The Health of Sexual Minorities

pp 268-300

Determinants of Health Among Two-Spirit American Indians and Alaska Natives

  • Karen C. FielandAffiliated withSchool of Social Work, University of Washington
  • , Karina L. WaltersAffiliated withSchool of Social Work, University of Washington
  • , Jane M. SimoniAffiliated withDepartment of Psychology, University of Washington

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In comparison to other racial/ethnic groups, American Indians and Alaska Natives (AIANs or “Natives”) suffer from glaring disparities in health-related resources and outcomes. Specifically, morbidity due to violence and substance use is higher and overall mortality is greater [IHS]. AIANs who identify as gay, lesbian, bisexual, or transgender (GLBT) or with the modern roughly equivalent Native term “two-spirit” (hereafter collectively referred to as “twospirits”) face additional stressors associated with negotiating their dual oppressed statuses. They often confront heterosexism from Natives and racism from GLBTs. Not surprisingly, two-spirits are thought to be at even greater risk for adverse health outcomes than other Natives (Walters, 1997; Walters et al., 2001). Preliminary empirical evidence supports the notion that two-spirits experience disproportionately greater anti-gay as well as anti-Native violence, including sexual and physical assault during childhood and adulthood (Walters et al., 2001; Simoni et al., 2004a) and historical trauma (Balsam et al., 2004)-experiences that are typically linked to adverse health and psychosocial functioning. Despite the considerable heterogeneity both within and across the more than 562 federally recognized tribes in the United States, the universal experience of colonization has created a shared history for two-spirit people, shaping distinctive conditions of health risk and resilience.