The word “Asian” can bring up mixed feelings in the Asian community.
Rooted in a history of discrimination, stereotypes and violence, being Asian and navigating identity can often feel disempowering and triggering – especially during a time when there continues to be a rise in anti-Asian racism.
Chloe Gao, a physician-scientist trainee and second-generation immigrant, has struggled with her cultural identity growing up. She sees her Asian-Canadian identity and cultural heritage as separate factors to navigate in all their “contradictory messiness”.
Straddling two cultural identities
“I am Asian Canadian; born in Canada and raised in the presence of a stark cultural and linguistic gap between my parents and I,” Chloe says. “However, I am also a daughter of immigrants, constantly striving to honour and reclaim my cultural heritage, and use it as a means of connecting with members of the Asian community.”
Chloe recalls the pride she feels about her Asian heritage – particularly when she’s able to translate for Mandarin-speaking Asian patients and feel their immediate ease when they see someone who looks like them, or when she’s making dumplings with her family on Chinese New Year.
At times, these two aspects often feel impossible to reconcile in a community that reinforces well-intended, yet harmful cultural expectations.
“I am deeply and intimately aware of how navigating two identities that are conflicting at times can be challenging and stressful,” Chloe notes. “The feeling of not truly belonging in either space can be overwhelming, which in turn, can be a contributing factor to the challenges associated with having two conflicting identities.”
This complexity motivated her to do research that focuses on addressing the lack of culturally safe, youth- and family-centred mental health and substance use (MHSU) services as her MD/PhD training. Over the next three years, she will be engaging diverse first- and second-generation East Asian immigrant youth to build a better understanding of their needs and co-design strategies to improve access to MHSU services – a passion that stems from an early age.
The healing power of hope
Chloe was hospitalized with anorexia nervosa in eighth grade.
During her recovery, her interest in youth mental health research and innovation was sparked – something she credits her psychiatrist for. From eating the same foods as her when she had mealtime anxiety, to having an “open door” policy so she could access help where and when she needed it, her psychiatrist became her greatest support.
“His commitment to my recovery taught me the healing power of hope,” Chloe says.
It was also as a patient that she observed unique barriers to receiving mental health care as a racial minority youth. In the treatment program, she was the only person of colour.
Family therapy and support groups, a holistic part of recovery, were almost impossible to meaningfully engage in. This was especially the case for Chloe’s immigrant family where mental health wasn’t part of their everyday vocabulary, leading to the cultural stigma that they carry to this day. In hindsight, even her initial body image struggles reflected the Eurocentric beauty standards that she had been subjected to her entire life – the ideals that made her feel like the colour of her skin, her long black hair, and small round eyes were things to be ashamed of.
“At the time, I could not yet name racial inequities in health care or understand how established structures affected East Asian youth, like me, seeking mental health care,” Chloe recalls. “Yet with each day, I continued developing a sense of responsibility towards other racial minority youth seeking mental health care.”
This experience motivated her to use what she learned as a patient, medical learner, researcher, and advocate to foster hope and improve systems of care for diverse youth and families impacted by mental illness – especially by challenging stereotypes as a woman of colour.
“Since a young age, I was taught to put the ‘model’ in ‘model minority’ – someone who is quiet, submissive, orderly, and proper,” Chloe elaborates. “Someone who works incredibly hard in absolute silence and does not celebrate their success because that would be too jiāo ào [骄傲] (which translates to “arrogant” in Mandarin)…”
As her family would often remind her, “You would have never had these opportunities if we didn’t immigrate to Canada, Chloe. Don’t complain about school or work. Be grateful.”
These lessons and cultural expectations were taken to heart by the researcher as she navigated her professional life, which came with advantages and challenges; Chloe would often work overtime without telling her colleagues and supervisors, skipping lunch breaks under the reassurance that she worked hard in silence – just as she’d been taught.
As an admittedly quiet person, she also avoided challenging authority, trying her best to embrace the “submissive and orderly” internalized stereotype.
It wasn’t until her mentors and role models empowered her to use her voice and defy the status quo that she slowly began unlearning the lessons and expectations that once held her back.
Redefining what it means to be an Asian women
For Chloe, being an Asian woman in 2022 means challenging every single stereotype that has been ascribed to her.
“It means no longer being the ‘meek, mild, non-authoritative, and submissive’ young woman that I was brought up to be – a woman who works hard in silence and makes herself smaller in the presence of others,” Chloe shares.
This includes using her voice as a platform for change and being unapologetically proud of her accomplishments, rather than hiding it for fear of being perceived as “too much” and “too big”.
When she reflects upon Asian Heritage Month, it’s also about celebrating all the Asian women in her life that have walked before and beside her, leading by example and inspiring her to reach higher while challenging pre-existing stereotypes.
“I want to be big, bold, and courageous as an Asian woman,” Chloe says, “and inspire future generations of brilliant, strong Asian women to be leaders, trailblazers, and innovators.”
It’s clear that she is on her way to achieving this through her MD/PhD journey at Foundry to improve youth mental health and substance use services with and for Asian communities across BC.
For those seeking mental health support and don’t know where to start, here are some recommendations from Chloe:
Based on my own lived experience and my work with racialized youth to date, I would encourage a young Asian person to sit down with their parents and be open and vulnerable about their experiences dealing with mental health concerns. I would encourage them to introduce their parents to cross-cultural resources such as these ones:
- Kelty cross-cultural resources (Simplified Chinese): Mental health and substance use information available in different languages for children, youth and families.
- Kelty cross-cultural resources (Traditional Chinese)
Mental health and substance use information available in different languages for children, youth and families.
- Canadian Association of Mental Health
Information on asking for help, addiction, coping with stress and other topics in more than 20 different languages. Also features a BrowseAloud tool that enables any page or resource on the website to be translated to languages other than English.
- Multicultural Mental Health Resource Centre
Search for patient information on mental health by language.
Resources like the ones listed above can help parents who may struggle with English to better understand the young person’s experience and help the young person to convey to their parents what it is that they are going through. I would also encourage the young person to emphasize that they are not alone; that every year, mental illness impacts approximately 1 in 4 Canadian youth aged 12 to 24 (Government of Canada, 2001; Kessler et al., 2005).
This can decrease the stigma around mental health and substance use concerns that often persists in immigrant families and decrease feelings of isolation and ostracization associated with self-disclosure. I would also encourage the young person to explore potential support with their parents, striving to engage them every step of the way.
For example, the Child and Youth Cross Cultural Mental Health Program in Vancouver (http://www.vch.ca/Locations-Services/result?res_id=560) provides direct mental health assessment and counselling services to youth and families in Mandarin and Cantonese. It also consults with other mental health professionals, community groups and schools that work with children who speak primarily Cantonese or Mandarin.
By engaging parents from the inception of help-seeking for a mental health or substance use concern, a young person can not only involve their parents as an integral support network, but also contribute to de-stigmatizing mental health and substance use issues in Asian communities more broadly.
Keywords: mental health, substance use, culturally safe, anti-asian racism, Foundry, Foundry research, cultural stigma, model minority, asian heritage month, child and youth cross cultural mental health program, Asian-Canadian, identity
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