New Project: “The Sexual Health Experiences of Recently Settled Women: A Comparison between Vancouver, BC and Sydney, NSW”

The CGSM is conducting one arm through the seed grant program of this collaborative Australian Research Council Linkage grant awarded to Janette Perz, Jane Ussher, Renu Narchal, Jane Estoesta, Jane Wicks, Melissa Monteiro, and Marina Morrow.

The project includes multiple partners: Family Planning NSW, The Hills Holroyd Parramatta Migrant Resource Centre Incorporated, and the Centre.

Over three years the team will examine the sexual health beliefs and practices of women from culturally and linguistically diverse (CALD) communities, who are recent migrants to Australia and Canada. This analysis will inform the development of guidelines for sexual health information, which will be evaluated as part of the project.

Ongoing Project: “Regulating the Boundaries of Motherhood: A Case Study of Trans Women’s Experiences in Relationship to Motherhood”

Within the field of reproductive mental health, the meaning of the term mother and the scope of those included within its boundaries, typically go unexplored.  In the field of motherhood studies, research has addressed marginalization from ideal motherhood, yet transgender (trans) women have not figured in these projects. Further, the small body of research pertaining to trans parenting has yet to explore the relationship to gendered categories of parenthood.  This project builds on the findings of the 2010 CGSM supported pilot study Transforming Family, which found that trans women were excluded from claims to motherhood across multiple sites including reproductive health services, legal processes related to parenting as well as within their own family networks. Through a case study analysis of 3 to 4 participants, we aim to better understand the barriers to trans women’s inclusion in motherhood and the impact on their mental health and wellbeing. The findings of this case study will form the basis of a manuscript for submission to a quality reproductive and sexual mental health or gender studies journal.

Completed project: “A pilot study to examine reproductive mental health experiences in culturally and linguistically diverse women from an intersectional perspective; and the preparation of an external research grant application to further this research”

There is a tension in current discourse surrounding women’s reproductive mental health between research that focuses primarily on the biological aspects of reproduction, and research that looks more critically at the social and cultural context of these health issues. Although there have been huge accomplishments with regards to acknowledging and responding to factors such as sex, gender, and socio-cultural diversity over the past decade of women’s health research and policy, the approaches that have been taken to date are limited, and many gaps in knowledge still exist.

There is a need for research using an intersectional approach in order to further understand and meaningfully respond to women’s reproductive health issues across the life span. The goal of this project was to follow-on from the systematic review and critical evaluation of different models of women’s reproductive mental health conducted by the group in 2011. The objectives and outcomes of the work were as follows:

1. To collect pilot data on women’s reproductive mental health within culturally and linguistically diverse populations (CALD) in Australia, using an intersectional framework that acknowledges the interaction of ethnicity, social and economic class, sexuality and gender.

Outcome: Pilot data was collected through interviews with 30 women from a CALD background who had migrated to Australia. This included: 10 women from a Muslim back ground; 10 Christian women from Sri Lanka; and 10 women from an orthodox Jewish background. Each of these sub-studies was submitted as an Honours or Masters thesis, and two publications have arisen from this research:

Perz, J., Ussher, JM, Wray, A. Purity, privacy and procreation: Constructions and experiences of reproductive and sexual health in three culturally and linguistically diverse (CALD) communities living in Australia. Paper presented at the Biannual Society for Menstrual Cycle Research Conference, New York, 6th-8th June, 2013.

Wray, A., Ussher, JM, Perz, J. Constructions and experiences of sexual health in young, heterosexual, unmarried Muslim women immigrants living in Australia. Culture, Health and Sexuality (accepted for publication June 2013).

 2. To coalesce an Evidence Panel with representation from multiple sectors (i.e., researchers, service providers, individuals with lived experience) and from relevant strands (i.e., gender, race, mental health, migration, trauma) who will collaborate to develop the methodology and study aims of the external grant application.

Outcome: An evidence panel was put together involving representatives from multiple sectors to collaborate to develop the methodology of the research study and contribute to the external grant application submitted.

3. Based on the pilot data and the Evidence Panel discussions, to develop a proposal for a collaborative international research project which will be submitted to the Australian Research Council (ARC) and the Canadian Institutes of Health Research and Social Sciences and Humanities Research Council (CIHR).

Outcome: A research grant application was submitted to the Australian Research Council (Linkage Scheme), in November 2013: Sexual health of migrant women from culturally and linguistically diverse (CALD) groups: An international comparison. This application was a collaboration between UWS (CIs Jane Ussher, Janette Perz, Renu Narchal), Centre for the Study of Gender, Social Inequalities and Mental Health, Simon Fraser University (PI Marina Morrow), Family Planning NSW (PIs Anne Stuart, Jane Wicks, Jane Estoesa), and Community Migrant Resource Centre, Parramatta (Melissa Monterio).

This grant application was successful, and funding was awarded in June 2013.

Completed Project: “Theoretical approaches to the study of reproductive mental health: A focus on intersectionality” –  Summary:

There is a tension in current research on women’s reproductive mental health concerns between research that focuses primarily on the biological aspects of reproduction, and research that looks more critically at the social and cultural meanings attached to labels like premenstrual syndrome and postpartum depression (Ussher, 2010; Ussher & Perz, 2008). Further, there is a need to understand the experiences of marginalized women (including ethnoracial minority women, sexual minority women, disabled women, women of low socioeconomic status, among others) and the impact of social exclusion in relation to reproductive mental health.

For the first initiative of the Reproductive Mental Health Theme Group, we opted to conduct a literature review to describe the current state of research and resources addressing reproductive mental health among marginalized women, and in particular, to examine theoretical perspectives employed in this research.

This review encompassed a total of 415 sources from both academic and grey literature. Taken together, these sources indicate a number of critical gaps in the literature addressing reproductive mental health, specifically with regards to marginalized groups of women.

For some topics related to reproductive mental health (e.g., postpartum depression) research is beginning to address the diverse experiences of different groups of marginalized women through models that consider the determinants of health. However, the majority of research in this field has done so in a limited way, for instance, by looking at one-dimensional correlates of mental health and wellness (i.e. race and health) with the exclusion of the interaction of larger social factors that collectively shape health experiences. Further, menarche and menstruation, adoption, contraception, miscarriage and infertility are all areas that demonstrated significant gaps in knowledge.

In order to more fully understand the determinants of mental health and wellness throughout the lifespan of reproductive experiences, more research is needed in these areas that interrogates how the interactive nature of privilege and oppression and the unequal distribution of resources constrain and enable individuals ability to achieve and maintain control over their health.

The results of this literature review will guide the Reproductive Mental Health Theme Group as we determine the focus of our work for the coming years.

At the May 2011 Critical Inquiries Workshop the project team presented a project poster and handed out project pamphlets that contain the most up to date material currently available on this project.