Breaking the Silence: Unveiling Microaggressions and Cultivating Support for Women’s Stigmatized Health Care

Abstract

Stigma surrounding sexual and reproductive health often silences women, limiting their access to essential care. Fear of social judgment deters many from seeking treatment for conditions like sexually transmitted infections, or even non-sexually transmitted conditions such as cervical cancer, as discussing these topics remains taboo. In South Korea, despite government efforts to promote sexual and reproductive health (SRH) care and shifts in sociocultural beliefs to decouple female sexuality from marriage, cultural norms continue to discourage unmarried women from seeking SRH care. This has resulted in significantly higher cervical cancer rates among Korean women compared to other populations and put them at high risk for severe health complications, including pelvic inflammatory disease, ectopic pregnancies, and infertility. Through my dissertation research, I aimed to empower and protect women seeking support on these culturally taboo topics while raising community awareness and building strategies to prevent the inadvertent perpetuation of harmful microaggressions. Ultimately, I sought to foster resilience and safety within these communities. In alignment with this goal, my research makes four contributions. First, I uncovered microaggressions as a primary barrier to accessing SRH care for unmarried Korean women, a contributor to health disparities that has received little attention in prior research. I identified how these microaggressions occur, who perpetrates them, and how emotional proximity shapes their harm. To explain these dynamics, I developed a framework illustrating how even well-meaning allies can become covert agents of stigma, reframing how microaggressions are understood in stigmatized healthcare contexts. Second, I introduced culturally sensitive strategies to counteract microaggressions, co-developed with unmarried Korean women. These strategies emphasized reflection, empathy, and education over punishment, aligning with cultural values such as emotional restraint and not burdening others, and offering a constructive alternative to punitive approaches. Third, I designed an anonymous online space using the Asynchronous Remote Communities (ARC) method that fostered mutual support and deep reflection among unmarried Korean women. This space enabled participants to safely discuss stigmatized health topics and reflect on in-group microaggressions, which are rarely addressed in existing research. Based on this study, I offer design insights for creating culturally sensitive and emotionally safe online spaces, emphasizing the importance of rapport-building, sequenced activities, and expanded evaluation criteria. These design choices supported meaningful engagement and led to real-world changes, including increased care-seeking and more open conversations. This work extends ARC beyond data collection to inform the design of empowering digital spaces for stigmatized communities. Finally, I examined the limitations and unintended harms of generative artificial intelligence in producing counterspeech for culturally stigmatized health contexts. Current AI-generated responses often fail to recognize cultural nuance, validate the experiences of those targeted, or challenge the structural context of stigma. In response, I proposed a culturally sensitive framework for improving counterspeech generation that embeds cultural sensitivity, affirms users’ perspectives, and accounts for social and structural factors shaping stigma. Together, these contributions offer new directions for designing inclusive technologies and support systems that reduce stigma, challenge harmful norms, and promote culturally sensitive care. By reimagining how communities and technologies can respond to microaggressions, this work helps create a future where individuals navigating stigmatized health concerns feel seen, supported, and empowered to seek the care they deserve.