Family Relationships and Adolescent Well-Being: Are Families Equally Protective for Same-Sex Attracted Youth?

Prevalence, severity and risk factors for mental disorders among sexual and gender minority young people: a systematic review of systematic reviews and meta-analyses

Evidence suggests heightened prevalence and severity of mental disorders among sexual minority (SM) and gender minority (GM) young people. Several risk factors have been associated with these disparities. A systematic review of systematic reviews and meta-analysis was conducted to provide a comprehensive overview of the literature and to determine the field's current position. MEDLINE, PsycInfo, Scopus and Web of Science were searched in March 2022 and updated January 2024. Eligibility criteria were systematic reviews or meta-analyses assessing contemporaneous prevalence, severity and/or risk factors of mental disorders among SM or GM young people aged 25 and under. 42 reviews were included, all of which were low quality. The prevalence of depression among SM was 26% (95% CI 21-32%), and among GM was 46% (95% CI 36-56%). Greater depression severity was found among SM compared to heterosexual young people, with a significant albeit small effect size (Hedges' g = 0.38, 95% CI = 0.25 to 0.50); effect sizes were similar when separating by gender. GM also reported greater symptom severity compared to cisgender young people. Other mental disorders were more prevalent compared to those reported in the general population, and of greater severity compared to heterosexual/cisgender young people. Several proximal and distal risk factors were focused upon within the systematic reviews identified. Past systematic reviews consistently indicate a heightened risk of mental disorders among SM and GM young people. Services need to be aware of these disparities and adapt their care accordingly.

The Association of Stigma, School, and Family Factors with Patterns of Substance Use Among LGBTQ Youth

Polysubstance use is associated with myriad short- and long-term health outcomes. Although prior research has documented differences in polysubstance use between lesbian, gay, bisexual, transgender, queer/questioning, and other sexual and gender minoritized (LGBTQ +) youth and their heterosexual/cisgender counterparts, as well as between subgroups of LGBTQ + youth, it is unknown how personal, family, and school factors are associated with substance use patterns among LGBTQ + youth. Using a large, national sample of 9646 LGBTQ + youth ages 13-17, we used latent class analysis to examine patterns of alcohol, tobacco, and marijuana use and to determine whether personal, family, and school factors predict class membership. We identified five classes of substance use: polysubstance use, polysubstance experimentation, dual alcohol and cannabis, alcohol, and no use. Greater depression and LGBTQ + victimization, and an ability to be oneself at school, were associated with greater odds of membership in the polysubstance use class, while higher levels of family connection and having a Gender Sexuality Alliance (GSA) at school were associated with lower odds of membership in the polysubstance use class. Our analysis also revealed sociodemographic differences in class membership. These findings highlight potential mechanisms for intervention to reduce polysubstance use among LGBTQ + youth.

Flourishing and Self-Control in Adolescence: The Role of Perceived Parenting

Self-control is the ability to control thoughts, emotions, and impulses to pursuit of long-term goals. Adolescents with high self-control experience higher flourishing levels. The latter refers to the fulfillment of needs for competence, relationship, and self-acceptance, as well as the possession of psychological capital such as flow and commitment. High levels of self-control also seem to be linked to a positive relationship with parents, which is crucial in adolescent flourishing. However, few studies investigated the association between flourishing, self-control, and perceived parenting in adolescence. The aim of this study was to investigate how the ability to exert self-control and the need to perceive and preserve a responsive relationship with parents would facilitate adolescents' experience of higher flourishing levels. The relationships among self-control, adolescents' perception of some paternal and maternal dimensions (closeness, communication, and parents' peer approval), and flourishing were analyzed in a sample of 335 Italian adolescents. Self-control was positively correlated with flourishing and the adolescent's perception of maternal and paternal dimensions. The PROCESS model showed that perceived maternal and paternal dimensions mediate the relationship between self-control and flourishing. These findings show the importance of self-control and parenting dimensions in promoting flourishing during adolescence.

Association between co-residence and loneliness during COVID-19 among sexual minority people in Hong Kong

BACKGROUND

Research has identified that loneliness during COVID-19 is associated with co-residence status, and individuals living alone were more likely to report loneliness. However, it may not apply to sexual minority people as those living with their family may experience different sexual orientation-related stressors.

AIMS

This study aims to (1) understand the pattern of living arrangement and loneliness among sexual minority people during COVID-19, (2) examine parental acceptance, family conflict and loneliness among sexual minority people with different living arrangements and (3) investigate the association between parental acceptance and loneliness among sexual minority people with different living arrangements during COVID-19.

METHOD

An online survey with 1,457 Hong Kong sexual minority people was conducted.

RESULTS

Sexual minority people living with their partner(s) were less likely to report loneliness. Concurrently, those living with their parent(s) showed a similar level of loneliness as those who lived alone. Living with parent(s) during COVID-19 does not necessarily alleviate feelings of loneliness among them, which we argue may be due to parental unacceptance of their sexual orientation. Nearly half of the respondents stated that their parent(s) were unaccepting of their sexual orientation and 41.8% of them indicated an increase in family conflict during COVID-19. For those living with their parent(s), parental unacceptance is related to more family conflict during COVID-19, which in turn is associated with higher levels of loneliness.

CONCLUSIONS

Not living with unaccepting parents may reduce family conflict and feelings of loneliness, but this has not been the case for many respondents from a city with high population density and cost of living. Social and mental health service providers need to come up with timely and appropriate interventions to address the unique needs faced by sexual minority people during and after the COVID-19 pandemic.

Protective Factors, Risk of Violence and Discrimination and Mental Health Indicators of Young LGB People

Lesbian, gay and bisexual (LGB) people have more risk of suffering from violence and situations of discrimination than heterosexual people. The current study compares LGB people with heterosexual people in protective factors, violence, health and well-being factors. The sample comprises 609 Spanish people between 14 and 25 years old. We established a cross-sectional design. A survey including questions about sociodemographic information and protective, violence and health and well-being factors was designed ad hoc for this study. The results show that the LGB group (n = 342) is more at risk of verbal and physical violence and feels more isolated than the heterosexual participants (n = 267). In contrast, heterosexual participants report having more employment discrimination. No significant differences were found in social support or psychological health. These results are important to understand the state of social normalization and non-discrimination for LGB people in certain contexts in Spain, and its impact on psychological health.

Sexualities and Geographic Mobility Between Childhood and Adulthood in the United States

Though research suggests that sexual minorities (e.g., nonheterosexual individuals) are more geographically mobile in the transition to adulthood than their heterosexual counterparts, quantitative estimates are rare and previously used data sources have significant limitations. Using data from the National Longitudinal Study of Adolescent to Adult Health (N = 11,705) that directly measure sexualities across dimensions (i.e., identity, behavior, and attraction), I examine variation in geographic mobility between childhood (ages 11-17) and adulthood (ages 26-34) across various sexualities (e.g., gay/lesbian and bisexual). Three findings emerge. First, mobility varies across sexualities. Individuals with gay/lesbian identity, same-sex behavior, and same-sex attraction are more geographically mobile than individuals with heterosexual identity, different-sex behavior, and different-sex attraction, respectively. By contrast, individuals with bisexual identity, both-sex behavior, and both-sex attraction tend to be statistically indistinct from individuals with heterosexual identity, different-sex behavior, and different-sex attraction, respectively. Second, mobility differences are largest and most prevalent when sexualities are operationalized according to identity. Third, evidence suggests that the effects of gay/lesbian identity, same-sex behavior, and same-sex attraction on mobility are larger for men than for women. In providing the first quantitative estimates of geographic mobility differences across broader sexual minority and heterosexual populations, this study expands inquiry related to sexualities and mobility.

Effects of Friendship among Same-Sex Attracted Youth on Sexual Minority Identity Development in Young Adulthood

Using data from Waves 1 and 3 of the National Longitudinal Study of Adolescent to Adult Health, this study investigated the interactive impact of adolescent friendship network characteristics and same-sex attraction (SSA) on the development of sexual minority (SM) identity in young adulthood. Results indicate that SSA youth who identified a best friend that also identified them as their best friend were 5.3 times more likely to identify as a SM compared to those who did not experience reciprocity. For each additional classmate who listed them as a friend, SSA youth were 1.2 times more likely to identify as a SM. Increased centrality in friendship network increased the likelihood that SSA youth would identify as a SM by 1.8 times. Sex-stratified results reveal that particular network characteristics impact boys and girls differently. These findings point to the importance of further investigating relationships between friendship characteristics and identity formation among adolescents.

Resilience among LGBTQIA+ youth in out-of-home care: A scoping review

BACKGROUND

Research on the experiences of LGBTQIA+ youth in out-of-home care has mainly focused on these youth's adversities and the resulting negative impact on their wellbeing. Little is known about the ways through which LGBTQIA+ youth in out-of-home care are resilient to these adversities. To date, a review study on resilience in this population is lacking.

OBJECTIVE

To map and synthesize the existing research on resilience among LGBTQIA+ children and youth in out-of-home care. Specific goals were to summarize and analyze 1) the general characteristics of the existing studies, and 2) the resilience resources found at the individual, relational, sociocultural, and ecological levels.

METHODS

We carried out a scoping review examining empirical published academic literature.

RESULTS

The 14 studies included in this scoping review indicated that resilience studies among LGBTQIA+ youth in out-of-home care are mainly qualitative, cross-sectional, US-based, and were centered on gay youth. Studies suggested that resilience resources were mostly focused at the socio/relational level (e.g., foster family acceptance) with fewer studies at the individual (e.g., LGBTQ positive identity), and community levels (e.g., LGBTQ centers). Importantly, no studies explored the interaction of resilience resources across these different domains.

CONCLUSIONS

Resilience among LGBTQIA+ youth in out-of-home care remains understudied and the results of this scoping review point to specific research gaps. Recommendations are provided for research, practice, and policy.

Changes in the network structure of mental health after a multicomponent positive psychology intervention in adolescents: A moderated network analysis

The effectiveness of multicomponent positive psychology interventions (MPPIs) on adolescents' mental health has been studied with the use of standard procedures throughout the scientific literature. However, little is known about the potential mechanisms underlying the network structure of mental health following the dual‐factor model after an MPPI. We relied on network analysis to explore the reorganization of the connections between mental health indicators after a school‐based MPPI. Adolescents from two high schools in Spain were randomly allocated to the 6‐week intervention group (n = 85) or to the control group (n = 135). Network analysis showed that the relations between the two differentiated network dimensions of mental health (i.e. well‐being and psychological distress) changed after the intervention. Unlike control participants, emotional well‐being was negatively associated with depression and stress, while psychological well‐being was positively related to stress after the intervention. The present study supports the viability of the network approach in analyzing the connections between mental health indicators as defined by the dual‐factor model and the contribution of MPPIs to change the complex pattern of relations between the dimensions of well‐being and psychological distress.

Social support in schools and related outcomes for LGBTQ youth: a scoping review

Recent research has increasingly focused on positive factors and supports for LGBTQ youth. This scoping review explores existing social support for LGBTQ youth in schools through the Ecological Systems Theory to respond to the following four objectives: (1) define social support systems in schools, (2) identify current research on outcomes for LGBTQ youth, (3) identify barriers to support LGBTQ youth in schools, and (4) identify areas for future research for LGBTQ youth and social support in schools. A systematic search (Arksey and O'Malley in Int J Soc Res Methodol 8(1):19-32, 2005) between 2007 through 2021 resulted in 94 articles. This review gave rise to an organizational framework to consolidate various systems of social support for LGBTQ youth in schools. Social support consisted of seven social support systems (family, curriculum, family, peers, school policies, GSAs and programs, and school climate) that are positively associated with the promotion of positive socioemotional, behavioural, and educational outcomes for LGBTQ youth. Though the literature has been clear surrounding the risks associated with LGBTQ youth, this scoping review provides a positive outlook on LGBTQ youth's school experiences and how these systems of social support allow for LGBTQ youth to act as active participants to foster a positive school climate and sense of safety.

Supplementary Information

The online version contains supplementary material available at 10.1007/s44217-022-00016-9.

Social Support, Stress and Emotional Symptoms Among LGBTQ+ College Students in Chile

Objective

to compare the relationships between emotional symptomatology and perceived social support according to gender identity and sexual orientation in LGBTQ+ university students.

Methods

322 Chilean LGBTQ+ college students answered an online survey based on sociodemographic information and validated instruments. Analysis of variance and linear regressions were made.

Results

Transgender people have more emotional symptoms and stress and less perceived social support from family than the rest of LGBTQ+ students. Depression and anxiety are negatively associated with perceived social support from friends and family.

Conclusions

Perceived social support decreases emotional symptomatology even when controlling for current stress in LGBTQ+ students.

The Role of Interpersonal Relationships and Household Socioeconomic Status in the Association Between Sexual Orientation and Health: A Moderated Mediation Analysis

Purpose: Emerging studies indicate that sexual minority youths experience worse health than their heterosexual peers, but few studies have examined the intervening mechanisms linking sexual orientation and health status. This study hypothesizes that interpersonal relationships, moderated by household socioeconomic status (HSES), are important mediators in the association between sexual orientation and health status. Methods: A total of 49,084 youths, consisting of 9499 youths who identified as sexual minority individuals and 39,585 youths who identified as heterosexual, were sampled from a national study on sexual and reproductive health conducted in China. Logistic regression analyses were performed to estimate the association between sexual orientation and self-rated health. Causal mediation and moderated mediation analyses were performed to analyze the mediating and moderating effects of interpersonal relationships and HSES, respectively. Results: Self-rated health was significantly poorer for sexual minority youths compared with heterosexual youths (p < 0.01). From 7.90% to 25.74% of the association between sexual orientation and self-rated health was mediated through poor interpersonal relationships with both parents and peers. A poor relationship with the father accounted for the highest percentage. HSES was found to moderate the mediation effect of interpersonal relationships, with the greatest effect found for sexual minority youths with lower HSES. Conclusion: HSES moderated the indirect effects of interpersonal relationships on the association between sexual orientation and self-rated health. Interventions focused on improving interpersonal relationships for sexual minority youths, especially those with low HSES, merit attention.

Violence Experiences in Childhood and Adolescence Among Gay Men and Transgender Women Living in Perú: A Qualitative Exploration

The overall goal of this study was to qualitatively explore the different types of violence experienced by gay men (GM) and transgender women (TW) living in Peru during childhood and adolescence, as well as their potential consequences and sources of protection. Participants were selected using purposive sampling. Recruitment took place in a community-based organization in Lima, Peru. In all, 32 GM and 23 TW participated in a total of four Focus Group Discussions (FGD) and 25 in-depth interviews (IDI). Qualitative data collection was conducted between July and October 2016. Four FGD took place with GM (n = 21) and one with TW (n = 9). In addition, 11 IDI with GM and 14 with TW were conducted. Data were analyzed using descriptive inductive analysis. Three main types of violence were experienced in childhood and adolescence: (a) violence occurring in the home or otherwise perpetrated by family members, (b) school-based violence, and (c) sexual violence. Both GM and TW experience violence within and outside school and home. School systems should make teachers and parents aware of the impact of homophobic and transphobic bullying and violence. Certain modifications in schools, such as having all-gender bathrooms and promoting activities that are not grounded in gender roles, could be very effective at reducing homophobic and transphobic violence. Schools should also address sexual violence more actively, among both male and female students. Parents' attitudes toward homosexuality and gender diversity need to be addressed by future interventions.

Mediators of the Disparities in Depression Between Sexual Minority and Heterosexual Individuals: A Systematic Review

Evidence suggests that sexual minorities (e.g., those identifying as lesbian, gay, or bisexual) experience increased rates of depression compared to heterosexual individuals. Minority stress theory suggests that this disparity is due to stigma experienced by sexual minorities. Stigma processes are proposed to contribute to reduced coping/support resources and increased vulnerability processes for mental health problems. This review provided a systematic examination of research assessing the evidence for mediating factors that help explain such disparities. A literature search was conducted using the databases PubMed, PsycINFO, and Web of Science. The review included 40 identified studies that examined mediators of sexual minority status and depressive outcomes using a between-group design (i.e., heterosexual versus sexual minority participants). Studies of adolescents and adult samples were both included. The most common findings were consistent with the suggestion that stressors such as victimization, harassment, abuse, and increased stress, as well as lower social and family support, may contribute to differing depression rates in sexual minority compared to heterosexual individuals. Differences in psychological processes such as self-esteem and rumination may also play a role but have had insufficient research attention so far. However, caution is needed because many papers had important methodological shortcomings such as the use of cross-sectional designs, inferior statistical analyses for mediation, or measures that had not been properly validated. Although firm conclusions cannot be drawn, the current evidence base highlights many factors potentially suitable for further exploration in high-quality longitudinal research or randomized studies intervening with the potential mediators.

Disparities in food insecurity at the intersection of race and sexual orientation: A population-based study of adult women in the United States

Food insecurity affects 1 in 8 American adults annually, and is more prevalent in Black and sexual minority women. We applied an intersectional approach to investigate food insecurity prevalence in women with intersecting minority race and sexual orientation. We used two United States surveillance systems-National Health Interview Survey (NHIS) 2013-2018 and National Health and Nutrition Examination Survey (NHANES) 2005-2014, to estimate how race and sexual orientation jointly influence food insecurity prevalence in women aged 18-59 years (NHIS: N = 47596; NHANES: N = 5106). All analyses were stratified for Supplemental Nutrition Assistance Program (SNAP) use. Relative measures estimated weighted prevalence ratios (PR) comparing Black and White sexual minority women (SMW) to heterosexual White women. Absolute prevalence measures estimated the excess prevalence of food insecurity due to multiple marginalization. Patterns of food insecurity prevalence were similar across NHIS and NHANES, and differed only for non-SNAP users. Relative prevalence of food insecurity was greater in Black SMW than heterosexual White women in NHIS (PR: 2.16; 95% confidence interval [CI], 1.41-3.30) and NHANES (PR: 2.79; 95% CI, 1.73-4.51). The strength of the association between multiple marginalization and food insecurity was stronger for Black SMW than White SMW. Absolute measures were significant only for NHIS and did not support our a priori hypothesis: For non-SNAP users, being Black and sexual minority reduced the joint disparity in food insecurity by approximately 50% (Synergy Index: 0.52; 95% CI, 0.11-0.93). Overall, our study illuminated population-level differences in food insecurity among women of diverse minority races and sexual orientations. Black SMW experienced high rates of food insecurity, which may contribute to chronic disease disparities. Yet, intersecting minority social positions (race and sexual orientation) reduced food insecurity; these findings are unexpected and must be further investigated. Increasing SNAP use among multiply marginalized women may attenuate food insecurity disparities.

Exploring childhood temperament as a moderator of the association between adolescent sexual minority status and internalizing and externalizing behavior problems

INTRODUCTION

Sexual minority youth experience worse mental health compared to their heterosexual peers, reflecting the consequences of sexual minority-based stigma. Previous research has focused on contextual variation to understand variability within this vulnerability. Childhood temperament factors such as negative affect, effortful control and surgency/extraversion are important for understanding differential susceptibility to environmental stressors. The objective of the current study was to understand how childhood temperament factors, measured prior to the most difficult developmental period for sexual minority youth, moderated the association between sexual minority status and internalizing and externalizing behavior problems.

METHODS

Youth reporting same-sex attraction in an ongoing longitudinal project on the development of conduct problems in Quebec, Canada were matched with heterosexual peers, for an analytic sample of 280 youth (62% girls). Structural equation models were used to examine (1) the association between youth-reported same-sex attraction (ages 13-16) and parent and youth-reported internalizing and externalizing problems a year later at ages 14-17, and (2) the moderating role of temperament (ages 6-9) in this association between sexual minority status and internalizing and externalizing problems.

RESULTS

Same-sex attraction was associated with higher levels of youth-reported internalizing and externalizing behavior problems. Surgency/extraversion moderated the association between sexual minority status and youth-reported internalizing and externalizing problems.

CONCLUSIONS

These findings suggest that temperament linked to individual visibility may be important for understanding variation in self-reported mental health among sexual minority youth, and supports the use of developmental constructs like temperament to better understand vulnerability to psychosocial difficulties within this population.

Health Disparities Between Sexual Minority and Different-Sex-Attracted Adolescents: Quantifying the Intervening Role of Social Support and School Belonging

Purpose: An emerging literature documents that sexual minority youth experience significantly and substantially worse health than their heterosexual peers, but few studies have examined the intervening mechanisms linking adolescents' sexual orientation to their health outcomes. This study hypothesized that social support from parents and friends and school belonging would act as important mediators of this relationship and is among the first to test this proposition empirically. Methods: The analyses used rich data from an Australian national probability sample of 14-15-year olds (Longitudinal Study of Australian Children, n = 3204) and regression models to estimate the associations between sexual attraction and four high-quality indicators of adolescent health/well-being capturing health-related quality of life, socio-emotional functioning, depressive symptoms, and life satisfaction. Mediation tests were subsequently performed to quantify the extent to which three scales capturing social support from parents and friends and school belonging mediated the relationships identified. Results: Sexual minority status, social support from parents and friends, and school belonging were significantly related to all health/well-being outcomes. Sexual minority adolescents reported significantly lower levels of support and belonging. Collectively, the support and belonging variables were responsible for 49%-70% of the associations between sexual minority status and the health/well-being outcomes, with school belonging being the most important mediator. Conclusion: These findings have important implications for health equity policy and practice. They suggest that interventions designed to improve the health/well-being of sexual minority adolescents should be directed at eliciting enhanced social support from families and peers and fostering integration at school. School-based interventions may be particularly fruitful.

Explaining Health Disparities between Heterosexual and LGB Adolescents by Integrating the Minority Stress and Psychological Mediation Frameworks: Findings from the TRAILS Study

Lesbian, gay, and bisexual (LGB) adolescents experience elevated levels of internalizing problems and use more substances than heterosexual adolescents. The minority stress and psychological mediation framework are complementary theoretical frameworks that were developed to explain these disparities. However, limited empirical research has integrated both frameworks to study health disparities between heterosexual and LGB adolescents. This study attempts such an integration, using data from the first five waves (participant age 11-22) of the TRacking Adolescents' Individual Lives Survey (TRAILS), a cohort study of Dutch adolescents (N = 1738; 151 LGB; 54.8% girls). It was tested whether an LGB identity was linked to internalizing problems and substance use through a serial mediation process, in which sexual identity would be associated with peer victimization and negative relationships with parents (first set of mediators, in keeping with the minority stress framework), which in turn would be associated with fear of negative social evaluation and a lack of social support (second set of mediators, in keeping with the psychological mediation framework), and eventually increasing the risk for internalizing problems and elevated levels of substance use. Moreover, it was tested whether the link between minority stress and substance use was mediated by peers' substance use levels, as hypothesized by the psychological mediation framework. Compared to heterosexual participants, LGB participants reported more internalizing problems, smoked more cigarettes, and used more marijuana, but did not consume more alcohol. The relation between sexual identity and internalizing problems was mediated by peer victimization and parental rejection, which is in line with the minority stress framework. No statistically significant support was found for the psychological mediation framework. These findings provide a better understanding of the pathways through which sexual identity disparities in mental wellbeing and substance use come about.

Sexual- and Gender-Minority Families: A 2010 to 2020 Decade in Review

OBJECTIVE

To review research on sexual and gender minority (SGM) families-including lesbian, gay, bisexual, transgender, queer, asexual, and intersex (LGBTQAI+) families- from 2010-2020.

BACKGROUND

Research on the SGM population has increased and diversified in the past decade.

RESULTS

This paper reviews three subareas that make up the majority of research on SGM families today: (1) SGM family of origin relationships, (2) SGM intimate relationships, and (3) SGM-parent families. This review also highlights three main gaps in the existing literature: (1) a focus on same-sex and gay and lesbian families (and to a lesser extent bisexual and transgender families) and a lack of attention to the families of single SGM people as well as intersex, asexual, queer, polyamorous, and other SGM families; (2) an emphasis on white, socioeconomically advantaged SGM people and a failure to account for the significant racial-ethnic and socioeconomic diversity in the SGM population; and (3) a lack of integration of SGM experiences across the life course, from childhood to old age.

CONCLUSION

The next decade should aim to examine the full range of SGM family ties, include more vigorous examinations of race-ethnicity and socioeconomic status, and develop more robust accounts of family across the life course with novel theory and data sources across the methodological spectrum.

Disparities in Persistent Victimization and Associated Internalizing Symptoms for Heterosexual Versus Sexual Minority Youth

This study investigated whether lesbian, gay, and bisexual (LGB) adolescents were at higher risk for persistent victimization of bullying compared to heterosexual adolescents, and how victimization trajectories were associated with internalizing symptom development across LGB and heterosexual adolescents. Data came from a five-wave study (M_age T1 = 11.1 to M_age T5 = 22.3; n = 151 LGB; n = 1,275 heterosexual) and informants were adolescents and their parents. Adolescents were classified in three victimization trajectories: persistent (5.6%), decreasing (28.1%) or low (66.3%) victimization. LGB adolescents reported more persistent victimization, relative to no (OR = 6.79, 95% CI [3.52, 13.13]) or decreasing victimization (OR = 3.09, 95% CI [1.53, 6.24]), compared to heterosexual peers. Further, persistent victimization was more strongly associated with anxiety among LGB than among heterosexual adolescents.

Adolescent–Parent Relationships: Progress, Processes, and Prospects

The nature of adolescent–parent relationships has been a topic of enduring concern in developmental science. In this article, we review theory and current research on several central topics. First, we define adolescence as a developmental period and briefly discuss current theoretical and analytical approaches. Then, we consider adolescent–parent relationship quality, including developmental trends and individual differences in negative interactions, positive relationships, and conflict resolution, as well as research that examines relationship quality within different family subsystems. Next, we discuss effects of emotional variability and flexibility on parent–adolescent relationships and review research on adolescents’ and parents’ beliefs about parental authority legitimacy. This is followed by a discussion of current research on parenting effects on adolescent–parent relationships, including approaches that provide greater specificity in defining parental control and its links with relationship quality, as well as research on parental monitoring and adolescent information management. We conclude this article with directions for future research.

Father support is protective against the negative effects of perceived discrimination on CRP among sexual minorities but not heterosexuals

BACKGROUND

Exposure to sexual orientation-related discrimination among sexual minorities may lead to elevated levels of C-reactive protein (CRP) as compared to their heterosexual counterparts. However, little is known about factors that may buffer the association between discrimination and CRP among sexual minorities versus heterosexuals. The current study examined if the association between discrimination, sexual orientation, and CRP differed across levels of social support from one's father/father-figure or mother/mother-figure between sexual minorities and heterosexuals.

METHODS

Data came from Wave IV of the National Longitudinal Study of Adolescent to Adult Health (Add Health). The sample sizes for father support and mother support was 3167 and 3575, respectively. Participants ranged in age from 24 to 33 years. Stratified linear regression models examined if father and mother support moderated the association between discrimination and CRP among sexual minorities and heterosexuals.

RESULTS

Father support significantly moderated the association between discrimination and CRP among sexual minorities but not heterosexuals. Sexual minorities with higher father support and who experienced discrimination had lower CRP as compared to those with lower father support and who experienced discrimination. Mother support did not moderate the association between discrimination and CRP among either sexual minorities or heterosexuals.

CONCLUSION

Father support may mitigate the negative effects of stress from discrimination on CRP among sexual minorities. Future research should further examine the potential differential role that father support may play in reducing cardiovascular risk among sexual minorities versus heterosexuals who experience discrimination.

Effects of familial and non-familial warmth during childhood and adolescence on sexual-orientation disparities in alcohol use trajectories and disorder during emerging adulthood

BACKGROUND

We investigated sexual-orientation differences in typologies of self-reported familial and non-familial warmth in childhood (before age 11) and adolescence (ages 11-17); and tested whether warmth explained sexual minority emerging adults' (ages 18-25) heightened odds of having heavier alcohol use trajectories (AUTs) and heightened risk for past-year alcohol use disorder (AUD) compared to completely heterosexuals.

METHODS

Using self-reported data from the U.S.-based Growing Up Today Study cohort, latent class analyses identified typologies of familial and non-familial warmth during childhood and adolescence. Multivariable regression models tested our objectives.

RESULTS

Six warmth classes emerged, including: High-High (i.e., high familial and high non-familial warmth, respectively); High-Moderate; Moderate-Moderate; Moderate-Occasional; Occasional-Occasional; and Low-Low. Among women, sexual minorities had higher odds than completely heterosexuals of being in the Moderate-Moderate, Moderate-Occasional, and Occasional-Occasional versus the High-High warmth class. There were not significant associations between sexual orientation and warmth classes for men. Lower warmth classes were generally associated with greater past-year AUD, and mediated heightened disparities in AUD for sexual minority women versus completely heterosexual women (4.3% mediated), but not among men. Warmth classes were generally unassociated with AUTs, and did not mediate sexual-orientation differences in AUTs.

CONCLUSIONS

Lower warmth was associated with greater alcohol-related problems, but not alcohol use itself. Warmth explained a small proportion of AUD disparities for sexual minority women-but not for men.

“Let Me Do What I Please With It . . . Don’t Decide My Identity For Me”: LGBTQ+ Youth Experiences of Social Media in Narrative Identity Development

Social media provides Lesbian Gay Bisexual Transgender Queer Plus (LGBTQ+) youth with daily access to a broader sociocultural dialogue that may shape narrative identity development. Through in-depth narrative interviews, this study sought to understand the lived experiences of 11 LGBTQ+ undergraduates ( age range = 19-23) building narrative identities in the cultural context of social media and the role of social media within this process. Interviews were analyzed using an interpretative, individual analysis of personal stories. These experiences were then compared and contrasted through thematic analysis to identify four shared narrative themes. Narratives of merging safe spaces highlight how LGBTQ+ youth now have regular access to safe environments online/offline which facilitate more secure identity development. Narratives of external identity alignment describe social media as a tool for LGBTQ+ youth to seek out identities that match their preexisting sense of self. Narratives of multiple context-based identities encapsulate how adolescents’ identity markers are multiple and invoked in a context-dependent manner. Finally, narratives of individuality and autonomy characterize how LGBTQ+ youth perceive themselves as highly individualized members of a wider community. These findings highlight the complex role social media plays within LGBTQ+ youth identity development. The implications are discussed within.

"It's Almost Like Gay Sex Doesn't Exist:" Parent-Child Sex Communication According to Gay, Bisexual, and Queer Adolescent Sons

Sex communication interventions facilitate positive sexual health outcomes with heterosexual adolescents. The same has yet to be established for male youth with same-sex attractions, behaviors, and identities. Our study describes the experiences of gay, bisexual and queer-identifying adolescent males with parent-child sex communication. We conducted 30 in-depth semi-structured interviews with a diverse group of 15 to 20 year-old gay, bisexual, and queer (GBQ) males. Interview transcripts were coded and themes were identified using thematic and content analysis. Narratives revealed that sex communication with parents occurs rarely, is heteronormative in content prior to adolescent males' disclosure as GBQ, and after disclosure is reactionary and based on stereotypes that associate this population with negative health outcomes. Parents were rated poorly as sex educators by adolescent males and the findings are mixed regarding perception of parents' knowledge about GBQ-specific information. Parents and healthcare providers were identified as preferred sources of sex information by GBQ adolescent males. Sex communication with parents throughout adolescence that excludes GBQ males' same-sex concerns is a missed opportunity for targeted sexual risk reduction. There are multiple ways healthcare providers can assist parents to plan age-appropriate, sexuality-inclusive, home-based discussions about sex for this group.

Early roots of sexual-orientation health disparities: associations between sexual attraction, health and well-being in a national sample of Australian adolescents

Background

Research documents substantial adolescent health disparities by sexual orientation, but studies are confined to a small number of countries—chiefly the USA. We provide first-time evidence of associations between sexual orientation and adolescent health/well-being in a new country—Australia. We also add to knowledge by examining health/well-being outcomes not previously analysed in national samples, considering adolescents reporting no sexual attractions, and rank-ordering sexual-orientation health disparities by magnitude.

Methods

Data from an Australian national probability sample of 14/15 years old (Longitudinal Study of Australian Children, n=3318) and regression models adjusted for confounding and for multiple comparisons were used to examine the associations between sexual attraction and 30 outcomes spanning multiple domains of health/well-being—including socio-emotional functioning, health-related quality of life, depressive symptoms, health-related behaviours, social support, self-harm, suicidality, victimisation, self-concept, school belonging and global health/well-being assessments.

Results

Lesbian, gay, bisexual and questioning adolescents displayed significantly worse health/well-being than their heterosexual peers in all outcomes (p<0.05). The magnitude of the disparities ranged between 0.13 and 0.75 SD, and was largest in the domains of self-harm, suicidality, peer problems and emotional problems. There were fewer differences between the heterosexual and no-attraction groups. Worse outcomes were observed among both-sex-attracted adolescents compared with same-sex-attracted adolescents, and sexual-minority girls compared with sexual-minority boys.

Conclusions

Consistent with the minority stress model and recent international scholarship, sexual-minority status is an important risk factor for poor adolescent health/well-being across domains in Australia. Interventions aimed at addressing sexual-orientation health disparities within Australian adolescent populations are urgently required.

Sexual Orientation and Diabetes During the Transition to Adulthood

Purpose: The purpose of this study was to examine how sexual orientation in adolescence and young adulthood was linked to diabetes risk. Methods: Data were drawn from the 1994-2008 National Longitudinal Study of Adolescent to Adult Health. The baseline sample included 4330 girls and 3510 boys ages 12-18. Guided by the life course approach, we considered both the timing and continuity of sexual orientation-broadly defined by sexual identity, sexual attraction, sexual contact, and romantic/sexual relationships-by differentiating respondents into four categories: sexual minority in both adolescence and adulthood, sexual minority in adulthood only, sexual minority in adolescence only, and heterosexual in both adolescence and young adulthood. Diabetes was identified using A1c and glucose biomarkers and self-reports of diabetes diagnosis or medication use. Results: Results from logistic regression models indicated that in comparison with their continuously heterosexual counterparts, respondents reporting sexual minority status in adulthood only or continuously in both adolescence and adulthood had higher diabetes risk in adulthood. However, respondents reporting sexual minority status in adolescence only were not different in diabetes risk in adulthood. The association between diabetes risk and continuous sexual minority status was stronger among women than among men. Conclusions: Sexual minority health disparities emerge early in the life course during adolescence and young adulthood. These findings highlight the importance of designing and implementing policies and public programs to alleviate minority stress early in life to reduce health disparities.

Policing Heteronormativity and Sexual Risk-Taking Among Young Adult Men Who Have Sex with Men in the Detroit Metro Area

Policing gender and sexuality can have enduring health implications for the well-being of young men who have sex with men (YMSM). Using data from a community-based sample of YMSM in the Detroit Metro Area (N = 364), we examined the prevalence of lifetime heteronormative policing by gender (e.g., punished/restricted for femininity) and sexuality (e.g., attempts to alter same-sex attractions). We examined the associations of heteronormative policing attempts and the number of condomless insertive and receptive anal intercourse partners, respectively. We also tested whether internalized homophobia moderated the association between sexuality policing and sexual risk. Multivariable models demonstrated that policing sexuality, but not gender, was associated with a greater number of partners in which participants engaged in condomless intercourse as the receptive partner. We observed no interaction between policing sexuality and internalized homophobia. Multilevel efforts are needed to reduce the contribution of heteronormative policing on YMSM's HIV risk.

Disparities in substance use behaviors and disorders among adult sexual minorities by age, gender, and sexual identity

BACKGROUND

Sexual minorities (SMs) experience elevated rates of substance use behaviors and disorders relative to heterosexuals; minority stress is theorized to contribute to these disparities. As SMs are not a homogenous group, analyses that aggregate SMs across sexual identity, age, or gender obscure important variation among this population. To date, age- and gender-specific disparities have not been rigorously examined using a large national sample.

METHODS

Using data on 67,354 adults (ages 18-49) from the 2015 and 2016 National Survey of Drug Use and Health we examined age- and gender-specific disparities in smoking, heavy episodic drinking, marijuana use, illicit drug use, and alcohol/substance use disorder. Age groups were ages 18-25, 26-34, and 35-49. Using logistic regression, we estimated age- and gender-specific odds ratios for gay/lesbian and bisexual individuals, relative to heterosexuals; analyses adjusted for demographic characteristics.

RESULTS

Bisexual women had significantly elevated odds of all outcomes at all ages, relative to heterosexual women. Gay/lesbian individuals had significantly elevated odds for nearly all outcomes compared to same-gender heterosexuals at ages 18-25, but not consistently at older ages. For bisexual men, significant disparities compared to heterosexual men were only observed at ages 35-49 for marijuana use and alcohol/substance use disorder.

CONCLUSIONS

We found notable within-group differences regarding SM disparities. While disparities were most pronounced in young adulthood for gay/lesbian individuals and mid-adulthood for bisexual men, bisexual women uniquely experienced disparities across all ages. Minority stress experiences may vary with respect to gender, age/cohort, and sexual identity, resulting in differential risk for substance use.

Risk and Protective Factors for Substance Use among Sexual and Gender Minority Youth: A Scoping Review

Purpose of Review

Alcohol and drug use are common among youth. Rates are especially high among sexual and gender minority youth (SGMY; lesbian, gay, bisexual, transgender). We conducted a scoping review of research on risk and protective factors for substance use among SGMY published between 2013-2017.

Recent Findings

Ninety-seven studies met our inclusion criteria. Most focused on individual-level minority stress risk factors, particularly stigma. Fewer studies addressed protective factors such as social support or affirming policies, and few focused on gender minority youth (GMY). We identified important, yet understudied differences by race/ethnicity, sex assigned at birth, and sexual orientation.

Summary

Findings highlight growing interest in this topic as well as methodological/topical gaps in the literature. Research is needed to examine SGMY substance use in nationally representative samples; expand information about GMY; investigate racial/ethnic and sex/gender differences; improve measurement; and increase translation of findings to support prevention and treatment interventions for this at-risk population.

The Complexity of Family Reactions to Identity among Homeless and College Lesbian, Gay, Bisexual, Transgender, and Queer Young Adults

Familial responses to lesbian, gay, bisexual, transgender, and queer (LGBTQ) young people's identities range on a spectrum from rejection to acceptance and these reactions strongly impact family relationships and young adult well-being. Less is known, however, about how family members' reactions may differ based on young people's contexts of socioeconomic status. Through a qualitative, life course analysis of in-depth interview data from 46 LGBTQ college students and LGBTQ homeless young adults, our study highlights the diverse, contextual nuances of young people's "linked lives" within their families. We find that the context of socioeconomic status influenced how a young person managed family rejection. Conversely, processes of familial acceptance were also connected to life course transitions that worked in some cases to enhance LGBTQ young adults' family relationships. Finally, the intricacy of familial reactions to a young person's LGBTQ identity transcended socioeconomic contexts as many respondents shared similar experiences of rejection and acceptance. These findings have implications for understanding how young people manage family relationships across different contexts of socioeconomic status and how these experiences can shape their life course trajectories. Results from this study can inform LGBTQ youth service providers by tailoring intervention programs that account for contextual social diversity.

The Association between Intentional Overdose and Same-Sex Sexual Intercourse in a Cohort of People who Inject Drugs in Melbourne, Australia

BACKGROUND

People who inject drugs (PWID) are at disproportionately high risk of suicidal behaviors, as are individuals who report same-sex attraction or experience. However, there is little evidence of compounded risk of suicide for individuals who report same-sex sexual intercourse (SSI) and are PWID.

OBJECTIVES

To explore the associations of lifetime intentional overdose amongst a cohort of PWID, with particular attention to those reporting SSI.

METHODS

The sample included 529 participants, from an ongoing cohort of 757 PWID. An "ever" SSI variable was created for participants who reported sexual intercourse with a same-sex partner at any longitudinal interview. We explored the adjusted associations between SSI and lifetime intentional overdose using logistic regression.

RESULTS

Ninety-one (17%) participants reported ever experiencing an intentional overdose. Forty-one (8%) participants reported SSI at any interview. Three hundred and sixty (68%) participants reported diagnosis of a mental health condition. Diagnosis of a mental health condition (AOR = 2.02, 95% CIs: 1.14, 3.59) and SSI (AOR = 2.58, 95% CIs: 1.22, 5.48) significantly increased the odds of lifetime intentional overdose. Conclusions/Importance: We found a heightened risk of intentional overdose amongst PWID reporting SSI, after controlling for diagnosis of a mental health condition. Services need to be aware of this heightened risk and target interventions appropriately.

Obtaining waivers of parental consent: A strategy endorsed by gay, bisexual, and queer adolescent males for health prevention research

BACKGROUND

Requiring parental consent in studies with sexual minority youth (SMY) can sometimes be problematic as participants may have yet to disclose their sexual orientation, may not feel comfortable asking parents' permission, and may promote a self-selection bias.

PURPOSE

We discuss rationale for waiving parental consent, strategies to secure waivers from review boards, and present participants' feedback on research without parents' permission.

METHODS

We share our institutional review board proposal in which we made a case that excluding SMY from research violates ethical research principles, does not recognize their autonomy, and limits collection of sexuality data.

DISCUSSION

Standard consent policies may inadvertently exclude youth who are at high risk for negative health outcomes or may potentially put them at risk because of forced disclosure of sexual orientation. Securing a waiver addresses these concerns and allows for rich data, which is critical for providers to have a deeper understanding of their unique sexual health needs.

CONCLUSION

To properly safeguard and encourage research informed by SMY, parental consent waivers may be necessary.

Trends in Parental Monitoring and Knowledge Over Time Between Sexual Minority and Heterosexual Girls

This study assessed whether trajectories of parental monitoring components were different for sexual minority girls (SMGs) compared to heterosexual girls. We recruited 14-19-year-old girls from two adolescent medicine clinics. We estimated growth curve models to compare how components of parental monitoring-adolescent disclosure, parental solicitation, and parental knowledge-changed over 2 years for SMGs and heterosexual girls. SMGs and heterosexual girls had similar trajectory slopes and quadratic forms of adolescent disclosure, but SMGs had consistently lower adolescent disclosure scores. Parental knowledge trajectories indicated differential intercepts and slopes for SMGs compared to heterosexual girls, suggesting potential higher risk for maladaptive behaviors. Results of this study suggest that parental monitoring may operate differently over time for SMGs compared to heterosexual girls.

Implications of Pubertal Timing for Romantic Relationship Quality Among Heterosexual and Sexual Minority Young Adults

PURPOSE

Relative to on-time or late-maturing peers, girls who begin puberty early typically begin romantic and sexual experiences earlier; however, advanced pubertal status does not necessarily coincide with commensurate interpersonal skills necessary for healthy romantic relationships. Research is limited on the long-term implications of early puberty for relationship quality, and virtually nothing is known about the social implications of early timing for sexual minority females.

METHODS

Using linear regression, we examine longitudinal associations between two measures of girls' pubertal timing (self-perceived timing and menarcheal age) and romantic relationship quality in young adulthood, stratified by sexual orientation, among 5,568 females in waves I and IV of the National Longitudinal Study of Adolescent to Adult Health. We also examine whether identified associations are mediated by parent-adolescent relationship quality.

RESULTS

Among sexual minorities, early self-perceived pubertal timing was associated with lower adult romantic relationship quality compared with on-time maturers (β = -2.32; standard error = 1.44; p = .05); this association was mediated by parent-adolescent relationship quality. Among heterosexuals, girls experiencing menarche before age 12 (early maturers) reported lower adult relationship quality compared to on-time maturers (β = -.43; standard error = .22; p = .03); parent-adolescent relationship quality did not mediate this association.

CONCLUSIONS

Early maturation is associated with lower romantic relationship quality in young adulthood. However, evidence of the association varies by measure of pubertal timing, and the processes by which pubertal timing is linked to later relationship quality may be different for sexual minority and heterosexual females. Potential explanations and public health implications are discussed.

Effects of Parental Monitoring and Knowledge on Substance Use and HIV Risk Behaviors Among Young Men Who have Sex with Men: Results from Three Studies

Young men who have sex with men (YMSM) are disproportionately impacted by HIV/AIDS and have elevated rates of substance use. Parenting practices, such as knowledge of child whereabouts and monitoring of behavioral rules, protect against these outcomes among heterosexual youth. This article examined the relationship between these parenting practices and substance use and HIV risk behaviors among YMSM. Data are reported from three similar studies of YMSM: ChiGuys (ages 14-18), Crew 450 (ages 16-22), and RADAR (ages 16-29). The ChiGuys and RADAR studies report cross-sectional analyses, whereas Crew 450 reports latent growth curve analyses. In ChiGuys and Crew 450, participants reported significantly higher scores for parental knowledge of general activities than parental knowledge of gay-specific activities. Parental knowledge of general activities was significantly associated with less binge drinking in both samples and with condomless sex in the ChiGuys sample. Parental monitoring was significantly associated with less marijuana use and condomless sex in younger RADAR participants (16-18 years) and with less drug use in older participants (>18 years). Findings support the need for further research on the influences of parents on YMSM health risk behaviors and the value of exploring family- and parent-interventions to address YMSM health.

Lesbian, Gay, Bisexual, and Transgender Youth and Family Acceptance

In this article, we address theories of attachment and parental acceptance and rejection, and their implications for lesbian, gay, bisexual, and transgender (LGBT) youths' identity and health. We also provide 2 clinical cases to illustrate the process of family acceptance of a transgender youth and a gender nonconforming youth who was neither a sexual minority nor transgender. Clinical implications of family acceptance and rejection of LGBT youth are discussed.

Families Matter: Social Support and Mental Health Trajectories Among Lesbian, Gay, Bisexual, and Transgender Youth

PURPOSE

Lesbian, gay, bisexual, and transgender (LGBT) adolescents are at greater risk for mental health problems than their heterosexual peers, in part due to victimization. Social support, particularly from families, has been identified as an important promotive factor. However, little is known about how LGBT youth experience multiple forms of support or how early support predicts mental health across adolescence and into young adulthood.

METHODS

In an analytic sample of 232 LGBT youth aged 16-20 years at baseline across 5.5 years, we compared developmental trajectories of psychological distress between three empirically derived social support cluster types at baseline: those who reported uniformly low support, those who reported uniformly high support, and those who reported nonfamily support (i.e., high peer and significant other but low family support).

RESULTS

Longitudinal multilevel modeling, controlling for age, victimization, and social support at each wave, indicated key differences between cluster types. Youth in the low and nonfamily support clusters reported greater distress across all time points relative to youth in the high support cluster; however, they also showed a sharper decline in distress. Youth in the nonfamily cluster gained family support across adolescence, such that they resembled youth in the high support cluster by early adulthood.

CONCLUSIONS

Findings underscore the importance of family support for LGBT youth. Youth who lack family support, but who have other forms of support, report a decrease in psychological distress and an increase in family support across adolescence. Youth who are low in all forms of support continue to exhibit high distress.

Mental health of sexual minorities. A systematic review

Many studies, reviews, and meta-analyses have reported elevated mental health problems for sexual minority (SM) individuals. This systematic review provides an update by including numerous recent studies, and explores whether SM individuals are at increased risk across selected mental health problems as per dimensions of sexual orientation (SO), genders, life-stages, geographic regions, and in higher quality studies. A systematic search in PubMed produced 199 studies appropriate for review. A clear majority of studies reported elevated risks for depression, anxiety, suicide attempts or suicides, and substance-related problems for SM men and women, as adolescents or adults from many geographic regions, and with varied SO dimensions (behaviour, attraction, identity), especially in more recent and higher quality studies. One notable exception is alcohol-related problems, where many studies reported zero or reversed effects, especially for SM men. All SM subgroups were at increased risk, but bisexual individuals were at highest risk in the majority of studies. Other subgroup and gender differences are more complex and are discussed. The review supports the long-standing mental health risk proposition for SM individuals, overall and as subgroups.

Associations of outside- and within-school adult support on suicidality: Moderating effects of sexual orientation

This study examined sexual-orientation differences in reports of outside- and within-school adult support, and whether sexual orientation moderates the associations between adult support and suicidality (i.e., thoughts, plans, and attempts). At 26 high schools across MetroWest Boston, 22,834 students completed surveys assessing: sexual orientation (heterosexual, gay/lesbian, bisexual, or questioning); presence of outside- and within-school adult support; and past-year suicidality. Multivariable regression analyses with General Estimating Equations (adjusting for gender, grade, and race/ethnicity) examined sexual-orientation subgroup differences in adult support, and how sexual orientation and adult support were associated with suicidality. Interaction terms tested whether relationships between adult support and suicidality were moderated by sexual orientation. Gay/lesbian, bisexual, and questioning youth were each less likely than heterosexuals to report having outside-school adult support (risk ratios range: 0.85-0.89). Each group also had greater odds than heterosexuals for suicidal thoughts (odds ratios [ORs] range: 1.86-5.33), plans (ORs range: 2.15-5.22), and attempts (ORs range: 1.98-7.90). Averaged across sexual-orientation subgroups, outside-school support was more protective against suicidality (ORs range: 0.34-0.35) than within-school support (ORs range: 0.78-0.82). However, sexual orientation moderated the protective effects of outside-school adult support, with support being less protective for bisexual and questioning youth than for heterosexuals. Adult support, and particularly outside-school adult support, is associated with lower suicidality. However, fewer gay/lesbian, bisexual, and questioning youth can rely on outside-school support and, even if present, it may be less protective against suicidality. Interventions are needed to help adults support gay/lesbian, bisexual, and questioning youth and reduce suicidality disparities. (PsycINFO Database Record

Disparities in Social Health by Sexual Orientation and the Etiologic Role of Self-Reported Discrimination

Some past work indicates that sexual minorities may experience impairments in social health, or the perceived and actual availability and quality of one's social relationships, relative to heterosexuals; however, research has been limited in many ways. Furthermore, it is important to investigate etiological factors that may be associated with these disparities, such as self-reported discrimination. The current work tested whether sexual minority adults in the United States reported less positive social health (i.e., loneliness, friendship strain, familial strain, and social capital) relative to heterosexuals and whether self-reported discrimination accounted for these disparities. Participants for the current study (N = 579) were recruited via Amazon's Mechanical Turk, including 365 self-identified heterosexuals (105 women) and 214 sexual minorities (103 women). Consistent with hypotheses, sexual minorities reported impaired social health relative to heterosexuals, with divergent patterns emerging by sexual orientation subgroup (which were generally consistent across sexes). Additionally, self-reported discrimination accounted for disparities across three of four indicators of social health. These findings suggest that sexual minorities may face obstacles related to prejudice and discrimination that impair the functioning of their relationships and overall social health. Moreover, because social health is closely related to psychological and physical health, remediating disparities in social relationships may be necessary to address other health disparities based upon sexual orientation. Expanding upon these results, implications for efforts to build resilience among sexual minorities are discussed.

Sexual minority youth of color: A content analysis and critical review of the literature

This study analyzed the content of 125 unique reports published since 1990 that have examined the health and well-being-as well as the interpersonal and contextual experiences-of sexual minority youth of color (SMYoC). One-half of reports sampled only young men, 73% were noncomparative samples of sexual minority youth, and 68% of samples included multiple racial-ethnic groups (i.e., 32% of samples were mono-racial/ethnic). Most reports focused on health-related outcomes (i.e., sexual and mental health, substance use), while substantially fewer attended to normative developmental processes (i.e., identity development) or contextual and interpersonal relationships (i.e., family, school, community, or violence). Few reports intentionally examined how intersecting oppressions and privileges related to sexual orientation and race-ethnicity contributed to outcomes of interest. Findings suggest that research with SMYoC has been framed by a lingering deficit perspective, rather than emphasizing normative developmental processes or cultural strengths. The findings highlight areas for future research focused on minority stress, coping, and resilience of SMYoC.

Investigating Correlates of Suicide Among Male Youth: Questioning the Close Affinity Between Suicide Attempts and Deaths

This study was based on a sample of male high school students who completed National Longitudinal Adolescent Health Surveys in 1994, 1995, and 2001. We studied these students prospectively, comparing those who later died by suicide (n = 21) with those who were still living (n = 10,101). We employed chi-square and analysis of variance tests for statistical significance between suicide decedents and living respondents. Results showed suicide decedents were more likely to have experienced the suicide loss of another family member, to have been expelled from school, to have engaged in more delinquent actions including fighting, and to have greater involvement with the criminal justice system. Although one might have expected suicide casualties to have exhibited a greater amount of suicidal thoughts, attempts, and higher incidences of suicidality among their friends, our analyses did not find that these factors were associated with actual suicides. Should these findings be replicated, this would point to a need to refine youth suicide risk assessments. Collecting life histories, as well as identifying patterns of delinquency and fighting, may serve as more potentially fruitful means for assessing genuine suicide risk than some traditional risk assessment methods.z.

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.

Sexual minority youth

This article provides an overview of the medical and mental health needs of the lesbian, gay, bisexual, and transgender (LGBT) youth population. Information is reviewed regarding both primary medical care and the special health risks that these youth face. Providers are introduced to the concept that societal and internalized homophobia lead directly to certain health disparities, including substance use, school and family rejection, depression, and increased sexually transmitted infection acquisition. This article familiarizes the primary care practitioner with the health care needs of the LGBT population and the research behind the various recommendations for caring for these youth.