Is My Femininity a Liability? Longitudinal Associations between Girls' Experiences of Gender Discrimination, Internalizing Symptoms, and Gender Identity

Intersectional discrimination and mental health inequalities: a qualitative study of young women's experiences in Scotland

BACKGROUND

In 2021, Scotland became the first UK country to launch a Women's Health Plan. This policy signals increasing commitment to broader ambitions surrounding gender equality in health. Research shows a connection between discrimination and health, representing a contributor to health inequalities. There remains sparse evidence on how certain groups experience discrimination that could be useful for policymaking. This research set out to address this evidence gap through exploring how discrimination shapes young women's experiences of mental health and inequalities in Scotland.

METHODS

We interviewed women aged 16-25 years (n=28), living in Scotland, UK, adopting an intersectional approach to recruitment and data analysis. We used a semi-structured topic guide to facilitate open discussion about discrimination and health. Transcripts were analysed by two researchers using Thematic Analysis and NVivo software.

FINDINGS

We identified three themes that illuminate intersectional discrimination and the impact on mental health. The first outlines how experiences of discrimination in school, work and public spaces (and the anticipation of such) creates stress leading to mental health problems, particularly for participants from ethnic minority groups. The second highlights the lack of support for mental health, both at structural and interpersonal levels, which was viewed by young women as a form of intersectional discrimination, largely because of their gender and age. Finally, we developed a mid-level theory termed the 'chain of dismissal' that displays that for both physical or mental health symptoms, young women's concerns are immediately "written off" as anxiety-related and in turn a natural attribute of young women. These themes show that discrimination has the potential to amplify mental health problems for young women and is a likely contributor to health inequalities.

CONCLUSIONS

Structural disadvantages such as racism intersect with gender and age to compound the experience of discrimination for marginalised young women. To improve mental health and reduce health inequalities for young women, multi-level approaches are needed, with strong consideration of how the structural and cultural landscape as well as assumptions made by healthcare professionals have critical implications for young women's health.

Endorsement of Masculine-Typed Behaviors Decreases During Middle Adolescence: The Contextualizing Role of Peer Experiences for Adolescents Living in the United States

While more research is emerging about the development of masculinity during adolescence, not much is known about how masculine-type behaviors develop over time in middle to late adolescence within the context of friendships and peer experiences. This study examined trajectories of masculine-typed behavior from ages 14 to 17. Multilevel modeling was used to account for cross-time and within-time variability in masculine-typed behavior and examined the role of positive and negative peer experiences in predicting this variability. This was done in a sample of 334 U.S. adolescents (51% boys; 50% White, 19% Black, 15% Latina/o/e). At the between-person level, boys and girls decreased in masculine-typed behavior over time. At the within-person level, negative peer experiences predicted fluctuations toward greater masculine-typed behavior, whereas friend support predicted fluctuations toward less masculine-typed behavior. Adolescence is a key period for navigating masculinity norms, and peer experiences are a key context for the development of masculine-typed behavior.

Future Directions in Mental Health Treatment with Stigmatized Youth

Stigma refers to societally-deemed inferiority associated with a circumstance, behavior, status, or identity. It manifests internally, interpersonally, and structurally. Decades of research indicate that all forms of stigma are associated with heightened risk for mental health problems (e.g., depression, PTSD, suicidality) in stigmatized youth (i.e., children, adolescents, and young adults with one or more stigmatized identities, such as youth of Color and transgender youth). Notably, studies find that stigmatized youth living in places with high structural stigma - defined as laws/policies and norms/attitudes that hurt stigmatized people - have a harder time accessing mental health treatment and are less able to benefit from it. In order to reduce youth mental health inequities, it is imperative for our field to better understand, and ultimately address, stigma at each of these levels. To facilitate this endeavor, we briefly review research on stigma and youth mental health treatment, with an emphasis on structural stigma, and present three future directions for research in this area: (1) directly addressing stigma in treatment, (2) training therapists in culturally responsive care, and (3) structural interventions. We conclude with recommendations for best practices in broader mental health treatment research.