Date of Award


Document Type


Degree Name


Organizational Unit

Graduate School of Social Work

First Advisor

Ramona Beltran, Ph.D.


Historical loss, Historical trauma, LGBTQ, Māhū, Transgender, Native Hawaiian, Suicide prevention


Native Hawaiian people, and especially lesbian, gay, bisexual, transgender, māhū and/or queer (LGBTQM) Native Hawaiians, face health and mental health disparities that are disproportionate when compared with other racial/ethnic minorities in Hawai`i, and when compared to the United States as a whole. Native Hawaiians have the highest mortality rates for numerous biomedical diseases, including higher rates of substance abuse, diabetes, and even asthma, of any ethnic group in the state of Hawai`i (Andrade et al., 2006; Liu & Alameda, 2011). Suicide rates, in particular, have been rising since Hawai`i began collecting data in 1908 (Else & Andrade, 2008), and continue to represent a major public health concern in Hawai`i (Goebert et al., 2018). Social workers need to understand the social, structural, and historical determinants of these health disparities in order to implement effective suicide prevention and intervention programs. In a review of the empirical evidence related to suicide risk and protections among Native Hawaiians, some unique factors have been identified. Social and cultural risk factors related to strong ethnic identity and mental health stigma, for example, have been found to contribute to high levels of suicide risk among Native Hawaiians (Goebert, 2014; Selaman, Chartrand, Bolton, & Sareen, 2014; Ta, Juon, Gielen, Steinwachs, & Duggan, 2008; Wong, Caine, Lee, Beautrais, & Yip, 2014).

Applying learnings from historical and intergenerational trauma theorists (Bagilishya, 2000; Brave Heart, 2003; Brave Heart, 2010; Brave Heart & DeBruyn, 1998; Duran, 2006b; Evans-Campbell, 2008; Sotero, 2006; Walters & Simoni, 2002), suicidality can be examined as a social and community-level response to colonial oppressions (Wexler & Gone, 2012). While Native Hawaiian scholars have written about the impacts of historical and colonial trauma on the Native Hawaiian people (Liu & Alameda, 2011; Mayeda, Okamoto & Mark, 2005; Trask, 1996) and argued for the importance of research that directly connects those traumas to suicide rates (Hishinuma et al., 2018), few studies have done so (see, for example, Andrade et al., 2006; Else et al., 2007; Yuen et al., 2000). Overall, there is a lack of connection to the complex, historical, sociostructural impacts of historical trauma on the life (and death!) of Native Hawaiian people. Through examination of colonial processes, including erasure of Native Hawaiian genders and sexualities from traditional stories, the domination of Christian church, and disconnection of Native Hawaiians from land, language, and cultural practices in relation to health and well-being as a people, a critical intersectional Native Hawaiian suicidology can begin to surface.

This dissertation seeks to understand cisgender/heterosexual Native Hawaiian and LGBTQM Native Hawaiian historical trauma experiences in the context of colonization and suicidality. Through the crossover application of a quantitative measure of historical trauma (i.e., the Historical Loss Scale (HLS), Whitbeck, Adams, Hoyt & Chen, 2004) to narratives about colonization and suicide from cisgender/heterosexual Native Hawaiians and LGBTQM Native Hawaiians, this project explores the following research questions: 1) How much and how often do Native Hawaiians endorse HLS items in qualitative narratives? 2) How do experiences of historical loss - as reflected in the pattern of endorsement of HLS items - differ between Native Hawaiians and baseline studies with American Indian communities? 3) How do experiences of historical loss - as reflected in the pattern of endorsement of HLS items - differ between cisgender/heterosexual and LGBTQM Native Hawaiians? 2) How are historical losses experienced and described from a Native Hawaiian perspective? What are the differences in definitions and interpretations of HLS items in the context of Native Hawaiian experiences? What additional themes emerge from uniquely Native Hawaiian perspectives? 3) How can Native Hawaiian perspectives on historical loss contribute to understanding Historical Trauma theory constructs in order to inform historical trauma-informed suicide prevention? By considering the impact of the colonial context of Hawai`i on the health and mental health of Native Hawaiian peoples, this study can bring to light both internal and structural ramifications of colonization on the minds, hearts, and bodies of the Native Hawaiian people.

Publication Statement

Copyright is held by the author. User is responsible for all copyright compliance.

Rights Holder

Antonia Rose Garriga Alvarez


Received from ProQuest

File Format




File Size

291 p.


Social work