Introduction: Structural stigma, or stigma at a society or policy level, has a negative impact on the mental and physical health of sexual and gender minorities (SGMs). In particular, political leaders and the policies they enact can limit the resources and safety of SGM. Following the 2016 presidential election, there was fear of an increase in structural stigma in the USA. However, research on the specifics of anticipated structural stigma is lacking. Methods: Using data from 187 participants who completed an online study conducted from 2016 to 2017, we used inductive thematic coding to examine anticipated structural stigma. Results: We found four themes: (1) anticipated negative consequences of specific anti-SGM political figures, (2) concerns about the loss of existing SGM rights, (3) fear of new anti-SGM policies, and (4) fears of vulnerability related to limited existing protections. Conclusion: We discuss how these themes tie into each other, map them onto existing structural stigma work, and use laws and policies that have been passed or proposed in the past 4 years to describe how these anticipated stigmas have become enacted.

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This interdisciplinary study combines epidemiological data with anthropological theory to investigate the relationship between HIV transmission rates and systemic homophobia. Previous research has illustrated the link between high levels of structural violence and structural stigma to increased risk of diseases such as the link between African-Americans and heart disease. This study investigates the relationship between systemic homophobia and HIV transmission rates. Through operationalizing homophobia into seven distinct factors, I evaluated systemic homophobia in six countries, assigning a score 1-10 to each factor using secondary source aggregation. I compared composite scores, as well as scores in each operationalized factor to HIV transmission rates in those countries. The results of this study indicate a correlation between systemic homophobia and increased HIV transmission, particularly in respect to the factors Marriage Equality, LGBT Laws, Religiosity, LGBT Visibility, and Hate Crimes. Though various sociocultural factors play a role in HIV transmission, this study indicates that homophobia plays an integral role in HIV transmission. This project has pertinent applications in epidemiology, anthropology and public health illustrating the integral role of sociocultural and systemic factors that increase structural violence and risk for a disease.

Föreliggande uppsats kan lokaliseras inom det vetenskapliga område som behandlar stigmatisering av pedofiler och barnsexförbrytare. Med utgångspunkt i en samtida förväxling mellan koncepten pedofil och barnsexförbrytare som tilldelar pedofiler barnsexförbrytarstatus, är studien avgränsad till barnpornografibrottet som en negativ statuskälla för pedofiler. Barnpornografibrottet särbehandlas i svensk lag, i synnerhet sedan brottet flyttades ut ur tryckfrihetsförordningen och yttrandefrihetsgrundlagen 1999. Syftet med uppsatsen är att fördjupa förståelsen för brottets betydelse, särbehandling och vad det innebär för pedofili. Med hänsyn till sådan bakgrund utgår uppsatsen från följande frågeställningar; Vilka underliggande motiv kan utläsas i lagmässig särbehandling av barnpornografibrottet i Sverige, Varför särbehandlas barnpornografibrottet och Vilken betydelse får den lagmässiga särbehandlingen för pedofili? Med hjälp av tematisk analys undersöks två lagförarbeten. Studiens resultat tyder på att barnpornografibrottet till stor del är ett symboliskt brott, att lagmässig särbehandling av brottet upprätthåller en social hierarki mellan barn och vuxna samt att särbehandling av brottet förstärker en annan social hierarki där social status är sammankopplat med hävdat socialt avstånd till barnpornografibrottet. Den senare nämnda hierarkin refereras till som den sociala avståndshierarkin. Konceptet pedofili tolkas kränka den förstnämnda hierarkin, ett koncept som människor kan särskilja sig mot och således stratifiera sig själva, vilket i sin tur producerar stigma och den sociala avståndshierarkin. / The present thesis can be located within the area of scientific research that deals with stigmatization of paedophiles and child sex offenders. Emanating from a contemporary confusion regarding the concepts paedophilia and child sexual offense, in which paedophiles are assigned the social status of child sexual offender, the present study is delimited to the child pornography offense as a negative source of status regarding paedophiles. The child pornography offense receives special treatment in Swedish law, particularly since the offense was moved out from The Freedom of the Press Act and The Fundamental Law on Freedom of Expression in 1999. The purpose of the study is to deepen the understanding of the meaning of the offense, the special legal treatment and what it entails for paedophilia. With regard to such background, the present study issues the following research questions; What underlaying motives can be identified within legal special treatment of the child pornography offense in Sweden, Why does the child pornography offense receive special treatment and What does the special legal treatment entail for paedophilia? Two legislative documents are investigated using Thematic Analysis. The results of the study indicate that the child pornography offense is to a large part a symbolic crime, that special legal treatment of the crime maintains a social hierarchy between children and adults and that such legal treatment reinforces another social hierarchy where social status is interconnected to asserted social distance to child sexual offenses. The latter hierarchy is referred to as the social distance hierarchy. Paedophilia is interpreted as a concept that violates the social hierarchy between children and adults, a concept which people can distinct themselves from and thus stratify themselves which in turn produces stigma and the social distance hierarchy.

Scarce community mental health resources have led to people in crisis (PIC) overusing the emergency department (ED) and encountering police more frequently. To divert PIC from the ED and criminal justice system, and support them in their community, police services have implemented crisis response teams (CRTs). CRTs refer to police, health and mental health crisis response. Evidence of CRTs’ effectiveness in achieving their desired outcomes is limited, mixed, and/or anecdotal. I completed three studies using various theoretical and methodological approaches, which included: (a) a critical interpretative synthesis (CIS) of the conditions under which CRTs are formed, their features, and their outcomes; (b) a policy analysis using a case study design to examine how and why a CRT model was adopted in Hamilton, Canada; and (c) a what’s the problem represented to be (WPR) critical policy analysis of why police are implicated in crisis response. The CIS presents a conceptual framework depicting how unresolved structural conditions produce system- and individual-level challenges. Second, the case study examines the mobile crisis rapid response team (MCRRT) development in Hamilton. The analysis shows that initiatives that incrementally expand on the boundaries of existing programs are likely to be adopted. Third, drawing on WPR, we excavate problem representations within policy and policy-related texts to understand why police-based CRTs are expanded in Ontario. When mental health is framed in terms of safety and implicated within discourses about risk and danger police intervention is legitimized. Collectively, these studies provide a theoretical framework connecting structural, system, and individual factors most relevant to CRTs; demonstrate that an incremental approach to CRT adoption did not disrupt existing system arrangements; and problematizations within government policies that legitimize police in mental health crisis response. / Thesis / Doctor of Philosophy (PhD) / Since deinstitutionalization, during which mental health patients were discharged into the community, this population has had more frequent encounters with police, contributing to criminalization and tragedies. They have also increasingly sought mental health crisis support in emergency departments. Police, health, and mental health crisis response teams (CRTs) have been implemented as an alternative response to people with mental health issues who are in crisis. To date, CRTs have been widely implemented but with little, mixed, and/or anecdotal evidence demonstrating their effectiveness. This dissertation contextualizes information about CRTs by presenting (a) a conceptual framework on CRTs, outlining the structural, system, and individual conditions under which CRTs are formed, their features, and outcomes; (b) a case study that examined under what conditions a CRT was developed and implemented in Hamilton, Canada; and (c) a critical discourse analysis of CRTs.