My year with Fulbright in Taiwan came to me sandwiched in between my third and fourth year of medical school. Only a week before boarding my red-eye flight for Taoyuan airport, I was still in the pediatric ICU, doing the same thing I had been doing all year, spending time in the hospital with the sickest patients and their heartbroken families.
Another important thing about me is that I am Chinese American: in the late 90’s my parents immigrated from Beijing to the Midwest and inadvertently ended up settling down and building lives abroad and away from the life and family they had always known. Every few years growing up, my family would “回國”, the word that Chinese diaspora use to refer to visits to Asia, literally translating to “going back to our country”. In between, I made my home in the States, but I struggled to determine how much I should assimilate, to whom I should pledge my allegiance. As a result, I’ve always felt kinship towards those who feel similarly restless, who claim multiple places as home—or who continue to search for a sense of belonging.
It was ultimately, and I think unconsciously, this search of home that brought me to Taiwan, and it was my connection with people whose sense of belonging spans across oceans that led me to my Fulbright research project. My first few years in medical school, the US was going through a nationwide reckoning with our relationship to immigration, plunging me deep into the immigrant mental health research landscape. But as a member of the immigrant community myself, research on migration and mental health conducted solely through a medical or epidemiological lens often felt flat and disconnected from my personal experience of the immigrant community. I knew that for most of us, our stories and our struggles either stayed inside or between tight knit communities, never reaching the research or healthcare industrial complex—therefore it made sense to me that those nuances were not reflected in the scientific literature. At the same time, I wanted the literature that I had now become a part of to reflect my personal experiences—of migration not just as an incidence of adversity or unidirectional movement towards assimilation, but as a dynamic process of searching, connecting, and coming to terms with ourselves and how we find belonging between others.
In Taiwan, I was hosted by National Yang Ming Chiao Tung University, and when I arrived, my advisor suggested that I look into how high school students in the international community experience mental health. My knee-jerk reaction was to reject her suggestion—why would I come to Taiwan to study internationals, in other words, people who were not Taiwanese? Yet when I started to get to know the international community in Taipei, I found that their experience was remarkably similar to my own, but inverted.
Although all students attending international schools are technically citizens of at least one other country (you must have a foreign passport), almost all of them are of at least some Taiwanese heritage. While these schools were originally built for traditional expatriate families—white Americans living abroad, intending to move back to the US in the future—by the time I arrived in Taiwan, migration and “transnational” identity had become more multifaceted. While expatriates still attended international schools, there were also many more “return migrants”, “local families”, and multigenerational internationals, although the lines between these categories were often blurry. Essentially, all these families had extensive connections abroad, usually in the US, and intentionally sought opportunities for their children to study and work abroad as well. Although they lived in Taiwan and looked Taiwanese, international school students essentially “studied abroad at home”, completing all their schoolwork in English, learning American history, and applying for US universities. As a result, these students and their families needed to develop flexible identities, remaining rooted locally while aspiring to be mobile globally.
To learn about the international community, not just from a surface level, but from the perspective of an insider, I decided to regard myself as part of the community—a role not entirely fabricated, as I was concurrently navigating my own journey of return migration. I attended their high school dance performances, church services, parent groups, and became a regular volunteer at the mental health services center. I also conducted in depth interviews with thirteen students, parents, and mental health professionals, including school psychologists, community therapists, and a psychiatrist. Synthesizing field notes and interview transcripts, I found a community enveloped by many misconceptions, under which lay the multidimensional logics of navigating culture and structure while living between multiple homes.
I want to share some reflections from my field work here by presenting two “myths” that Taiwanese and American people alike may believe about the international community in Taiwan and how these pervasive “myths” are too shallow to describe a community that is more multilayered and nuanced than it may at first appear.
Myth #1: International students are trying to become less “Taiwanese” and more “American”.
This is a quote from someone said to me, describing international school students.
“It’s like they’re colonizing themselves.”
It sounds extreme, but a country like Taiwan with intense pride in national identity, it can feel like an act of betrayal for parents to intentionally choose to reject the local educational system and cultivate an American future for their children.
Yet in Taiwan, international schools serve not only as an agent of cultural transmission, but a product of Western cultural hegemony, and therefore for these families, an institution of class reproduction. The “West” has always been not only a cross-cultural entity but also a symbol of upward mobility—American accents, US degrees, and Western institutional fluency signals are not just an experience but a form of capital. For Taiwanese-looking return migrants, international schools become a necessary avenue through which families retain their upwardly mobile disposition; their children can continue schooling as if they never left the US and still matriculate into a US university. For more local families, international school becomes an arena in which they can convert their economic resources (tuition is expensive!) into cultural and social capital, which is often regarded as more legitimate than sole economic capital, which is often regarded as more legitimate than solely having economic capital.
Despite this process, families are not simply embracing American identities and rejecting Taiwanese ones. Instead, they selectively cultivate both sides in order to make children culturally flexible. One simple example is that almost all children are bilingual, though there is often both pride and shame in how competent or incompetent they are in one or both languages. However, this flexibility sometimes generates friction where the two do not overlap. For example, I spoke to one mom who described how she wanted her daughters to be independent thinking but found herself acting more deferential towards her own parents and in-laws. Others would also praise her daughters as “乖”, or well-behaved and obedient, but she did not take this as a compliment, as it was not her intention to raise daughters who were obedient but daughters who could think for themselves. But while she intentionally rejected “traditional” values for her daughters, she made it a priority for them to learn Mandarin, make local friends, and participate in activities that would be culturally legible in Taiwan, such as martial arts and Chinese calligraphy. In this way, she was not simply rejecting Taiwan or embracing America but selectively choosing between aspects of the two in order to practice class reproduction, requiring her daughters to maintain local legibility while preparing for future global mobility.
Myth #2: “Asian culture” does not believe in mental health.
“I feel like it’s a very Asian cultural mindset. Like I feel like in Asia, there’s like a lot less awareness of like mental health because everybody just thinks it’s just like, you know, stress—stress just does that to you.”
This is just one excerpt from an interview I had with a student, but it was a common complaint reiterated throughout my conversations this year: Asians do not believe in mental health. Growing up in the Asian American community, I also felt this sentiment among my friends and family—a hesitation to seek care out of fear that their experience would be delegitimized. Yet when I explored these themes deeper, why individuals and families chose to seek or not seek care, and how they went about it, I found that the decisions people made were not just due to a blanket practice of “Asian culture”.
For one, families and institutions did not necessarily reject mental healthcare, rather, they sought to control the consequences of recognition. Every person I spoke agreed that there were circumstances in which it would be important to seek professional help. However, distress was morally ambiguous. Within the high pressure, achievement-based school environment, suffering could be interpreted as ordinary or even honorable. For some of my interviewees, distress manifested in physical symptoms such as partial immobility, dry eyes, insomnia, digestive issues, and vertigo, which were sometimes interpreted as signs of a physical illness. For others, distress was interpreted as a mental health problem, but recognition of distress as mental health problem did not automatically and only activate necessary treatment.
In my conversations, I found two major pathways for consequences following the recognition of distress as a mental health problem: treatment and stigma. In this way, diagnosis served as a double-edged sword. A person could only receive treatment from a mental health professional if they labeled their experience as something that someone with mental health training could help with. However, this label of “mentally ill” did not just unlock access but also became a stigma. Usually, these pathways would be activated simultaneously, but some families had practiced certain strategies to block the stigma pathway from being activated.
For example, families could block stigma by blocking the recognition of distress as a mental health problem. However, this strategy also forced them to forfeit professional treatment. Therefore, some families engaged in practices to strategically block stigma without blocking treatment, such as keeping their child’s condition a secret, paying out of pocket for care to keep children’s health records clean (rather than paying through Taiwan’s universal public health insurance program), or choosing therapists outside their school’s discounted referral program. And families who practiced these strategies were not overreacting as the consequences of becoming stigmatized could be severe and persistent—expulsion from school, ostracization by family, and employment discrimination were all possibilities.
Therefore, it wasn’t that “Asian culture” rejected mental health, but that there were multiple, morally ambiguous ways of interpreting distress, and labeling distress as a “mental health problem” did not just activate treatment but also stigma. In order to seek professional care, families had to strategically navigate these barriers to care, making the hesitancy to seek care not simply a reflection of “culture” but of the structure in which families sought help.
My conversations this year have helped to show me that migration is not random: it is strategic and reflective of our larger social structures, whether that is class hierarchies or certain cultural hegemonies. Nor is culture a blanket prescription for behavior, but rather a map that we use to navigate the social structures we face. But in the same breath, these conversations have showed me that migration does not have to be a forced shedding of former identities but can be a layering on of new perspectives, a broadening of interpretive repertoires, and access to more pathways to understand and relieve suffering.
In Taichung, there is one exhibit in their fine arts museum that has continued to stick with me, and that is a collection of five different voices taking turns singing a song to Taiwan. There’s an older grandma singing in Japanese, a blue collared worker singing in Taiwanese Hokkien, a young person signing in Mandarin—each representing a different thread of Taiwan’s past, storylines which were not all pretty or wholesome, but important and present all the same. And it was the cohesion of these diverse voices and sometimes conflicting storylines that has become the national identity embraced by Taiwanese today.
Personally, my time in Taiwan has helped me understand my own place within the large and branching Chinese diaspora. I have started to see that perhaps, I do not have to be embarrassed about the ways that I have been “Americanized”, nor do I have to be embarrassed about my Mainland accent when I speak Mandarin. And now after this year, Taiwan has wormed its way into me too—I will reflexively say “不好意思” to every little thing, and my 捲舌 has become flatter than ever. And the now Taiwanese part of me is not something to be embarrassed about either because all these spaces I’ve inhabited and places I’ve moved through are a part of me; they do not negate one another but instead layer and intermingle to create a new, cohesive whole.
While my project is niche in some ways, I think that in other ways, we are all on our own journeys of migration: we all belong to multiple places and feel out of place in some of the spaces we wish to belong. We take bits and pieces from the places we’ve been and use them to negotiate our current place in the world and where we want to go. Then we look back at our past and try to make sense of it as a cohesive whole. And my time in Taiwan has taught me to be proud of all the places that have shaped me while also not being afraid to be shaped by the people around me.
