JMIR Publications

ABSTRACT

Background:

Online communities that many women use for support and safety on stigmatized sexual and reproductive health issues often expose them to microaggressions, discouraging necessary medical care. The discouragement from online communities and reluctance to seek care due to stigma poses significant health risks for unmarried women, such as cervical cancer, pelvic inflammatory disease, ectopic pregnancy, and infertility.

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. Goals 2, 3, and 6 focus on coping with microaggressions. Goal 2 (positive support) and Goal 6 (holistic understanding) help targets use reflective coping by providing objective standards and a full picture to reassess situations, while Goal 3 (emotion management) encourages less emotional responses to make claims appear less subjective and support suppressive coping. Goals 1, 4, and 5 focus on educational approaches. Goals 1 (shared knowledge) and 5 (respectful education) highlight 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. Additionally, Goal 4 (expert guidance) involves forum-approved experts leading 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.