(1) Revealing How Microaggressions Suppress Women's Health Care-Seeking
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)
Summary
This study investigates how microaggressions visible in social media reflect and reinforce unmarried Korean women’s hesitance to seek sexual and reproductive health (SRH) care. Through content analysis of online forums frequently used by unmarried Korean women, I identified microaggressions occurring both online and offline, applying a microaggression framework to examine their types, sources, and contexts. The findings revealed that even superficially supportive online messages can contribute to the suppression of care-seeking behaviors, while in offline interactions, close emotional ties (e.g., mothers, male partners) often play a paradoxical role as microaggression perpetrators.
Contributions
1. I uncovered microaggressions as a primary barrier to healthcare access for unmarried Korean women—a previously underexplored contributor to SRH disparities.
2. I identified where and how these microaggressions occur and who is responsible, revealing emotional proximity as a key factor in their impact.
3. I developed the emotional proximity connections and microaggression framework, illustrating how perceived allies can serve as covert agents of stigma.
(2) Co-Designing Women's Strategies for Supportive Online Spaces
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
Summary
This study explores how culturally responsive design can counteract microaggressions while preserving the agency of vulnerable users. Through co-design sessions with 14 unmarried Korean women, I developed strategies to create a safe and resilient online space for discussing SRH care. Participants identified microaggressions and collaboratively designed features to mitigate their effects. Their designs, rooted in cultural values such as avoiding excessive emotional expression and not overburdening support networks, focused on reflection, constructive support, and education rather than punishment.
Contributions
1. I contributed culturally reflective design strategies that help targets and allies manage the psychological effects of microaggressions.
2. I introduced design features that prioritize empathy and education over punishment, offering a culturally relevant alternative to punitive approaches.
3. I demonstrated that a co-design approach can empower vulnerable users while preserving their agency in the face of stigmatization.
(3) Designing for Resilience and Reflection with Asynchronous Remote Communities
Ryu, H., Kim, J., Kang, S., and Pratt, W. 2025. "Improving Online Communities for Stigmatized Healthcare: Countering In-Group Microaggressions and Fostering Supportive Connection", CSCW 2025.
Ryu, H. and Kang, S. 2025. "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.
Summary – Design and Community Insights
In this study, we demonstrate how our design of a protected, anonymous online space using the Asynchronous Remote Communities (ARC) method encouraged deep self-reflection, mutual support, and open discussions among 26 unmarried Korean women over 9 weeks. This safe community setting enabled participants to share and reflect on stigmatized SRH topics and their experiences with in-group microaggressions. The designed environment not only prompted richer online dialogue but also translated into real-world behavioral changes, such as increased care-seeking and broader SRH discussions within participants’ personal networks.
Contributions – Design and Community Insights
1. I designed an anonymous online community that fostered mutual support and resonance among women confronting stigmatized health topics.
2. I demonstrated that well-structured online communities can extend beyond reflection to catalyze behavioral changes, including initiating care-seeking and opening up about SRH issues.
3. I contributed a new approach for addressing in-group microaggressions using relatable, non-victim-based scenarios that build empathy among participants.
Summary – Methodological Enhancements to ARC
This study highlights the methodological innovations I introduced to the ARC approach in order to better support meaningful interactions and participant engagement, particularly with stigmatized populations. Recognizing the limitations of traditional ARC guidelines, such as discouraging sequential activities, I refined the method through three key strategies: enhancing rapport before the study began, broadening the criteria for evaluating activity usefulness, and designing a sequence of activities that built upon one another.
These adaptations contributed to a 96% enrollment rate and 100% participation across the nine-week study, leading to deeper reflection and richer insights from participants. Contrary to existing guidance, I found that thoughtfully sequenced activities, when paired with strong rapport and sufficient reflection time, could promote sustained engagement and behavioral change. By moving beyond usability as the sole evaluation criterion and considering emotional and perceptual impact, I demonstrated ARC’s broader potential—not only to collect data but also to catalyze growth and empowerment within marginalized communities.
Contributions – Methodological Enhancements to ARC
1. I demonstrated that the ARC method can be adapted to support sensitive and stigmatized topics through targeted methodological refinements that emphasize meaningful interaction and deep participant engagement.
2. My adaptations—specifically enhanced rapport-building, broadened activity evaluation, and structured sequential activities—resulted in high enrollment and full participation, thereby ensuring high-quality data and richer insights.
3. I broadened the ARC evaluation framework to capture both behavioral and perceptual changes, revealing ARC’s potential as not only a research tool but also a mechanism for empowerment and social change.
(4) Identifying and Addressing AI's Cultural Blind Spots and Proposing a Culturally Sensitive Counterspeech Generation Process
Summary
This study explores how generative artificial intelligence (AI) can be used to produce culturally sensitive counterspeech that addresses microaggressions related to unmarried Korean women’s access to sexual and reproductive health (SRH) care. Counterspeech, which challenges harmful speech with empathy, education, and alternative perspectives, has shown promise in other domains but remains underexplored in culturally stigmatized healthcare contexts.
To examine the strengths and limitations of current generative AI systems, I collected 50 microaggression samples from online forums and used ChatGPT-4 and Copilot GPT-4 to generate 100 counterspeech responses. These responses were analyzed using deductive coding based on microintervention strategies and the Dangerous Speech Project’s guidelines of recommended and discouraged counterspeech strategies, alongside inductive coding to identify unintended harms. While the AI-generated counterspeech often aligned with strategies such as empathy and stereotype-challenging, the analysis revealed significant issues: superficial validation, misrepresentation of stigma as outdated, failure to challenge stereotypes, and a tendency to place the burden on microaggression targets.
To address these limitations, I proposed a five-step framework for inclusive counterspeech generation. This framework emphasizes identifying both explicit and implicit biases, offering personalized validation, embedding educational content within systemic critiques, providing tangible support, and balancing assertiveness with constructive dialogue.
Contributions
1. I identified the limitations and unintended harms of AI-generated counterspeech in culturally stigmatized contexts, offering critical insight into its risks and potential.
2. I proposed a culturally responsive framework for improving counterspeech generation, emphasizing the importance of addressing cultural nuance, validating targets' experiences, and embedding systemic awareness into AI responses.
3. I demonstrated how generative AI systems can be refined using this framework to better support individuals navigating stigmatized healthcare concerns, offering concrete design implications for developing empathetic and socially aware AI interventions.