Homophobic name-calling among secondary school students and its implications for mental health

Outlining Individual and Contextual Factors Related to LGBTQ+ Bullying: A Systematic Review of Two Decades of Research

Scientific interest in lesbian, gay, bisexual, transgender, queer and any other sexual orientation, gender identity and/or expression (LGBTQ+) bullying in educational settings has grown exponentially in recent years. However, the varied ways of measuring its occurrence and associated factors have made it difficult to achieve a holistic understanding of this problem. Therefore, this systematic review aimed to provide an updated overview of individual and contextual factors related to LGBTQ+ bullying over the past two decades, based on the measurement approach to this phenomenon. Studies published from 2000 to 2020 were analyzed following the Preferred Reporting Items for Systematic reviews and Meta-Analyses strategy. Inclusion and exclusion criteria were applied in a staggered process, and 111 articles met all the criteria. Studies focusing on LGBTQ+ bullying victimization or aggression were eligible for inclusion. Our analysis revealed LGBTQ+ bullying is usually examined by measures of general aggressions (47.8%) from the victims' perspective (87.3%). The best-represented factors across studies were individual characteristics (63.1%; n = 70), especially participants' sexual orientation and gender identity and expression (68.5%). Boys/males, from a binary gender perspective, and sexual and gender minority youth in general, were more at risk of being targeted for LGBTQ+ bullying. Although contextual factors were far less well-represented, the results revealed that gay-straight alliances, anti-homophobia policies, and social support act as protective factors. This review highlights the need to analyze LGBTQ+ bullying considering the full spectrum of sexual and gender diversity, to examine in more detail its contextual risk/protective factors, and to design public policies and psychoeducational programs in order to address the low effectiveness of generic interventions. Implications for future research and practice are discussed.

Sexualization of Children or Human Rights? Attitudes Toward Addressing Sexual-Orientation Diversity in School

Lesbian, gay, and bisexual (LGB) adolescents are more likely to experience mental health problems than their heterosexual peers because they are victimized more often or fear discrimination. Governmental plans to improve this situation by addressing sexual diversity in German schools have been accompanied by public resistance and misinformation, e.g., that they aim to sexualize children. The present study assessed how widespread negative attitudes toward such plans really are and how they can be explained. A random sample of 2,013 German residents was surveyed by phone. Only 10% opposed promoting acceptance of LGB in school. Approval of such plans was predominantly predicted by respondents' beliefs about sexual orientation and the plans' aim, and only marginally by societal values. Respondents who knew that the plans' aim was to promote acceptance of LGB and not to sexualize children and that children with same-sex parents are just as well off as those with heterosexual parents showed higher approval, whereas respondents who believed that homosexuality is affected by socialization showed higher opposition.

Health disparities in one of the world's most progressive countries: a scoping review of mental health and substance use among sexual and gender minority people in the Netherlands

BACKGROUND

Evidence from many parts of the world shows that sexual and gender minority (SGM) people have poorer health than their cisgender heterosexual counterparts. Minority stressors, particularly stigma and discrimination, have been identified as major contributors to sexual orientation- and gender identity-related health disparities, particularly negative mental health and behavioral health outcomes. To better understand factors that contribute to these disparities, we conducted a scoping review of SGM mental health and substance use research in the Netherlands-a country with a long-standing reputation as a pioneer in SGM equality.

METHODS

Using Joanna Briggs Institute guidelines and the PRISMA-ScR protocol, we searched seven databases to identify studies published between 2010 and 2022 that focused on substance use and/or mental health of SGM youth and adults in the Netherlands.

RESULTS

Although there was some evidence that SGM people in the Netherlands report fewer substance use and mental health concerns than those in less progressive countries, with very few exceptions studies found poorer outcomes among SGM participants than cisgender, heterosexual participants. However, this observation must be considered cautiously given major gaps in the literature. For example, only one study focused exclusively on adult sexual minority women, two focused on older SGM adults, and very little attention was given to nonbinary individuals. Most studies used non-probability samples that were quite homogenous. Many studies, especially those with youth, assessed sexual orientation based on sexual attraction; some studies of adults operationalized SGM status as having a same-sex partner. Importantly, we found no studies that directly assessed associations between structural-level stigma and health outcomes. Studies were mostly focused at the individual level and on health problems; very little attention was given to strengths or resilience.

CONCLUSIONS

Findings of persistent health disparities-despite the relatively long history of SGM supportive policies in the Netherlands-highlight the need for more research and greater attention to population groups that have been underrepresented. Such research would not only provide guidance on strategies to improve the health of SGM people in the Netherlands, but also in other countries that are seeking to reduce health inequities. Addressing SGM health disparities in the Netherlands and elsewhere is complex and requires a multifaceted approach that addresses individual, interpersonal and structural factors.

Holding the Space: Individual- and Group-level Factors Predicting Member Retention in Gender-Sexuality Alliances

Involvement in extracurricular groups is associated with positive outcomes for youth. Gender-Sexuality Alliances (GSAs) are school-based clubs that may provide benefits to sexual and gender minority (SGM) youth and their allies, yet little is known about what factors predict member retention. The current study explores individual- and group-level predictors of youth's sustained or discontinued membership in GSAs during a school year. Participants were 410 youth (Mage = 15.56; 83% sexual minority; 57% cisgender female; 70% White) and 50 advisors in 32 GSAs purposively sampled across Massachusetts who completed surveys at the beginning and end of the school year. Sexual minority youth and youth who took on more leadership roles at the beginning of the year were less likely to have left their GSA by the end of the school year. Youth who perceived higher levels of social support from their GSA trended less likely to leave their GSA as well, although the association was not significant. Youth who engaged in more advocacy were more likely to have left. Youth in GSAs with greater structure to their meetings were less likely to discontinue their membership; specifically, having a meeting agenda was uniquely predictive of member retention. Implications for GSA inclusivity and practices to promote retention within GSAs and similar social justice-oriented clubs are discussed.

The relationship between school bullying victimization and mental health among high school sexual minority students in China: A cross-sectional study

BACKGROUND

School bullying has become a matter of global concern for the general public. Sexual minority youth (SMY) may experience minority stress and victimization which are known to adversely affect mental health and happiness. However, a few scholars explored and linked sexual orientation with campus bullying, depression, and anxiety symptoms under the specific cultural background of China.

OBJECTIVE

This study was to examine the effect of traditional and cyber bullying victimization on depression and anxiety among Chinese sexual minority adolescents.

METHODS

This is a cross-sectional survey with a total of 3841 subjects among senior high school students in Hunan Province, China. Related information was collected through a series of self-reported questionnaires. The association between variables was examined via a set of logistic regressions.

RESULTS

Homosexuality (OR: 6.398; 95 % CI: 3.321 to 12.325), bisexuality (OR: 3.146; 95 % CI: 1.499 to 6.603) and uncertainty of sexual orientation (OR: 2.341; 95 % CI: 1.516 to 3.615) were significantly associated with a combination of traditional and cyber bullying victimization. Compared to the heterosexual group, the sexual minority students, especially the bisexual students has a higher risk of depressive mood (OR: 2.349; 95 % CI: 1.664 to 3.316) and anxiety mood (OR: 3.049; 95 % CI: 2.150 to 4.324). Further multivariate binary hierarchical regression showed that the effects of sexual orientation and mental health were statistically significant only among those who are not involved in bullying victimization, OR values are from 1.929 (95 % CI: 1.061 to 3.507) to 3.209 (95 % CI: 2.090 to 4.927).

CONCLUSIONS

Homosexuals are most likely to be victims of a combination of traditional and cyber bullying victims. Bisexuals are most at risk for emotional problems. Sexual minorities in particular, showed differences in mental health risks between bullied and non-bullied groups. More attention needs to be paid to bullying and mental health among sexual minority students in China.

Student Intervention Against Homophobic Name-Calling: The Role of Peers, Teachers, and Inclusive Curricula

Encouraging bystander intervention is an effective strategy to prevent episodes of bullying victimization at school. Yet there remains a paucity of evidence on this behavior in situations of homophobic name-calling, a form of peer victimization aimed at mocking individuals based on their actual or perceived sexual orientation. The existing research has focused on intentionality rather than actual student intervention behaviors, and, of note, no previous studies have taken into consideration contextual factors at the classroom and school levels. The present study examined whether students' observations of teacher and peer interventions against homophobic name-calling and perceptions of the representation of lesbian, gay, bisexual, and transgender (LGBT) issues in class are associated with student intervention behaviors against homophobic name-calling. A three-level multilevel approach was used to account for the nested nature of students' experiences in classrooms and schools. The sample included 1,296 students (43.57% girls) recruited from 84 classrooms of 22 Italian public high schools. Preliminary analyses showed that the variability in students' reports had more to do with which classrooms versus which schools students attend. Results from multilevel regressions indicated that students who observe teachers intervening during episodes of homophobic name-calling, and who perceive the representation of LGBT issues in class as positive, were more likely to intervene against homophobic name-calling and to observe other classmates intervene as well. Also, participants who observed other students intervening were more likely to intervene. These findings highlight the importance of the role of teachers in modeling classroom norms to encourage bystander interventions. Teachers can do so indirectly such as when providing a positive representation of LGBT issues in class, or directly when intervening to condemn episodes of homophobic name-calling. In addition, our results affirm the importance of peer influence in encouraging bystander interventions during episodes of homophobic name-calling.

Abiétar D, Sánchez-Martínez F, Forcadell-Díez L, Pérez G, Sanz-Barbero B. Dating violence and associated factors among male and female adolescents in Spain

Background

Dating Violence (DV) is a public health problem that is on the rise. In this paper, we aim to analyse different factors associated with DV victimization among female and male adolescents in Spain, considering socioeconomic circumstances, sexual orientation and the presence of different attitudes and experiences related to violence.

Methods

Cross-sectional data from a convenience sample of 640 ever-partnered adolescents aged 13 to 17 at schools in the cities of Alicante (n = 359, 50.1% girls) and Terrassa (n = 281, 51.9%) in the context of an educational intervention to promote healthy relationships. We calculated the prevalence of different forms of DV (physical, sexual and control and fear) and carried out multivariate regression models by sex.

Results

5.5% of girls and 8.7% of boys declared having suffered lifetime physical and/or sexual violence, while 22% of girls and 20.5% of boys reported control and/or fear victimization. The likelihood of DV was higher among migrants and those with foreign-born parents (aPR girls = 2.1 CI95%: 1.1–3.9; aPR boys = 1.9: CI95%: 1.0–3.6); prior experiences of abuse (aPR girls = 1.6; CI95%: 1.0–2.6; aPR boys = 1.7; CI95%: 1.1–2.6); and those who showed higher levels of machismo (aPR girls = 1.0; CI95%: 1.0–1.1; aPR boys = 1.0; CI95%: 1.0–1.1). In girls, DV increased among those who reported lesbian/bisexual orientation and poor relationship with teachers.

Conclusions

DV is socially patterned and increases among LGB adolescents (especially in the case of girls), migrants, and those with foreign-born parents, and adolescents who reported prior experiences of violence in childhood. Future DV prevention programs should consider social inequalities in the likelihood of DV and by reinforcing adolescents’ abilities to recognize social support sources and reject machismo and violence.

Impact of Covid-19 on Transgender Persons: The Need for an Inclusive Approach

Objectives

The Covid-19 pandemic created significant impact and challenges particularly for vulnerable persons like transgender individuals worsening the prevailing stigma, discrimination, and exclusions against them. This review intends to assimilate the literature on the outbreak of Covid-19 and its impacts on transgender individuals across the world.

Methods

A narrative literature review on the impact of the Covid-19 pandemic among transgender persons has been done.

Results

This review reveals that transgender persons face exclusive structural, interpersonal, and personal risks from this pandemic and its response measures, endangering their lives, livelihoods, economy, health, and wellbeing.

Conclusions

Findings point to the need to design proactive and multi-level interventions that are sensitive to the unique needs of transgender individuals.

Effects of homophobic name-calling and verbal sexual harassment on substance use among young adults

Verbal aggression victimization, such as homophobic name-calling, has been linked to heavier substance use among young people, but little longitudinal research has examined how different types of victimization may affect substance use or whether certain psychosocial factors moderate these risks. In a diverse cohort (N  = 2,663), latent transition analysis was used to model heterogeneity in victimization (age 19) and substance use (age 20). Four victimization (high victimization, homophobic name-calling only, verbal sexual harassment only, and low victimization) and three substance use (poly-substance use, alcohol, and cannabis only, low all) classes were identified. The high victimization and homophobic name-calling only classes had the highest probabilities of transitioning into the poly-substance use class, and the high victimization class had the highest probability of transitioning into the alcohol and cannabis only class. The probability of transitioning into the low all substance use class was highest in the low victimization class and lowest in the high victimization class. For the high victimization class, greater depressive symptoms increased the odds, and better peer relationship quality decreased the odds, of transitioning into the poly-substance use and alcohol and cannabis only classes. For the homophobic name-calling only class, greater depressive symptoms increased the odds of transitioning into the poly-substance use class. Homophobic name-calling, alone or in combination with verbal sexual harassment, is a risk factor for escalating substance use in young adulthood, especially among victims with depressive symptoms.

Country-Level Structural Stigma, School-Based and Adulthood Victimization, and Life Satisfaction Among Sexual Minority Adults: A Life Course Approach

Country-level structural stigma, defined as prejudiced population attitudes and discriminatory legislation and policies, has been suggested to compromise the wellbeing of sexual minority adults. This study explores whether and how structural stigma might be associated with sexual minorities' school-based and adulthood experiences of victimization and adulthood life satisfaction. Using a sample of 55,263 sexual minority individuals (22% female; 53% 18-29 years old; 85% lesbian/gay, 15% bisexual) living across 28 European countries and a country-level index of structural stigma, results show that sexual minorities, especially men, reported school bullying in both higher- and lower-stigma countries. Higher rates of school bullying were found among sexual minorities living in higher-stigma countries when open about their identity at school. Past exposure to school bullying was associated with lower adulthood life satisfaction, an association partially explained by an increased risk of adulthood victimization. These findings suggest that sexual minorities living in higher-stigma countries might benefit from not being open about their sexual identity at school, despite previously established mental health costs of identity concealment, because of the reduced risk of school bullying and adverse adulthood experiences. These results provide one of the first indications that structural stigma is associated with sexual minority adults' wellbeing through both contemporaneous and historical experiences of victimization.

QueerVIEW: Protocol for a Technology-Mediated Qualitative Photo Elicitation Study With Sexual and Gender Minority Youth in Ontario, Canada

BACKGROUND

The experiences of resilience and intersectionality in the lives of contemporary sexual and gender minority youth (SGMY) are important to explore. SGMY face unique experiences of discrimination in both online and offline environments, yet simultaneously build community and seek support in innovative ways. SGMY who identify as transgender, trans, or gender nonconforming and have experiences with child welfare, homelessness, or immigration have been particularly understudied. A qualitative exploration that leverages technology may derive new understanding of the negotiations of risk, resilience, and identity intersections that impact the well-being of vulnerable SGMY.

OBJECTIVE

The objectives of the QueerVIEW study were to (1) enhance understanding of SGMY identities, both online and offline, (2) identify experiences of intersectionality among culturally, regionally, and racially diverse SGMY in Ontario, Canada, (3) explore online and offline sources of resilience for SGMY, and (4) develop and apply a virtual photo elicitation methodological approach.

METHODS

This is the first study to pilot a completely virtual approach to a photo elicitation investigation with youth, including data collection, recruitment, interviewing, and analysis. Recruited through social media, SGMY completed a brief screening survey, submitted 10 to 15 digital photos, and then participated in an individual semistructured interview that focused on their photos and related life experiences. Online data collection methods were employed through encrypted online file transfer and secure online interviews. Data is being analyzed using a constructivist grounded theory approach, with six coders participating in structured online meetings that triangulated photo, video, and textual data.

RESULTS

Data collection with 30 participants has been completed and analyses are underway. SGMY expressed appreciation for the photo elicitation and online design of the study and many reported experiencing an emotional catharsis from participating in this process. It is anticipated that results will form a model of how participants work toward integrating their online and offline experiences and identities into developing a sense of themselves as resilient.

CONCLUSIONS

This protocol presents an innovative, technology-enabled qualitative study that completely digitized a popular arts-based methodology-photo elicitation-that has potential utility for contemporary research with marginalized populations. The research design and triangulated analyses can generate more nuanced conceptualizations of SGMY identities and resilience than more traditional approaches. Considerations for conducting online research may be useful for other qualitative research.

INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID)

DERR1-10.2196/20547.

Homophobic bullying victimization trajectories: The roles of perpetration, sex assigned at birth, and sexuality

There is a paucity of research on developmental trajectories of bias-based aggression. We examined homophobic bullying victimization trajectories among high school students (N = 3,064; M age = 13.67; Girls = 50.2%) and how these developmental pathways vary as a function of factors like homophobic bullying perpetration, sex assigned at birth, and sexuality. Using data from a 3-wave longitudinal investigation over a 2-year period, we utilized latent growth mixture modeling to explore the aforementioned trajectories. Findings suggested that there were three distinct classes characterized by high initial rates and declines over time, low initial rates, and increases over time, and low, stable, rate across time. Furthermore, results indicated that homophobic bullying perpetration, sex assigned at birth, and sexuality all predicted class membership.

Peers and Homophobic Attitudes in Adolescence: Examining Selection and Influence Processes in Friendships and Antipathies

Homophobic attitudes and behavior are a widespread problem among adolescents, but what the role of peer relationships such as friendships and antipathies is in shaping these attitudes remains unclear. Therefore, this study examined to what extent homophobic attitudes are influenced by friends' and foes' homophobic attitudes, and whether homophobic attitudes serve as a selection criterion for the formation of friendships and antipathies. Participants came from three Dutch high schools across two waves (wave 1 November 2014, wave 2 March/April 2015, ages 11-20, N = 1935, 51.5% girls). Stochastic actor-oriented models were estimated for testing hypotheses. The results showed that adolescents adjusted their homophobic attitudes to their friends' homophobic attitudes, but homophobic attitudes were not consistently related to friendship selection. Further, findings indicated that being dissimilar in homophobic attitudes increased the likelihood to dislike cross-sex peers. Together, the findings suggest that adolescents' homophobic attitudes were to some extent subject to peer influence, but homophobic attitudes did not steer who adolescents befriended or disliked.

Psychometric Properties of the Spanish Version of the Homophobic Content Agent Target Scale Among Adolescent Students

This study examined the psychometric properties and factor structure of the Spanish version of the Homophobic Content Agent Target (HCAT) scale in a sample of 1848 high school students. Participants completed an online survey including measures of homophobic bullying, depression, and anxiety. The factor structure showed adequate fit indices in Spanish adolescents similar to the original scale. An exploratory factor analysis showed a simple factor solution of two related factors strongly correlated describing the extent to which students use homophobic language (agent) and the extent to which students are called homophobic epithets (target) due to sexual orientation. The Spanish HCAT scale showed high Cronbach's alpha coefficient at the subscale score levels, as well as good convergent validity. This study contributes a Spanish-language validated measure of homophobic victimization to be used among adolescents. Implications for understanding homophobic bullying in adolescents are discussed.

Gender Nonconformity and Peer Victimization: Sex and Sexual Attraction Differences by Age

Among 2,185 Dutch adolescents (ages 11 to 18), we assessed whether the association among gender nonconformity, homophobic name-calling, and other general peer victimization differs for boys and girls and for youth with and without same-sex attraction (SSA). We also examined whether sex and sexual attraction differences in the association between gender nonconformity and both types of peer victimization are dependent upon adolescents' age. Data were collected in the academic year 2011-2012. Results showed that gender nonconformity was positively associated with homophobic name-calling and general peer victimization. These associations were stronger for boys compared with girls and were also stronger with increasing levels of SSA. Sex differences in the relationship between gender nonconformity and general peer victimization were significant for early and middle adolescents but not for late adolescents. Sexual attraction differences in the relationship between gender nonconformity and both types of peer victimization were significant for early and middle adolescents but not for late adolescents. These results emphasize that key educational messages that address sexual and gender diversity should be delivered during childhood before early adolescence.

Health-Related Quality of Life and Mental Health of Adolescents Involved in School Bullying and Homophobic Verbal Content Bullying

Bullying has been traditionally related to a significant reduction in well-being and Health-Related Quality of Life (HRQoL) of adolescents. This negative impact on HRQoL seems to be modulated by the developed role in bullying (uninvolved, bully, victim or bully-victim). However, no studies have identified if these negative results are the same when other types of bullying, such as homophobic bullying, are evaluated. The main aim of the present study was to analyze the prevalence of different roles of bullying and homophobic bullying and the relationship between these roles in both types of bullying with HRQoL, depression and anxiety levels in a sample of 1723 Spanish adolescents. Although results exhibited lower prevalence of homophobic bullying roles when compared to traditionally bullying in general, in the case of victims, the prevalence was high in the case of homophobic bullying. When differences between roles in HRQoL, depression and anxiety were evaluated, in both types of bullying, uninvolved adolescents showed the best results and bully-victim adolescents the worst. The obtained results suppose an improvement in the understanding of the negative effects of different types of bullying on HRQoL and mental health in adolescents. Future research could advance in this comprehension, analyzing possible differences with other types of bullying, such as cyberbullying.

Stress and substance use among sexual and gender minority individuals across the lifespan

Sexual and gender minority (SGM) individuals face marked disparities in substance use. The present narrative review explores research on substance use in SGM communities using a minority stress theory lens. We define the SGM population and minority stress, and explore stresses and substance use disparities in adolescence, adulthood, and older age. Though research on this topic is beginning to highlight the relationship between stress and substance use for SGM individuals, more work is needed on older SGM populations and in translating research findings to effective interventions.

The Impact of Gender Variance on Adolescents' Wellbeing: Does the School Context Matter?

Schools are often heteronormative environments, negatively influencing the wellbeing of LGB students. Less is known about the impact on gender-variant adolescents. Hence, this study investigates the wellbeing of gender-variant students-as evidenced by their gender (a)typicality and pressure for gender conformity- in different school cultures-as evidenced by the level of traditional gender role attitudes and homonegativity. We examine these context-dependent associations in a sample of 4987 Flemish students, who were questioned three times in 2012-2014. Multilevel regression analyses show that both gender-typical and atypical adolescents feel worse in heteronormative than inclusive schools. Furthermore, the social acceptance of boys seems to be more conditional on gender-conformity in heteronormative than inclusive schools. Overall, inclusive schools ensure higher wellbeing for all students (regardless of sex or gender variance), and student-teacher relationships seem central in explaining these school differences. Implications for school policy as well as research considering heteronormativity and gender-variance are discussed.

The Co-evolution of Bullying Perpetration, Homophobic Teasing, and a School Friendship Network

Bullying and homophobic teasing behaviors affect the lives of many school aged children, often co-occur, and tend to peak in middle school. While bullying and homophobic teasing behaviors are known to be peer group phenomena, studies typically examine the associations at the individual or school levels. An examination of these behaviors at the peer group level can aid in our understanding of the formation and maintenance of peer groups that engage in these forms of aggressive behavior (selection), and the extent to which friends and the peer group impact individual rates of these aggressive behaviors (influence). In this longitudinal study, we assess the co-evolution of friendship networks, bullying perpetration, and homophobic teasing among middle school students (n = 190) using a Stochastic Actor-Based Model (SABM) for longitudinal networks. Data were collected from 6-8th-grade students (Baseline age 12-15; 53% Female; 47% Male) across three waves of data. The sample was diverse with 58% African American, 31% White, and 11% Hispanic. Since bullying and homophobic teasing behaviors are related yet distinct forms of peer aggression, to capture the unique and combined effects of these behaviors we ran models separately and then together in a competing model. Results indicated that on average individuals with higher rates of bullying perpetration and homophobic teasing were associated with becoming increasingly popular as a friend. However, the effects were not linear, and individuals with the highest rates of bullying perpetration and homophobic teasing were less likely to receive friendship nominations. There was no evidence that bullying perpetration or homophobic teasing were associated with the number of friendship nominations made. Further, there was a preference for individuals to form or maintain friendships with peers who engaged in similar rates of homophobic name-calling; however, this effect was not found for bullying perpetration. Additionally, changes in individual rates of bullying perpetration were not found to be predicted by the bullying perpetration of their friends; however, changes in adolescent homophobic teasing were predicted by the homophobic teasing behaviors of their friends. In a competing model that combined bullying perpetration and homophobic teasing, we found no evidence that these behaviors were associated with popularity. These findings are likely due to the high association between bullying perpetration and homophobic teasing combined with the small sample size. However, friendship selection was based on homophobic name-calling, such that, there was a preference to befriend individuals with similar rates of homophobic teasing. We also examined several risk factors (dominance, traditional masculinity, impulsivity, femininity, positive attitudes of bullying, and neighborhood violence), although, impulsivity was the only covariate that was associated with higher levels of bullying perpetration and homophobic teasing. More specifically, youth with higher rates of impulsivity engaged in higher rates of bullying perpetration and homophobic teasing over time. The findings suggest bullying perpetration and homophobic teasing have important influences on friendship formation, and close friendships influence youth's engagement in homophobic teasing. Implications for prevention and intervention efforts are discussed in terms of targeting peer groups and popular peers to help reduce rates of these aggressive behaviors.

Systematic Development of a Dutch School-Based Sexual Prejudice Reduction Program: an Intervention Mapping Approach

Experiences of sexual prejudice threaten the quality of life and psychological well-being of sexual minority youth. The aim of this paper is to provide a comprehensive overview of how we developed a theory- and evidence-based sexual prejudice reduction program suitable for the Dutch high school context, guided by the intervention mapping approach (IM). In line with IM, six steps were followed: an initial needs assessment in which empirical, theoretical, and new data were gathered to acquire a thorough understanding of the problem (step 1); the formulation of program objectives for both students and teachers (step 2); the selection of theory-based methods and applications (step 3); program development (step 4); the provision of an adoption and implementation plan (step 5); and the development of an evaluation plan (step 6). In conclusion, developing a sexual prejudice reduction program for schools is a challenging but feasible process. IM is an effective tool for the systematic (theory- and evidence-driven) development of such a program.

The Influence of Peers During Adolescence: Does Homophobic Name Calling by Peers Change Gender Identity?

Adolescents actively evaluate their identities during adolescence, and one of the most salient and central identities for youth concerns their gender identity. Experiences with peers may inform gender identity. Unfortunately, many youth experience homophobic name calling, a form of peer victimization, and it is unknown whether youth internalize these peer messages and how these messages might influence gender identity. The goal of the present study was to assess the role of homophobic name calling on changes over the course of an academic year in adolescents' gender identity. Specifically, this study extends the literature using a new conceptualization and measure of gender identity that involves assessing how similar adolescents feel to both their own- and other-gender peers and, by employing longitudinal social network analyses, provides a rigorous analytic assessment of the impact of homophobic name calling on changes in these two dimensions of gender identity. Symbolic interaction perspectives-the "looking glass self"-suggest that peer feedback is incorporated into the self-concept. The current study tests this hypothesis by determining if adolescents respond to homophobic name calling by revising their self-view, specifically, how the self is viewed in relation to both gender groups. Participants were 299 6th grade students (53% female). Participants reported peer relationships, experiences of homophobic name calling, and gender identity (i.e., similarity to own- and other-gender peers). Longitudinal social network analyses revealed that homophobic name calling early in the school year predicted changes in gender identity over time. The results support the "looking glass self" hypothesis: experiencing homophobic name calling predicted identifying significantly less with own-gender peers and marginally more with other-gender peers over the course of an academic year. The effects held after controlling for participant characteristics (e.g., gender), social network features (e.g., norms), and peer experiences (e.g., friend influence, general victimization). Homophobic name calling emerged as a form of peer influence that changed early adolescent gender identity, such that adolescents in this study appear to have internalized the messages they received from peers and incorporated these messages into their personal views of their own gender identity.

Longitudinal Associations of Homophobic Name-Calling Victimization With Psychological Distress and Alcohol Use During Adolescence

PURPOSE

Homophobic victimization, and specifically name-calling, has been associated with greater psychological distress and alcohol use in adolescents. This longitudinal study examines whether sexual orientation moderates these associations and also differentiates between the effects of name-calling from friends and nonfriends.

METHODS

Results are based on 1,325 students from three Midwestern high schools who completed in-school surveys in 2012 and 2013. Linear regression analysis was used to examine the associations among homophobic name-calling victimization and changes in anxiety symptoms, depressive symptoms, and alcohol use one year later, controlling for other forms of victimization and demographics.

RESULTS

Homophobic name-calling victimization by friends was not associated with changes in psychological distress or alcohol use among either students who self-identified as heterosexual or those who self-identified as lesbian, gay, or bisexual (LGB). In contrast, homophobic name-calling by nonfriends was associated with increased psychological distress over a one-year period among LGB students and increased drinking among heterosexual students.

CONCLUSIONS

Homophobic name-calling victimization, specifically from nonfriends, can adversely affect adolescent well-being over time and, thus, is important to address in school-based bullying prevention programs. School staff and parents should be aware that both LGB and heterosexual adolescents are targets of homophobic name-calling but may tend to react to this type of victimization in different ways. Further research is needed to understand the mechanisms through which homophobic victimization increases the risk of psychological distress and alcohol use over time.

Disparities in Depressive Symptoms Between Heterosexual and Lesbian, Gay, and Bisexual Youth in a Dutch Cohort: The TRAILS Study

Lesbian, gay, and bisexual (LGB) youth experience elevated levels of depressive symptoms compared to heterosexual youth. This study examined how differences in depressive symptoms between heterosexual and LGB youth developed from late childhood to early adulthood. The association between sexual orientation and depressive symptoms was estimated from age 11 to 22 using data from the TRacking Adolescents' Individual Lives Survey, a longitudinal Dutch cohort study. Of the 1738 respondents (54.8 % girls) that provided information on sexual orientation, 151 self-identified as LGB. In line with the Minority Stress Framework, it was tested whether self-reported peer victimization and parental rejection mediated the association between sexual orientation and depressive symptoms. Results indicated that LB girls and bisexuals were at increased risk of depressive symptoms already at age 11. The difference increased over time and was related to pubertal development in girls and bisexual individuals. Furthermore, self-reported peer victimization (for both boys and girls), as well as parental rejection (for girls/bisexuals), mediated the association between sexual orientation and depressive symptoms. The authors conclude that already in late childhood, associations between sexual orientation and depressive symptoms are found, partly due to minority stress mechanisms.

Gender Nonconformity, Homophobic Peer Victimization, and Mental Health: How Same-Sex Attraction and Biological Sex Matter

We assessed whether homophobic name-calling accounts for the relationship between gender nonconformity and mental health (social anxiety and psychological distress) in a sample of 1,026 Dutch adolescents (boys: n = 517) ages 11 to 16 (Mage = 13.4). We also explored whether this hypothesized mediation differs by sexual attraction and biological sex. Data were collected by means of paper-and-pencil questionnaires at five secondary schools located in urban areas in the Netherlands. Mediation analysis indicated that gender nonconformity was related to both social anxiety and psychological distress partially via homophobic name-calling. Moderated mediation analysis further showed that the mediating role of homophobic name-calling varied according to levels of same-sex attraction (SSA) and biological sex. The mediation effects increased in magnitude when levels of SSA increased and were significant only for adolescents with mean and high levels of SSA. The mediation effects were significant for boys and girls in general, although the mediation effects were stronger for boys than for girls. Our findings emphasize the importance of research and school-level interventions to focus on factors that promote acceptance of cross-gender behavior among adolescents.

Teen victimization: prevalence and consequences of traditional and cyberbullying

PURPOSE OF REVIEW

In recent years, there has been increased recognition that the experiences of youth who have endured bullying cannot be ignored or dismissed as harmless acts by 'kids being kids'. The present article reviews several key risks and consequences of bullying for adolescent victims.

RECENT FINDINGS

Bullying victimization has been linked with a number of adverse health and social outcomes, including mental health issues, weapon-carrying, substance abuse, academic problems, and other adverse consequences - some of which may persist into adulthood. Recent findings on cyberbullying, in particular, highlight the real-life consequences of virtual victimization.

SUMMARY

Pediatricians play a critical role in identifying and supporting victims of bullying and counseling parents about surveillance and intervention strategies.

Who intervenes against homophobic behavior? Attributes that distinguish active bystanders

Research on homophobic behavior has focused on students engaging in this behavior or students toward whom this behavior is directed. There has been little attention to the large segment of students who observe this behavior, including active bystanders who defend or support students when homophobic behavior occurs. Among 722 high school students (55% female, 87% white, 86% heterosexual), 66.8% had observed at least one instance of homophobic behavior in the past 30 days. Gender (in this case, girls more so than boys), leadership, courage, altruism, justice sensitivity, and number of LGBT friends were associated with engagement in more active bystander behavior in response to observing homophobic behavior. Further, gender, courage, altruism, and number of LGBT friends each made unique contributions in accounting for variability in students' defending behavior in a comprehensive regression model. Findings highlight qualities that interventionists should cultivate in students that could lead to more active bystander engagement against homophobic behavior.

Associations between common mental disorders and sexual dissatisfaction in the general population

BACKGROUND

Little is known about the associations between common mental disorders and sexual dissatisfaction in the general population.

AIMS

To assess the associations between the presence of 12-month and remitted (lifetime minus 12-month) mood, anxiety and substance use disorders and sexual dissatisfaction in the general population of The Netherlands.

METHOD

A total of 6646 participants, aged 18-64, took part in a face-to-face survey using the Composite International Diagnostic Interview 3.0. Childhood trauma, somatic disorders and sexual dissatisfaction were also assessed in an additional questionnaire. Associations were assessed with multivariate regression analyses.

RESULTS

In total, 29% reported some sexual dissatisfaction. Controlling for demography, somatic disorders and childhood trauma, significant associations with 12-month mood disorder (B = 0.31), substance use disorder (B = 0.23) and anxiety disorder (B = 0.16) were found. Specifically, relatively strong associations were found for alcohol dependence (B = 0.54), bipolar disorder (B = 0.45) and drug dependence (B = 0.44). The association between remitted disorders and sexual dissatisfaction showed significance for the category substance use disorder.

CONCLUSIONS

People with mood, anxiety and substance use disorders show elevated scores on sexual dissatisfaction, even when relevant confounders are controlled for. Sexual satisfaction appears to be reduced most by alcohol and drug dependence and bipolar disorder. Once remitted, substance use disorder shows a persisting association with present sexual dissatisfaction.

[Factors Associated with Suicide in Adolescents and Young People Self-Identified as Lesbian, Gay, and Bisexual: Current State of the Literature]

INTRODUCTION

A framework within sexual and reproductive health is presented to understand the mental health issues of the population of lesbian, gay and bisexual (LGB) adolescents and young people. Different ways of understanding the nature of internalized homophobia were developed. On the other hand, in suicidology studies it is understood that the risk of suicide consists of the steps of ideation, planning and attempted suicide, and that there is an increased risk of suicide in the LGB population. Numerous factors have been associated with suicide risk in this population, one of the main internalized homophobia and other mental health problems.

OBJECTIVES

By means of a literature review, to establish the possible relationship between internalized homophobia and ideation and attempted suicide in the LGB population, as well as to identify the mental health problems associated to suicide risk in sexually diverse communities.

METHOD

Articles in English and Spanish, mainly within the last five years, were reviewed. They included articles in peer reviewed journals, and databases, such as Google Scholar, Redalyc, Byreme, Ovid, Science Direct, Taylor and Francis, MEDLINE, Scopus, PsycINFO, and Ebsco.

RESULTS

It was found in the available literature that internalized homophobia is associated with suicide ideation and attempts in adults. A state of science of the major mental health problems associated with suicide risk in young LGB people reported contradictory findings. While some studies showed an association between depression, anxiety and distress and suicidal ideation and attempts, in others, the data do not allow such a conclusion. The theoretical framework presents the most important conceptualizations of suicide risk and emphasizes the social type. It identifies issues of suicide prevention, protective factors that contribute towards this, as well as elements of psychotherapy for LGB consultants.

CONCLUSIONS

It concludes and discusses the importance of studying the sexually diverse as regards determining factors of mental health in Latin America, given the limited amount of literature found in the Spanish language, and myths of major disease that persist in many segments of the population. This review considers it necessary to overcome such contradictions, in order to inform the general population and avoid further stigmatization.