Making the Invisible Visible: Action Research Through Social Work

Darren Cosgrove 

Social work means so much more than most may realize. This is something Dr. Darren Cosgrove would like more people to know.

“It’s easy to miss how vast and diverse this profession is,” Cosgrove says. “Certainly, there’s important work in child protective services, or elder protective services. But there's important work to be done as a clinician, as a therapist, as a caseworker, as a community organizer, or doing policy reform or advocacy work. You can do so much.”

As a Miami University assistant professor of social work, Cosgrove embraces classic social work values to confront problems and injustices caused by deep structural inequities, and he uses a method called participatory action research to bring those he strives to help directly into the process.

“The research I’m doing is in partnership with, and often led by, community members,” he says. “It’s incredibly important to me to make sure that the work is affecting real, meaningful, and community-driven change. The benefit is that the findings are much more grounded in the community's lived experience, and thus have a greater likelihood of having a positive impact.”

Because of the dynamic and expanding nature of the field, it’s an approach that can be used to create positive social change across a number of areas including disaster relief, immigration reform, food insecurity, homelessness, and family violence, as well as within hospitals, for those with disabilities, and more.

For Cosgrove, this approach is primarily reflected in his work with LGBTQ+ individuals to explore identity, affirmation, and social stigma.

In a new study published in the Affilia: Journal of Women and Social Work, Cosgrove worked with nonbinary youth to understand the challenges and barriers they face while attempting to seek health care services.

Unlike binary transgender individuals (i.e. trans men and women), nonbinary people do not identify within the dichotomous bounds of being “male” or “female.” Nonbinary genders are very diverse including those that are a blend of masculinity and femininity, genders that exist on a fluid spectrum, or even those that are outside the spectrum altogether.

To understand their experiences, Cosgrove and his co-authors involved participants using a technique called photovoice.

First, participants worked with the researchers to form research questions that were relevant to their lived experiences. Then they answered those questions through photography, by creating images, which were analyzed -- both individually and as a group -- to identify a series of unifying themes that described their shared experiences.

“Nonbinary people report feeling quite literally invisible,” says Cosgrove. “They report not being able to have their gender seen or understood, and making their experiences become visible through photography was a way to build the body of knowledge, and in a way that was meaningful to those that the project engaged.”

Afterwards, the photos were also shown during a public exhibit that invited educators, community advocates, social workers, mental health professionals, and medical providers to learn about their experiences.

“It's not enough to say, ‘I had a bad experience when I went to that mental health clinic, or when I went to my doctor's office,’” Cosgrove says. “It doesn't matter if it’s not being shared with stakeholders. So the hope was that attendees could leave the exhibit and implement changes, to take the findings and create a more affirming environment.”Darren Cosgrove

According to the findings, nonbinary youth seeking healthcare services often felt stigmatized, not supported, and sometimes even outright hostility or discrimination. Most also felt pressure to either hide their true identities, or present a false version of themselves to avoid being pathologized by deeply entrenched assumptions about gender, and what it meant to be “normal.”

These pathologizing experiences were found to be particularly problematic while seeking mental health services, for example.

“Folks in the group talked about working with their therapist around issues related to depression and anxiety,” Cosgrove explains. “In their experience, their depression or anxiety was not a result of being nonbinary. But it was assumed that, ‘Well, of course you're anxious or depressed. You're nonbinary. You're confused. You're not sure what's going on.

“Very quickly their gender became the focus of clinical treatment, rather than what they were actually there for,” he says.

Cosgrove’s research shows a need to create more spaces and provide more support to affirm and validate the identities and experiences of nonbinary individuals across society. He also asks us to challenge our basic assumptions about gender, which can ultimately help overcome situations where health and human service providers might be more likely to either deny or offer inferior services.

This goal aligns with the core values and the code of ethics that map across social work’s rich historical commitment to community-based work. To meet the needs of any client, Cosgrove says, it is necessary to first understand the contexts in which they live.

“We as social workers cannot do our work without recognizing the ways people exist within their environments -- environments that are impacted by policy, politics, poverty, racism, or any of the things impact their lives,” he says. “Whether we are working as a caseworker, as a therapist, or as a community organizer, we're constantly looking at the issues we're dealing with through a critical, anti-oppressive lens. That's what makes our discipline so unique.”

“From direct practice to policy, if you are interested in creating a more just and anti-oppressive society, social work is the right choice.”