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This study examined the association between sexual and physical abuse and health outcomes among 152 urban two-spirit American Indian (AI) and Alaska Native (AN) women. A woman's actual or perceived control over life circumstances (mastery) was used as a mediator of the association. The data was collected from a larger study, the HONOR Project across 7 cities: New York City, Los Angeles, San Francisco/Oakland, Tulsa/Oklahoma City, Denver, Minneapolis/St. Paul, and Seattle/Tacoma. Findings indicated that 78% of the women had experienced lifetime physical assault and 85% had experienced lifetime sexual assault. Seventy-six percent of women reported sexual contact before age 18. Physical and sexual assault, childhood trauma, and partner violence were associated with worse mental and physical health. Women who experienced sexual assault by both an acquaintance and stranger had worse mental health outcomes than women who reported assault by one type of perpetrator. Prevention and health promotion interventions for Native communities should incorporate mastery in a culturally and socially appropriate manner.
LGBTQ, prevalence, racial/ethnic differences, underserved populations