Search Results (215)

2S/LGBTQIA+ survivors of intimate partner violence (IPV) face multiple, intersecting barriers to accessing care, yet little is known about how these barriers are shaped by IPV-caused brain injury (IPV-BI). Background/Objectives: This study aimed to explore how stigma and institutional trust influence 2S/LGBTQIA+ survivors’ experiences of help-seeking following IPV-BI. Guided by a Community Advisory Board, four semi-structured focus groups were conducted with 29 2S/LGBTQIA+ IPV-BI survivors. Methods: Reflexive thematic analysis was used to examine participants’ help-seeking accounts, with attention to minority stress and intersecting stigmas related to IPV, BI, and 2S/LGBTQIA+ identity. Results: The findings indicate that survivors navigated compounded stigmas that limited access to safe, affirming services and heightened vulnerability during help-seeking. Institutional trust was central to participants’ decisions to disclose sensitive information and engage in care, with confidentiality emerging as a critical determinant of perceived safety. Participants described negotiating disclosure, anticipating discrimination, and avoiding services when systems were perceived as unsafe or unresponsive. Conclusions: These findings highlight the need for service systems to integrate IPV-BI into screening and support protocols, provide training on the intersections of IPV, BI, and 2S/LGBTQIA+ identities, and centre confidentiality as a condition for trust and access, ultimately fostering safer, more responsive systems of care. Full article

Substance use disorder (SUD) undermines social connection, identity, and well-being. While art therapy is formally incorporated into clinical treatment, far less is known about how informal, group-based creative activities contribute to recovery. This qualitative study examines whether and how participation in a creative arts group fosters social support and human flourishing among individuals with SUD. We conducted semi-structured, individual interviews of eight adults enrolled in SUD outpatient treatment at the Johns Hopkins Broadway Center for Addiction who voluntarily participated in a creative arts class. Recordings were transcribed and analyzed using an iterative, thematic approach. Analysis revealed four themes: (1) Social connectedness and support—artmaking fostered camaraderie, accountability, and peer encouragement; (2) Holistic and supportive environment—the group offered a safe, nonjudgmental space that affirmed participants beyond their addiction; (3) Emotional renewal through art—creative engagement reduced anxiety, promoted joy, and provided a constructive outlet for emotions; and (4) Reclaiming agency through artistic expression—participants experienced autonomy, skill development, and identity building, which fostered hope and personal growth. Overall, participants viewed artmaking as a catalyst for relational and personal transformation. These exploratory findings generate hypotheses for future research on the role of informal creative arts groups within recovery-oriented care settings. Full article

The transition to college can be psychologically demanding. This study examines how a more mature and consolidated academic identity (AI) is related to three types of self-regulation strategies in college students during their first semester: cognitive reappraisal (CR), self-handicapping (SH), and self-affirmation (SA). Two self-related resources, quiet ego (QE)—a compassionate, growth-oriented self-identity—and self-esteem (SE)—an individual’s global self-assessment of self-worth—were theorized as complementary, but also unique, predictors of the relationship between AI and self-regulation strategies. QE reflects a less defensive, growth/balance-oriented self-structure with implications for self-regulation and adaptive development above and beyond SE. A multiple regression model testing only indirect effects was tested using R (lavaan) in a sample of first-semester college students (N = 352). The hypothesized model fit was acceptable (with five of six indirect hypotheses supported), but a model that added a direct path from AI to SH significantly improved fit without altering the indirect effect results. AI was positively related to CR and SA via both QE and SE, with the path via SE being the strongest. AI was related to lower SH both directly and indirectly only via QE. These results support and add to the literature on the benefits of QE and SE as important yet distinct psychosocial resources for college students. Implications for strengthening QE resources in first-year students are discussed. Full article

The Hyakuzahōdan Kikigakishō (百座法談聞書抄, hereafter Hyakuza 百座), compiled in the late Heian period, is an important Buddhist document that records a hundred-day lecture series on the Lotus Sutra (法華経). While previous scholarship has recognized the constructed nature of the text as a kikigaki (聞書), it has predominantly focused on content analysis, implicitly treating the text as a transparent window into the actual preaching event. To move beyond this limitation, this study proposes the analytical framework of dual performativity and, drawing on Diana Taylor’s theory of the archive and the repertoire, reexamines the text’s generative logic and political implications. This study argues that the Hyakuza embodies two interrelated forms of performance: first, the performativity of the hōdan (法談) as a live ritual, understood as a repertoire performance that constructs immediate authority through body, voice, and situational dynamics; second, the performativity of the kikigaki as textual construction, understood as an archival performance that transforms the ephemeral oral event into an authoritative, transmissible text through formulaic rhetoric, localized adaptation, and systematic arrangement. Integrating methodologies from textual history, rhetorical analysis, ritual theory, and intellectual history, this study demonstrates that the Hyakuza is not a neutral transcript of sermons but a meticulous, intentional act of writing with two fundamental aims: on a cultural level, to hierarchically integrate shinbutsu shūgō (神仏習合) through narrative appropriation; on a social level, to symbolically bind Buddhist merit with the institutional identities of aristocrats such as naishinnō (内親王), ultimately serving the self-affirmation internal cohesion, and cultural demarcation of the elite community from the masses, while simultaneously contributing to the state’s project of constructing a unified ideology in the late Heian period. By examining both cross-civilizational universal logic and specific historical context, this study reveals how the Hyakuza’s dual performativity produces and categorizes knowledge narratives while embedding political power dynamics, offering a critical path for the study of kikigaki-genre literature from discourse analysis to politics of textuality. Full article

The female oral tradition of harawi constitutes a living cultural expression in Quechua-speaking Andean communities, where song is configured as an instrument of collective memory and identity. This study aimed to understand how women, through harawi, construct spaces of cultural resistance in the face of processes of forgetting and social transformation. A qualitative approach was adopted, using an ethnographic and phenomenological design. Data collection was conducted over a period of one hundred and twenty days through semi-structured interviews, participant and non-participant observation, audiovisual recording, and documentary review. The findings show that harawi not only preserves ancestral knowledge but also strengthens female identity and the intergenerational transmission of the Quechua language. Subtle forms of symbolic resistance to linguistic and cultural stigmatization were identified. It is concluded that female harawi oral tradition constitutes a mechanism of living memory and an active practice of cultural affirmation in Andean communities. Full article

As museums and science centers work to reach broad and diverse public audiences, staff face challenges in aligning learner-centered educational approaches with the needs and motivations of audiences with varying identities and agendas. This article synthesizes several years of practitioner-driven work, in which science center staff revised an engineering design exhibition in response to visitor feedback and observations in practice. Analyses examine practitioners’ perspectives about the unanticipated challenges within the original design of the exhibition, and the ways in which museum staff updated their expectations and pedagogical strategies. Analyses are grounded in two theoretical models: (1) Falk’s Museum Visitor Experience Model, which describes how people use museum visits to affirm specific aspects of their identities; and (2) Dawson’s Access and Equity Framework, which describes structural forms of inaccessibility and exclusion that become embedded within museum spaces. These frameworks are used to examine the systemic changes that staff made to multiple facets of the visitor experience, including signage, framing and facilitation of activities, curation and preparation of materials, and the design of adjacent exhibits. This ever-expanding process was a necessary investment to realize the exhibition’s original intention of building on visitors’ existing knowledge, identities, and lived experiences. Full article

Background/Objectives: Gender-affirming surgery (GAS) has become more accessible in recent years. It aims to align the physical characteristics of transgender individuals with their gender identity to alleviate distress associated with gender dysphoria. This may involve procedures such as genital reconstruction, breast augmentation or removal, and voice modification surgeries. However, the associations of these treatments on long-term mental health outcomes remain debated. This paper aims to review and synthesize current research on the associations of GAS on psychiatric outcomes and quality of life in transgender individuals. Methods: In accordance with the PRISMA statement, a search on PubMed, PsychInfo, and Embase yielded 867 articles, of which 14 studies of 3023 participants met the full inclusion criteria. Results: There is an initial improvement in psychological well-being and quality of life within the first year post-GAS, followed by subsequent plateau or decline thereafter. Factors such as younger age, higher levels of education, noticeable improvement in secondary sexual characteristics, and a supportive social environment have been identified as predictors of positive outcomes. Conversely, non-homosexual orientation and higher levels of pre-GAS psychopathology have been associated with poorer outcomes, highlighting the importance of tailored support and pre-operative mental health care to optimize long-term success. Conclusions: This study underscores the need for further research into long-term outcomes and tailored support strategies to optimize the mental health and well-being of transgender individuals undergoing GAS. Full article

This paper investigates the application of Transit-Oriented Development (TOD) principles to the retrofitting of historic Gulf urban cores through a comparative analysis of Souq Waqif (Doha) and Qasr Al Hokm (Riyadh). The research employs field observation, thematic mapping, and qualitative diagnosis using the Integrated Modification Methodology (IMM) to assess compactness, intricacy, and connectivity within walkable station catchments. The findings indicate that Souq Waqif has a highly compact and intricate historic core with robust pedestrian activity, yet exhibits discontinuities at its periphery, such as car-dominated streets, fragmented green spaces, and weak connections between the metro station, parks, and adjacent blocks. In Qasr Al Hokm, the analysis affirms the value of its fine-grained historic fabric and civic landmarks, but also identifies deficiencies in shading, last-mile connectivity, and land-use balance surrounding the new metro station. Drawing on lessons from Souq Waqif, the paper proposes a TOD-oriented urban design framework for Qasr Al Hokm, emphasizing shaded pedestrian corridors, active ground floors, intermodal hubs, and heritage-compatible mixed-use intensification. This comparative approach demonstrates how TOD can foster more livable, accessible, and climate-responsive historic cores in Gulf cities, while maintaining respect for local identity and governance structures. Full article

Trans and gender-diverse (TGD) people experience significant mental health inequalities. These disparities are associated with structural stigma, social exclusion, and persistent barriers to accessing health services, representing a critical public health issue. Although existing research has largely emphasized biomedical and clinical responses, less is known about non-biomedical resources that support mental health across life trajectories. This qualitative study explored, based on participants’ narratives, how artistic and playful resources contribute to mental health across life trajectories, considering contexts of social inequities and social determinants of health. Four trans and gender-diverse participants aged 18–27 years were recruited through snowball sampling and took part in two in-depth semi-structured interviews conducted remotely. Data were analyzed using Reflexive Thematic Analysis combining deductive and inductive coding. Findings indicate that artistic and playful practices were described as non-biomedical resources for emotional regulation, coping with minority stress, identity affirmation, and social connection across different life stages. These practices were narrated as helping participants manage psychological distress associated with stigma, discrimination, and limited access to affirmative mental health care. From a public health perspective, the results underscore the importance of recognizing culturally situated, everyday expressive practices as complementary forms of mental health support. Integrating such resources into broader mental health strategies may contribute to more comprehensive, equitable, and non-pathologizing public mental health approaches for trans and gender-diverse populations. Full article

Relationship and sexuality education research has largely centred on adult perspectives, particularly in exploring home-based sexuality education. This study shifts the lens to youth voices by examining how adolescents from LGBTQ+ families in South Africa experience and actively participate in home-based sexuality conversations. Using arts-based collage-creating methods with the adolescent participants, youth interpretations of sexuality learning in LGBTQ+ family homes were explored. The findings reveal that youth are not passive recipients but active co-creators of family sexuality knowledge, developing critical literacies about heteronormativity through ongoing and responsive home-based conversations. Youth identified home as a distinct pedagogical space characterised by safety, personalisation, ongoing responsive dialogue, inclusivity of diverse sexual and gender identities, and responsiveness to their developmental needs. However, youth also navigate tensions between LGBTQ+-affirming home environments and heteronormative public spaces, developing sophisticated strategies for managing these boundaries. This study contributes empirical evidence for valuing informal sexuality education spaces and positions youth from LGBTQ+ families as knowledge producers whose experiences can inform more inclusive, dialogue-based approaches. The findings have implications for supporting family-based sexuality education and challenging adult-centric assumptions about youth capacities in sexuality learning. Full article

Background/Objectives: Transgender and gender-diverse (TGD) individuals experience disproportionately high rates of childhood trauma and depression; however, the mechanisms linking gender identity and depressive symptoms remain insufficiently understood. This study examines differences in depressive symptoms and childhood trauma between cisgender (CG) and TGD adults. It investigates whether specific subtypes of childhood maltreatment mediate the association between gender identity and depression. Methods: The cross-sectional online study included 249 participants aged 18–72 years (M = 30.85, SD = 12.72), including 144 CG (75 women and 69 men) and 105 TGD individuals (44 transgender and 61 gender diverse individuals). Depression symptoms were assessed using the nine-item Patient Health Questionnaire (PHQ-9), while childhood trauma experiences were measured using the Childhood Trauma Questionnaire–Short Form (CTQ-SF). Results: The independent-sample Student’s t-test showed that TGD participants reported significantly higher levels of depressive symptoms and all forms of childhood trauma than cisgender individuals. Mediation analyses indicated that overall childhood trauma partially mediated the association between gender identity and depression. In parallel mediation models, emotional abuse emerged as the primary statistical mediator, with sexual abuse showing a smaller indirect effect. Conclusions: The findings extend prior prevalence-focused research by identifying specific childhood trauma pathways associated with depressive symptoms in TGD adults. Experiencing traumatic events during childhood may be a key factor contributing to an increased risk of depression in adulthood, particularly among the TGD population. Therefore, intervention and prevention programs should target TGD individuals and their families to minimize the risk of adverse childhood experiences and mental health disorders. The results underscore the importance of trauma-informed and gender-affirming mental health care and highlight emotional abuse as a particularly salient correlate of depression in this population. Full article

LGBTQ+ individuals continue to experience substantial barriers to accessing affirming healthcare, including discrimination, structural inequities, and provider-level limitations. This study aimed to develop an emergent grounded theory model of constructing wholeness in healthcare. Methods: This study employed a secondary constructivist grounded theory analysis of qualitative data from The Rainbow Connections Study, a community-based system dynamics project. Data were collected through eight group model-building sessions conducted via Zoom with 28 LGBTQ+ participants, including older adults, youth, transgender and gender-diverse individuals, and staff from the LGBTQ+ community center who also held service and practitioner roles; analytic claims are framed to reflect this mixed-role sample. Sessions were audio- and video-recorded, transcribed verbatim, and analyzed using open, axial, and selective coding procedures. Constant comparative methods, reflexive memoing, and member checking were used to support analytic rigor and trustworthiness. Results: Analysis revealed a dynamic process in which LGBTQ+ individuals encounter external forces within healthcare systems that alternately support or fragment their sense of self. In response, participants engaged in four interconnected internal processes—interconnecting selves, intra-community support, self-determined care, and meaning-finding—that facilitated movement toward wholeness. These processes were non-linear, iterative, and present across diverse identities and life stages. Conclusions: The emergent theory of Constructing Wholeness in Connecting to Healthcare highlights that LGBTQ+ healthcare experiences extend beyond access and utilization to include identity integration, community reliance, and meaning making. Supporting LGBTQ+ health requires healthcare approaches that affirm wholeness, reduce structural harm, and recognize the central role of community in navigating care. Full article

Background and Objectives: With the increasing demand for gender-affirming procedures, facial feminization surgery (FFS) has become an essential component in the management of patients with gender dysphoria. In this study, ‘male’ and ‘female’ refer to biological sex as recorded in the medical record; gender identity was not assessed. The mandible is widely recognized as one of the most sexually dimorphic facial bones and plays a critical role in defining masculine and feminine facial contours. However, quantitative mandibular data directly applicable to surgical planning for FFS, particularly in Asian populations, remain limited. The purpose of this study was to analyze gender differences in mandibular morphology using three-dimensional (3D) computed tomography (CT) images and to provide clinically relevant anatomic data applicable to mandibular contouring in FFS. Materials and Methods: In this single-center retrospective study, 275 Korean patients who underwent facial CT between January 2017 and December 2019 were enrolled. Three-dimensional cephalometric analysis was performed to obtain surgically relevant mandibular measurements, including angular, linear, and transverse parameters, as well as non-metric characteristics such as chin shape and inferior mandibular border contour. Statistical comparisons were conducted to evaluate gender differences. Results: Significant gender differences were observed in mandibular angle (p < 0.001), mandible length (p < 0.001), antegonial notch distance (p < 0.001), intercondylar width (p < 0.001), and intergonial width (p < 0.001). Ramus length and chin width did not demonstrate statistically significant differences. Non-metric analysis revealed significant gender differences in chin morphology and inferior mandibular border contour (p < 0.01). Males predominantly exhibited a round or square chin (79.5%) and a rocker-shaped inferior border, whereas females commonly demonstrated a pointed chin (82.3%) and a straight inferior mandibular border (94.4%). Conclusions: The sexual dimorphism of the mandible in the Korean population is characterized by differences in angularity, transverse width, antegonial morphology, and inferior border contour. These findings provide population-specific morphological reference ranges that may support individualized preoperative assessment for mandibular contouring in facial feminization surgery. Full article

Out-of-school-time (OST) programs in the United States offer significant opportunities for youth to engage with and develop their identities in science, technology, engineering, and mathematics (STEM). However, professional learning that supports OST educators in developing identity-affirming STEM facilitation remains chronically underfunded and undervalued. Dominant approaches to measuring program “costs”—often centered on per-participant expenditures or short-term cost-effectiveness—obscure the systemic, relational, and capacity-building investments required to sustain high-quality OST STEM practices. This commentary examines how available cost frameworks shape what is rendered visible as “value” in OST STEM professional learning and where they fall short. To ground this analysis, I draw on the Afterschool Coaching for Reflective Educators in STEM (ACRES) program, a long-running national coaching initiative, as an illustrative case through which to examine how investments unfold over time and across contexts. Using ACRES, I demonstrate how costs are more productively understood as multidimensional investments in infrastructure, human capacity, relationships, and knowledge—forms of value that resist per-participant or short-horizon accounting. I offer an alternative tool, the Capacity-Based Cost Assessment (CBCA), to facilitate reflection on the outcomes of these investments. I include recommendations for how to define, document, and evaluate investments in OST STEM professional learning. Full article

Despite the introduction of inclusive and gender-affirming approaches in healthcare, transgender and non-binary people continue to show poorer physical, psychological, and social outcomes, shaped by social determinants within historically pathologizing and stigmatizing contexts. This study used qualitative participatory action research with photovoice among seven transgender individuals residing in Murcia, Spain; data were generated through semi-structured interviews and focus group dialogue, applying the SHOWED technique to the visual and discursive narratives of the participants, and analyzed with Atlas.ti v8. Educational, employment, and healthcare contexts significantly condition well-being. Well-being was determined by the circumstances and support in which gender identity is constructed, within sociocultural environments marked by gender stereotypes, exclusion from social spaces, and fears regarding the irreversibility of certain transition steps. Reported lifetime negative events, social barriers, exclusion, and persistent questioning of identity were associated with increased anxiety, depressive symptoms, and insomnia. At the same time, the relevance of resilience and support networks also emerged during the sessions. Replicating photovoice in diverse settings may help identify social and territorial inequities and inform improvements in clinical practice, healthcare education, public policies, and legislation for transgender and gender-nonconforming people. Full article