"We Are Valuable, We Have a Mission": Pictures of Resilience of Mid-Life Latina Women

Background and Purpose: As women enter the menopausal transition, they experience increased risk of depression and anxiety — a risk exacerbated by disparities in the social determinants of health among women with marginalized identities. Immigrant Latina women face unique intersecting risk and protective factors, including discrimination based on ethnicity, gender, and immigration status, language barriers, cultural values, and religiosity, that shape their mental health during this biological milestone. We partnered with midlife Latina women to identify key psychosocial factors positively and negatively impacting their mental health during the menopausal transition.

Methods: Grounded in a Community-Based Participatory Research (CBPR) framework, this study employed Photovoice methodology. The project was developed in partnership with a Community Advisory Board (CAB) representing community leaders and health providers in Tuscaloosa, Alabama. Participants were recruited through word of mouth between March and April 2025; five of nine interested women enrolled between May and August 2025 due to time constraints. Participants attended four in-person sessions at a local library over six weeks. In the first session, participants learned about Photovoice methodology and collaboratively developed the research question — a foundational CBPR principle. Women then photographed responses to the research question using their smartphones over two weeks. During the second and third sessions, women shared photographs and engaged in the SHOWeD method for collective analysis. In the final session, participants and the researchers co-developed themes, selected representative photographs, and planned community action. All sessions were conducted in Spanish, audio-recorded, and professionally transcribed. Transcripts were thematically analyzed using participant-generated themes, and member-checking was conducted with CAB members.

Results: The mean age of the sample (n=5) was 53.2 (SD=4.38); most women reported Mexican descent (80%) and peri-menopausal status (60%). Most reported elevated depressive (80%) and PTSD symptoms (60%). Seven themes captured mental health challenges (e.g., traumatic experiences, social pressures, lack of access to care) and resilience practices (e.g., self-education, supportive relationships, self-worth, acceptance). Notably, a powerful theme of collective empowerment emerged: across all themes, women expressed deep commitment to creating positive change for future generations of Latinas — reflecting the consciousness-raising and solidarity that Photovoice is designed to foster. Acting on this commitment as agents of community change, participants organized and led an educational event with a bilingual psychologist to deepen their own knowledge of self-compassion practices and equip themselves to share these tools with their community.

Conclusions: This study illuminates key challenges faced by midlife Latina women — a population underrepresented in menopause research — while documenting existing strengths that can be leveraged to improve wellbeing. The participants' self-directed commitment to educating future generations of Latinas points to important implications for asset-based community development approaches and the cultivation of informal support networks as sustainable, culturally grounded vehicles for mental health promotion. Social workers serving this population should assess life-stage-specific challenges, support resilience practices, and consider facilitating peer-led community networks. Future studies should partner with midlife Latina women to develop both individual-level interventions (e.g., self-compassion) and community-level programs (e.g., women's health education) to bolster Latina women's health across the life course.