Two recent papers by UIC College of Nursing faculty found that microaggressions – common, subtle indignities – can be just as harmful as a major discriminatory event, contributing to negative mental and physical health outcomes in bisexual women.
Bostwick is principal investigator on a National Institute on Minority Health and Health Disparities grant which funded the Women’s Daily Experience Study, one of the first ever to focus on bi-identified women and mental health. Participants completed a baseline survey, followed by 28 days of e-diaries to capture microaggressions that they may have experienced during the previous 24 hours.
“The old saying goes, ‘sticks and stones may break your bones, but words can never hurt you,” Smith says. “But you look at the data and realize that’s simply not true. Microaggressions that someone has experienced over a lifetime are correlated with mental and physical ailments they experience even today.”
The researchers looked at microaggressions related to sexual orientation, race and gender. Microaggressions could include denying a person’s bisexuality—suggesting it’s “just a phase”—or a rude or insulting comment about lesbian or gay individuals. A comment minimizing or denying the existence of racial discrimination is an example of a racial microaggression.
Participants reported an average of eight microaggressions of any type in the previous month, with almost all women—97%—reporting at least one microaggression throughout the duration of the study.
Gender-based microaggressions were reported the most frequently. Women reported being sexually objectified on more than 15% of the days recorded.
The papers also found microaggressions were associated with poor mental health and binge drinking, smoking and marijuana use. The most consistent finding was an association between microaggressions and anxiety.
“Our findings suggest that for bisexual women, the weight of denigrating comments about their sexual identity, gender and race can contribute to poor health outcomes—whether such comments happened last year or yesterday,” Bostwick says. “Of course, these comments are situated in a larger context of systemic inequities, which may render bisexual women with fewer resources to cope when confronted with dismissive and disparaging comments about core aspects of who they are and their own lived experiences.”
Bisexual women of color were a majority in the study—57%—a group that is notably absent in the literature, the researchers say. Latina bisexual women reported worse health outcomes than Black and White bisexual women in their daily diaries. Smith says the impact of microaggressions on bisexual women of color is an area where further research is needed.
“So often we focus on the large discriminatory events, like being denied housing or being fired from a job,” Smith says. “These subtle comments and slights can be just as harmful. That’s why it’s important to address it through education – understanding and recognizing what a microaggression is and then adapting policies to raise awareness.”
Co-authors included UIC Nursing visiting research specialist Larisa Burke, MPH, Amy L. Hequembourg, Alecia Santuzzi and UIC Nursing professor emerita Tonda Hughes, PhD ’89, RN, FAAN.
One of the hottest topics amongst nurse educators today is finding strategies to promote safe learning in the classroom environment. According to the American Association of Colleges of Nursing (AACN), it is estimated that over 73% of “nontraditional” students are studying in undergraduate nursing programs. The term “nontraditional” refers to all students who meet the following criteria: over the age of 25, ethnic minority groups, speaks English as a second language, a male, has dependent children, has a general equivalency diploma (GED), required to take remedial courses, and students who commute to the college campus. Nurse educators have a responsibility to ensure that all of their nursing students are learning in a safe environment.
For instance, microaggression is something that nurse educators must address in order to promote a safe classroom environment. Microaggressions are subtle, verbal and nonverbal snubs, insults, putdowns, and condescending messages directed towards people of color, women, the LGBTQ population, people with disabilities, and any other marginalized group. These insults are often automatic and unconscious in nature, according to Derald Wing Sue, PhD, author of Microaggression in Everyday Life: Race, Gender, and Sexual Orientation. Microaggression can cause a person to question themselves regardless of whether the microaggression occurred or not because they were unsure if they were just being oversensitive to the offense or if the perpetrator really intended to harm them with what they said. Microaggressions are usually committed by “well-intentioned folks” who are unaware of the hidden message that is being transferred.
Types of Microaggression
Microaggressions are similar to carbon monoxide—“invisible, but potentially lethal”—continuous exposure to these types of interactions “can be a sort of death by a thousand cuts to the victim,” says Sue. He further outlines three themes in three microaggression categories. The three themes are: racial, gender, and sexual orientation. The themes appear to occur in three different forms of microaggression: microassaults, microinsults, and microinvalidations.
Microassaults. Also known as “old-fashioned racism,” microassaults are conscious verbal or nonverbal attacks meant to hurt, oppress, or discriminate against the marginalized groups. This can range from telling racial jokes, name-calling, or isolating a student base on their racial, sexual, or gender identity. For instance, a student may deliberately refer to an Asian classmate as an Oriental. (Hidden message: You are not a true American. You are a perpetual foreigner in your own country.) Another example of a microassault is a teacher asking an African American male student, “Are you a first-time generation college student?” (Hidden message: African American males usually do not go to college.) Microassaults leave the students feeling unwanted, uncomfortable, and invisible.
Microinsults. A microinsult is an unconscious and unintentional discriminatory action against one’s identity. For instance, a teacher not asking a transgender student what pronoun to use when addressing the student (Hidden message: You are not acknowledging my identity.) Another example of microinsult is a teacher calling on an Asian student to come to the blackboard to work out a drug calculation problem. (Hidden message: All Asians are supposed to be good at math.) Or a student jokingly making the comment “that’s so gay.” (Hidden message: Being gay is associated with negative and undesirable characteristics.) A microinsult can also be nonverbal. For instance, when a white professor fails to call on the African American students in the classroom. (Hidden message: People of color contributions are unimportant.) Microinsults can have a far-fetching negative impact on a student, and they can affect a student’s motivation and commitment as well as mental health.
Microinvalidations. Microinvalidations are unconscious communications or environmental cues that faintly exclude, negate, or nullify the psychological thoughts, feelings, or experiential reality of a person’s identity. One example of microinvalidation is a student asking an Asian student, “Where are you from? You speak perfect English.” The Asian student replying, “I was born and raised in Florida.” (Hidden message: You are not American.) Or when a teacher continues to mispronounce the name of a student even after the student has repeatedly corrected the teacher. (Hidden message: I am not willing to learn how to pronounce a non-English based name.) Or a white science professor asking the male nursing students, “Why are you going into a nursing? It’s a female profession.” (Hidden message: Nursing is not “a real man’s job.”) Or the classic case of a white student telling her black roommate, “I don’t see color. There is only one race: the human race.” The color blindness offense is one of the most frequently delivered microinvalidations. Another example of microinvalidation is a student who unconsciously opens the door for a classmate who is in a wheelchair. (Hidden message: You are not able to independently take care of yourself.) The student should wait for the student in the wheelchair to ask for help if she or he needs it. Microinvalidation is one of the most harmful forms of microaggression because it leaves the victim feeling ashamed and asking themselves “Am I being oversensitive or paranoid?”
How to Address Microaggressions in the Classroom
Professors and students are the most common perpetrators of microaggressions in the nursing classroom environment. In the course of interaction, the professor or student may say something that offends a student intentionally or unintentionally. Since microaggressions are usually invisible to the perpetrator and may seem to have reasonable alternative explanations, the student may be left feeling uneasy and questioning themselves about what the implied message was.
Microaggression is processed in five different phases, Sue says. Phase one is the incident (verbal, nonverbal, or environmental). The perpetrator intentionally or unintentionally commits the offense. Phase two is the receiver’s perception of the offense. For instance, the receiver may ask themselves, “Was I just discriminated against?” or “Did she say what I think she said?” Phase three is the receiver’s immediate response to the offense. The receiver may respond by taking a defensive stand. Phase four is the receiver’s interpretation of the meaning of the offense. They may even ask themselves, “Should I say something?” or “If I say something it may make it worse.” Phase five is the consequence that may happen to the receiver of the offense. For instance, students may lose confidence in their ability to complete the course. Microaggressions can cause psychological consequences on the students over time, such as anxiety, depression, helplessness, and loss of drive, which can impede the student’s academic performance.
Therefore, the first step to addressing microaggression in the classroom environment is to acknowledge that it exists, says Jared Edwards, PhD, a psychology professor at Southwestern Oklahoma State University. Nurse educators need to get to know their students. You should be aware of their campus cultural environment and the specific challenges that your students from different backgrounds may face. Do not dismiss the classroom experience of microaggressions as “isolated” incidents. You should work with your students to create a safe classroom atmosphere by establishing solid ground rules and classroom expectations. You can incorporate open classroom discussions about microaggressions into your courses. For instance, have students conduct a group presentation on the impact of microaggressions in a classroom environment. This will promote teambuilding skills and communication and writing skills as well as help create awareness surrounding the common occurrences of microaggressions. Nurse educators need to be aware of what programs (e.g., student counseling center, disability services) are available on their campus so they can refer students who may need help dealing with the psychological consequences of microaggressions.
Nurse educators must be prepared to teach and advocate for culturally diverse students in a multicultural classroom setting. Additionally, they can show they value their students in many ways. For instance, taking the time to learn how to properly pronounce every student’s name can show the students that you value the student’s identity.
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