Primary Submission Category: Gender
The use of structural stigma as a concept for research on the health effects of cissexism: A scoping review
Authors: Edwina Kisanga Evan Eschliman Danielle German Sarah Murray Michelle Kaufman
Presenting Author: Evan L. Eschliman*
Despite the proliferation of research’s use of “structural stigma” to uncover and document the negative health effects of cissexism, the use of this concept to date has yet to be formally characterized. This scoping review aims to identify all usages of the term ‘structural stigma’ in health-related peer-reviewed empirical research on cissexism to elucidate trends in how the term has been defined and operationalized. The search syntax “structural stigma*” was used to identify all peer-reviewed articles that contain the term ‘structural stigma’ in five databases (i.e., PubMed, PsycINFO, Embase, Web of Science, and CINAHL) before September 1, 2022. Duplicates were removed, and two reviewers screened all title and abstracts, then reviewed full-texts. Articles were eligible for inclusion if they were empirical, peer-reviewed research articles written in English that included the term ‘structural stigma’ anywhere in the main text and had a focus on the health of transgender, nonbinary, intersex, or other gender-expansive people. Of the 37 included articles, all were published within the past 10 years and 79% were published in 2020 or later. 16 (43%) used solely quantitative methods, 14 (38%) used solely qualitative methods, and 7 (19%) used multiple or mixed methods. A majority of these articles (n = 27, 73%) were in the U.S., and most studies looked at either cissexism’s effects on mental health or experiences of stigma and discrimination. 35% of the studies did not provide a definition of structural stigma, and just over one-fifth (n = 8, 22%) of the articles engaged with intersectionality. Participants in these studies were overwhelmingly white and high socioeconomic status, and few studies included gender expansive individuals outside of transgender women and transgender men. No articles focused solely on nonbinary people’s health or intersex people’s health. The concept of structural stigma is increasingly being used to examine the negative health effects of cissexism, yet gaps remain in its operationalization. Furthermore, there is a need for more diverse representation within studies that discuss structural cissexism, as well as greater utilization of intersectionality to understand the ways that intersecting axes of stigma and oppression shape gender expansive people’s experiences of cissexism.