The paradox of action: Trajectories in distress, meaning, and gene regulation following self-directed activist engagement among Black women.

Background: Black women have a long history of engaging in activism and community advocacy as both a political imperative and a survival strategy (Hill Collins, 2000; Ransby, 2003). Activism may confer psychological benefits such as increased meaning in life, identity affirmation, and social connection (Hope et al., 2019; Klar and Kasser, 2009); simultaneously, activism can involve sustained stress exposure, burnout, and heightened vulnerability to surveillance and (re)traumatization (Gorski, 2019). Biological indicators offer one avenue for examining how social conditions are embodied particularly when psychosocial experiences involve chronic threat, vigilance, and cumulative stress exposure. Given growing attention to activism as a health-relevant practice, this study is framed though an intersectional and critical medical anthropology lens to explore how activism may relate to both psychosocial and biological stress processes among Black women. Methods: Using an embedded mixed-methods pilot design, this study evaluated the feasibility of assessing psychosocial indicators and the Conserved Transcriptional Response to Adversity (CTRA) at baseline (T1) and ~2-month follow-up (T2) during a self-selected intentional activism period among Black women, with baseline semi-structured interviews contextualizing interpretation of T1→T2 patterns. Participants (N = 29; M age = 39.4 years, SD = 11.7; range = 21-63) completed online surveys, a baseline interview, and coached dried blood spot (DBS) collection at T1, then completed follow-up surveys and DBS collection at T2. Analyses followed a three-part workflow: (1) feasibility metrics (enrollment/retention and useable DBS returns), (2) within-person quantitative change (paired-samples t tests for psychosocial measures; mixed-effects linear models of a 53-gene CTRA set), and (3) thematic analysis of baseline interviews with integration via joint display (convergence/complementarity/divergence). Results: Procedures supported remote biobehavioral assessment; useable DBS/CTRA data were available for most participants (T1 n = 28; T2 n = 27). Psychosocial scores decreased from T1 to T2 for psychological distress, activist orientation, and meaning in life (presence and search), with activist identity/commitment also decreasing but not reaching conventional thresholds. At the sample level, mean CTRA showed no net change from T1 to T2; however, within-person increases in activist identity/commitment and increases in search for meaning were associated with more favorable CTRA change. Baseline qualitative themes (Activism's Paradox; Identity Dialectics; Resistance and Restoration; Community-Rooted Well-being) highlighted co-occurring strain, meaning, identity negotiation under misogynoir, and relational coping infrastructure. Conclusion: Findings support feasibility and provide hypothesis-generating evidence that biobehavioral responses may be contingent on identity and meaning processes rather than uniform mean shifts in a heterogeneous activism window.