Theses Doctoral

Weight Discrimination, Intersectional Oppression, and Mental and Emotional Health of Sexual and Gender Minority People

Leonard, Sarah

This dissertation aims to fill important gaps in the weight discrimination literature by applying a non-pathologizing, intersectional approach and by focusing on previously understudied groups (i.e., sexual and gender minority (SGM) people, racial and ethnic minoritized people, and early adolescents).

Chapter 1 is an introduction to weight discrimination, including its origins in anti-fatness, its intersections with other systems of oppression, and the necessity to de-pathologize fatness to confront anti-fat oppression. Chapter 2 describes a scoping review of weight stigma/discrimination and its relationship with mental and emotional health among SGM people across the lifespan. Across 23 included studies, findings include consistent relationships between weight stigma and worse mental and emotional health and a scarcity of research focused on gender minority people, racial and ethnic minoritized people, early adolescents, and important outcomes such as self-injurious thoughts and behaviors (SITBs).

Aiming to address these gaps, Chapters 3 and 4 both describe cross-sectional analyses of data from a large national sample of 10- to 14-year-old adolescents from the Adolescent Brain Cognitive Development Study. Chapter 3 reports analyses of prevalence of weight discrimination among early adolescents with minoritized sexual, gender, racial, and ethnic identities and those who are gender nonconforming, as well as those at the intersections of these identities. Minoritized adolescents, including intersectionally minoritized adolescents, were significantly more likely to report weight discrimination compared to their peers. Chapter 4 reports analyses of weight discrimination in association with SITBs, and includes testing of sexual identity, gender identity, gender nonconformity, race/ethnicity, sex assigned at birth, and social support as potential moderators. It also includes analysis of intersectional discrimination (based on weight plus sexual identity and/or race/ethnicity) in association with SITBs.

Findings indicate that weight discrimination is associated with higher odds of SITBs; none of the proposed moderators had a significant effect. Intersectional discrimination was associated with heightened odds of SITBs. Finally, Chapter 5 presents a synthesis of results and discusses overall strengths, limitations, and implications. This includes implications for future research to fill identified gaps, policy changes to confront anti-fatness and protect adolescents from weight discrimination, and clinical interventions to make healthcare safe and affirming for fat and intersectionally minoritized adolescents.

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More About This Work

Academic Units
Nursing
Thesis Advisors
Bruzzese, Jean-Marie
Jackman, Kasey B.
Degree
Ph.D., Columbia University
Published Here
July 3, 2024