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How Can She Bare It?

The Struggles of Homeless Women

As a young female living in the middle-class suburbs, obtaining feminine hygiene

products has never been much of an issue for me. The only problems I have faced have been

not having enough in my backpack or fitting time in my schedule to drive to the local pharmacy

to buy myself my preferred brand or amount. With being a female, I have to learn how to protect

my body from people who have the ability to violate it. My family would tell me that my body is

my own, and that no one is allowed to have access to it without my consent. My doctor would

ask me specific questions about my health and advise me on how to stay healthy. I live in a safe

neighborhood, I have shelter, an excellent education, and a healthy family unit. In my future, I

will have enough of the basic needs to build a family and with a future spouse. However, many

young women do not have these things.

One day, I was driving to San Francisco with my parents. As we were going to meet

some relatives for dinner, I saw homeless women on Mission Street with their shopping carts and

their tents. Many were mothers, with young children at their side, begging for money. I was

shocked at how they calmed their children in the cold while pleading for change from the

business people who walked to their next meeting, or from a nuclear family who were trying to

catch a taxi to go to the California Academy of Science. It was an odd juxtaposition which left a

large impact on me. It was shocking to see so many people walk past a helpless human being

who was struggling and in dire need of help. I thought to myself how they survive on the streets

where they are prone to so many dangers and diseases. More specifically; ‘What are the unique

challenges homeless women face and how do they cope without the basic necessities to survive?’

A homeless individual is defined in section 330(h)(5)(A) as an individual who lacks

housing (without regard to whether the individual is a member of a family), including an

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individual whose primary residence during the night is a supervised public or private facility

(e.g., shelters) that provides temporary living accommodations, and an individual who is a

resident in transitional housing. (National Health Care for the Homeless Council) However,

many view homelessness as a result of bad actions committed by an individual. The public eye is

very unfavorable towards the subject of homelessness. Much of society tends to resort to victim-

blaming and believe the causes are laziness and substance abuse. These ideas are very dangerous

and problematic, for they ignore the other causes that often lead to homelessness. In a study

conducted by Anne J. Kisor and Lynne Kendal-Wilson of SAGE Journals, “The study found that

mental health problems, low income, family disputes, and abuse or neglect by family members

are the primary factors in homelessness.” (SAGE Journals). I did some more research regarding

the catalysts that cause homelessness among women. I found that the challenges targeted towards

homeless women specifically are sexual abuse, teen pregnancy, substance addiction, a decline in

physical health, an erosion of a stable mental health, and being ignored by our community.

The term sexual assault refers to sexual contact or behavior that occurs without explicit

consent of the victim (RAINN). Forms of sexual assault would include attempted rape, unwanted

sexual touching, forcing a victim to perform sexual acts, and penetration of the victim’s body. As

a result of being unarmed and defenceless, being homeless increases an individual’s chance of

being sexually violated. Homeless women especially have a higher risk of getting sexually

assaulted and taken advantage of compared to homeless men. Most people stereotype the female

population as the weaker part of the demographic, therefore leading to more violence enacted

upon women. Compared to most middle and upper class women however, homeless women are

particularly vulnerable to multiple forms of interpersonal victimization, including sexual and

physical assault at the hands of strangers, acquaintances, pimps, sex traffickers, and intimate

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partners on the street, in shelters, or in precarious housing situations (Vawnet Applied Research

Forum). According to The Little Black Book for Girls: A Book on Healthy Sexuality, “A lack of

housing, being a runaway, and/or being financially desperate are all factors that can make a

woman more vulnerable to sexual assault” (St. Stephen’s Community House 175). Many

perpetrators of sexual violence look for people they can take advantage of to make them feel

more powerful, or those who are less likely to contact authorities about the assault. Being a

homeless women, this decreases the reports of rape committed. As a result of being a homeless

women who is raped without using a form of protection, many become pregnant and give birth to

an unwanted child. This puts a burden on the mother, who either has the choice of neglecting her

child’s education or putting them through a program that will encourage learning for the child’s

future.

While a large number of homeless women are unable to provide education for their

children, many schools offer educational assistance to those in need. A few months ago, I was

introduced to my mentor, Meredith Lyons, who has been a teacher at Crossroads High School for

five years. This high school is part of the Mount Diablo Unified School District, and focuses on

educating young mothers who are unable to enroll into regular high schools. The school not only

tends to struggling mothers, but the school also offers child care during school hours. Crossroads

lets students graduate after two quarters of learning, which is very different from other school

graduation schedules. Lyon teaches English, government, economics, art, cooking, US history,

and world history. She told me what it was like to work at such an interesting educational

environment:

“It's incredibly rewarding to see a student who barely speaks any English, learn

conversational English and begin to be invested in their education. I've seen this happen several

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times. We also have students who drop out for awhile and then come back and are very

appreciative of what we offer. This school is a safe place for kids who are often lost in

comprehensive high schools. They're willing to answer questions here and ask for help without

worrying that classmates will judge them or a teacher will think they're not smart. I've seen very

young girls at ages 13 and 14 become mothers and embrace the roll.”

Lyon later gave me a tour of the school and showed me her classroom and the three day

care facilities for the students’ children. Each room was dedicated to a certain age group, with

small beds and blankets against the walls and tucked in the wooden shelves. I was amazed at

how the school and the school faculty cared for these young mothers and treated them as actual

individuals instead of people who were once alone on the streets. These girls were being cared

for and assisted with anything they needed as they trekked through the journey of accomplishing

their educational goals. There were many schools like Crossroads that are dedicated to caring for

teenage mothers and their children. In fact, in 2000, the California Department of Education

created the Cal-SAFE program in 127 locations to provide comprehensive, community-linked,

school-based programs for pregnant and parenting teens and their children, with the goals of

decreasing the dropout rate for teen mothers, decreasing dependency on welfare, improving

parenting skills, and reducing the likelihood of repeat pregnancies to teen mothers (Social Work

Today). As a result of this improvement of education, more young, homeless mothers are being

educated enough to afford a sustainable job and and affordable place to live. They are able to

make money on their own, send their child to school, and live safely in their own home.

Through the stories Lyon told me, I did not hear of a student suffering from substance

abuse. Substance addiction is especially harmful for homeless women, many of whom have to

raise children while living on the streets. For some women with children, alcohol and other drug

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use may be an important risk factor for homelessness because it may interfere with a woman's

capacity to compete for scarce resources such as housing, employment, or services (National

Center for Biotechnology Information).

The main reason why homeless individuals turn to drugs and alcohol is “to cope with

highly stressful life situations – such as family conflicts or dysfunction, traumatic loss or harm,

devastating medical condition, abrupt career detour or disastrous financial loss, the newly

homeless may turn to alcohol and/or drugs in an effort to self-medicate.” (Michael’s House)

When one is homeless, they are able to obtain illegal drugs in order to satisfy their crave for a

pleasing high, to distract them from their past traumas. Likewise, a large number of homeless

women buy addictive substances, becoming dependant on certain stimulants as a result of

various traumas, such as sexual assault or sex trafficking. Homeless women are more likely to

excessively abuse drugs and alcohol compared to the economically thriving women of today’s

society. However, many homeless women who take illegal drugs and abuse adult beverages are

influenced by others within their community. In 2009, a study was conducted and stated that

homeless women with a greater proportion of heavy alcohol users in their personal networks had

greater odds of engaging in binge drinking, and women with a greater proportion of drug users in

their networks had greater odds of using marijuana, cocaine, crack, and methamphetamine or

other amphetamines. (Alcohol Research Group, Institute for Epidemiology and Behavioral

Medicine) However, women with a greater proportion of individuals in their communities they

met in school or through work had lower chances of marijuana, cocaine, and crack use. As a

result of the dependence of narcotics and alcohol, homeless women often suffer from a large

variety of health risks.

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Along with drug addiction, there are other health risks that impact a homeless woman’s

health. As stated by American College of Obstetricians and Gynecologists, “Homeless women

are at higher risk of injury and illness and are less likely to obtain needed health care than

women who are not homeless.” (Health Care for Homeless Women) Without the help from

health care facilities and the numerous health problems, the number of deaths of homeless

females will increase. According to Healthy Women, Healthy Lives: A Guide to Preventing

Disease, from the Landmark Nurses' Health Study, “Unwitting bias also served to exclude

women from research studies, and for years, women has to follow health recommendations based

primarily on data in men.” (Hankinson 3) Women specifically suffer from breast cancer, lung

cancer, strokes, diabetes, colon cancer, osteoporosis, endometrial cancer, ovarian cancer, skin

cancer, asthma, and arthritis. Along with the a large number health risks women suffer from,

many homeless women do not have access to feminine hygiene products increasing risks for

vaginal infections. I interviewed Carmen Wah Liang, DO, MPH, who is a Doctor of Osteopathy

and obtained a Master in Public Health degree. Dr. Liang works at an outpatient Urgent Care

Center (UCC), a clinic affiliated with SF General. If someone is really sick and needs to be

admitted to the hospital, she and her staff transfer that person to the hospital. The clinic she

works at cares for an underserved, culturally diverse, low-income population. Dr. Liang

explained to me:

“ In the UCC, we see a lot of women who multiple urgent care needs. From what I can

recall, the majority want to be seen for upper respiratory infections, muscle and joint pain (e.g.,

back pain, knee pain, shoulder pain), abdominal pain, urinary tract infections (UTI), and

screening for sexually transmitted infections (STIs – no longer called STDs, or sexually

transmitted diseases). Women who are allegedly sexually assaulted are sent directly to the

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Emergency Department, where they have a team that uses a ‘rape kit’. I think one of the personal

challenges I have faced in my career is encountering women who admit to me that they have

been sexually assaulted, and I have to care for them with sensitivity. Because I am a female

physician, women tend to want to see me more than my male counterparts, especially if they are

reported alleged sexual assault.”

Ultimately, sexual assault, poor physical health, and substance addiction can ultimately

lead to the decline of a stable mental health among homeless women. Common mental disorders

the homeless struggle with include: bipolar disorder, paranoia, delusions, schizophrenia or

schizoaffective disorder, post-traumatic stress disorder, major depressive disorder, and severe

anxiety. (Addiction Center) These mental illnesses are mostly a result of depression,

abandonment, sexual abuse, and physical assault. Women are told to be the primary caretakers if

their husbands are mentally ill, and it is also her responsibility to take care of family members

who were ill as well. However, this is not the case. Many women are being diagnosed with a

wide variety of mental illnesses, especially those who are abandoned by society and are left on

the city streets. Homeless women are often treated as though they created their current situation,

with too many people questioning why they should be assisted. In 2015, the National Alliance to

End Homelessness reported that “about 565,000 people living in the United States were

homeless on any given night. Of that number, an estimated almost 40 percent of those

individuals are women. According to the American Psychological Association, 47 percent of

those women are living with a major depressive disorder.” (Bustle) Thus, this percentage

doubled the amount of women in the population who have a major depressive disorder. A result

of a large number of homeless females having mental disorders is the fact that many care

facilities are unable to lend emotional assistance to those who need it. Many homeless women

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with serious mental illness are not receiving needed care, apparently due in part to the lack of

perception of a mental health problem and the lack of services designed to meet the special needs

of homeless women (Annual Reviews).

There are many homeless shelters and women’s shelters within the United States. Alone

there are over 100 facilities within the Bay Area that tend to homeless women and families who

help them get their lives back on track. However, many facilities are lacking in the professional

or emotional help when dealing with many homeless women who are victims of specific

traumas. As stated by The Guardian, “staff who work in homelessness services may well feel

they lack the training to talk in greater depth around the emotional and psychological needs that a

woman resident may have if they've experienced serious childhood abuse or trauma, or not know

where to refer women for help.” (The Guardian). It is very alarming to hear that such a facility; a

place that is supposed to help women struggling in society, is full of individuals who cannot

provide the slightest bit of emotional assistance. In our society, it is easier to turn the other cheek

than to lend a helping hand to a homeless individual in need. If one was to see a homeless

woman on the street, they would continue walking as if they were invisible to the naked eye. As

stated by the Community West Foundation, “Poverty is an ugly reality and when confronted with

it, many of us choose to look away, not wanting to accept a reality that doesn't align with our

own.” (Community West Foundation) Many people refuse to see the harshness of our

community, thus increasing the rate of homelessness all together. This is more harmful for

homeless females, who suffer from different health problems and mental health problems

compared to homeless men.

Many women have become accustomed to the darkness of the streets; vulnerable and

kept silent by our society. They suffer from things that the modern, middle class female would

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never be able to experience. It is important to realize that homeless woman have large social,

emotional, mental, and physical struggles in our society. While writing this paper and gathering

evidence, I found that homeless women cope with their struggles by searching for the help of

others, whether it be through begging for money on the street, searching for food on the

sidewalks, look for comfort in others, or visiting care facilities for help. This topic matters to me

because women’s health should be homeless women’s health should be held to an equal standard

to middle class women’s health. There is a lot of work that needs to be done in order to make

sure that all women have a healthy life overall.

Works Cited

Community West Foundation. “Why Do People Ignore The Homeless?”.

communitywestfoundation.org. Community West Foundation. 26 March 2018. Web. 5 March
2019 https://www.communitywestfoundation.org/blog/bid/379480/why-do-people-ignore-the-
homeless
Fielding, Sarah. “On Mental Health Day, It's Time To Talk About How Homeless
Women Aren't Getting The Care They Really Need”. bustle.com. Bustle. 10 October 2017. Web.
6 March 2019 https://www.bustle.com/p/on-mental-health-day-its-time-to-talk-about-how-
homeless-women-arent-getting-the-care-they-really-need-2788056
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Goodman, Lisa. Fels, Katya. Glenn, Catherine. “No Safe Place: Assault in the Lives of
Homeless Women” vawnet.org. National Online Resource Center, Violence Against Women,
2006 September. Web. 11 February 2019
https://vawnet.org/sites/default/files/materials/files/2016-09/AR_SAHomelessness.pdf
Hankinson, Susan E. Healthy Women, Healthy Lives: A Guide to Preventing Disease,
from the Landmark Nurses' Health Study. Simon & Schuster Source, 2001
Kisor, Anne J, and Kendal-Wilson, Lynne. “Older Homeless Women: Reframing the
Stereotype of the Bag Lady”. sagepub.com. SAGE Journals. 1 August 2002. Web. 19 February
2019 https://journals.sagepub.com/doi/abs/10.1177/0886109902173006?journalCode=affa
Liang, Dr. Carmen Wah, DO, MPH. Personal Interview. 6 March 2019
Lunette. “Period Power: Homelessness and Periods In The US”.lunette.com. Lunette.
2018. Web 5 March 2019 https://store.lunette.com/blogs/news/periods-and-homelessness-in-the-
us
Lyon, Meredith. EMail Interview. 30 January 2019
Michael's House Treatment Centers. “THE CONNECTION BETWEEN
HOMELESSNESS AND ADDICTION”. michaelshouse.com. Michael’s House. 11 November
2017. Web. 5 March 2019 https://www.michaelshouse.com/drug-abuse/study-homelessness-
addiction/
Murphy, Alexia. “Why homeless services are failing women” theguardian.com. The
Guardian, 7 March 2014. Web. 19 February 2019 https://www.theguardian.com/housing-
network/2014/mar/07/homeless-services-failing-women-st-mungos
Murray, Krystina. “The Connection Between Homelessness and Addiction”.
addictioncenter.com. Addiction Center. 19 November 2018. Web. 26 February 2019
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National Health Care for the Homeless Council. “What is the official definition of
homelessness?” nhchc.org. 2019. Web. 26 February 2019 https://www.nhchc.org/faq/official-
definition-homelessness/
Pelt, Jennifer V. “Keeping Teen Moms in School — A School Social Work Challenge”
socialworktoday.com. Social Work Today, 2012 April. Web. 17 February 2019
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RAINN. “Sexual Assault” rainn.org. Rape, Abuse & Incest National Network, 2019.
Web. 19 February 2019 https://www.rainn.org/articles/sexual-assault
Robertson, MJ.“Homeless Women With Children. The Role of Alcohol and Other Drug
Abuse” ncbi.nlm.nih.gov. Alcohol Research Group, Institute for Epidemiology and Behavioral
Medicine, Nov 1991. Web. 11 February 2019 https://www.ncbi.nlm.nih.gov/pubmed/1772157
Robertson, Marjorie J. Winkleby, Marilyn A. “Mental Health Problems of Homeless
Women and Differences Across Subgroups” annualreviews.org. Annual Review of Public
Health, 1996 May. Web. 11 February 2019
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St. Stephen’s Community House. The Little Black Book For Girls: A Book on Healthy
Sexuality. Annick Press Ltd. 2006
Wenzel, Suzanne L., etc. “The Social Context of Homeless Women’s Alcohol and Drug
Use”. ncbi.nlm.nih.gov. Alcohol Research Group, Institute for Epidemiology and Behavioral
Medicine. 18 July 2009. Web. 26 February 2019
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Women's Health Care Physicians. “Health Care for Homeless Women”. acog.org. The
American College of Obstetricians and Gynecologists. October 2013. Web. 26 February 2019
https://www.acog.org/Clinical-Guidance-and-Publications/Committee-Opinions/Committee-on-
Health-Care-for-Underserved-Women/Health-Care-for-Homeless-Women

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