that stimulated positive self-feelings. By engaging in some level of openness, participants in this study were able to overcome some of the adverse effects of their minority stress.

MILITARY SERVICE AND THE LIFE COURSE

Depression is a leading cause of disability globally. Transgender older adults experience depression and serve in the U.S. military at disproportionality high rates. Military service has been implicated in mental health outcomes, yet there is scant empirical evidence relating military service to transgender mental health, particularly in relation to identity stigma. Cross-sectional data has limited our understanding of the directional relationship between identity stigma and mental health. Using longitudinal data we examined temporal relationships between these factors among transgender older adults with and without prior military service. We used weighted multivariate linear models to evaluate the relationships between previous military service, identity stigma, depressive symptomology, and psychological health related quality of life (HRQOL) among a subsample of transgender older adults (n = 183) from Waves 1 and 2 of the Aging with Pride: National Health, Aging, Sexuality & Gender Study.Over time, Identity stigma was significantly associated with HRQOL only for those without prior military service. Regardless of military service history, changes in depressive symptomatology predicted changes in HRQOL. The U.S. recently joined 18 other countries in allowing transgender individuals to serve openly in the military. This study provides new insights into the roles of military service and identity stigma in the long-term mental health of transgender older adults, and highlights within-group heterogeneity. As such, it contributes to promoting resilience and better mental health outcomes for both of transgender older adults and current and future transgender service members – tomorrow’s transgender older adults. Implications for practice, policy, and research are discussed.

GLOBAL FORCES IN THE FUTURE OF LGBT AGING: DISCRIMINATION, IDENTITY, AND HEALTH OVER TIME

Worldwide the population of older adults is growing in complexity and diversity, including by sexual orientation and gender identity. Based on an innovative life course equity framework, this study reveals new cutting-edge findings on the interplay between marginalization, identity, health behaviors, quality of life and health of lesbian, gay, bisexual, and transgender (LGBT) older adults, and assesses key differences by sex and age group. Based on three most recent waves of longitudinal data (N = 2,450) from Aging with Pride: National Health, Aging, and Sexuality/Gender Study (NHAS), this study applied fixed effect models examining within-subject changes in experiences of discrimination, identity stigma and affirmation, and health behaviors over time on quality of life and cognitive and functional impairment. Within-subject increases in day-to-day discrimination, identity stigma, and poor nutrition across time points predicted lower levels of physical, psychological, social, and environmental QOL. Within-subject increases in day-to-day discrimination and poor nutrition and decreases in physical activity predicted higher levels of cognitive and functional impairment, while an increase in microaggresions and decrease in identity affirmation predicted higher levels of cognitive impairment. Gender and generational differences were found. Change in day-to-day discrimination had a greater impact on men; poor nutrition had a greater impact on the oldest old. As the population ages, it is imperative to identify groups at highest risk and those aging well to ascertain modifiable mechanisms so that global research, practices, and policies can be tailored to improve the health and well-being of our growing worldwide demographically diverse older adult population.

Stigma Identity Concealment in Hybrid Organizational Cultures

Previous stigma identity management theory has considered organizational cultural pressures as unitary in either supporting or discouraging open identity expression, leading individuals to either disclose or conceal their identities, respectively. However, within many organizations are cultures with opposing demands for how individuals should express their stigmatized identities. We integrate theory on stigma identity management and institutional logics to develop expectations about how individuals with stigmatized identities manage their identities in organizational cultures with opposing demands for identity expression, namely, organizational cultures that are informed by both supportive and unsupportive logics. We consider how configurations of supportiveness–unsupportiveness, along dimensions of logic centrality and logic compatibility, affect stigma holders’ identity management choices and their well‐being and job performance. We argue that the consequences of affirming (e.g., disclosure) and distancing (e.g., concealing) identity management strategies vary depending on whether stigma holders comply with or resist against these hybrid configurations.

Predicting Sense of Coherence and Sense of Identity among Transgender People – Role of Perceived Social Stigma and Social Support

&lt;div&gt;&lt;p&gt;&lt;em&gt;Sense of coherence is a global orientation expressing a person's pervasive and enduring feeling of confidence. The term "identity" refers to the capacity for &lt;/em&gt;&lt;em&gt;self-reflection&lt;/em&gt;&lt;em&gt; &lt;/em&gt;&lt;em&gt;and the &lt;/em&gt;&lt;em&gt;awareness of self&lt;/em&gt;&lt;em&gt;. Stigma refers to a mark or sign of some sort that is seen as disqualifying individuals from the full social acceptance of the society. Perceived social support refers to an individual’s belief that social support is available, is generally considered positive or negative and provides what is considered needed by that individual. The present study is a quantitative study which adopts a correlational design in which perceived social support &amp;amp; transgender identity stigma are the predictor variables, and sense of coherence and sense of identity among transgender people, are the criterion variables. Purposive and snowball sampling techniques were used to include 120 transgender people aged between 18 – 50 years from in and around the twin cities of Hyderabad and Secunderabad. Analysis of results through stepwise multiple regression analyses showed that social support is a predictor of sense of coherence and its dimensions – manageability and comprehensibility; and sense of identity. Perceived stigma was a significant predictor of comprehensibility while enacted stigma, predicted sense of coherence and comprehensibility. The application value of the study findings are high when it comes to formulating policies to improve the status of transgender community, taking into consideration their plight and the dearth of psychological research with this marginalised group.&lt;/em&gt;&lt;/p&gt;&lt;/div&gt;

Understanding How Sexual and Gender Minority Stigmas Influence Depression Among Trans Women and Men Who Have Sex with Men in India.

Few studies have assessed how sexual and gender minority stigmas affect the mental health of trans women and self-identified men who have sex with men (MSM) in India, populations with a high HIV burden. We tested whether social support and resilient coping act as mediators of the effect of sexual and gender minority stigmas on depression as proposed by Hatzenbuehler's psychological mediation framework, or as moderators based on Meyer's minority stress theory. We conducted a cross-sectional survey among trans women (n = 300) and MSM (n = 300) recruited from urban and rural sites in India. Standardized scales were used to measure depression (outcome variable), transgender identity stigma/MSM stigma (predictor variables), and social support and resilient coping (tested as moderators and parallel mediators). The mediation and moderation models were tested separately for trans women and MSM, using Hayes' PROCESS macro in SPSS. Participants' mean age was 29.7 years (standard deviation 8.1). Transgender identity stigma and MSM stigma were significant predictors (significant total and direct effects) of depression, as were social support and resilient coping. Among trans women and MSM, social support and resilient coping mediated (i.e., significant specific indirect effects), but did not moderate, the effect of stigma on depression, supporting the psychological mediation framework. Sexual and gender minority stigmas are associated with depression, with social support and resilient coping as mediators. In addition to stigma reduction interventions at the societal level, future interventions should focus on improving social support and promoting resilience among trans women and MSM in India.