(1) Finding Clues of Pre-, Mid-, and Post-Visit Microaggression Against Unmarried Korean Women in Social Media
Ryu, H. and Pratt, W. 2022. "Microaggression clues from social media: revealing and counteracting the suppression of women's health care", JAMIA Special Focus Issue on Informatics for Sex- and Gender-Related Health 2022. https://doi.org/10.1093/jamia/ocab208
*Article Coverage: https://ischool.uw.edu/news/2022/03/online-feedback-harms-womens-access-health-care-research-finds
*Received 2022 Samantha Adams ELSI Best Paper Award from American Medical Informatics Association (Award Article Coverage: https://ischool.uw.edu/news/2023/02/phd-students-work-health-microaggressions-wins-acclaim)
Objective: The purpose of this study was to demonstrate how analyzing social media posts can uncover microaggressions and generate new cultural insights. We explore why Korean women hesitate to seek recommended gynecological care and how microaggressions visible in social media reveal insights for counteracting such harmful messaging.
Materials and Methods: We scraped the posts and responses on social media related to unmarried women’s uncomfortableness or unpleasantness in receiving gynecological care. We conducted content analyses of the posts and responses with the microaggression framework to identify both the types of microaggressions occurring within and outside the clinic as well as the responsible perpetrators. With an open coding and subsequent deductive coding approach, we further investigated the socio-cultural context for receiving gynecological care as an unmarried woman in South Korea.
Results: Our analysis uncovered that mothers, male partners, and superficially supportive social media res- ponders contribute to pre- and post-visit microaggressions toward unmarried women seeking gynecological care whereas healthcare providers contribute to only mid-visit microaggressions. We also exposed how social media was not only revealing but also reinforcing the suppression of women’s health care.
Discussion: Mid-visit microaggressions are currently addressed by cultural competence education, but pre- and post-visit microaggressions are overlooked. We uncover the gaps in current practices of informatics and public health methods and suggest ways to counteract online and offline microaggressions.
Conclusions: Social media provides valuable information about the cultural context of health care and should be used as a source of insights for targeted interventions to improve health care, in this case for unmarried Korean women.
(2) Online Microaggression Counteraction on Social Media
Ryu, H. and Pratt, W. 2024. "Women’s Educating and Coping Strategies for Cultivating Supportive Online Spaces for Sexual and Reproductive Health: A Co-Design Study", JMIR. http://dx.doi.org/10.2196/62716
Background: Stigma surrounding women’s sexual and reproductive health often prevents them from seeking essential care. In South Korea, unmarried women face strong cultural taboos, increasing their risk for conditions like pelvic inflammatory disease, infertility, and cervical cancer. While many unmarried women turn to online communities for support, these spaces frequently expose them to microaggressions, further discouraging access to healthcare and worsening their health risks.
Objective: In this study, we aimed to cultivate a resilient and safe space for support on the culturally taboo topic of sexual and reproductive health by counteracting and reducing online microaggressions. We sought to make these last-resort safe spaces truly supportive by reducing the negative effects of microaggressions on the targets and allies’ health and well-being and educating rather than solely punishing perpetrators.
Methods: We conducted co-design sessions with 14 unmarried Korean women. In the first co-design session, we first introduced the term microaggression and collaborated with participants to create base design components aimed at countering and preventing them. In the second co-design session, participants went through three stages: initially viewing post-comment samples, then designing with provided base design templates inspired by their suggestions, and finally, designing for a scenario where they themselves would be seeking support. We used inductive and deductive methods to analyze the co-design session transcripts.
Results: Our analysis revealed six goals that focus on coping and educational, rather than punitive approaches for counteracting microaggressions. Three goals focused on coping with microaggressions. Indicating positive support numerically and having a holistic understanding of different opinions help targets use reflective coping by providing objective standards and a full picture to reassess situations, while less emotional responses make claims appear less subjective and support suppressive coping. The other three goals highlighted educational approaches, aiming to inform all users about microaggressions and their impacts, while emphasizing respectful education to perpetrators regarding the negative effects of their actions. Forum-approved experts were deemed suitable to lead the discussions to provide accurate information and critical reactions. Resulting designs reflected the participants’ culture by discouraging approaches that would either burden their social support network or fuel perceptions that women are too emotional.
Conclusions: Our work advocates for prioritizing educational and explanatory approaches over punitive detection and deletion measures to create supportive online spaces for stigmatized sexual and reproductive health. This shift not only aids targets and allies in coping with microaggressions but also encourages perpetrators to reflect on the impact of their actions. Our work provides a first step toward counteracting microaggressions and ultimately encouraging women to seek needed sexual and reproductive health care.
(3) Leveraging ARC to Create Safe and Supportive Spaces for Stigmatized Health Support
Ryu, H. and Kang, S. 2024. "Exploring Design Tensions in Countering Microaggressions in Online Communities for Stigmatized Health Support", CHI 2025 Case Study.
Ryu, H. and Pratt, W. 2024. "Reducing the Stigma of Sexual and Reproductive Health Care Through Supportive and Protected Online Communities", AMIA 2024 Annual Symposium.
Paper 1 (AMIA): In many cultures where discussions and care-seeking for sexual and reproductive health (SRH) are stigmatized, unmarried women often suffer silently, facing risks of sexually transmitted infections and gynecological complications. South Korea exemplifies this challenge, with SRH topics remaining stigmatized, potentially contributing to Korean women’s high incidence rates of cervical cancer. To address this problem, we designed and studied a protected online community for unmarried Korean women with 9 weeks of guided activities relating to SRH. We describe how these activities helped participants reflect on and discuss the typically taboo topics surrounding SRH. Results indicate that the online community effectively supported participants in initiating additional offline conversations about SRH with more people, and even encouraged some women to seek clinical care. This work sheds light on the potential of supportive and protective online communities to facilitate SRH, offering newfound options for supporting women in cultures where such care is stigmatized.
Paper 2 (CSCW): Women face significant challenges in seeking support for SRH due to cultural taboos and microaggressions, even within supposedly safe online spaces. This study focuses on unmarried South Korean women who encounter these difficulties and often risk detrimental health outcomes by avoiding timely care. To investigate how to create safer and more supportive spaces for these women, we designed a 9-week study using the Asynchronous Remote Communities method for 26 unmarried Korean women participants. We created structured and unstructured activities to encourage sharing SRH narratives, which led to increased empathy and understanding among participants. Additionally, we designed educational and reflective interventions that helped participants recognize the nuances and harms of microaggressions. This increased awareness promoted self-reflection and supportive actions among participants. Our approach demonstrates the potential to create supportive, reflective online spaces for people from marginalized communities who face stigmatized healthcare challenges. We hope our research inspires the development of more inclusive online spaces, driving positive social change in stigmatized healthcare support.
Paper 3 (CHI 2025 Case Study): Many women from diverse cultures seek support in online communities for stigmatized sexual and reproductive health, but often encounter subtle microaggressions that invalidate their experiences and discourage them from seeking care. This study focuses on unmarried Korean women, who face similar challenges in these spaces, often resulting in severe health complications. Through an asynchronous remote focus group with 26 unmarried Korean women, we explored design tensions in developing features to counteract microaggressions in online health communities supporting stigmatized health care. Our findings revealed four key design tensions: balancing content filtering with open communication, promoting personal growth while preserving free expression, providing adaptive support, and encouraging reflection without restricting dialogue. We propose design recommendations to address the design tensions. These tensions, and their proposed resolutions, offer insights for designing provocative prototypes that provide further guidance in creating safer online spaces for supporting stigmatized health care for women.
Paper 4: People facing stigma often encounter extensive barriers to participate in traditional design research, especially on sensitive topics like SRH. The Asynchronous Remote Communities (ARC) method offers a safe, effective alternative by enabling remote participation in structured research activities. Although recent ARC guidelines discuss working with people facing stigma, we contribute new ways to enhance interactions, reflection, and engagement. In this paper, we present how we adapted ARC to support 26 unmarried Korean women facing stigma due to cultural norms that marginalize SRH discussions and care-seeking. Our adaptations included enhancing rapport-building, broadening criteria for evaluating activities, and reconsidering sequential activities. Over 9 weeks, these approaches deepened reflection and led to substantial changes in perception and behavior with 100% participation. We showed that our adaptations to ARC can drive personal and communal growth, highlighting its potential for lasting, meaningful engagement in research for people facing stigma.