Racial Microaggressions, Discrimination, and Health: Key Concepts and Models in Psychology and Public Health

Sue et al. 2007 -What are racial microaggressions and their main types?

subtle, everyday slights (verbal/behavioral/environmental) that convey negative racial messages, often unconsciously

Microassault: Conscious, explicit derogations (ex: slurs, avoidant behavior).

Microinsult: Often unconscious; conveys rudeness or demeaning assumptions about identity (ex: "You're so articulate").

Microinvalidation: Negates or dismisses lived racial experiences (ex: "I don't see color").

What psychological dilemmas do racial microaggressions create?

Clash of racial realities - Dominant groups may deny the racism that marginalized groups experience.

Invisibility of bias - Perpetrators often unaware or deny bias.

Perceived minimal harm - Microaggressions dismissed as trivial.

Catch-22 of responding - Confronting bias risks being dismissed; staying silent leads to internal conflict.

Schmitt et al. (2014) - Meta-Analyses on Discrimination & Mental Health

Discrimination consistently predicts poorer well-being: lower self-esteem, higher depression and anxiety.

Stronger effects for:

• Disadvantaged groups

• Children (vs. adults)

• Pervasive/systemic discrimination (vs. isolated events)

Experimental evidence: Chronic discrimination causally lowers well-being.

Weinstein et al., 2021 - How do online and offline bullying and racial discrimination interact for minority adolescents?

Strong overlap: Youth bullied offline are often bullied online

Offline bullying → predicts later online bullying and offline racial discrimination

Racial discrimination happens in both settings, creating cumulative stress.

Time online is linked to current victimization, but does not cause future bullying.

Effective interventions:

Must address both online and offline contexts.

Targeting offline bullying can reduce overall victimization (online + racial).

Reducing “time online” alone is ineffective

Bernard et al. (2021) – C-ACE Framework: Racism as Childhood Adversity

Racism = chronic, culturally specific ACE (Adverse Childhood Experience)

Causes HPA axis disruption, PTSD-like symptoms, and worsens other ACE effects.

Impacts occur through intergenerational, social, and biological pathways → lifelong vulnerability.

Traditional ACE model: Links childhood trauma (abuse, neglect, dysfunction) to later behavioral and mental health problems in dose-response pattern (more ACEs → greater risk)

- It omits sociocultural stressors (racism, poverty, community violence), limiting its relevance for marginalized youth

C-ACE expansion:

- Roots adversity in the legacy of slavery, segregation, and structural inequity.

- Notes that Black youth often face reduced access to care, diagnostic bias, and invalidation after trauma.

C-ACE reframes racism as a core form of childhood adversity with deep, systemic, and lasting effects.

Atkin et al., 2018 - How does internalizing the Model Minority Myth (MMM) affect Asian American adolescents, and how does school racial composition moderate this?

Stereotype: Asian Americans are universally high-achieving and successful due to hard work and meritocracy.

Origin: 1960s Civil Rights era, used to undermine systemic racism claims.

Masks diversity within Asian groups and ignores structural inequities.

M-Achievement: Success through hard work and perseverance

- if internalized: Not linked to distress

M-Mobility: Belief that Asians face fewer barriers and get fair treatment

- if internalized: Higher depression+anxiety in predominantly Asian schools, Lower stress in non-Asian schools

School racial composition moderates how MMM internalization impacts mental health, context shapes whether it harms or protects well-being.

Mostly Asian schools: M-mobility is associated with more depression and anxiety (more competition)

Mostly White school: M-mobility is associated with less stress (percieved advantage)

Students in a predominantly Asian school had less internalization of the MMM (bc they saw more diversity within asians)

Matheson et al., 2021 - Conflicting evidence of microaggression ambiguity's impact on health

Ambiguous racism was more related to depressive affect than explicit experiences

Black and White Canadians tended not to appraise ambiguous events as racist, but in-the-moment distress from hearing ambiguous racist events related to higher cortisol only in Black Canadians

Results of Studies on Microaggressions

Ambiguous prejudice (microaggressions) causes more cognitive impairment than blatant prejudice (Murphy, Salvatore & Shelton)

Microassaults (least ambiguous) show strongest links to adjustment difficulties

Microinvalidations and microinsults show weaker links

Williams et al. (2019) - Systemic/Structural Racism

Racism embedded in laws, policies, and institutions at all levels (local, state, federal), Benefits groups seen as “superior,” oppresses or neglects those seen as “inferior”

Health disparities:

- Black Yale graduates have 3× higher death rate than white graduates; disparities persist despite equal education

- White people live longer than Black people at every education level

Structural factors:

- Residential segregation clusters marginalized groups, reinforcing inequality

- Urban areas are more diverse due to pricing and accessibility

Ziad Obermeyer et al. (2019) – Algorithmic Bias:

- Common health algorithm identified <50% as many Black patients for extra care vs. white patients with same needs

- Resulted in less spending on Black patients despite equal health needs

Housing inequality for mortgages

Wells Fargo discriminated against ~4,000 African-American and Hispanic wholesale borrowers, by steering them into subprime mortgages, while white borrowers with similar credit profiles received prime loans.

Additionally, ~30,000 African-American and Hispanic wholesale borrowers were charged higher fees and rates than white borrowers because of race or national origin, not creditworthiness or objective risk criteria

Gerrymandering

partisan (political party in power) redrawing district map in way that brings like-minded voters together or splits them apart

Concentrates or dilutes the power of a party

In Canada, districts are redrawn by non-partisan (non-political) groups within districts

Shan & Li, 2023 - Report on housing need in Canada

Core housing need: Failing ≥1 of 3 standards — adequacy, affordability, or suitability — and requiring >30% of income to afford acceptable housing.

Racialized people are more likely to live in metro areas with higher living costs.

Major contributors: Location, income, and immigrant status

Canadian Centre for Housing Rights (2022) – Rental Discrimination Findings

Women disclosing newcomer status + racialized accent → 62% more discrimination than those without an accent

Men with racialized accents → 267% more discrimination than men without accents

Racialized newcomer women who disclosed childcare responsibilities → 563% more discrimination than those who did not disclose

Key takeaway: Accent, newcomer status, and caregiving roles compound housing discrimination, especially for racialized women.

Racial Disparities in Unemployment (Canada)

Racialized individuals have higher labor force participation but also higher unemployment rates.

Hiring bias: Applicants with Asian- or Black-sounding names are 20–40% less likely to receive callbacks compared to those with White-sounding names.

Eduardo Bollina-Silva (2021) - What drives systemic racism

Racism > Racists in terms of importance, focusing on racists takes attention from the structure and collective practices that maintain racial domination

If racism were a matter of fighting or educating the "racists, when old people die, racism would end

Colen et al., 2018 - Racial Disparities in Health & Discrimination (Nonpoor Black and Latinx Populations)

Black and Latinx people report more acute and chronic discrimination overall than White people.

Upwardly mobile Black ppl face more acute discrimination than those with stable SES.

Upwardly mobile Latinx ppl face more chronic discrimination than those with stable SES.

Upwardly mobile Black and Latinx ppl have a 17-23% (Black) and 28-29% (Latinx) higher risk of poor self-reported health compared to White ppl

When acute discrimination is accounted for, the health gap shrinks, showing discrimination partly explains the disparity

Chen et al., 2022 - What are the health consequences of upward social mobility?

Striving - very high effort coping

Competing demands

Lack of Belonging - Do I Fit In? Differences in social capital

Mismatch of low-SES traits in high-SES environments → What got you up the ladder may not be helpful once you are up at the top

Assari, 2018 - reducing income inequality

Reducing income inequality helps, but doesn’t fully eliminate disparities for minorities due to differential exposure to and effects of discrimination

“Diminished returns” of income improvements are linked to structural inequalities:

• Labor market preferences and practices

• Discrimination

• Cumulative disadvantages from initial inequality

• Costs of upward social mobility

Vulnerability/risk factors

variables that are associated with maladjustment/negative outcomes

Variable presence predicts outcome but absence of variable does not necessarily lead to positive outcome

Ex: child abuse, teenage pregnancy

Promotive factors

variables associated with positive outcomes across all levels of risk

The presence of variable predicts positive outcome, but absence does not necessarily lead to negative outcome

Ex: Talent in one specific area, having a Mentor

Protective factors

variables that disrupt the impact of a risk factor

Ex: social support, when the risk factor is high, the protective factor leads to better outcomes

Curvilinear effects

Extremes of a variable can have different impacts than moderate levels.

Ex: Family income and drug addiction — both poverty and affluence may increase risk, while moderate income may reduce it.

Relationships between variables are not always linear; both high and low extremes can produce unique outcomes.

Moderation & Mediation

Moderation (“how strong”): The strength of the relationship between X and Y changes depending on M (the moderator)

- Ex: Social support = low, discrimination is strongly associated with depression.

- Social support = medium, the association = weaker.

- Social support = high, the association disappears.

Mediation (“how?why?”): X causes M, and M causes Y

X may have a direct effect on Y (partial mediation) or no direct effect (full mediation)

- Ex of partial: LGBTQ discrimination → internalized heterosexism → depression, with discrimination affecting depression both directly and indirectly through internalized heterosexism.

The Need for Models for Marginalized Groups

Deficit-Based Approaches: White individuals (or men) are often used as the reference group, differences by marginalized groups are framed as abnormal/inferior

- This applies across contexts (ex: cis men, heterosexual people)

- Ex: POC parents more authoritatively than Whites → interpreted as "worse parenting."; Black children suspended more than White → interpreted as "more deviant"

Problem: judgments ignore cultural + structural contexts (ex: working-class families may value strictness due to high consequences of rule-breaking)

Lack of Representation in Research:

- Only 4% of top cognitive neuroscience articles reported racial/ethnic demographics

- In forensic psychology, 47.5% of studies didn't mention race/ethnicity, despite relevance

Cynthia Garcia Coll - Integrative Model for the Study of Developmental Competencies in Minority Children (1996)

Created a model that explains factors that impact POCs' mental health and development

Focuses on 8 factors: social position variables, racism, segregation, promoting/inhibiting environments, adaptive culture, child characteristics, family, and developmental competencies

Clark et al., 1999 - Biopsychosocial Model of Perceived Racism

Process:

1. Stressful stimuli occur

2. Individual perceives it (as racism or another stressor).

3. Coping response follows.

4. Coping can trigger physiological and psychological reactions, leading to health outcomes.

Moderators of perception:

- Constitutional factors: skin color, gender, age, values

- Socioeconomic factors: education, income

- Psychological factors: emotion regulation, personality, self-esteem, optimism

Health effects of racism depend on how it’s perceived, interpreted, and coped with, shaped by individual and social factors.

Constitutional Factors

Skin Color: Ongoing preference for lighter skin tones → colorism (discrimination based on skin shade).

- Linked to poorer mental health and family divisions.

Age: As children grow, awareness of discrimination increases, they better recognize prejudice and adult/institutional discrimination

- No rise in peer discrimination with age.

- 92% of 10-year-olds understand discrimination; common examples include name-calling, exclusion, and refusal to share.

SES (Socioeconomic Status) Factors

Education: Highly educated individuals from marginalized groups are more likely to work in predominantly White settings

Universities may increase awareness of race and discrimination by providing more opportunities for discussion.

Higher income among Black individuals in predominantly White areas is linked to a greater risk of depression.

Brondolo et al. (2018) – Biopsychosocial Model: Discrimination → Health

Explains how discrimination impacts health through social and cognitive processes.

Affects schemas and appraisal pathways (how we interpret experiences).

Influences cognitive control processes, including:

• Higher-order processing

• Attentional control

• Cognitive flexibility

• Integration of semantic, emotional, and sensory information

Frost & Meyer, 2023 - Minority stress theory

Developed to explain how prejudice and stigma toward SGM ppl impact health

Types of stressors:

- General: (losing a job for poor performance)

- Minority-specific: (losing a job due to SGM status)

• External: violence, exclusion, microaggressions.

• Internal: self-doubt, internalized homophobia or racism.

Framework: Links social stigma, discrimination, and prejudice to mental and physical health outcomes.

Chronic exposure → hypervigilance, rumination, and physiological stress (↑ blood pressure, inflammation).

Protective factor: Minority identity can foster strength, support, and collective coping within affirming communities.

Minority stress explains how chronic stigma and discrimination harm health, but community connection can buffer these effects.

Meta-analysis

'study of studies'

Synthesizing quantitative studies on similar topics

What is the average effect across these studies

Great at examining moderators - does this average effect differ based on age, background, gender, study design, study quality, outcome of interest

Emmer et al., 2024 - Meta-analysis of experimental/causal discrimination → Mental health studies

Discrimination is moderately associated with worse mental health

Those from marginalized backgrounds are more impacted

Racism, sexism, and heterosexism were the most harmful forms of discrimination (heterosexism #1)

Pervasive discrimination is more impactful

Benner et al. (2018) – Discrimination and Adolescents

Higher exposure to discrimination → greater negative effects on well-being.

Children, especially younger ones, are more affected by discrimination than adults.

The type of perpetrator (peer vs. adult) does not change negative impact

De Lange et al., 2022 - discrimination against LGBTQ people

Minority stress → suicidal ideation and attempts

LGBTQ young adults - 12-25 years old

LGBT bias-based victimization v. Discrimination

Mason et al., 2020 - Eating Pathology

55 studies looking at relations between discrimination and eating disorders

General discrimination, Racial discrimination, Gender discrimination, Weight discrimination (Strongest effect) are associated with greater combined eating disorder pathology

Substance Use Outcome

Gay-related victimization and general victimization associated with substance use in LGB youth

Racial discrimination relates to more substance use among racially minoritized Americans

Teacher-based racial discrimination associated with substance use among youth... Effects are stronger for younger kids and Black youth compared to Latinx or Indigenous youth

Civitillo et al., 2023 - Academic Outcomes

Meta-analysis of teacher-based racial-ethnic discrimination

Includes well-being, substance use, and academic outcomes

Teacher-based discrimination is overall related to worse academic outcomes

Effects are stronger in schools with fewer racially minoritized students

Heard-Garris et al., 2018 - Vicarious Racism

Systematic review of how parents’ experiences with racism affect children’s health outcomes.

Maternal racism exposure linked to: More depressive symptoms during pregnancy, Child outcomes (preterm birth, altered cortisol reactivity, and lower birthweight)

Ex: Parents discussing racist incidents with children, Witnessing racism (ex: George Floyd video), Hearing about a friend’s experience with discrimination

Racism-related stress before and during pregnancy can have long-term effects on children’s health.

HPA axis

When activated leads to the release of cortisol

Experiencing stressors should lead to a normal release

Past discrimination leads to future events of exaggerated response or blunted/reduced cortisol response when experiencing discrimination

Berger & Sarnyai (2015) - Stress Neurobiology Model of Racial Discrimination

HPA Axis

- Activated by stress → releases cortisol

- Chronic discrimination → exaggerated or blunted cortisol response to future stress

Heart Rate Variability (HRV)

- heartbeat range (higher = better heart health)

- Racial discrimination → lower HRV, especially in Black youth

Allostatic Load

- "Wear and tear" on the body

- Results from dysregulated cortisol + HRV → increased inflammation

Brain Effects

- Discrimination alters prefrontal cortex function (emotion regulation, stress control)

- Linked to reduced grey matter in the Anterior Cingulate Cortex (emotion, impulse control, decision-making)

Life course perspective

Considers how individual, social, contextual, and historical factors influence a person’s life across different stages of development

The prevalence, importance, and impact of these factors change with age and over time.

Age-patterned exposures: The types and frequency of experiences—such as discrimination—may shift across the lifespan

Gee et al., 2007 - Age-based discrimination across time

Study Design: Tracked two groups of women in 5-year intervals

- "Young women": ages 14-24 at baseline, "Mature women": ages 30-40 at baseline

Findings:

- Age discrimination decreases from the 20s to mid-30s.

- Peaks around age 55, then declines.

- Those reporting more age discrimination also reported more gender and racial discrimination.

- The Healthy Minds Study showed a similar pattern for discrimination due to race, ethnicity, gender, sexual orientation, and cultural background — with spikes in early 20s and late 50s.

Assari et al., 2018 - Study on discrimination among Black youth followed across 18 years

Half from Georgia (southern US state), half from Iowa (rural Midwestern US state)

10-12 at baseline, 6 follow-ups

Found that black youth had an increasing trajectory of exposure to racial discrimination over time

Steeper increase in racial discrimination exposure across time for men, Iowans (a very white state), and those whose families earned more money

Sensitive periods

Certain events have a more profound effect on health when they are experienced during specific developmental stages

Outside of this period, the effect is much less

Exposure to discrimination at certain developmental periods may have a greater effect on health than at other developmental periods

Kids are more sensitive to discrimination by adults; early childhood is the most sensitive, and it goes down from there to adulthood

Christophe & Stein, 2021 - Discrimination and Sensitive Periods (Midlife Study)

Overall, depression decreases with age across decades

However, individuals who experience discrimination within a decade show higher depressive symptoms during that period

Discrimination in one’s 40s predicts greater depression in the 50s, suggesting the midlife period may be a sensitive period for the mental health impacts of discrimination

Adam et al. (2015) - Discrimination & Sensitive Periods Cortisol Study

Goal: Examine how adolescent vs. early adulthood discrimination affects adult daily cortisol rhythms.

Cortisol rhythm factors: Wake level, Cortisol Awakening Response (CAR), Slope across the day, Area Under the Curve (AUC) = total daily cortisol

Findings (Black participants):

- Racial discrimination → lower waking cortisol levels.

- Adolescent discrimination → lower waking cortisol and lower AUC in adulthood.

- Young adulthood discrimination → greater CAR, but weaker effects overall.

- Sensitive period: Adolescence is a key window—discrimination during this time predicts lower initial cortisol, flatter slopes, and less total output in adulthood.

Linked Lives

Emphasizes that people’s lives are interconnected — discrimination affecting someone close to you can impact your own health and well-being.

Vicarious discrimination → witnessing or hearing about discrimination toward someone in your in-group (parent, sibling, friend).

Discrimination doesn’t just harm the direct target — it also affects those connected to them through shared identity or close relationships

Latency Period

The time gap between experiencing an event and seeing its tangible effects.

Ex (Pavalko et al., 2003):

- Workplace discrimination against women at baseline → not linked to psychological distress 7 years later, but was linked to functional limitations.

- Current discrimination (at follow-up) → linked to distress, but not to functional limitations.

Some effects of discrimination appear only after time has passed — showing a delayed (latent) impact on health.

Lawrence et al., 2023 — Differences in Mortality over time

Study of US 45-84 year olds across 5 waves (16-18 years)

For each 1-point increase in lifetime discrimination, Black adults had 8% increase in all-cause mortality risk and 18% increase in cardiovascular mortality

Not significant for White adults

Life expectancy gaps in Canada (Statistics Canada, 2023)

Indigenous peoples have a significantly shorter life expectancy than White Canadians.

Black Canadians show a lower risk of all-cause mortality compared to White Canadians (a finding that remains even after controlling for demographics and social determinants of health)

Period effects vs cohort effects

Period Effects: Historical or social events that impact everyone, regardless of age or birth year.

- Ex: After 9/11, all pregnant Arab American women had worse birth outcomes in the following 6 months.

Cohort Effects: Events that affect people differently based on when they were born.

- Ex: After the Civil Rights Act, younger Black people saw improved health and mortality, while older generations benefited less due to lifelong systemic inequality.

Cross-Sectional Design

collecting data from a population at a single point in time, providing a "snapshot"

Benefits: Compare cohorts of different ages to one another at a given time, relatively cheap and practical

Drawbacks: Can't learn about how individual people change with age - effects are between-person, Age effects are confounded with cohort effects

Longitudinal Design

same individuals/groups are repeatedly observed and measured over an extended period to track changes, trends, and relationships over time

Benefits: Can make within-subject comparisons, No cohort effects

Drawbacks: Subjects drop out, May be effects of repeated testing, Requires foresight + funding, Time-consuming, Age effects confounded with time of measurement effects

Weaknesses of both cross-sectional and longitudinal designs

Often, retrospective reports: recall bias and recency bias

Snapshots or long-term follow-ups don't tell us what is happening in the day-to-day

Experience Sampling

Measure people repeatedly across a short time span

Ex: every day for 21 days

Reduces retrospective and other biases

Captures intra-individual changes

Potter et al. (2019) - Daily Discrimination Review

Most common types: Weight and gender discrimination, often from close others (family, partners).

- Stranger discrimination is also frequent, especially in public spaces.

Frequency by Type:

Weight-based: ~4/7 days to 3 experiences/day

Gender-based: Women: 1-2/week (checklist: ~1/day); Men: report <1/week against women.

Race-based: <1/week to 2/day; younger ppl and women report more

Sexual orientation-based: ~2/day

Wang & Yip (2020) - Sleep, Discrimination, & Coping

Design: 14-day daily diaries + sleep tracker

Q: Does the previous night's sleep (duration & quality) moderate links between discrimination, coping, and well-being? → Yes

Better sleep → more adaptive coping:

- Longer sleep → more problem-solving when facing discrimination

- Less time awake at night → more problem solving + peer support seeking on discrimination days

Coping → Well-being:

- Problem solving → ↑ daily mood & life satisfaction

- Peer support → ↑ daily mood & life satisfaction

Indirect effect: Discrimination & Sleep → Coping (problem solving, peer support) → Positive well-being

Seaton & Zeiders, 2021 - Daily Racial Discrimination & Diurnal Cortisol

What are the same-day and next-day effects of racial discrimination on cortisol, and how does racial identity matter?

Findings:

- On days with more discrimination than usual → higher overall cortisol (AUC) and higher bedtime cortisol.

• Microaggressions predicted greater AUC one week later.

- Next day: Flatter cortisol awakening response (CAR) and steeper diurnal slope, especially among those who viewed being Black as central to their identity

Livingston et al. (2017) - Discrimination & Substance Use (SGM Young Adults)

SGM Discrimination: 13 participants reported 93 experiences across 63 prompts

- Increased odds of use: Nicotine +299%, Other substances +359%

- Stronger effects later in the day; lagged effects on substance use observed

Other Discrimination: 210 experiences across 137 prompts

- Increased odds of use: Nicotine +202%, Other substances +163%

- Lagged effects on substance use observed

Both SGM and other discrimination linked to concurrent nicotine & substance use

SGM discrimination showed stronger associations, despite being reported by fewer participants

Wang et al. (2025) - Meta-Analysis: Discrimination & Youth Mental Health

Question: How do within-person (WP) and between-person (BP) associations between ethnic-racial discrimination and mental health differ?

WP: On days with more discrimination, youth show worse mental health. WP effects = significant but smaller than BP effects.

BP: Youth who experience more discrimination overall have worse mental health. BP effects are larger, reflecting accumulated daily impacts over time

Key idea: Small daily "mosquito bites" → big cumulative impact → explains stronger BP effects we watched when talking about microaggressions

Wang, 2023 - Where does the field need to go in the measurement of daily discrimination & Health?

1. Better measurement

2. Moving beyond interpersonal discrimination

3. Capturing intersectional experiences & integrating mixed methods

4. Not just lagged effects, examining recovery to baseline after discrimination

5. Integrating daily methods with longitudinal work

6. Protective factors -interpersonal, familial, and contextual

- Social support and ingroup identification sometimes buffer effects.

- Engagement coping (active problem-solving) more protective than avoidance.

- Resilience depends on access to collective support and coping resources

Online racism

A system of anti-POC practices that uphold White political, cultural, and economic power in digital spaces.

Occurs through technologically mediated, interpersonal (verbal or nonverbal) online interactions, often leaving a digital record

A broad audience can contribute to harm by commenting, liking, or sharing racist content

Sexism & Heterosexism in Online Gaming

79% of participants said sexism is common in online gaming

63.3% of women reported being harassed while playing

58% of women gamers experienced abuse from male players

28% faced sexual harassment (objectifying comments, death, or rape threats)

Tynes et al. (2018) - Taxonomy of Online Racism (three forms)

1. Online Racial Microaggressions

- Microinvalidations: Messages (text, video, symbols) that deny or downplay racism (colorblindness, meritocracy myth, denial of racism, "reverse discrimination")

- Microinsults: Subtle slights implying lower intelligence, second-class status, pathologizing culture, criminality assumptions.

2. Online Racial Discrimination (Microassaults): Less subtle, more intentional online discrimination.

3. Online Hate Crimes: Severe, targeted attacks: stalking, cyber-mobs, harassment, privacy violations.

"Reverse racism": idea that members of the dominant group are systematically discriminated against

- individuals can be discriminated against bc of their membership in a dominant group, but social structures and systems dont discriminate against individuals from dominant groups because those groups control the systems and structure

English et al. (2020) - Daily Discrimination Among Black American Adolescents

Most frequent types of discrimination:

- Online discrimination (direct or seeing it happen to others) happens most often

- Individual online (directly targeting the teen online) is slightly more common than vicarious online (seeing someone else targeted online)

- Other forms like teasing or general discrimination in-person happen less often

Key findings:

- Online discrimination (direct + vicarious) is more common than in-person.

- Discrimination occurs far more often than previously estimated when measured daily.

- The majority of daily discrimination comes from online experiences (both individual and vicarious).

Bedrosova et al. (2025) – Review of Online Discrimination

Key distinctions:

- Exposure: Seeing biased content online not directed at you

- Victimization: Targeted at you directly or witnessing others being targeted (vicarious)

Findings:

- Age: Younger → more exposure; Older → more victimization

- Minority status: Being from an ethnically/racially minoritized group increases risk of both exposure and victimization across all types of online discrimination (racial/ethnic, religious, gender, sexual orientation)

- Internet use: More time online → more exposure overall; also more victimization for religion- and race/ethnicity-based discrimination

Benner et al., 2024 - Mixed methods (qual + daily diary) study of racist jokes and adolescent wellbeing

Many adolescents downplayed racist jokes, viewing them as harmless or normal peer interactions.

Daily Diary Findings:

- More frequent or upsetting jokes from friends → higher daily anger and anxiety (between-person effect).

- On days with more upsetting jokes than usual, teens felt more anger, anxiety, depression, and stress (within-person effect).

Jokes from others:

- Acquaintances: More racist jokes → higher daily anxiety and depression (between-person).

- Strangers: More exposure across days → higher daily anxiety, depression, and stress (between-person).

Richard Lee's TED Talk

White adoptive families of Korean American children: 4/5 couldn't have constructive talks about race/ethnicity.

Asian American parents: 2/3 couldn't talk about racism with their kids.

Impact: Racism can make individuals doubt their own memories and shape identity differently — some identify more strongly with their group, others distance themselves.

PTSD diagnostic criteria

Must have: Criterion A stressor, 1+ Intrusive symptoms, 1+ Avoidance behaviors, 2+ Cognition & mood alterations, 2+ Reactivity & arousal alterations

Criterion A stressor: Exposure to actual or threatened death, serious injury, or sexual violence

Discrimination & Criterion A: Severe events (hate crimes) may qualify. Most discrimination (online exposure) doesn't qualify unless job-related (media workers repeatedly exposed to traumatic content).

Debates: Some advocate expanding DSM to include racism-related trauma, while others caution against changes to protect diagnostic integrity.

PTSD

Primary causes: Women: Sexual assault; Men: War or combat experiences

Symptoms: Persistent distress that doesn’t fade over time, may worsen with intrusive thoughts, nightmares, flashbacks, hypervigilance, and sleep disturbances

Implications: People showing PTSD-like symptoms from racial trauma are often misdiagnosed with other conditions instead of PTSD.

Historical/Generational trauma

cumulative emotional and psychological wounding across generations and over the lifespan, emanating from a massive group trauma experience

Epigenetics of Historical Trauma

Trauma can alter the epigenome of germ cells (sperm/eggs)

If trauma occurs during pregnancy, a female fetus’s germ cells can also be affected → easier intergenerational transmission through females (since they’re born with all their eggs).

Offspring effects: Gene expression changes (“on/off” switches) lead to neuroendocrine differences (ex: in children of Holocaust survivors vs. non-exposed Jews)

Cultural transmission: Survivors pass down trauma through shared narratives and collective memory, preserving the impact across generations

Kirkinis et al., 2021 - Systematic review of racial discrimination and trauma literature

Scope: 28 studies, all from the U.S. → highlights need for research in other countries

Findings: Moderate to strong positive correlations between racial discrimination and trauma symptoms

Greater exposure → higher PTSD symptoms.

Consistency: Effects observed across traditional PTSD measures and the Race-Based Traumatic Stress Symptom Scale

Racial Discrimination, ACEs, and Behavior Problems in Racial/Ethnic Minority Youth – Systematic Review

Goal: Examine how racial discrimination and Adverse Childhood Experiences (ACEs) relate to internalizing (anxiety, depression) and externalizing (aggression, rule-breaking) symptoms in youth

Findings:

- Racial discrimination ranked 5/top 10 adverse experiences for externalizing behaviors

- Ranked 6/12 for internalizing symptoms

- Impact was stronger than several ACEs (neglect, family conflict, domestic violence, abuse).

Racial discrimination is a major adverse experience—often more harmful than traditional ACEs in predicting youth behavior problems.

Galan et al. (2022) – Intersectional Approach to Racial Trauma Exposure

Builds on: Bernard et al. (2020) by emphasizing intersectionality, focused on Black youth, ideas apply across many marginalized groups.

Sexual Abuse → Prison Pipeline

- 31–81% of girls in the justice system have sexual abuse histories.

- Trauma reactions (truancy, substance use) increase justice involvement.

Police Violence & Intersectional Invisibility

- Media spotlights Black men killed by police, but Black women face similar force.

- Black women are disproportionately victims of police sexual violence, but experiences are often ignored due to intersectional invisibility

Intersectionality

Impact of living with multiple marginalized statuses

Different forms of social oppression are not additive but intersect and are unique

overlapping identities (race, gender, sexuality, class, etc.) create unique, interdependent systems of discrimination.

LGBTQ-POC experience "double or triple jeopardy," racism from LGBTQ spaces + homophobia/heterosexism from racial/ethnic communities

Not additive but interactive stress: identities combine to shape exposure, perception, and coping.

Calls for moving beyond single-axis models (studying "LGBTQ" or "POC") toward integrated, intersectional analysis

Disparities approach

Differences between specific groups approach

Analyzed using big samples, mediation, and moderation

Ex: Discrimination is more harmful for anxiety among Asian Non-binary people than Latinx men

Advantages: Highlights disparities, drives policy change + allocation of resources because you know who is doing better and worse, Large sample sizes, so powerful claims

Limitations: Sample size for interactions, or small cell sizes for different interactional groups, Don't experiences look different & mean different things depending on one's intersectional group identities? General items may not capture that

Qualitative Work

ex: individual interviews, focus group

interviews, analysis of forums/blogs/social media posts, etc.

Between or within-group - often within-group

Hearing about experiences from the source

More nuance than checking boxes

Meaning-making behind experiences

Nadal et al. (2015) - Intersectional Microaggressions

Past research: Focused on single-identity microaggressions → overlooked intersectional experiences.

This study: Tested whether people with multiple marginalized identities mention intersectional microaggressions without being prompted.

Findings: Participants spontaneously described intersectional experiences, showing their strong presence in daily life.

Implication: Intersectionality-focused qualitative research reveals more nuanced, within-group experiences.

Within-group quantitative work

Targeted measures assessing experiences unique to intersectional identity groups

Qual advantages: deeper dive; Quant advantages: generalizability to the group under study

Not as deep as qual, tells you about factors influencing disparities, but doesn't highlight disparity itself since there is no group comparison

Liu & Le, 2025 - Gendered Racial Microaggressions & Eating in Asian American Women

More gendered racial microaggressions → more disordered eating (direct effect).

Also linked to higher internalized racism, which in turn predicts greater disordered eating.

Internalized racism partially mediates the link between microaggressions and disordered eating.

Unique Risks for SGM Racially Minoritized Individuals

Face racial discrimination in dating contexts

Experience racism within LGBTQ+ communities

Encounter heterosexism within racial/ethnic communities

Result: “Doubly oppressed” — marginalized by both race and sexual/gender identity

Swann et al., 2024 - SGM stigma, community, & mental health in SGM-POC

How do POC heterosexism and SGM racism impact mental health, identity authenticity, and community support?

Findings:

- POC heterosexism increases anxiety & depression

- SGM racism has no effect

- Identity authenticity has no change

- SGM community connection decreases anxiety & depression

- Moderation: High POC heterosexism reduces or nullifies the mental health benefits of SGM community connection

Multiracial SGM Youth

Race × sexual orientation/gender identity, and multiple racial group memberships

Challenge: Multiracial youth violate the monoracial paradigm of race

Prevalence: High among SGM youth, 42% of Ryan Watson's 17,000-person nationally representative SGM youth of color sample

Mental health risk: ↑ suicidal ideation & attempts compared to monoracial youth, especially dual-minority Multiracials

Jackson et al., 2023 - Multilevel Stigma & Depression among Black & Latinx LGBTQ+ Adolescents

How interpersonal discrimination (racial & sexual orientation) and state-level structural stigma/protections (general and adolescent-specific) affect depressive symptoms

Findings:

- Anti-LGBTQ structural stigma at the state level → increased depressive symptoms

- Endorsed racial/ethnic bullying and endorsed sexual orientation bullying → severe increases in depressive symptoms

Homan et al. (2019) – Intersecting Structural Inequalities & Health

Developed state-level measures of structural sexism and racism, and used existing data on income inequality across U.S. states.

Structural inequalities are correlated → states high in sexism also tend to be high in racism.

Health impacts were strongest for Black women: Worse health in states with high racism, high racism + sexism, and especially high racism + sexism + income inequality (White health - little change)

Intersecting systems of racism, sexism, and economic inequality compound to worsen health outcomes, particularly for Black women.

Clark & Clark (1947) - Doll Experiment

Assessed psychological effects of segregation on young Black children in the US

Findings:

Black children often chose white doll as "best/nice" → evidence of internalized racism

Children could differentiate racial groups; racial self-identification present but less accurate

Positive attributes → white doll; negative → Black doll; stability varied by age

Awareness of racial differences + self-identification + internalized racism can appear before age 7

Used in Brown v. Board of Education, helping to end school segregation; major milestone for research on race and psychology

Huynh et al., 2022 - Internalized Heterosexism (IH)

Sexual minority individuals show higher substance use; IH is linked to increased use, but findings are mixed.

Meta-Analysis Aims: Summarize the IH-substance use relationship and Identify potential moderators

Findings: Race/ethnicity not significant moderators (may reflect coding issues).

Limitations:

- Could not assess differences among bisexual, transgender, nonbinary, or gender-nonconforming participants.

- Men overrepresented in samples.

- Most research focused on alcohol, tobacco, and marijuana, limiting findings for other substances

Mereish & Miranda (2025) - Vicarious Heterosexism & Internalized Oppression

Tested effects of vicarious heterosexism on internalized heterosexism, rejection sensitivity, and sexual orientation rumination

Findings: Heterosexism stress incrases internalized heterosexism, rejection sensitivity, rumination

- Effects small-to-medium, larger for those exposed to high structural heterosexism in adolescence

Implications:

- Supports theory that heterosexism can be internalized and harm well-being

- Direct target not necessary; even brief vicarious exposure has acute impact

- Relevant because sexual minority young adults often face persistent heterosexism

Fuller-Rowell et al. (2021) – Daily Racial Discrimination & Sleep

Measured: Internalized racism (baseline), Daily racial discrimination and sleep problems

Findings:

- On days when ppl experienced more discrimination, they had more sleep problems that night

- This link was moderated by internalized racism, meaning the impact of discrimination on sleep varied based on how much racism participants had internalized

Nine Common Themes of Microaggressions

Alien in one's own land - Assuming non-Whites are foreigners ("Where are you really from?")

Ascription of intelligence - Assigning ability based on race

Color blindness - Denying race or racism's role

Criminality/assumption of danger - Presuming threat or deviance

Denial of individual racism - "I'm not racist, I have Black friends."

Myth of meritocracy - Belief that success is purely based on effort, ignoring structural barriers

Pathologizing cultural values - Deeming non-White behaviors as abnormal ("Why are you so emotional?")

Second-class status - People of color treated as less deserving/competent.

Environmental microaggressions - Systemic exclusion (lack of representation in institutions)

Aversive Racism & Modern Racism

Post-Civil Rights racism: Subtle, socially acceptable, often unconscious.

Aversive racism: Tension between conscious egalitarian values and unconscious negative feelings toward people of color.

Most common among well-intentioned White liberals, often showing up as avoidance, discomfort, or microinvalidations

Stigma Characteristics

Concealable stigmas (sexuality, mental illness): more harm due to secrecy, isolation.

Controllable stigmas (weight, unemployment): more harm because stigma is seen as deserved.

Visibility and perceived responsibility shape coping and social support