A Composite Counternarrative of Discrimination as a Social Determinant of Health: Black College Women's Experiences of Gendered Racism.

Purpose: Discrimination is a social determinant of health (SDOH) that negatively affects racially minoritized students and patients. Nurses and nurse educators must understand discrimination, including nuanced and intersecting ways that it negatively affects academic and health outcomes.

Method: In-depth interviews were conducted with 12 Black women at a primarily White institution in the Southeast United States. The interview guide, informed by critical race and intersectionality theories, explored experiences of gendered racism, particularly in the students' social environments. Narrative analysis was conducted, then a composite counternarrative was composed to portray experiences of gendered racism across multiple levels, including intrapersonal, interpersonal, and institutional.

Results: The composite narrative revealed experiences of multi-leveled gendered racial microaggressions that shape the daily lived experiences of Black college women students. Three main themes emerged: Limited Autonomy, Differential Treatment and Differential Assumptions, and Differential Access to Power and Resources.

Conclusion: Gendered racism differs from White women's experiences of sexism and Black men's experiences of racism. Institutional efforts to support Black college women must be intentional in addressing the unique ways they experience discrimination in various settings on campus. Nurses' and nurse educators' understanding of gendered racism as a SDOH may ease the hesitancy in addressing health inequities. [Journal of Psychosocial Nursing and Mental Health Services, xx(x), xx-xx.].