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Impact of Gender on Separation-Reunification Experiences of Latino Adolescent Immigrants

Impact du genre sur les expériences de séparation et de regroupement familial des adolescents immigrés latinos
Impacto del género en las experiencias de separación – reunificación de los inmigrantes latinos adolescentes
Naomi A. Schapiro, Susan M. Kools, Sandra J. Weiss and Claire D. Brindis

Abstracts

Many Latino immigrants who enter the US in late childhood or adolescence are reunifying with parents after lengthy separations, and yet there is limited research on this process from their point of view. This article discusses the impact of gender relations on family re-engagement and immigrant adaptation of young men and young women. Young people were interviewed as part of a grounded theory study exploring the process of family separation and reunification for Latino immigrant adolescents who have been separated from their parents for at least four years during immigration. Focus groups, individual interviews and participant observation were used to gather data from 20 Mexican and Central American immigrant adolescents, 12 young men and 8 young women. Participants reported a range of personal and family beliefs about gender roles and their impact on separation and reunification, Young men reported greater exposure to violence, generally had less access to health care, and reported more emotional isolation from families and peers than young women. Fathers and adult male role models were missing from most of their lives, and this absence was particularly difficult for young men. Young women reported greater skills and persistence in emotional re-engagement with their families in the United States.

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Introduction

  • 1  Pseudonyms chosen by participants to protect anonymity, last initials if duplicate first names

1Brian M1, 14 years old, was living with his grandmother and brothers in Mexico City when his mother re-entered his life:

Well my mom suddenly came, just like that. With us, she told us ‘I am at the airport.’ Uh-huh, she returned for us. ‘I have come for you.’ And we, and I, wow, because we saw our mom. It had been about five years, I think, since we had not seen her. We had some time. Well, it was fine, but she told us that she was taking us with her. Well I already had like, my life planned. Do you know what I mean?

2Brian was part of a transnational family, with parents working in the United States (US) and sending money home to his grandmother to support her and the children (Isaksen, Devi, & Hochschild, 2008). It is not known how many youths who have been left behind, like Brian, eventually rejoin their parents. However, it is estimated that up to 80% of immigrants who arrive in late childhood have been separated from one or more parents during immigration, rejoining parents in the US after separations of many years (Potochnick & Perreira, 2010; Suárez-Orozco, Suárez-Orozco, & Todorova, 2008; Suárez-Orozco, Todorova, & Louie, 2002). The majority of these young immigrants in the US are Latino, primarily from Mexico (Passel, 2011).

Health Risks of Latino Youth

3Latino youth in the US are at risk for a number of poor health outcomes, including higher rates of depression, substance use, (Eaton et al., 2012) pregnancy and births, (Ventura, Abma, Mosher, & Henshaw, 2009) and failure to complete high school, the gateway to socioeconomic improvement for many (Chapman, Laird, Ifil, & KewalRamani, 2011). Immigrant Latinos are even less likely to complete high school (63%) than US-born Latinos (83.7%) or non-Latino immigrants (92%) (Chapman et al., 2011). Immigrant Latino youth with low English proficiency, especially young men, are more likely to be victimized at school than other immigrant youth (Peguero, 2008). Family interdependence and parental support may mitigate these outcomes by promoting adolescent strengths (Ong, Phinney, & Dennis, 2006), while family disruption and separation have been shown to adversely affect mental health outcomes in children and parents, both in Mexico and the US (Aguilera-Guzmán, de Snyder, Romero, & Medina-Mora, 2004; Rivera et al., 2008; Suárez-Orozco et al., 2002).

Gender Roles and Parenting

4In Mexico and other parts of Latin America, the father’s parenting role is described as providing economic support, engendering respect and disciplining children, while mothers are seen to be in charge of emotional and moral development (Dreby, 2006; Levitt, 2001; Pribilsky, 2004; R. C. Smith, 2006). However, economic and cultural shifts have impacted gender relations, and Guttman (1996/2007) and others have described a warmer, more emotionally involved style of fathering in Mexican men on both sides of the US border (Behnke, Taylor, & Parra-Cardona, 2008; Taylor & Behnke, 2005). Parents who migrate together and both work outside the home tend to shift gender role responsibilities and share parenting (Levitt, 2001; R. C. Smith, 2006), and Zavella (2011) has found that definitions and expectations of gender roles greatly vary both within and between generations of Mexican immigrants in California.

5After immigrant parents separate, fathers may or may not maintain financial or emotional connection with their distant children, while mothers tend to send remittances and maintain contact even if they begin new relationships (Dreby, 2006, 2010; Menjívar, 2000; Menjívar & Abrego, 2009).

Family Separation and Reunification

6A growing body of literature describes the problems that occur during immigration-related family reunification from the adolescent’s point of view (Artico, 2003; Glasgow & Gouse-Sheese, 1995; Hine-St. Hilaire, 2008) and their potential long-term effects. (Arnold, 2006; A. Smith, Lalonde, & Johnson, 2004). Some studies document greater pre-migration stress (Aguilera-Guzman, et al., 2004; Pribilsky, 2001) and poorer post-migration adaptation (Qin-Hilliard, 2003; Suarez-Orozco et al., 2002, 2008) in boys relative to girls. Absent, however, are in depth explorations of factors contributing to successful family reunifications, of the impact of gender on family reunification, and the voices of young women and young men elucidating their experiences of reunification in real time (Mazzucato & Schans, 2011; Schapiro, Kools, Weiss, & Brindis, 2013).

Study Design

7The purpose of this study was to explore the process of family separation and reunification for Latino immigrant adolescents who have been separated from their parents for at least four years during immigration, in the context of transnational economic and family ties and changing gender roles.  This paper will discuss gender relations as part of the conditions under which children and adolescents experience parental separation and the process of reunification, including gender of child, caretaker and migrating parent. We will discuss the varied ways in which youth themselves described gender differences in their adaptation to parental separation and the process of reunification.  We will also discuss the main strategies that youth used to reconnect with their parents.

8This study used a grounded theory (GT) design, a qualitative research method in which theory is inductively and deductively generated from systematic and simultaneous data collection and analysis, allowing the incorporation of multiple perspectives and larger domains of social interaction (Clarke, 2003; Strauss & Corbin, 1994). We used dimensional analysis (DA) (Schatzman, 1991), a GT approach which allows the researcher to explore all of the interactions and their meanings in a complex social situation (Kools, McCarthy, Durham, & Robrecht, 1996) by identifying multiple interlinked dimensions of a complex phenomenon under study, drawing them into a clear narrative around a central, organizing perspective (McGuire & Martin, 2007). The study was set in a metropolitan area of the Western US with a large proportion of Latino immigrants. Permission was granted by the IRB of the University of California, San Francisco and by the Boards of three community nonprofit organizations that served as research sites.    

Recruitment

9We recruited a purposive sample of 20 adolescents between the ages of 14 to 22 who had immigrated from Mexico or Central America at age 9 or later, reuniting with a parent or parents in the US after a separation of at least 4 years. Participants were recruited via flyers and via bilingual bicultural project liaisons who worked in the research sites. A verbal consent/assent form for the participants was approved in order to protect their anonymity, and parents were contacted by phone for verbal consent if the participant was under 18 years of age. Participants were informed of the confidentiality of the research and that the researcher was also bound by State laws mandating the reporting of child abuse and any intention to harm self or others.

Procedures

10We conducted 27 interviews of the 20 adolescents in Spanish, English or a mixture, as the participant chose. The first author, who conducted all of the interviews, is a Spanish speaking nurse practitioner with over 25 years of experience working with immigrant adolescents and their families.  Only three interviews were conducted entirely in English.  Second interviews were conducted of 7 adolescents after initial analysis, in order to explore particular issues in more depth.  Each interview lasted between 20 and 90 minutes.  Participants chose pseudonyms that were used to identify them during the interviews and analysis, in order to preserve anonymity.  Participants were compensated with a $25 gift card to a local store after each interview.

11Theories of attachment (Bowlby, 1978, 1988), ambiguous loss (Boss, 1999, 2007), and positive youth development (Bowers et al., 2011; Ginsburg & Carlson, 2011) provided theoretical underpinnings for interview questions. All authors developed a semi-structured interview guide with initial questions and suggested probes in Spanish and English. In GT, early data analysis is used to refine data collection, and the interview guide was refined after early interviews. For example, we were determined to elicit participant perspectives on gender differences in immigration and family experiences. With the exception of one young woman who stated, “I have thought about this a lot!” most participants were not sure how to answer this question in the abstract. Young men were puzzled and seemed offended if they were asked how their life would be different if they were a girl, and we later used the technique of asking participants to imagine having a twin of the opposite gender and imagining how his or her life might be different. This line of questioning allowed participants who had an opposite gender sibling to reflect on the differences in their lives, and for those with only same gender siblings, to theorize about potential differences, providing richer data.

12A bilingual immigrant from Central America who was familiar with both Mexican and Central American adolescent slang translated transcripts from recorded interviews. Any questions in transcription or translation were discussed between the first author and the translator, and checked with the participant on second interview.  The transcripts were analyzed using a GT coding schema, starting with open coding (Charmaz, 2006; Kools et al., 1996; Schatzman, 1991).  Once a large number of codes were generated, the data were delimited by merging similar codes into categories for deeper conceptualization. An explanatory matrix was used to organize the categories and their dimensions.

Findings

Sample Characteristics

13The sample included 12 young men and 8 young women. Only four had migrated to rejoin their married biological mother and father.  Two adolescents migrated to live with their fathers, 14 with mothers. Most participants reported being raised by single mothers, and they reported that their mothers migrated because they were unable to earn enough to support the family in their home country:  “We had nothing, absolutely nothing.” Several participants stated specifically that their mothers had left “to give us a better life.”  A few youths reported that their mothers had left violent relationships with their fathers when they migrated. Youth who were left behind were raised by one or both grandparents, aunts, uncles and older sisters, and in two cases mothers who stayed behind. We also found that young men in our study were more likely to be exposed to violence and maltreatment in their home countries and the US than young women, and had less access to health care on arrival to the US. These findings are reported elsewhere (Schapiro, 2012).

Explanatory Model

14“Believing in a Better Life,” [Figure 1] was the model that best explained the phenomenon of parents migrating without their children, the transnational relationships that sustained both parent and child during the years of separation, and finally the adolescent’s processes of migration, family reunification and adaptation to life in the US. (Schapiro, 2012). In the interviews, youth described the contexts of abject poverty, political barriers to family immigration, and interpersonal violence that impelled mothers and fathers to migrate without them.  The conditions under which they lived during separation, the difficult and often dangerous border crossings when they migrated, and the reception they found in their home, neighbornoods and schools impacted the extent to which they also believed that migration would lead to A Better Life for them. (See Figure 1).

Figure 1. Believing in a Better Life Explanatory Model

Figure 1. Believing in a Better Life Explanatory Model

15For the purposes of this paper, the major gender-related themes and their relationships in this model will be presented, including participants’ views of their migrating parent and caretakers, their views on gender roles, and the impact of gender roles on the strategies they used to re-engage with parents once they had migrated to the US. (See Figure 2). In our sample, fathers were absent from most participants’ lives. We also found that young men in our study were more likely to be exposed to violence and maltreatment in their home countries and the US than young women, and had less access to health care on arrival to the US. These findings are reported elsewhere (Schapiro, 2012).

Figure 2. Impact of Gender on Believing in a Better Life

Figure 2. Impact of Gender on Believing in a Better Life

Lack of Paternal Involvement

16Fathers were absent from most participants’ lives. Those whose mothers migrated alone reported that their fathers who lived nearby were rarely involved in their lives.  Luis stated:

He, (pause) became nothing, basically. Because of, because of the money. He didn’t want to give us money. He distanced himself a lot from us. He cared more for his other family, for his other kids, than for me, for me and my sister. And so, I was, I had communication with him like every six, seven months. After six, seven months, he would call me. But it was just to argue or (pause) to make things worse.

17Damaris, whose father lived in another part of the US, said:

And he did not even call me when I turned fifteen. And, and I told him, his mom had my number.  And I told her that I wanted to talk to him. Because he, I don’t know, because I think that it is important to have a father. And, but, he never called me.

18Catherine stated that her father, who currently lived in the same city, went out of his way to insult her through extended family and social media and she referred to him as “my so-called father.” A few participants of both genders reported being close to their mothers’ husbands or boyfriends, however the majority stated that these men did not take on a parenting role. Other participants reported absent or negative relationships with their fathers before and after migration, whether their father remained in their home country or had also migrated separately. Despite the predominance of negative father relationships in this sample, one young woman, who lived with her paternal grandparents after her mother migrated, reported that her father occasionally took her to school in her home country.

Gender Roles and Parenting: Fathers Teaching How to be a Man and Mothers as Heroines

19When asked what they missed about their absent father, participants gave a range of answers. David S, who defied his parents’ wishes and left Mexico to rejoin his father in the US, stated: “My father would have taught me better. Because my mom taught me well also, but since she is a woman, she didn’t know, didn’t know what I felt. For example, things about gangs or something. Nothing, I can’t tell my mom about that because I don’t know, she wouldn’t know how to deal with it.” Edgar disagreed: “Well it wasn’t a problem to me because, like, my mom gave me a lot of good examples.”  The two young men who migrated to rejoin both parents did not distinguish between their father’s and their mother’s roles in their upbringing. Brian M, the initially reluctant immigrant, noted with pride “It was different because well, my parents, well, they put things on our shoulders. Like, structure, like, how, to do this, and that.”

20Andrea, who was raised by her grandparents and came to the US with her older brother and younger sister, expressed the views of many young women in the study when she said:  “She has always been my Mom, like my hero.  I think that I have respected her a lot because she has done what my Dad didn’t even have the courage to do, to come here. So I think that she is, like my father and my mother, at the same time.”

21Study participants had a range of viewpoints on gender roles. David S, whose father worked in the US to support their ranch in Mexico, stated that, unlike his sister, it was his obligation to study in order to get a good job: “And the women, no they are going to get married with, their husband, and she, they (the men) have to support them.  And that’s how it has to be done, everything in its place and something like that.  But if they wanted to study and get a good job and do something like that, the women could do it also. But I, I had the obligation of, of studying to be able to, for to work. To get a good job and to be able to support my family in the future.”

22Catherine, who rejoined a single mother and whose father in the US did not help her financially or emotionally, at first stated that there was no difference between the experiences of men and women, but then continued: “let’s say if you get together with someone, and then he, the husband is a bad man, or he doesn’t help you and he leaves you with this kids. So she has to work to be able to take her kids ahead. And then herself, also. And in return, the guy, he can just go mess around, there. I think it’s more difficult for the woman. And so the culture, that’s how it is.”

23Luis lived in just such a family: his mother came to the US to work, and his father in Guatemala reneged on agreements to care for Luis and his sister, concentrating on his children with another mother.  Luis felt that his sister had a more difficult time, with the pressure she had to take care of him, “basically, because she was a woman, and she was the oldest, she was a little older than I. She would get mad because of what my dad would do to me. But aside from that, nothing more. Everything the same, the problems.”

24Questioning participants about a hypothetical opposite gender twin provided rich information. Several young men who had not reconnected emotionally with their mothers felt that a sister would listen to them and take care of them.  Lázaro stated that she would have an easier time talking to his mother than he did. Monica remarked that her actual brothers never cleaned up after themselves and expected her to clean for them. Andrea stated that her brother was not as close to her mother, and remarked that if she were a boy, she might not have appreciated her mother’s sacrifice as much.

25Participants of both genders stated that women were more “sensitive” and “sentimental” than men, and this might affect their adaptation. David O, who witnessed his father’s violence against his mother before she migrated, stated that his sister “felt sad. Sometimes she needed someone to talk to. But my dad paid her no mind.” Catherine noted:  “And that women will say ‘I miss my family in my country’ or something like that. And in contrast, the guys said ‘well, let’s just keep moving forward’…But I think that it’s the same for both, because, both genders have to get used to a new, a different life.”

Impact of Gender on Family Re-engagement

26Participants in our study used four strategies to reconnect with their families in the US: 1) letting time take its course, 2) reconnecting through crises, 3) isolating and holding a grudge, and 4) telling their story and actively renegotiating parent-child relationships (Figure 3).

Figure 3. Strategies for Reconnecting with Parents

Figure 3. Strategies for Reconnecting with Parents

27In the first strategy, also described by participants as poco a poco (little by little), adolescents and families used activities of daily life and real time face to face communication about these activities to allow trust and connections to build. Participants who used this strategy reported more personal optimism. Both they and their parents were able to tolerate ambiguous feelings, such as joy at being together and sadness at lost connections with home country caretakers. Both young men and young women participants used this strategy. However, in general young women reported doing more household chores than young men, so it is possible they had more structural opportunities to spend time together. Brian M stated “We would be at home, and we couldn’t even look at each other...because we didn’t know one another.” When asked what made his adjustment easier, he replied,

Because my dad, instead of being my dad, he is my friend at the same time. My dad is like, he’s very, very good. Like, I get along really well with him. My dad was like my right hand when I got here. I didn’t know what to do and my dad would tell me “no, well you have to do this.” He helped me a lot when I came. When he would help me, I started to get to know him.

28In the second strategy, reconnecting through crises, a parental health crisis or an adolescent’s mental health crisis or safety issue at school, were catalysts for emotional re-engagement. These crises were not common among participants, and occurred in the lives of both young men and young women.

29In the third strategy, isolating and holding a grudge, participants held onto resentments about the length of separations, living conditions in their home country or the US, or the order in which they were brought to the US. Teens who held a grudge would isolate themselves from parents and other family members, sometimes refusing to go to school or accept parental authority, and sometimes using alcohol and drugs. Expressing resentments was common for participants of both genders. However, young men tended to stay lonely and isolated, “with no one by my side,” while young women persisted in trying to connect with their parents, even if these attempts were not successful. Carla stated, “And I would say that if she came here, it’s because she did not love me. It’s why she left me and my brother stranded.” Lázaro, in contrast:

When I got here when I started living with her. I felt as, desperate, uncomfortable with her, I’d see her as a stranger because I didn’t know her. Since I was separated from her for such a long time. Yeah, I felt desperate. And well, we don’t really get along.

30Young men rejoining single mothers stated that they were looking for work so that they could help their mothers economically. They were more likely to keep their feelings and even the details of traumatic experiences to themselves, saying that they did not want to burden their mothers or that they were “too old” to confide in this way. One young man stated at the end of his interview that he learned his half-sister had been killed in a drive-by shooting in his home country while he was en route to the US three years before, that he had never told his mother about this and was only now starting to talk to a counselor at his school.  Most young men reported that they did not trust their friends in the US with sensitive information, but might confide in a girlfriend.

31The fourth strategy was an active re-negotiation of the parent-child relationship. Carla, who had been resentful of her mother both in Honduras and in the US, talked about the eventual change in their relationship:

 It changed because she spoke to me a lot. She would tell me “daughter, look” and so I began to understand. And I said, “she is right. She is right. She came here to give me a better life, and for my whole family also,” I said. And at that moment, well, I started analyzing and analyzing. I said “she is right” I said. I don’t know why I’m fighting with her. And so I asked her to forgive me. I said to her, because I had been really bad with her. And she told me that it was fine. “I understand you,” she says. “I know that never” she says “when you were little” she says “I was never with you.”

32Andrea had been helping her younger sister connect with their distant mother via webcam for many years, and continued actively nurturing their relationship in the US. She also volunteered for extra chores on the weekend so her mother could rest: “I know what will help her out.” Other young women reported talking to their mothers about missing relatives in their home country and about their difficult and dangerous border crossings, and persisted in attempting to connect with their mothers, even when they reported conflict in this relationship. Monica lamented her mother’s emotional distance from her, but still stated:

Because with my mom, it has been very easy to get comfortable with her, with the way she is. Though the trust is not the same, but, like, like it’s easier to get close to her and talk to her about what is going on with me.

33Luis and David O, whose older sisters had negotiated for better living situations in their home countries and maintained active long-distance partnerships with their mothers, were beneficiaries of their sisters’ active roles, and David O called his sister his “second mother.”  

Discussion

34Gender roles and ideals of masculinity are influenced by class, culture, geographic location and globalized media in both home countries and the US. (Connell, 1998; Connell & Messerschmidt, 2005). Expressions of masculinity in Latino culture are changing in Latin America and the US (Gutmann, 1996/2007), and yet suppression of public and even private display of emotions is still part of gender socialization (Escobar Latapí, 2003).Although our participants acknowledged changing gender roles, many still endorsed traditional views of  production in public spaces as the appropriate arena for men, and maintaining relationships in private spaces as the appropriate arena for women (Páramo & Burbano Arroyo, 2011).

35In our study, young women displayed greater skill and persistence in emotional engagement with their mothers than young men, and in fact, young men may have actively resisted this engagement, feeling that they were “too old” to reconnect emotionally and that their contribution to family life should be economic support. This belief was particularly poignant as the research was conducted during 2010 to 2012, a time of severe economic downturn and stricter surveillance of workers’ documentation status. Our adolescent participants espoused gender role beliefs and expectations that were similar to the range of beliefs of Latino adults.  Ideals of masculinity can be in conflict with the health of men, and the profound isolation expressed by young men who had not had reconnected with family or friends could be a harbinger of long term health risks for these young immigrants. Although the differential involvement of young women in household chores, relative to young men, is related to gendered and unequal spheres of influence, helping with chores at home served as a space in which connections with mothers could be reestablished and repaired. These connections are a source of strength for the young women in our study, and have been shown to foster adaptation to school and peers, as well as family (Qin-Hilliard, 2003).

36A large randomized study of Latino immigrant adolescents in North Carolina found that the majority lived in two parent families (Potochnick & Perreira, 2010). However, in our small sample of youth living in two urban counties of the Western US, most had migrated to join their mother only and fathers were either unknown, uninvolved or negatively involved.  Our sample consisted of more young men (12) than young women (8), and this proportion is consistent with recent studies of youth detained at the border (Jones & Podkul, 2012). In a small, purposive study, we do not claim to have a representative sample, yet our findings suggest regional differences in proportions of single parent (primarily female-headed) families versus two-parent families, and variations in the enactment of gender roles and expectations.  We interviewed adolescents alone as we wanted to understand the perspectives of this under-studied group, and we are unable to verify their accounts of their upbringings, nor were we able to observe or elicit their parents’ views and interactions in the reunification process.

37In general, young men are underrepresented in health care research (Marcell & Ellen, 2012), and we were fortunate in interviewing a large proportion of male participants. Our study contributes to understanding the impact of gender on family reunification and overall adaptation for those who immigrate in late childhood from Mexico and Central America. We have indicated that in some parts of the US, we are seeing a larger proportion than expected of youth rejoining single-parent families. We have documented a stark lack of adult male role models for both young men and young women after they arrive in the US, and have suggested that this lack may be particularly devastating for young men because they generally do not see their mothers as capable of teaching them how to become a man.

38Our participants, including young men, endorsed the value for immigrants of talking about their life experiences, and yet many felt they could not share these stories in their homes, with their peers, or in health care settings. There were gender differences in access to health care, but even young women who were well-connected to a clinic reported that they were rarely asked about their migration story. Next steps in research could involve designing interventions to better support successful family strategies for reunification, to engage young men with appropriate role models, and to assist health care providers and others working with immigrant youth to offer an arena for telling their stories.  There are health care policy implications as well, as the Affordable Care Act does not cover new or undocumented immigrants and the safety-net clinics which serve them are facing declining revenues and may have to limit services in the future (Jerome-D'Emilia, & Suplee, 2012).

39Most participants in our study showed tremendous resilience and creativity in their adaptation strategies.  Young men and their families who were willing to tolerate mixed emotions and were patient with each other were able to achieve closer relationships, poco a poco, even if they did not talk about their experiences in depth.  Still, young immigrants of both genders are looking for venues in which they can tell their story and be understood. These findings can give some guidance to health and mental health providers, educators and policymakers working with this vital and important population.

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Notes

1  Pseudonyms chosen by participants to protect anonymity, last initials if duplicate first names

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List of illustrations

Title Figure 1. Believing in a Better Life Explanatory Model
URL http://factsreports.revues.org/docannexe/image/3860/img-1.jpg
File image/jpeg, 80k
Title Figure 2. Impact of Gender on Believing in a Better Life
URL http://factsreports.revues.org/docannexe/image/3860/img-2.jpg
File image/jpeg, 88k
Title Figure 3. Strategies for Reconnecting with Parents
URL http://factsreports.revues.org/docannexe/image/3860/img-3.jpg
File image/jpeg, 63k
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References

Electronic reference

Naomi A. Schapiro, Susan M. Kools, Sandra J. Weiss and Claire D. Brindis, « Impact of Gender on Separation-Reunification Experiences of Latino Adolescent Immigrants », Field Actions Science Reports [Online], Special Issue 13 | 2015, Online since 14 April 2015, connection on 27 April 2017. URL : http://factsreports.revues.org/3860

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About the authors

Naomi A. Schapiro

University of California, San Francisco naomi.schapiro@ucsf.edu

Susan M. Kools

University of California, San Francisco

Sandra J. Weiss

University of California, San Francisco

Claire D. Brindis

University of California, San Francisco

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Copyright

Creative Commons Attribution 3.0 License

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