Carrying Her Trauma

Salvadoreñas Find Community Amidst Hardship

by Melanie Pineda

Salvadoran women struggle to cope with mental health both in the United States and in their home country.

Los Angeles, Calif. – Elisa Callejas Dominguez held a magazine in one hand and scissors in the other, visualizing what images to put on her poster. She nodded along as her friends around her told jokes, stories, and dreams, concentrating on her task. One lone curl popping out of her hair bun kept getting in her line of vision, but she ignored it in favor of the project in front of her. She smiled as she successfully cut out a photo, taped it down, and started the process all over again.

I met Dominguez, a senior at UC Riverside, at an event hosted by Las Girls in Action, a Salvadoran-led initiative based in Los Angeles, which aims to provide Salvadoran girls and women with funds for higher education. While creating vision boards to help raise money for textbooks for Salvadoreñas  studying at the colleges in the University of California system, she opened up to me about her passion for mental health advocacy. 

Dominguez was three years old when her mother migrated to the United States in the mid-1980s, leaving her and two of her brothers in El Salvador to be raised by her grandparents. She wouldn’t see her mother again until she arrived in the United States in the ‘90s when she was 19.“I am grateful that my grandparents were able to raise me,” Dominguez said, pausing to collect her next thought. “But they’re not my parents. And that definitely affected me.”

Dominguez is among the thousands of Salvadoran children raised by family members in the 1980s and 1990s after their parents migrated to the United States to provide for them during El Salvador’s brutal civil war. During the conflict, the United States provided an estimated $4 billion of military aid to El Salvador and trained military units, making the country complicit in further instigating violence and terror that is psychologically damaging Salvadorans to this day. When Dominguez was three, unknown assailants killed her father, compelling her mother to look for economic opportunity up north. “I represent a generation of kids that survived a war,” she said. “The psychological consequences of living through something like that are inevitable.”

The US National Library of Medicine reported in 2017 that Latinas are twice as likely to experience depression than Latinos, and are more at risk for mental health issues than both white and African American women. Although there are no official statistics for Salvadoran women specifically, nor the particular constellation of mental health issues they face. Generational trauma from the war, a lack of adequate mental health resources available and a prevalent stigma against mental health––all of these factors combined put Salvadoran women especially at risk for disorders such as depression, anxiety, and post-traumatic stress.

Last May, Univision reported that the majority of women who die by suicide in El Salvador are younger than 24 years old. This is nearly the same age group of Latinas who are at risk of mental health issues in the United States. The Center for Disease Control and Prevention reported in 2017 that 17% of Latina students attempt suicide, in comparison to 7% of Latino students. 

When Dominguez started her “journey of education,” as she describes it, she quickly noticed a lack of understanding in her community about seeking help for psychological problems. During her freshman year three years ago, a therapist diagnosed Dominguez with anxiety and post-traumatic stress disorder. She remembers tensing up while sitting in her history class, dreading the days her professor played documentaries on conflict in Latin America. “Every time I would see the violence, I would want to run away and cry. Those images were so triggering, but at the time, I didn’t even know what a trigger was.” 

The professor suggested she seek psychological help provided by her university’s health center. The regular therapy sessions made Dominguez realize that her diagnosis was not unique. “My whole community is going through the same thing,” she said. But a eurocentric bias in most mental health sectors limits the available resources for Salvadoran women. According to Dominguez, there isn’t enough information to help Latinos navigate through the complex systems of psychology.

This bias is nothing new. A study by researchers at South Africa’s Stellenbosch University concluded that psychological practices in the United States derive from the values of middle-class white people, thus neglecting the various mental health issues that concern minority groups. For Salvadoran women, this means issues that originate in their home country and cause mental health problems can easily go ignored. And while the mental impact of the war on survivors and their descendants is damaging, there are other sources of conflict that are just as perilous. Salvadoran women are particularly vulnerable to psychological and physical abuse from their partners. In 2013, El Salvador passed the “Special Integral Law for A Life Free of Violence For Women,” a law that criminalizes several types of violence against women. This includes the concept known as femicide-suicide, that is, when a partner’s physical or emotional abuse drives a woman to take her own life. Despite the law’s enactment, El Salvador’s Observatory of Statistics on Gender reports that 15% of all femicides in 2019 were suicides by women, more than double the rate of femicide-suicides in 2018.

“The people — specifically, the men —  of El Salvador know that this law exists,” said Dr. Abigail Girón, an ob-gyn and mayor of the municipality San Juan Opico. She is one of El Salvador’s few women in a political position of power. Last fall, on the International Day for the Elimination of Violence Against Women, she traveled to Washington DC to advocate for Salvadoran women at a panel on El Salvador hosted by local leaders. “We have been promoting [the law] for years,” Dr. Girón told me after the panel, gesturing with her hands and never breaking eye contact. “The reason why we are still dying and suffering psychologically is because of machismo culture,” which places an emphasis on toxic masculinity and male dominance prevalent in Latin America. It is often cited as the impetus for the high rates of violence against women in the region, which only became more normalized after the civil war. “There is, unfortunately, a vicious cycle of hatred against women in El Salvador,” Dr. Girón said. “And a lack of women in power in the country leaves room for this hatred and for our personal struggles to grow.”

This cycle leaves Salvadoran women at a greater risk for gender-based violence, domestic abuse, and abuse from their own legislature. Maria Isabel, a defense attorney for wrongfully incarcerated women in El Salvador from the city of La Union, is a victim of this cycle. Isabel endured four years in prison for being a vocal activist for women’s rights. As she describes it, those who attempt to call the government out on corruption, such as students and community leaders, are the No. 1 enemies of the state. “They don’t like a woman who thinks,” Isabel told me in a phone interview. She excused herself for a minute to settle down her five kids for dinner, laughter and screaming evident throughout our conversation. “But I’ve learned that mobility is power. I am just one of thousands, and I know that together we are stronger.” 

Isabel is currently providing legal aid and other resources to more than 60 women, both in and out of El Salvador’s prison system. Hand-writing dozens of affidavits and other court documents has left her with carpal tunnel syndrome. She, too, suffers from mental health issues. “Our mental health is destroyed by the system, both inside and out of prison,” she said. “Each generation is taught that they are less than men. We have minimal access to universities and education in general. Depression is so common because we are taught that our lives have no future.” 

A lack of access to mental health resources allows this problem to grow. A study published by the Pan American Health Organization in 2018 concluded that 45% of Salvadorans in need of mental health resources have no way to obtain them. Isabel said that all of these conditions, often in combination, propel a large number of women to flee Salvador for new lives in the United States. Statistics from US Customs and Border Protection collected between 2018 and 2019 show a staggering increase in the number of Salvadorans apprehended at the US-Mexico border of more than 400%.

I met one of these migrant women at the heart of the Salvadoran Community Corridor, a neighborhood outside of Downtown L.A. filled with Salvadoran owned businesses. She* sat in front of me with a plate of pupusas — a popular Salvadoran dish of cheese, meat and beans cooked inside a flatbread — red salsa, sour cream and fried plantains in the midst of a lunch rush. The restaurant she’s worked at for six years, La Pupusa Urban Eatery, is known for its Salvadoran cuisine. She looked at the meal across from her before beginning to speak of her ex-husband, a painted mural of El Salvador’s blue and white flag standing guard behind her. “I never stopped loving him,” she said. “But it got to the point where his voice was constantly in my head. I never felt good enough. He was always telling me just how worthless I was, even if he wasn’t there. It was killing me.”

A painting of El Salvador’s flag in the Pupusa Urban Eatery. Photo by Melanie Pineda.

The now-single mother of three came to the United States with her husband in 1993, shortly after the end of the Salvadoran civil war. Two of her three children were born in California in the early 2000s. The move was her husband’s idea. He had convinced her that a better life was waiting for them and their children up north, that all of their marital and economic problems would be resolved if they could just make the journey. But after borrowing enough money to migrate and settle in Los Angeles, she came to realize that her husband’s abusive tendencies were in fact becoming worse.

There would be days where she wondered if she was going to make it out alive. But after nearly 20 years of enduring physical and emotional abuse, she and her husband divorced in 2013. “I grew up watching my mom endure emotional abuse at the hands of the men in her life” she said. “I didn’t want my kids to be around that environment anymore.” Although she does not believe that she personally  experienced mental health struggles during her marriage, she understands the need for more mental health resources in the community. “I never considered myself a woman who needed help, from anyone or anything. But I know a lot of us do need that help, especially after we come here.”

The journey to the United States itself can be just as scarring. In addition to enduring gruelling, perilous conditions while travelling through three countries, — Mexico, Guatemala, and their own — Salvadoran migrant women often face physical and sexual abuse as well. According to the Migration Policy Institute, there are disproportionate rates of sexual violence against migrant women during their journey to the US. A New York Times investigation found more than 100 documented reports of sexual assault on women crossing the border over the past 20 years. The actual number of sexual assault cases is presumed to be much higher.

The struggles and dangers of the journey continue even after arrival in the United States. I met an undocumented fruit vendor from El Salvador who has lived in California for the past six years. She* migrated to provide for her two children and five grandchildren. But her struggles with the displacement have led to depression and at times, suicidal feelings. “Loneliness kills humanity,” she said as she cut into a fresh stack of oranges and mangos, her addictive smile soon fading from her face, revealing tired lines and a small scar on her cheek. “It haunts me every day. And I feel like there is no one here to help me, since I don’t have papers. I am so stressed and alone. I have no one.” 

Her story is unfortunately not unique. High uninsured rates for healthcare are one reason; another is the stricter immigration laws passed in recent years that have heightened fear among undocumented communities. These laws have also been linked to an increase in worsening mental health in Latino populations in general, according to the American Public Health Association. “I feel like there’s no escape,” the fruit vendor said, serving another customer with a smile, her energy magnetic despite her heartbreaking words. “I want to go back home, but I can’t.”

The day I met Dominguez, we sat with a group of about a dozen women part of the Las Girls in Action initiative, mostly Latina and native to Los Angeles. We sat around two tables in foldable chairs in the middle of The Hive, a hair salon in the Echo Park neighborhood of Los Angeles. Despite the overpriced businesses and real estate speculation in this heavily gentrified area, it remains a Salvadoran stronghold with a rich and vibrant culture. The reflection of smiling faces looked back at the women through the store’s many mirrors. 

Dominguez and all the other women in the room turned to the door as Vanessa Gutierrez Romero, the founder of Las Girls in Action, walked in with a drooling child on her hip and another grabbing her leg. She greeted every person at the event with a smile, never letting go of her toddler as she hugged new or familiar women, handing out vegan cupcakes and granola bars. Gutierrez quickly came to our side of the table and introduced me to Dominguez, greeting the mental health activist with a hug and a kiss on the cheek. One of the core beliefs of Las Girls in Action, Gutierrez said, “is that the first step to empowering your community is by empowering yourself.”

A mural in the heart of Salvadoran Community Corridor which reads, “bring peace to your community.” Photo by Melanie Pineda.

Gutierrez, a DACA recipient, migrated to the United States at the age of two, and has no memories of her time in El Salvador. But she believes the barriers that restrict Salvadoran women from seeking aid for mental health are deeply rooted in the stigma against mental health. “I grew up with friends who suffered from eating disorders, anxiety, depression, and self esteem issues,” she said. “But none of us knew how to seek help because we were taught to internalize our struggles.”

Gutierrez remembers how a lack of self esteem affected her when she started public school at age six. Her dark hair and complexion made her stand out against white students, and the target of constant teasing. “I grew up feeling less than the rest of my peers,” she said, “And that type of mentality affects whether or not you participate in classes or feel worthy of the space you’re taking up. You feel like you need to make room for others before yourself.”

The stigma against mental health is present in all Latino communities. Only about 10% of Latinos struggling with mental health issues use the relevant services provided through insurance, and only 5% actually receive psychological help. This stigma is especially rampant amongst Salvadorans. Dominguez recalls attempting to speak about mental health to family members, only to be shut down immediately. “My brother thinks therapy is only for crazy people,” she said. “And he’s not the only one. My aunts, uncles, and my own mom don’t think therapy is for them because they refuse to view their struggles as a problem, let alone that it’s something they don’t have to go through alone.”

Gutierrez’s family reacted similarly whenever she brought up the topic of mental health. “Anyone who was even rumored to be going to therapy was labeled as crazy,” she said. “They would say that something was severely wrong or broken about people who openly admitted to suffering with mental health. But the reality is, these issues can be helped if they’re talked about. Because they’re frowned upon though, no one talked about them.”

Jasmine Tobar, a civil war survivor, experienced similar confrontations while she was growing up in Los Angeles. She is a friend of Gutierrez’s with a masters in social work from Columbia University. “My family always carried a sadness after the war,” Tobar said, her brown eyes glossy as she recalled her mother dealing with trauma during her childhood. “My mom couldn’t even talk about it. Any time the war was mentioned, there was just this fear in her eyes.” 

Academics and activists are among Tobar’s close family members from El Salvador, groups which were both targeted by militia during the war, forcing them to flee. They’ve taken refuge in 11 different countries since the war started in the 1980s.

Tobar is also the Manager of the Mentoring and Academic Programs at Salvadoran American Leadership and Educational Fund, a social services organization, known as SALEF, which promotes representation of US-based Salvadoran communities. It also advocates for political and economic growth in El Salvador. On the other side of Echo Park, near Los Angeles’ vibrant Salvadoran Community Corridor, lies SALEF’s headquarters, where Tobar met with me before she introduced me to Gutierrez. Tobar believes the inability to discuss mental health issues, specifically in Salvadoran communities, is a gateway to other hardships as well, such as substance abuse. This cycle of adversity her family continues to face made her realize that the problem is not circular, but in fact linear. “Once I became really interested in how mental health was affecting those I love, I started to understand that there is a history of generational trauma in how we handle these problems,” Tobar said. “I carry the anxiety of my mother, like how she carries her mother’s. But a lack of understanding in how trauma carries limits our ability to heal.”


“I carry the anxiety of my mother, like how she carries her mother’s. But a lack of understanding in how trauma carries limits our ability to heal.”


Dominguez sees efforts within the latest generation of Latinas to break through this cycle of repression. Mental health issues, she said, starts with bringing awareness to the older generations. “Awareness is the first step in acknowledging the problem,” she said. “If we as a community start asking questions like, ‘what is a stigma?’ then we can plant the seeds needed for these conversations to grow.” 

Other Salvadoran women are also attempting to broaden and widen the conversation about mental health. Tobar is also the co-founder of the Central American Healing Collective, an initiative which combines clinical therapeutic methods with narrative approaches, such as oral histories, in an attempt to heal emotional and psychological wounds. “The first step to understanding a collective trauma is by providing a community with healing tools,” Tobar said. “The silencing of our voices makes us not question why we’re hurting the way we are. The problem has to be approached not like something is wrong with you, but as something like asthma, which can be treated with the right resources.”

Yesika Salgado, a Salvadoran Echo Park native, uses her poetry to explore her journey with bipolar disorder, depression, multiple romantic relationships, and family issues. During a book tour this past fall to promote her latest work, Hermosa, she discussed the generational nature of mental health issues and abuse against women in Salvadoran communities. One of the most common themes throughout her work is the complexities of her relationship with an abusive alcoholic father. “I didn’t really start to understand my dad’s own problems until after he passed away,” Salgado told a crying fan who asked how she was still able to love her father despite his abuse. “That’s when I started to see that there are so many more layers to mental health problems than we think.” What makes these conversations so difficult, she said, is the way they are rooted in both trauma and love. “There is still love there,” she said. “ I do love him.”

Dominguez said she practices this by talking to any and all family members about her mental health experiences. To family reunions, she always brings psychology books centered on the struggles of Latinas in general or PTSD specifically. She reaches out to aunts or cousins who show the same signs of trauma that she did, and urges them to see a psychologist. She’ll bring up mental health in as many conversations as she can. “The stigma affects all of us,” she said. “But the longer we pretend that our behaviors aren’t directly tied to our traumas, the worse it’s going to get.”


If you or a loved one are struggling with thoughts of suicide, please contact the National Suicide Prevention Hotline at 1-800-273-8255, or text the Crisis Text Line at 741-741. 

Note: some of these interviews were conducted in Spanish, and quotes have been translated to English for clarity.

** Some names have been omitted for the individual’s safety.