International Journal of Environmental Research and Public Health

Research

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16 pages, 284 KiB

Open AccessArticle

Resilience amid Adversity: A Qualitative Narrative Study of Childhood Sexual Abuse Among Bangladeshi Transgender Individuals

by Sanzida Yeasmin and Jennifer J. Infanti

Int. J. Environ. Res. Public Health 2025, 22(4), 615; https://doi.org/10.3390/ijerph22040615 - 15 Apr 2025

Viewed by 4825

Abstract

Childhood sexual abuse (CSA) is a prevalent form of violence against children, associated with profound negative impacts on survivors’ health and well-being. In Bangladesh, sociocultural and economic barriers hinder CSA prevention and intervention, particularly for vulnerable populations such as transgender individuals. This study [...] Read more.

Childhood sexual abuse (CSA) is a prevalent form of violence against children, associated with profound negative impacts on survivors’ health and well-being. In Bangladesh, sociocultural and economic barriers hinder CSA prevention and intervention, particularly for vulnerable populations such as transgender individuals. This study explores the experiences of CSA among Bangladeshi transgender individuals, focusing on their coping mechanisms and resilience-building strategies. A qualitative narrative approach was employed, using life story-telling interviews with four transgender CSA survivors, and data were analyzed thematically. The findings reveal significant challenges, including social exclusion, humiliation, and lack of family support. Participants reported experiencing physical injuries, mental trauma, and loss of trust due to CSA, while the conservative nature of Bangladeshi society often prevented them from disclosing their abuse or seeking healthcare. These barriers exacerbate health inequalities among gender-minority children. Despite these adversities, participants described engaging in resilience-building strategies such as self-care, personal development, advocacy, and efforts to derive meaning from their experiences, while highlighting the perceived importance of family support. This study provides insights into the unique experiences of transgender CSA survivors in Bangladesh and calls for efforts towards gender-inclusive education, mental health support, and further research to address CSA-related adversity, encourage disclosure, and promote health equity for gender-minority groups. Full article

(This article belongs to the Special Issue Advancing Health Equity for Sexual and Gender Minority Populations)

14 pages, 844 KiB

Open AccessArticle

A Trans and Queer Discursive Approach to Gender Diversity and Misgendering in the Transgender and Gender Diverse Population: Queering a Study for ICD-11

by Anna Baleige and Frédéric Denis

Int. J. Environ. Res. Public Health 2025, 22(2), 178; https://doi.org/10.3390/ijerph22020178 - 28 Jan 2025

Viewed by 736

Abstract

Producing knowledge about transgender and gender-diverse (TGD) individuals is a core public health strategy challenge. Yet several systemic limitations arise, notably the exclusion or exploitation of TGD individuals by research systems reproducing systemic discrimination by embedding social norms as self-evident facts of nature. [...] Read more.

Producing knowledge about transgender and gender-diverse (TGD) individuals is a core public health strategy challenge. Yet several systemic limitations arise, notably the exclusion or exploitation of TGD individuals by research systems reproducing systemic discrimination by embedding social norms as self-evident facts of nature. This is particularly worrying in biomedical research, and contributes to the invisibilization of participants’ gender diversity. This trans research illustrates methodological challenges through queering an earlier study by focusing on misgendering as a discursive element. We based our work on discursive materials reported by TGD participants in an ICD-11 study on gender incongruence. We used network analyses to illustrate potential differences between declared gender identity and discourse practices. Our results highlight a gap between declared gender identity and discourse practices, bringing the number of non-binary participants in the sample from 15 (20.8%) to 36 (50.0%). Moreover, misgendering and the use of derogatory terms are more common toward gender-diverse individuals. Sexual orientation shows a similar trend. This study reveals the reproduction of social norms within research processes and medical knowledge, as well as how, from an individual perspective, their non-compliance seems to be a key factor in TGD individuals’ experience. By providing this simple methodological example, we hope to promote better integration of gender and its various dimensions into biomedical and public health research. Full article

(This article belongs to the Special Issue Advancing Health Equity for Sexual and Gender Minority Populations)

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14 pages, 494 KiB

Open AccessArticle

Religious Affiliation, Internalized Homonegativity and Depressive Symptoms: Unveiling Mental Health Inequalities among Brazilian Gay Men

by Felipe Alckmin-Carvalho, António Oliveira, Patricia Silva, Madalena Cruz, Lúcia Nichiata and Henrique Pereira

Int. J. Environ. Res. Public Health 2024, 21(9), 1167; https://doi.org/10.3390/ijerph21091167 - 2 Sep 2024

Cited by 2 | Viewed by 1564

Abstract

Introduction: Different religious narratives associate same-sex sexuality, in its various manifestations, with moral deviation or sin. Gay men who are socialized in more religious communities appear to experience and internalize greater levels of homonegativity, as well as to present greater indicators of depressive [...] Read more.

Introduction: Different religious narratives associate same-sex sexuality, in its various manifestations, with moral deviation or sin. Gay men who are socialized in more religious communities appear to experience and internalize greater levels of homonegativity, as well as to present greater indicators of depressive symptoms. The purpose of this study was to evaluate indicators of perceived homonegativity in the community and internalized, and signs/symptoms of depression reported by Brazilian gay men with a nominal religion and compare them to those reported by Atheists or Agnostics. Method: Our sample comprised 194 Brazilian gay men, distributed into three groups: Christians (Protestants and Catholics, n = 71; 36.6%); Spiritualists (Kardecists or religions of African origin, n = 52; 26.8%) and Atheists or Agnostics (n = 71; 36.6%). The following measurement instruments were used: sociodemographic questionnaire, Internalized Homophobia Scale and Beck Depression Scale. Results: High mean scores of depression were verified in all groups, and 60% of the sample presented some level of depression. There was a higher level of self-reported homonegativity among Christians and Spiritualists compared to that reported by Atheists or Agnostics, with the differences between the groups being significant. The regression analysis indicated a significant effect of religion on homonegativity, but not on depression. Conclusion: Our results suggest that gay men’s chronic exposure to non-affirming religious affiliation contexts may harm the construction of a positive gay identity and should be taken into consideration when addressing mental health inequalities of sexual minorities. Full article

(This article belongs to the Special Issue Advancing Health Equity for Sexual and Gender Minority Populations)

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13 pages, 480 KiB

Open AccessArticle

“Empowerment for Us by Us (E4UBU)”: Developing a Model of Empowerment Using Feminist Participatory Methods with LBQT+ Persons Assigned Female at Birth in Western Kenya

by Heather M. Tucker, Rebecca Odhiambo, Laura Jadwin-Cakmak, Anita Mbanda, Ashley Lacombe-Duncan, Caroline Rucah, Ini-Abasi Ubong, Cynthia Akoth Ouko, Wilson Odero and Gary W. Harper

Int. J. Environ. Res. Public Health 2024, 21(7), 948; https://doi.org/10.3390/ijerph21070948 - 19 Jul 2024

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Abstract

Lesbian, bisexual, queer, trans and other gender diverse persons assigned female at birth (heretofore referred to as “LBQT+ persons”) in Western Kenya experience intersectional oppression and stigma. This stigma can manifest in acts of sexual and gender-based violence (SGBV) and sexual and gender [...] Read more.

Lesbian, bisexual, queer, trans and other gender diverse persons assigned female at birth (heretofore referred to as “LBQT+ persons”) in Western Kenya experience intersectional oppression and stigma. This stigma can manifest in acts of sexual and gender-based violence (SGBV) and sexual and gender minority (SGM)-based violence, as well as various forms of discrimination—all of which have been linked to disproportionately higher levels of negative health outcomes for this group. Despite these challenges, many LBQT+ persons have been able to gain personal and collective power and thrive in this oppressive environment. The Empowerment for Us by Us (E4UBU) project is a mixed methods feminist participatory research study focused on exploring how LBQT+ persons conceptualize and define empowerment for themselves, and to understand their perspectives on how feelings of power and powerlessness influence their physical and mental health. This paper focuses on data from the first phase of the study, in which qualitative in-depth interviews were conducted with 40 LBQT+ persons (ages 19 to 50) from Kisumu and Homa Bay in Western Kenya. A participatory interpretive phenomenological analysis was conducted to understand the lived experiences of LBQT+ persons as they navigate intersectional oppression and its influence on their experiences of empowerment and subsequent health outcomes. Findings from this analysis were presented to two different focus groups composed of participants who had participated in the in-depth interviews to gather their insights on the interpretations of the interviews as a form of member checking. Findings revealed that “empowerment” was not experienced and viewed by LBQT+ persons as a monolithic construct, but rather a process through which LBQT+ persons are able to transform negative forces of intersectional oppression and powerlessness into experiences of power and subsequent individual and collective action and impact—all leading to improved mental health and well-being. This process is facilitated at several junctures by participatory seeking and attainment of community-appropriate resources at multiple socio-ecological levels that, when accessed with sufficient intensity, frequency, and duration, enhance one’s journey through the process of empowerment. These facilitation junctures are viewed as likely points of focus for public health intervention. Analysis also revealed that the process of empowerment is dependent on the context within which the process is occurring, the specific issues being faced, and the population of focus. Recommendations for how this model can be used for future research and practice to improve the lives of LBQT+ persons in Kenya are discussed. Full article

(This article belongs to the Special Issue Advancing Health Equity for Sexual and Gender Minority Populations)

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13 pages, 539 KiB

Open AccessArticle

Distress as a Function of Social Exclusion and Assertiveness among Homosexual/Bisexual People

by Chau-kiu Cheung and Eileen Yuk-ha Tsang

Int. J. Environ. Res. Public Health 2024, 21(5), 633; https://doi.org/10.3390/ijerph21050633 - 16 May 2024

Viewed by 1474

Abstract

Homosexual (lesbian or gay) and bisexual (i.e., LGB) people tend to suffer from social exclusion and thus distress. To prevent or relieve distress, the people’s assertiveness about justice and rights is an advocated means, but its effectiveness is uncertain, considering possible conflict with [...] Read more.

Homosexual (lesbian or gay) and bisexual (i.e., LGB) people tend to suffer from social exclusion and thus distress. To prevent or relieve distress, the people’s assertiveness about justice and rights is an advocated means, but its effectiveness is uncertain, considering possible conflict with social exclusion. To clarify the effectiveness, this study analyzed data collected from 189 Chinese LGB adults in Hong Kong, which is a special administrative region of China generally Westernized and liberal to sexual orientation. Controlling for prior distress reported, the analysis showed that distress was lower when assertiveness was higher or social exclusion experienced was lower. However, distress was higher when both assertiveness and social exclusion experienced were higher. The higher distress implies a conflict between assertiveness and social exclusion to raise distress. It also implies the need to avoid conflict when promoting assertiveness and eliminating social exclusion to prevent distress in LGB people. Full article

(This article belongs to the Special Issue Advancing Health Equity for Sexual and Gender Minority Populations)

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13 pages, 472 KiB

Open AccessArticle

Internalized Sexual Stigma and Mental Health Outcomes for Gay, Lesbian, and Bisexual Asian Americans: The Moderating Role of Guilt and Shame

by Kian Jin Tan and Joel R. Anderson

Int. J. Environ. Res. Public Health 2024, 21(4), 384; https://doi.org/10.3390/ijerph21040384 - 22 Mar 2024

Cited by 3 | Viewed by 3138

Abstract

The literature unequivocally demonstrates that lesbian, gay, and bisexual (LGB) individuals experience disproportionate mental health and social wellbeing impacts. Here, we respond to recent calls for research in the field of sexual minority health to better understand why various overlapping and intersecting identities [...] Read more.

The literature unequivocally demonstrates that lesbian, gay, and bisexual (LGB) individuals experience disproportionate mental health and social wellbeing impacts. Here, we respond to recent calls for research in the field of sexual minority health to better understand why various overlapping and intersecting identities can further drive health disparities. In this paper, we focus on the specific intersections of ethnicity and sexuality for Asian LGB individuals and the role of internalized stigma in driving poorer mental health outcomes for this group. We recruited 148 LGB Asian participants residing in the United States (M_age = 22.82 years, SD = 4.88) to participate in our online cross-sectional survey in which we collected data on their internalized stigma, levels of guilt and shame about their sexuality, and measures of depression, anxiety, and distress. Contrary to our predictions, there were no bivariate relationships between internalized sexual stigma and any of the mental health outcomes. However, a parallel mediation analysis revealed that guilt, but not shame, mediates the relationship between internalized sexual stigma and all mental health outcomes (depression, anxiety, and stress) for LGB Asian American individuals. This research highlights the important of exploring additional variables that may exacerbate of protect against poor mental health for individuals with multiple intersecting identities. Full article

(This article belongs to the Special Issue Advancing Health Equity for Sexual and Gender Minority Populations)

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15 pages, 381 KiB

Open AccessArticle

Correlates of Attitudes toward Sexual Minorities among Vietnamese Social Work Practitioners

by Trang Mai Le, Nilan Yu and Stephanie Webb

Int. J. Environ. Res. Public Health 2023, 20(5), 4241; https://doi.org/10.3390/ijerph20054241 - 27 Feb 2023

Cited by 1 | Viewed by 1762

Abstract

This article examines the correlates of Vietnamese social work practitioners’ attitudes toward individuals who identify as lesbian or gay. This study, among the very few studies on the general topic in non-Western contexts and the first of its kind in Vietnam, investigates correlates [...] Read more.

This article examines the correlates of Vietnamese social work practitioners’ attitudes toward individuals who identify as lesbian or gay. This study, among the very few studies on the general topic in non-Western contexts and the first of its kind in Vietnam, investigates correlates of attitudes toward sexual minorities that are known in the literature. The data are drawn from a survey of 292 Vietnamese social work practitioners. The findings suggest that the attitudes of Vietnamese social work practitioners are associated with gender, educational attainment, level of social work education, practice experience, practice sector, professional contact with sexual minority clients, personal contact with sexual minorities, exposure to content on sexual minorities in social work courses and professional development activities, and independent learning activities about sexual minorities but not with age, religious affiliation, and marital status. Implications for social work education and practice are considered. Full article

(This article belongs to the Special Issue Advancing Health Equity for Sexual and Gender Minority Populations)

Review

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21 pages, 1202 KiB

Open AccessReview

A Scoping Review of Heteronormativity in Healthcare and Its Implications on the Health and Well-Being of LGBTIQ+ Persons in Africa

by Lebogang Manthibe Ramalepe and Tshepo B. Maake

Int. J. Environ. Res. Public Health 2025, 22(5), 717; https://doi.org/10.3390/ijerph22050717 (registering DOI) - 1 May 2025

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Abstract

This scoping review explores the patterns of heteronormativity in healthcare sectors across Africa and its impact on the health and well-being of LGBTIQ+ individuals. By analyzing publications from major academic databases, this study identifies key themes and research gaps in the discourse on [...] Read more.

This scoping review explores the patterns of heteronormativity in healthcare sectors across Africa and its impact on the health and well-being of LGBTIQ+ individuals. By analyzing publications from major academic databases, this study identifies key themes and research gaps in the discourse on LGBTIQ+ health and heteronormativity in Africa. The findings underscore the urgent need to address these heteronormative barriers in alignment with the United Nations Sustainable Development Goals (SDGs), particularly SDG 3 (good health and well-being) and SDG 10 (reduced inequalities). Addressing heteronormativity in healthcare is essential for promoting equitable, inclusive healthcare systems and improving health outcomes for LGBTIQ+ populations across the continent. Full article

(This article belongs to the Special Issue Advancing Health Equity for Sexual and Gender Minority Populations)

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