“I'm in this world for a reason”: Resilience and recovery among American Indian and Alaska Native two-spirit women

Abstract

American Indian and Alaska Native sexual minority (two-spirit) women are vulnerable to substance misuse and mental health challenges due to multiple minority oppressed status and exposure to stress and trauma. Yet, these women find pathways toward healing and wellness. We conducted a qualitative data analysis of interviews derived from a national health study and gained an understanding of 11 two-spirit women's resilience and recovery patterns. Emergent from the data, a braided resiliency framework was developed which elucidates multilayered abilities, processes, and resources involved in their resiliency. We recommend that resilience-promoting strategies be incorporated into substance misuse and mental health interventions.

A Transdisciplinary Conceptual Framework of Contextualized Resilience for Reducing Adverse Birth Outcomes

“…Resilience, among the social sciences, has traditionally been defined by psychology as a personal and socially influenced trait that allows an individual to return to a normal state after adverse or traumatic events (Antonovsky, 1993; Dunkel Schetter, 2011; Dunkel Schetter & Dolbier, 2011; Eriksson, 2017; Hobfoll, 2014; Masten, 2001; Southwick, Bonanno, Masten, Panter-Brick, & Yehuda, 2014). The fields of social work (Burnette & Billiot, 2015; Burnette & Hefflinger, 2017; Ungar, 2008, 2011a, 2011b, 2012), transcultural psychology (Allen et al, 2014; Elm, Lewis, Walters, & Self, 2016; Kirmayer, Dandeneau, Marshall, Phillips, & Williamson, 2011; Kirmayer, Sehdev, Withley, Dandeneau, & Issac, 2009), anthropology (Bourgois, 2003; Castañeda et al, 2015; Farmer, 2004; Panter-Brick, 2014, 2015), public health (Krieger, 2001), and sociology (Pinderhughes, Davis, & Williams, 2015) have added contextual ecological layers to build upon how resilience can be best understood. While medicine and nursing has focused on the experiences of survivors’ resilience via connectedness (Epstein & Krasner, 2013) and how health care providers (Turner & Kaylor, 2015) buffer adverse experiences for patients while increasing positive health outcomes (see Supplementary Table S1).…”

Examining protective and buffering associations between sociocultural factors and adverse childhood experiences among American Indian adults with type 2 diabetes: a quantitative, community-based participatory research approach

“…AI/ANs have longstanding traditional knowledge that include instructions on how to stay well and thrive, and Indigenous theoretical literature supports the assertion that sociocultural resources and cultural participation is health-promoting. 26–28 AI/AN resilience is dynamic and accessed through familial, communal and cultural knowledge and expressions (eg, traditional activity participation, spiritual practices, positive identity promotion, social support, feelings of connectedness to family and nature). 26 28 These deeply rooted beliefs and practices have been identified as multilevel factors that can buffer poor outcomes, strengthen resilience and promote health.…”

“… 26–28 AI/AN resilience is dynamic and accessed through familial, communal and cultural knowledge and expressions (eg, traditional activity participation, spiritual practices, positive identity promotion, social support, feelings of connectedness to family and nature). 26 28 These deeply rooted beliefs and practices have been identified as multilevel factors that can buffer poor outcomes, strengthen resilience and promote health. 29 …”

Ethical Research with Hard-to-Reach Groups

“…Another potential regarding this approach is that the provision of payment or reward for participation can also increase the participants' vulnerabilities. Specifically, there have been cases when those being paid have been coerced into surrendering their payment to dealers as a further way of generating income for themselves (Fry 2005). In the wider sense, further exploitation has been identified historically by payment incentives where vulnerable individuals have been threatened with violence unless they participate in surveys that provide payment for participation (Mosher et al 2015).…”

“…Perhaps necessarily those with substance misuse problems also often have associated mental ill health as a consequence. This can range in severity from common mental health disorders (anxiety-based disorders), depression with associated anxiety, to serious mental illness such as schizophrenia and affective disorders (Edwards 2000) & Edwards (2013.…”