Prevalence of dating violence among sexual minority youth: variation across gender, sexual minority identity and gender of sexual partners

A scoping review of nursing interventions to reduce PTSD in adolescents who have been sexually abused

Incidences of sexual violence have increased over the past few years. The negative impacts of sexual violence on adolescents are social isolation, low self-esteem, and disrupting the developmental stages of adolescents, and can even cause the risk of suicide. Nurses as providers of comprehensive nursing care have a role in reviewing various aspects to reduce the impact of sexual violence on adolescents. The purpose of this study is to explore methods of nursing intervention for reducing the symptoms of post-traumatic stress disorder among adolescents who are victims of sexual violence. The design used in this study is scoping review. Article were searched from CINAHL, PubMed, and Scopus databases. The inclusion criteria for articles in this study were full text, randomized control trial or quasi-experimental research design, English language, samples is adolescents (10-19 years based on WHO) who are victims of sexual violence, and the publication period of the last 10 years (2013-2022). We found 12 articles which discussed about nursing interventions in reducing PTSD symptoms in adolescents who are victims of sexual violence. Range of the samples is 40-405 adolescents. Several articles from developed countries. There are three nursing intervention methods that can be carried out, namely improve skill interventions, relaxation interventions, and cognitive behavior therapy. Nurses act as educators, facilitators and counselors so that victims can recover from their traumatic experiences. Providing nursing interventions to adolescents who are victims of sexual violence needs to pay attention to all aspects that affect the physical and psychological condition of the victim.

Attitudes Toward Unhealthy Relationship Behaviors and Boundary-Setting: Variation Among High School Students

Teen dating violence (TDV) is common during adolescence and has lasting negative impacts on those who experience it. Yet, there is limited research exploring how well teens recognize unhealthy behaviors and communicate boundaries, both crucial aspects in preventing TDV. This study aimed to investigate how demographic characteristics (i.e., gender, age, sexual identity, and race/ethnicity) relate to adolescents' abilities to recognize unhealthy relationships and willingness to communicate boundaries. Participants (N = 873) completed online surveys during school hours on demographic characteristics (e.g., gender), recognition of unhealthy relationship behaviors, communicating boundaries, and navigating breakups. We found that girls, participants who identify as a sexual minority (e.g., lesbian), and White participants demonstrated significantly higher recognition of controlling behaviors compared to boys and their heterosexual and non-White counterparts, respectively, but there was no significant difference in identifying abusive behaviors such as shouting, yelling, and insulting a partner. Older participants (i.e., ages 16-18) were significantly more likely to recognize controlling and abusive behaviors as unhealthy compared to younger participants (i.e., 13-15). Further, we found that girls and older participants were significantly more willing to communicate boundaries in relationships than boys and their younger counterparts. Our findings align with prior research emphasizing the necessity for prevention strategies that raise awareness of controlling behaviors that can escalate to more severe forms of TDV and equip adolescents with the means to establish and communicate personal boundaries.

Attitude Is Everything: Examining Acceptance of Violence Items for Differential Item Functioning Across Heterosexual and Sexual Minority Youth

Acceptance of dating violence (ADV) is a cognitive risk factor for violence perpetration and a common target of prevention programs. However, frequently used items assessing ADV are characterized by heteronormative item wording, and limited research has evaluated the degree to which ADV items function equivalently for both heterosexual and sexual minority youth (SMY). The current study sought to determine if there are differences in the way heterosexual and SMY respond to ADV survey items. Secondary data from a total of 2,014 adolescents (Mage = 16.78) were used to examine differences in ADV. Results of differential item functioning analysis indicated nonuniform differential item functioning for two of eight ADV items, with heterosexual youth being more likely to express strong levels of agreements with (a) female-perpetrated physical violence in response to male-perpetrated violence and (b) female-perpetrated violence against males broadly, relative to SMY. Although these differences were of negligible magnitude and only resulted in minimal differences in overall expected average scores, heterosexual youth were more likely to strongly accept female-perpetrated dating violence compared to SMY. Findings highlight differences in ADV item response patterns across heterosexual and sexual minority identifying youth and provide preliminary evidence for group differences in acceptance of female-perpetrated dating violence. Implications for prevention programming based on current findings include greater focus on measure adaptation and development as well as more consensus on the necessity of preventing female-perpetrated violence.

Disclosure and Help-Seeking Experiences of Sexual and Gender Minority Victims of Intimate Partner Violence: A Mixed-Methods Study

Sexual and gender minorities assigned female at birth (SGM-AFAB) experience high rates of intimate partner violence (IPV), with negative effects on health and well-being. Disclosure of and help-seeking for IPV can support the well-being of IPV survivors, yet are understudied among SGM-AFAB people. To better understand the IPV disclosure and help-seeking experiences in this population, we conducted semi-structured interviews with 41 SGM-AFAB young adults who experienced physical, sexual, or severe psychological IPV. Qualitative analyses explored to whom SGM-AFAB disclosed IPV, barriers to disclosure/help-seeking, the types of responses received, and perceived helpfulness of responses. Exploratory mixed methods analyses assessed frequency of code endorsement, demographic differences, and associations among codes. Three-quarters of participants disclosed IPV, though rates were lower for sexual and physical than psychological IPV and very few sought help from formal sources. The most common barriers to disclosure were not viewing the IPV as abuse and anticipation of negative responses, often due to stigma; other participants described inability to access formal help and concerns about SGM incompetence in those services. Most actual responses received were considered helpful, including emotional support, labeling the IPV as unhealthy, nonjudgmental listening, actions to stop the IPV, and practical support. Minimizing IPV or criticizing the victim was common unhelpful response; advice to end the relationship was considered helpful and unhelpful. Whereas 92% of friend responses were described as helpful, around half of family (56%) and therapist (62%) responses were helpful. Findings suggest that efforts to increase access to culturally affirmative services and educate SGM youth to recognize IPV in their relationships may help promote help-seeking and well-being among SGM-AFAB IPV survivors.

"It's Their Consent You Have to Wait For": Intimate Partner Violence and BDSM Among Gender and Sexual Minority Youth

Gender and sexual minoritized (GSM) youth are more likely than their cisgender heterosexual peers to experience intimate partner violence (IPV) and practice bondage and discipline, domination and submission, sadism, and masochism (BDSM). Although IPV and BDSM are vastly different phenomena, superficial similarities (e.g., violent behaviors) can lead to misidentification in both practice and research. This study explores how GSM youth (a) experience and understand the differences between IPV and BDSM and (b) report consensual violent and controlling behaviors when answering items on IPV measures. Nine demographically diverse GSM youth (mean age 21.2) were drawn from a GSM youth-serving organization in the Northeast United States. Participants were interviewed about their experiences with IPV, BDSM, and consent. Participants also were asked to describe the process of completing two standardized measures of IPV. Interviews were coded using conventional and directed content analysis. Eight of nine participants reported IPV victimization, and seven reported BDSM interest or experiences. Four themes emerged: (a) GSM youth experience a spectrum of IPV victimization, often related to their gender and sexual identity; (b) interest in BDSM does not imply an acceptance of IPV; (c) GSM youth have a nuanced understanding of consent and strategies to communicate consent with their partners; and (d) Consent is the organizing framework by which GSM youth distinguish IPV from BDSM. Participants reported various degrees of certainty that they would include BDSM behaviors when answering questions about violent behaviors. Findings underscore the importance of conceptually and operationally differentiating IPV and BDSM. Programs that serve GSM youth should address IPV victimization, offer sex-positive education regarding healthy relationships and BDSM, and assist GSM youth in differentiating abusive behaviors from consensual BDSM. Standardized measures that do not conflate BDSM with IPV are crucial for studying IPV among GSM youth.

Measurement of Adolescent Dating Violence in Sexual Minority Youth: A Scoping Review

Effectively addressing adolescent dating violence rests on the quality of its measurement, as that has substantial implications for our understanding of prevalence, correlates, outcomes. Although dating violence is highly prevalent among sexual minority youth, the state of measurement in this population has scarcely been explored. This scoping review presents information on the measurement of adolescent dating violence in exiting studies conducted with sexual minority youth. Three databases were searched, and the ancestry approach was used to identify relevant literature published in the United States between 1992-2022 that included sexual minority adolescents aged 19 years or younger. Twenty-one articles were identified. Five enrolled entirely sexual minority samples. Sexual minority distribution ranged from 2.1%-100%. All studies operationalized sexual identity as an orientation (not sexual behavior, attraction). Nineteen studies focused on measuring dating violence behavior. Twelve reported on female and male victimization, 4 on female and male perpetration and victimization, 2 on female perpetration and victimization, and 2 on female victimization-only. Most commonly used items were from the Youth Risk Behavior Survey (11 studies) and the Conflict in Adolescent Dating Relationships Inventory (3 studies). Two studies assessed knowledge of and attitudes toward dating violence. Domains explored included rape myth acceptance, victim empathy, bystander opportunity, and dating abuse knowledge. Only two scales had undergone previous systematic psychometric evaluation. There was no evidence of cross-cultural validation in sexual minority populations. Rigorous research on adolescent dating violence measurement among sexual minority youth is greatly needed and should be given priority among researchers.

Interpersonal Violence Victimization Experiences of Middle School Youth: An Exploration by Gender and Sexual/Romantic Attraction

Sexual minority youth (SMY) are at increased risk for interpersonal violence victimization compared to heterosexual youth. The current study examined how self-reported victimization (i.e., bullying, sexual harassment and dating violence) among middle school youth varied as a function of sexual/romantic attraction as well as gender identity. Cross-sectional data were gathered from students at seven middle schools in New England (n = 2245). Mean comparisons with post-hoc Tukey tests determined differences in rates of past 6-month and lifetime interpersonal violence victimization by sexual/romantic attraction and the intersection of gender and attraction. As hypothesized, interpersonal violence victimization among middle school youth differed as a function of sexual/romantic attraction as well as gender. To date, most research has focused on older samples, particularly high-school youth and young adults. These data are consistent with these prior studies documenting increased risk for interpersonal violence victimization among youth who indicate same-gender attraction but add to the literature in demonstrating the expansive forms of peer victimization that same-gender-attracted youth already experience by early adolescence. Given that victimization is associated acutely and longitudinally with many deleterious outcomes, including poorer mental health and increased risk for subsequent victimization, greater structural supports are needed for early adolescent SMY.

Dating Violence Trajectories in Adolescence: How Do They Relate to Sexual Outcomes in Canada?

Dating violence during adolescence is a major public health issue: it is highly prevalent and extensive research has documented its physical and psychological consequences, yet very little has focused on its sexual consequences. The present study investigated the longitudinal associations between dating violence victimization (psychological, sexual or physical) and sexual well-being (sexual satisfaction and sexual distress) among 1442 sexually active adolescents aged between 14 and 17 years who completed at least one of three data waves (51.1% girls; 45.7% boys; 0.3% non-binary; 3.0% varying gender identity). The study also examined whether these associations differed by gender identity and sexual minority status. Adolescents completed online questionnaires on electronic tablets during class. The results indicated that psychological, physical (except for boys), and sexual dating violence victimization were all associated with lower sexual satisfaction and greater sexual distress over time. Moreover, the between-level associations between dating violence and poorer sexual outcomes were stronger among girls and gender varying adolescents than among boys. The within-level association between physical dating violence and sexual satisfaction was significant among adolescents with a nonvarying sexual minority status, but not among those with a nonvarying heterosexual status or that varied in sexual minority status. Findings offer cues for dating violence prevention and intervention programs by suggesting the need to examine sexual well-being over time.

Cumulative Incidence of Physical and Sexual Dating Violence: Insights From A Long-term Longitudinal Study

Decades of inquiry on intimate partner violence show consistent results: violence is woefully common and psychologically and economically costly. Policy to prevent and effectively intervene upon such violence hinges upon comprehensive understanding of this phenomenon at a population level. The current study prospectively estimates the cumulative incidence of sexual and physical dating violence (DV) victimization/perpetration over a 12-year timeframe (2010-2021) using diverse participants assessed annually from age 15 to 26. Data are from Waves 1-13 of an ongoing longitudinal study. Since 2010 (except for 2018 and 2019), participants were assessed on past-year physical and sexual DV victimization and perpetration. Participants (n = 1,042; 56% female; Mage baseline = 15) were originally recruited from seven public high schools in southeast Texas. The sample consisted of Black/African American (30%), White (31%), Hispanic (31%), and Mixed/Other (8%) participants. Across 12 years of data collection, 27.3% experienced sexual DV victimization and 46.1% had experienced physical DV victimization by age 26. Further, 14.8% had perpetrated at least one act of sexual DV and 39.0% had perpetrated at least one act of physical DV against a partner by this age. A 12-year cumulative assessment of physical and sexual DV rendered prevalence estimates of both victimization and perpetration that exceeded commonly and consistently reported rates in the field, especially on studies that relied on lifetime or one-time specified retrospective reporting periods. These data suggest community youth are at continued and sustained risk for DV onset across the transition into emerging adulthood, necessitating early adolescent prevention and intervention efforts that endure through late adolescence, emerging adulthood, and beyond. From a research perspective, our findings point to the need for assessing DV on a repeated basis over multiple timepoints to better guage the full extent of this continued public health crisis.

Are school-based interventions to prevent dating and relationship violence and gender-based violence equally effective for all students? Systematic review and equity analysis of moderation analyses in randomised trials

School-based interventions for the prevention of dating and relationship violence (DRV) and gender-based violence (GBV) take advantage of universal opportunities for intervention. Information on differential effectiveness of interventions is important to assess if they ameliorate or worsen social gradients in specific outcomes. This is especially important in DRV and GBV prevention given the gendered context of these behaviours and their common aetiologies in patriarchal gender norms, and social acceptance in school contexts of sexual harassment, such as catcalling or unwanted groping. We undertook a systematic review of moderation analyses in randomised trials of school-based interventions for DRV and GBV prevention. We searched 21 databases and used supplementary search methods without regard to publication type, language or year of publication, and synthesised moderation tests relating to equity-relevant characteristics (principally sex and prior history of the outcome) for DRV and GBV perpetration and victimisation. Across 23 included outcome evaluations, programme effects on DRV victimisation were not moderated by gender or prior experience of DRV victimisation, but DRV perpetration outcomes were greater for boys, particularly for emotional and physical DRV perpetration. Findings for GBV outcomes were counterintuitive. Our findings suggest that practitioners should carefully monitor local intervention effectiveness and equity to ensure that interventions are working as intended. However, one of the most surprising findings from our analysis-with clear relevance for uncertainties in practice-was that differential impacts by sexuality or sexual minority status were not frequently evaluated.

Looking Within: An Analysis of Intimate Partner Violence Victimization Among Sexual Minority Youth

Sexual minority youth are at increased risk of intimate partner violence (IPV) victimization compared to their heterosexual peers. However, the sexual minority population is not a homogenous group and risk of IPV victimization varies by LGB+ subgroup (e.g., gay/lesbian, bisexual, and unsure). Using two waves of data (2017, 2019) from the National Youth Risk Behavior Survey (YRBS), this study analyzes (a) differences in physical and sexual IPV victimization between heterosexual and sexual minority youth, (b) within group differences among sexual minority youth, and (c) if the relationship between IPV victimization and sexual identity is attenuated after controlling for sociodemographic characteristics and theoretically relevant risk factors. Results indicate that sexual minority youth are at elevated risk of IPV victimization compared to their heterosexual peers. Within-LGB+ analyses show that bisexual youth are more likely than gay/lesbian youth to be victims of sexual IPV. The association between physical and sexual IPV victimization and sexual identity is partially attenuated by sociodemographic variables and observed risk factors. Findings indicate that intervention and prevention programming should be tailored to identify, and treat, the risks and needs of unique, at-risk populations.

Victimization and Perception of Abuse in Adolescent and Young Homosexual and Heterosexual Couples in Spain

Currently, violence in adolescent and young couples has a significant social impact on young people's physical and psychological health. However, the study of violence in homosexual couples must also be addressed. This research analyzes the levels of violent victimization and the perception of abuse in both homosexual and heterosexual couples. Participants' ages ranged between 14 and 29 years (M = 20.14, SD = 3.464). We used The Dating Violence Questionnaire-Revised (CUIVNO-R), which was applied in two consecutive studies. The results indicate high levels of victimization, especially in the sample of homosexual participants. The scores generally show a low perception of couple violence but high victimization rates. The results of this study reveal the importance of the issue of violence in couples from minority groups and suggest that couple violence should not be understood as unidirectional, i.e., exclusively from men to women. These findings show the need for education in healthy relationships and consideration of different types of couples in these relationships.

Sexual Relationship Violence Among Young, Partnered Sexual Minority Men in the United States

While there has been a growth in studies examining sexual violence among sexual minority men, little research attention has been paid to the experience of sexual violence among young sexual minority men (YSMM). In this article we analyze secondary data from the baseline of a pilot randomized control trial with 318 YSMM aged 15 to 24 years in the United States who were in relationships with other males to examine the associations between sexual minority-specific stigma and sociodemographic and relationship characteristics and experiences of intimate partner violence (IPV) and sexual IPV in their relationships. Approximately one-in-five participants reported experiencing any form of IPV and 6% reported sexual IPV in their current relationship. Participants who reported sexual minority-specific familial rejection (Adjusted Odds Rato (aOR) = 2.33, 95% confidence interval [CI] [1.03, 5.26], p < .05), internalized heterosexism (aOR = 3.17, 95% CI [1.45, 6.95], p < .01), and housing insecurity (aOR = 7.22, 95% CI [1.66, 31.34], p < .01) reported higher odds of sexual IPV in their relationship. Study findings point to the role of multiple sexual minority-specific forms of stigma in creating vulnerabilities for the experience of sexual IPV among YSMM, and highlight the need for continued research and interventions that address sexual minority-specific stigma and structural vulnerabilities to guide violence prevention efforts with YSMM.

Physical Dating Violence Victimization among LGBTQ Youth: Disclosure and Association with Mental Health

Youth dating violence and youth suicide are both major public health concerns. However, little research examines the intersection of these issues among lesbian, gay, bisexual, transgender, queer, and questioning (LGBTQ) youth. The current study examined the association between physical dating violence victimization and mental health using online survey data collected from 39,126 LGBTQ youth of ages 13 to 24 in the United States. Overall, 11% of LGBTQ youth who were in a relationship in the past year experienced physical dating violence victimization, with 4% having experienced it once and 7% having experienced it multiple times. Rates of experiencing physical dating violence victimization varied based on a number of youth characteristics and environmental factors. Past-year physical dating violence victimization was associated with nearly four times the odds of attempting suicide in the past year. Given the intersection of suicide risk and dating violence among LGBTQ youth, dating violence prevention organizations must be LGBTQ-inclusive, and suicide prevention must be equipped to address dating violence victimization. The higher rates of physical dating violence victimization among multiple marginalized and socioeconomically disadvantaged LGBTQ youth suggest the need for an intersectional approach that addresses the structural factors that place LGBTQ youth at risk for physical dating violence.

Sexual Health and Relationship Abuse Interventions in Pediatric Primary Care: A Systematic Review

PURPOSE

Supporting adolescents in developing healthy relationships and promoting sexual and reproductive health (SRH) is an important responsibility of pediatric primary care providers. Less is known about evidence-based interventions in pediatric settings focused on healthy relationships and SRH.

METHODS

We conducted a systematic review to describe SRH and healthy relationship/adolescent relationship abuse (ARA) interventions for pediatric primary care over the past 20 years. Eligible articles were original research on an SRH-focused or ARA-focused intervention, conducted in-person within pediatric primary care or school-based health centers specifically for middle or high school-aged adolescents. Data abstracted from included articles included intervention description, content, delivery, evaluation design, and effectiveness of primary outcomes. Heterogeneous outcomes and evidence levels made conducting a meta-analysis infeasible.

RESULTS

Nineteen studies described 17 interventions targeting a variety of SRH and ARA topics (e.g., sexually transmitted infections, contraception, ARA). Interventions largely focused on screening/counseling adolescents (89%). Interventions generally were reported as being effective in changing adolescent health or practice-level outcomes.

DISCUSSION

This review provides preliminary evidence that SRH and ARA interventions in pediatric primary care settings can be effective in promoting adolescent health. Future work should consider ARA-specific prevention interventions, including parents in interventions, and strategies for implementation, dissemination, and scaling.

Psychosocial Risk Pathways from Childhood Sexual Abuse to Intimate Partner Violence among Sexual Minority Men: A Test of the Psychological Mediation Framework of Minority Stress

Although sexual minority men experience elevated rates of childhood sexual abuse (CSA) and equal or greater rates of intimate partner violence (IPV) victimization compared to heterosexual individuals, little research has examined mechanisms linking these forms of victimization in this high-need population. We examined general (i.e., emotion regulation difficulties) and sexual minority specific (i.e., internalized homophobia) mediational pathways between CSA and IPV victimization in a longitudinal sample of 940 sexual minority men. Path analyses revealed significant associations between CSA and internalized homophobia, between internalized homophobia and emotion regulation difficulties, and between emotion regulation difficulties and IPV victimization. No indirect effects of CSA on IPV via general or minority specific pathways were observed. Findings suggest that minority stress specific (i.e., internalized homophobia) and general psychological risk factors (i.e., emotion regulation difficulties) co-occur and may function along independent pathways to link CSA to IPV revictimization. Future work is needed to investigate how mitigation of these modifiable pathways may be targeted to inform violence prevention interventions for sexual minority men.

Sexual minority status, school-based violence, and current tobacco use among youth

INTRODUCTION

Sexual minority individuals experience elevated risk for smoking and violence due to a combination of general and unique identity-based risk factors. This study examined associations among sexual minority status, school-based violence, and tobacco use, among youth.

METHODS

Data for this secondary data analysis consisted of Chicago-specific data from the 2019 Youth Risk Behavior Surveillance System (n=1562). Current use (≥1 day during the previous 30 days) of any tobacco product (cigarettes, e-cigarettes, smokeless tobacco, and cigars) and school-based violence (avoided school because they felt unsafe, were threatened/injured with a weapon, were in a physical fight, and were bullied) were estimated by sexual orientation (heterosexual vs gay, lesbian, bisexual, and unsure). A chi-squared test was used to investigate associations among the variables. Path analysis was employed to examine possible mediation effects of school-based violence.

RESULTS

Thirty percent of sexual minority youth and 11.5% of heterosexual youth reported current tobacco use (χ²=55.91; p<0.001). Nearly one-third (31.8%) of youth reported school-based violence, with a higher rate (41.2%) reported by sexual minority youth compared to heterosexual youth (28.1%; χ²=19.48; p<0.001). Path analysis confirmed these associations, controlling for sex, age, and race/ethnicity. The model showed that sexual minority status increased odds of current tobacco use by a factor of 1.8 (95% CI: 1.3-2.6) via its relationship with school-based violence, explaining 33.8% of the total association between sexual minority status and tobacco use.

CONCLUSIONS

Tobacco use was higher among sexual minority youth. School-based violence partially mediated the association between sexual minority status and tobacco use. Findings highlight the need for tobacco prevention and treatment efforts for sexual minority youth and school-based interventions to reduce exposure to violence.

Understanding Associations Between Exposure to Violent Pornography and Teen Dating Violence Among Female Sexual Minority High School Students

Previous research indicates that teen dating violence (TDV) is more common among sexual minority than heterosexual adolescents, with approximately half of female sexual minority adolescents (SMA) endorsing TDV victimization in the last year. In samples of adolescents without regard to sexual orientation, exposure to violent pornography is associated with TDV, but this relationship has not been assessed in female SMA. The current study sample consisted of 10th-grade high school students aged 14-17 who identified as cisgender females (N = 1,276). Data were collected from a baseline survey prior to the delivery of a sexual assault prevention intervention. Female SMA had 2.54 times the odds (95%CI [1.75, 3.69]) of being exposed to violent pornography and 2.53 times the odds (95%CI [1.72, 3.70)]) of TDV exposure compared to heterosexual girls. Exposure to violent pornography was not associated with involvement in TDV among female SMA, controlling for episodic heavy drinking (aOR = 2.25, 95%CI [0.88,6.22]).Given the relatively higher rates of violent pornography and TDV exposure among female SMA compared to heterosexual girls, it is critical that sex education curricula address these experiences and meet the needs of adolescents of all sexual orientations. Future research can assess how these TDV interventions might be tailored for female SMA. Although we did not find that exposure to violent pornography was associated with TDV among female SMA, these investigations should be replicated with larger data sets, given that the association between exposure to violent pornography and engagement in TDV was in the expected direction.

Sociodemographic Differences in Intimate Partner Violence Prevalence, Chronicity, and Severity Among Young Sexual and Gender Minorities Assigned Male at Birth: The P18 Cohort Study

Intimate partner violence (IPV) is prevalent among young sexual and gender minorities assigned male at birth (YSGM-AMAB). However, few studies have examined the chronicity or distinguished between minor and severe forms of IPV among YSGM-AMAB. Furthermore, while past research has documented differences in IPV by race/ethnicity, sexual identity, gender identity, income, and education in other populations, few studies have examined these sociodemographic characteristics in relation to IPV in YSGM-AMAB. Thus, the present study aims to: (1) estimate past year prevalence and chronicity of minor and severe forms of IPV victimization and perpetration in a diverse sample of (N = 665) YSGM-AMAB in New York City, and (2) examine differences in IPV prevalence and chronicity by the aforementioned sociodemographic characteristics. Cross-sectional data from [BLINDED] informed these descriptive and inferential analyses. Nearly half of all participants reported past year IPV victimization and approximately 40% reported perpetration. Psychological violence was the most common form of victimization, followed by sexual, physical, and injury victimization. Psychological violence was the most common form of perpetration, followed by physical, sexual, and injury perpetration. Regarding sociodemographic differences in last year IPV prevalence, bisexual, transgender, and lower income YSGM-AMAB were more likely to report several subtypes of IPV victimization. Whereas Asian/API, bisexual, transgender, and lower income participants were more likely to report several subtypes of IPV perpetration. Regarding last year IPV chronicity, non-graduate YSGM-AMAB reported more instances of two subtypes of IPV victimization, while Black, White, cisgender, upper income, non-graduate participants reported more instances of several subtypes of IPV perpetration. These findings may be used to develop IPV prevention and intervention programs, inform future research endeavors, and develop and strengthen policies that reduce sociodemographic inequalities and promote more favorable sociopolitical conditions for YSGM-AMAB.

Associations of Relationship Experiences, Dating Violence, Sexual Harassment, and Assault With Alcohol Use Among Sexual and Gender Minority Adolescents

Sexual and gender minority (SGM) adolescents report higher rates of dating violence victimization compared with their heterosexual and cisgender peers. Research on dating violence often neglects diversity in sexual and gender identities and is limited to experiences in relationships. Further, given that dating violence and alcohol use are comorbid, research on experiences of dating violence could provide insights into alcohol use disparities among SGM adolescents. We aimed to map patterns of relationship experiences, sexual and physical dating violence, and sexual and physical assault and explored differences in these experiences among SGM adolescents. Further, we examined how these patterns explained alcohol use. We used a U.S. non-probability national web-based survey administered to 13-17-year-old SGM adolescents (N = 12,534). Using latent class analyses, four patterns were identified: low relationship experience, dating violence and harassment and assault (72.0%), intermediate dating experiences, sexual harassment, and assault and low levels of dating violence (13.1%), high dating experiences, dating violence, and sexual assault (8.6%), and high dating experiences, dating violence, and sexual harassment and assault (6.3%). Compared to lesbian and gay adolescents, bisexual adolescents reported more experiences with dating, dating violence, and sexual assault, whereas heterosexual adolescents reported fewer experiences with dating, dating violence, and sexual harassment and assault. Compared to cisgender boys, cisgender girls, transgender boys, and non-binary/assigned male at birth adolescents were more likely to experience dating violence inside and outside of relationship contexts. Experiences of dating, dating violence, and sexual harassment and assault were associated with both drinking frequency and heavy episodic drinking. Together, the findings emphasize the relevance of relationship experiences when studying dating violence and how dating violence and sexual harassment and assault might explain disparities in alcohol use.

Interpersonal Violence Among Heterosexual and Sexual Minority Youth: Descriptive Findings From the 2017 Youth Risk Behavior Surveillance System

Interpersonal violence is pervasive among youth in the United States. Sexual minority youth are disproportionately impacted. Utilizing data from the 2017 Youth Risk Behavior Surveillance System (YRBS, N = 12,868), this study describes the disparities in victimization among heterosexual and sexual minority youth. Sexual minority status was operationalized to include nonheterosexual identity (e.g., bisexual) and/or behavior (e.g., reporting same- and different-sex partners). Other predictors included sex (male/female), a sexuality*sex interaction term, age, and race/ethnicity. Outcomes included lifetime forced sexual intercourse and 12-month incidence of sexual violence, physical violence in relationships, sexual violence in relationships, in-school bullying, and cyberbullying. Approximately 15% (n = 1,974) of participants were classified as sexual minority youth and 48% (n = 6,213) self-identified as female. More than half (56%, n = 7,190) identified as racial and/or ethnic minorities. In bivariate logistic regression, sexual minority youth were significantly more likely to report all outcomes (p < .001). In multivariable logistic regression, sexual minority and female youth were significantly more likely to report all outcomes (p < .001). With the exception of physical violence in dating, sexuality*sex interaction terms were significant predictors for all outcomes (p < .001), indicating that the risks associated with sexual minority status are heightened for male youth. This study concludes with a call for more attention toward violence among and against sexual minority youth. Although some prevention and response efforts address the unique needs and experiences of these youth, particularly antibullying initiatives, efforts to address sexual and dating violence often emphasize heterosexual contexts and communities.

Understanding the Link Between Adolescent Same-Gender Contact and Unintended Pregnancy: The Role of Early Adversity and Sexual Risk Behavior

Past research suggests an apparent paradox: Women who engage in same-gender sexual behavior show higher rates of unintended pregnancy than women with exclusive other-gender sexual behavior. Such women also have disproportionate rates of early adversity (both harshness, such as abuse or neglect, and unpredictability, such as father absence). We used the Add Health data (N = 5,617 cisgender women) to examine the relative contributions of early adversity, adolescent same-gender sexual behavior, and general sexual risk behavior to women's risks for adult unintended pregnancy. Women who engaged in adolescent same-gender sexual behavior were more likely to report childhood adversity, and both childhood adversity and adolescent same-gender behavior made independent contributions to subsequent rates of unintended pregnancy. The association between adolescent same-gender sexual behavior and adult unintended pregnancy was partially attributable to the fact that women with adolescent same-gender sexual behavior engaged in greater sexual risk behavior more broadly. These findings suggest that same-gender sexual behavior in adolescence may relate to a broader set of sexual risk behaviors that augment future risk for unintended pregnancy, independent of sexual identity. We draw on life history theory to explain this pattern of results and suggest directions for future research.

Dating Violence Experiences among Youths with Same-gender and Multi-gender Dating Partners: A Dyadic Concordance Type Approach

Dating violence (DV) among youth is widespread and is now established as a significant public health problem. Yet, few studies have assessed DV experiences among youth with same-gender or multi-gender dating partners, and most failed to consider bidirectional DV. We analyzed self-reported dyadic concordance types (DCTs) among 295 youths (52% girls) who dated same-gender and multi-gender partners in the last 12 months using an adapted version of the Conflict in Adolescent Dating Relationships Inventory. Youths were classified in one of three DCTs: self-only (unidirectional perpetration of DV by the participant), partner-only (unidirectional victimization perpetrated by their partner) or both (bidirectional DV, where partners are both perpetrators and victims of DV). Overall prevalence rates of DV among sexual minority youths (SMYs) range from 11.5% for threats, to 51.2% for psychological violence, with physical and sexual violence reported by about one-fourth of participants. The both DCT was the most common pattern for psychological (59.6%) and physical (50.6%) DV across gender, while most threatening behaviors were reported as perpetrated by the partner only (47.1%). Girls were more likely to report sexual DV as partner-only perpetrated (63.6%), whereas boys reported higher rates of both (44.2%) and self-only (34.9%) perpetrated sexual violence. Because healthy intimate relationships can play a supportive and positive role in transitioning toward adulthood, it is crucial that DV prevention becomes more inclusive of sexual and gender diversity.

Longitudinal Transitions in Intimate Partner Violence among Female Assigned at Birth Sexual and Gender Minority Youth

Female-assigned at birth sexual and gender minorities (FAB SGM) are at elevated risk of experiencing intimate partner violence (IPV), yet little longitudinal research has been conducted with this population. In the current study, we attempted to understand how patterns of IPV victimization and perpetration, measured across a wide range of IPV behaviors (psychological, physical, sexual, cyber, and SGM-specific), changed over time for FAB SGM youth. Participants came from a longitudinal cohort study of FAB SGM late adolescents and young adults (FAB400; N = 488) and included anyone who reported a romantic partner at one of the first three waves (six months apart; N = 433). Latent class analysis (LCA) was run at each wave to determine the best-fitting class structure across IPV experiences. These were followed up with latent transition analyses (LTAs) to determine patterns of movement between classes over the course of the three waves. Lastly, we looked at the effects of staying with the same romantic partner on transitions. We found that the same three-class structure replicated across all three waves of the study. That class structure identified no/low, psychological, and high IPV classes at each wave. In the LTA, when transitions occurred for FAB SGM, they were much more likely to transition to a class defined by lower likelihoods of experiencing IPV (i.e., psychological to no/low) than they were to a class defined by higher likelihoods of IPV (i.e., psychological to high). However, we found that FAB SGM youth were less likely to transition to a less severe IPV class if they maintained the same serious romantic partner across waves. This finding, in particular, suggests that IPV is often relationship specific for FAB SGM and that efforts to reduce IPV in SGM communities must consider intervening at the relationship level to effect meaningful change.

Directionality of Dating Violence Among High School Youth: Rates and Correlates by Gender and Sexual Orientation

Sexual minority adolescents are at greater risk for experiencing teen dating violence (TDV) in their dating relationships. Although adolescents in dating relationships often report experiencing and perpetrating various forms of TDV, the directionality of TDV based on youth's reported gender and sexual orientation is not known. A sample of 10th-grade students (N = 1,622) recruited from high schools in the Northeastern United States completed assessments of TDV victimization and perpetration and reported their past-month heavy alcohol use and marijuana use. Sexual minority girls (58%) and boys (36%) were more likely to experience TDV than heterosexual girls (38%) and boys (25%), respectively. Sexual minority boys were less likely, although the confidence intervals included one, to engage in dual-role physical TDV (odds ratio [OR] = 0.14, 95% confidence interval [CI] [0.00, 1.26]) and threatening TDV (OR = 0.14, 95% CI [0.00, 1.02]), and instead were more likely to be victimized. In contrast, the profiles of TDV were similar for girls, with sexual minority girls only being more likely than heterosexual girls to report dual-role physical TDV (OR = 2.23, 95% CI [1.07, 4.66]). Compared with unidirectional TDV, bidirectional TDV was significantly associated with sexual minority girls' substance use, but not with heterosexual girls' substance use. Sexual minority youth report higher rates of TDV, with sexual minority boys being distinctly at-risk for being victimized within their dating relationships. Engagement in both TDV victimization and perpetration was distinctly associated with substance use for sexual minority girls, highlighting the need for integrated prevention efforts and support.

Intersectional Minority Stress and Intimate Partner Violence: The Effects of Enacted Stigma on Racial Minority Youth Assigned Female at Birth

Many sexual minority youth of color experience enacted stigma based on each of their minority identities. We examined whether experiences of racist discrimination and heterosexist microaggressions were associated with intimate partner violence (IPV) among female-assigned at birth (FAB) sexual minority youth of color. Data were drawn from a larger study of FAB sexual and gender minority youth (FAB400; N = 488). We selected racial/ethnic minority participants who reported a sexual minority identity and reported a romantic relationship in the previous 6 months (N = 249). Negative binomial models were used to test for associations between enacted stigma (racial discrimination and heterosexist microaggressions) and IPV (psychological, physical, sexual, and sexual minority-specific) perpetration and victimization. When considered separately, both forms of enacted stigma was positively associated with perpetration and victimization across all four types of IPV. In multivariate models, racial discrimination and heterosexist microaggressions both had unique, additive effects on psychological IPV perpetration and physical- and sexual minority-specific IPV victimization. Only racial discrimination was uniquely associated with physical perpetration and psychological victimization. Only heterosexist microaggression was uniquely associated with sexual minority-specific perpetration and sexual IPV perpetration and victimization. Findings illustrate how enacted stigma based on each minority identity intersect to raise risk for IPV among sexual minority youth of color.

Narcissistic grandiosity and risky health behaviors in college students

Objective This study explored associations between narcissistic grandiosity (including its component traits) and reported risky health behaviors in college students. Participants: College men and women (N = 122) participated between December 2015 and January 2016. Methods: Participants completed self-report measures of grandiosity, alcohol consumption, number of sex partners, and condom use. Results: Grandiosity was positively associated with alcohol consumption. Gender interacted with grandiose traits, driving associations with reported sexual behaviors. College men high in entitlement/exploitativeness reported more sex partners. Grandiose exhibitionism was associated with condom use among women but not men, such that college women higher in grandiose exhibitionism were more likely to report not using a condom with their most recent partner. Conclusions: Grandiosity (and grandiose traits) may influence health behavior and/or the reporting of health behavior in college students, but associations may differ for men and women.

Bullying and suicide risk among sexual minority youth in the United States

Bullying is associated with increased suicide risk and maladaptive development for sexual minority youth (SMY). The purpose of this study is to determine whether multiple forms of bullying mediate the relationship between biological sex and suicide risk among SMY and to determine whether sexual identity moderates these relationships (i.e., moderated mediation). Data from the 2015-2019 National Youth Risk Behavior Surveillance Survey was analyzed using multiple group structural equation modeling with the 5967 youth that self-identified as Lesbian/Gay, Bisexual, or Not sure of their sexual identity. All forms of bullying were associated with suicide risk. After controlling for bullying, Male SMY reported less suicide risk in comparison to female SMY. Female SMY were more likely to be cyberbullied while male SMY were more likely to be threatened or injured with a weapon. Sexual identity did not moderate these relationships. These finding align with the minority stress theory which posits the victimization experiences are linked to negative mental health outcomes among minority youth. Although sexual identity did not moderate these relationships, this study reveals new mechanistic pathways influencing sex-based suicide risk disparities among SMY. Findings can inform future research and the development of suicide prevention interventions that address the unique needs of SMY occurring at the intersection of sex and sexual identity.

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.

Intimate Partner Violence and Illicit Substance Use Among Sexual and Gender Minority Youth: The Protective Role of Cognitive Reappraisal

Sexual and gender minority youth (SGMY) disproportionately experience intimate partner violence (IPV) and report illicit substance use compared with cisgender heterosexual youth. Cognitive reappraisal strategies have been shown to decrease trauma-exposed individuals' likelihood of engaging in substance use. However, virtually no research has examined the relationship between various forms of IPV, including identity abuse, and illicit substance use, as well as the protective role of cognitive reappraisal among IPV-exposed SGMY. The current study addressed these limitations and examined cognitive reappraisal as a moderator of the associations between various IPV forms and illicit substance use among 149 SGMY (ages 18-25; 28.9% bisexual, 42.3% transgender or gender nonbinary, 45.0% racial and ethnic minority) between 2016 and 2017. Results indicated that many SGMY used cocaine in the past 6 months (24.8%), followed by hallucinogens (24.8%), stimulants (22.8%), and heroin (20.8%). More than half (62.4%) of SGMY experienced psychological abuse, 44.3% physical abuse, and 43.6% identity abuse in the past year. Cognitive reappraisal buffered the associations between two forms of IPV, identity abuse and physical abuse, and illicit substance use among SGMY, underscoring its importance for clinical intervention. Specifically, past year identity abuse and physical abuse were associated with greater illicit substance use only for SGMY with lower cognitive reappraisal, not for youth with higher cognitive reappraisal. This study adds to the burgeoning literature on identity, physical, and psychological forms of IPV and illicit substance use among SGMY. Our findings provide evidence that cognitive reappraisal strategies buffer the effect of identity abuse and physical abuse on illicit drug use among SGMY. These findings shed light on new avenues for clinical intervention that may help to reduce the prevalence of illicit substance use among IPV-exposed SGMY.

Sexual and Gender Minority Intimate Partner Violence and Childhood Violence Exposure

Limited research on female-assigned-at-birth sexual and gender minorities (FAB SGM) suggests that their risk of psychological, physical, and sexual intimate partner violence (IPV) victimization and perpetration may be linked to childhood violence exposure (CVE), such as experiencing child abuse, or witnessing sibling or interparental abuse. That said, there is a dearth of research in this population examining whether there is typically a violence type match between CVE and IPV (e.g., physical CVE predicting physical IPV), a gender match between those involved in CVE and later IPV (e.g., witnessing the abuse of female parents predicting IPV among women), or an increase in IPV risk commensurate with the number of different CVE types experienced. Addressing these gaps, this article draws on the baseline survey data of FAB400, a merged cohort accelerated longitudinal study of 488 FAB SGM adolescents and young adults. Analyses focused on the subsample of 457 participants with prior intimate relationship experience. Findings revealed that each assessed form of CVE-parental verbal abuse victimization, parental physical maltreatment victimization, childhood sexual abuse victimization, witnessing sibling abuse, and witnessing interparental violence-predicted risk of IPV perpetration and victimization, without evidence of violence type match. Witnessing interparental violence was associated with IPV irrespective of the abused parent's gender. In addition, exposure to a greater number of forms of CVE was associated with an increased risk of all types of IPV victimization and perpetration. Results offer preliminary evidence that the intergenerational transmission of violence is an applicable framework for FAB SGM, and as such this should be considered when screening and intervening for childhood, family, and partner violence in this population. Suggestions for future directions are discussed.

Increased Likelihood of Forced Sexual Intercourse, Sexual Violence, and Sexual Dating Violence Victimization Among Sexual Minority Youth

Sexual violence victimization among adolescents, specifically sexual minority youth, is a significant public health concern. The purpose of this study was to compare sexual violence victimization rates among sexual minority and heterosexual youth using nationally representative data from the 2019 Youth Risk Behavioral Surveillance System. Results indicated that lesbian, gay, bisexual, and questioning youth were significantly more likely than heterosexual youth (p < .05) to experience sexual violence (22.3% vs. 9.1%), sexual dating violence (16.3% vs. 6.4%), and forced sexual intercourse (17.6% vs. 5.9%). Among sexual minority youth, female participants were more likely than male participants (p < .05) to experience sexual violence (23.5% vs. 18.0%), sexual dating violence (17.2% vs. 11.6%), and forced sexual intercourse (19.0% vs. 13.1%). This study identified varying rates of sexual violence victimization among a national sample of youth while examining the differences between heterosexual and sexual minority communities. The additional behavioral risks experienced by sexual minority youth should be further researched to determine impact on overall quality of life and to help guide health education intervention development.

Help-Seeking Patterns Among LGBTQ Young Adults Exposed to Intimate Partner Violence Victimization

Although intimate partner violence (IPV) is highly prevalent among lesbian, gay, bisexual, transgender, and queer (LGBTQ) young adults, only little is known regarding gender identity disparities in this population. Furthermore, virtually no research has examined IPV-related help-seeking patterns among LGBTQ young adults, including whether there are gender identity disparities in these rates and whether specific services are most likely to be used by LGBTQ young adults across IPV type. Participants were 354 LGBTQ young adults (ages: 18-25, 33.6% transgender and gender nonconforming [TGNC]) who experienced IPV victimization during their lifetime. TGNC young adults experienced more identity abuse victimization and reported 2.06 times the odds of seeking medical services, 2.15 times the odds of seeking support services, and 1.66 times the odds of seeking mental health services compared to cisgender sexual minority young adults. LGBTQ young adults with physical abuse victimization reported 2.63 times the odds of seeking mental health services, 2.93 times the odds of seeking medical care, and 2.40 times the odds of seeking support services compared to LGBTQ young adults without physical abuse victimization. Finally, LGBTQ young adults with identity abuse reported 2.08 times the odds of seeking mental health services and 2.58 times the odds of seeking support services compared to LGBTQ young adults without identity abuse. These findings provide a more complete understanding of gender identity as both risk and protective factors for IPV and IPV-related help-seeking. This study also provides implications for training providers, service availability, and resource allocation for LGBTQ young adults with IPV victimization.

Psychometric Properties and Confirmatory Factor Analysis of the Spanish Version of the Maudsley Violence Questionnaire among Adolescent Students

The Maudsley Violence Questionnaire (MVQ) is an instrument specifically developed to evaluate violent thinking through two subscales examining macho attitudes and the acceptance of violence. This study analyzed the psychometric properties and factor structure of the Spanish version of the MVQ questionnaire in a large sample of 1933 Spanish adolescents. An online questionnaire was used to collect variables, such as sociodemographic and sexism data. The factor structure showed good fit indices in Spanish adolescents, which were similar to the original scale. The exploratory analysis yielded a first factor that explained 11.3% of the total variance and a second factor that explained 10.8% of the total variance. The Goodness of Fit Index (GFI) (0.902), Adjusted Goodness of Fit Index (AGFI) (0.90), Normed Fit Index (NNFI) (0.85), and the Comparative Fit Index (CFI) (0.86) suggested that the model fit the data adequately (with values ≥ 0.90) and the Root Mean Square Error of Approximation (RMSEA) (≤0.10) values indicative of an adequate fit. This study contributes a Spanish-language validated tool to measure machismo and the acceptance of violence among adolescents.

Risk and Protective Factors for Adolescent Relationship Abuse across Different Sexual and Gender Identities

Little is known about the characteristics and context of adolescent relationship abuse victimization across youth of different sexual and gender minority identities. This study sought to examine this in a national sample of 14-15-year-old youth. The sample comprised 3296 youth who reported having been in a relationship, of which 36% (n = 1197) were exclusively cisgender heterosexual; 41% (n = 1, 349) cisgender sexual minority; and 23% (n = 750) gender minority, the majority of whom were also sexual minority. More than half of all youth who had been in a relationship, dated or hooked up with someone had experienced some form of adolescent relationship abuse victimization. Gender minority youth, in particular transgender boys and non-binary youth assigned female at birth, were more likely to be victims of multiple types of adolescent relationship abuse compared to cisgender youth. Perpetrator gender varied for sexual and gender minorities and was more homogenous for cisgender heterosexual youth. Several factors were associated with adolescent relationship abuse for all youth, although alcohol use, and parental trust and communication emerged as particularly important for sexual and gender minority youth. Overall, findings address multiple gaps in the literature and contribute to the understanding of adolescent relationship abuse across different sexual and gender identities.

Profiles and Predictors of Dating Violence Among Sexual and Gender Minority Adolescents

PURPOSE

Sexual and gender minority adolescents report higher levels of dating violence compared with their heterosexual and cisgender peers. The objectives of the present study were to (1) identify latent profiles of dating violence; (2) examine if sexual and gender minority adolescents were particularly vulnerable to certain profiles of dating violence; and (3) explore how experiences of peer victimization, discrimination, and parental maltreatment explained this greater vulnerability.

METHODS

High school students in Grades 9 and 11 from the 2016 Minnesota Student Survey (N = 87,532; mean age = 15.29 years, SD = 1.23) were asked about their sexual and gender identities, their gender nonconformity, their experiences of verbal, physical, and sexual dating violence victimization and perpetration, as well their experiences of childhood maltreatment, peer victimization, and gender-based and sexual minority status-based discrimination.

RESULTS

Multinomial logistic regression analysis in a three-step latent class analysis procedure suggested five profiles of dating violence victimization and perpetration across the entire sample. Sexual and gender minority adolescents were generally more likely to be in classes high in dating violence victimization, perpetration, or both, compared with their heterosexual and cisgender peers. Gender nonconformity was also associated with greater risk for being in high dating violence classes. These differences, however, were generally nonsignificant when the social stressors of childhood maltreatment, peer victimization, and experiences of discrimination were accounted for.

CONCLUSIONS

Although findings suggested greater vulnerability for dating violence among sexual and gender minority adolescents, they underscore the importance of how minority stressors generally accounted for this greater vulnerability for dating violence.

Mental and Sexual Health Disparities Among Bisexual and Unsure Latino/a and Black Sexual Minority Youth

Purpose: Sexual minority youth (SMY), particularly bisexual youth and youth unsure of their sexual identity, are at greater risk of poor mental and sexual health outcomes than heterosexual youth. The purpose of this study was to examine disparities in intimate partner violence (IPV) and mental and sexual health for Black and Latino/a bisexual and unsure youth compared with their White bisexual and unsure and Black and Latino/a heterosexual peers. Methods: We used aggregated state and school district 2015 Youth Risk Behavior Survey data to demonstrate differences in mental health (e.g., depressive symptoms and suicidality), sexual health (e.g., number of sexual partners and contraceptive use), and physical and sexual IPV between Black and Latino/a bisexual and unsure youth, and their White bisexual and unsure and Black and Latino/a heterosexual peers. Results: Bisexual and unsure youth had higher odds of depressive symptoms, suicidal ideation and plans, and physical IPV than their same-race heterosexual peers. Black and Latina bisexual and unsure females were more likely to report sexual health risk behaviors than Black and Latina heterosexual females. There were few differences between bisexual and unsure youth of color and White youth. Conclusion: We add to a growing body of literature showing disparities in IPV and mental and sexual health among bisexual and unsure youth of color. Pronounced risk for poor health outcomes among bisexual and unsure females of color needs to be especially addressed by prevention and intervention efforts. We encourage further research on the health of SMY with multiple marginalized identities.

Substance Use and Disparities in Teen Dating Violence Victimization by Sexual Identity Among High School Students

Sexual minority youth (SMY) report more substance use and experience more physical and sexual dating violence victimization than heterosexual youth; however, few studies have explored the relationship between substance use and disparities in teen dating violence and victimization (TDVV) using national-level estimates, and examined if these relationships vary by sexual minority subgroups. Data from the nationally representative 2015 and 2017 national Youth Risk Behavior Surveys were used to examine differences in TDVV and substance use by sexual identity, and to determine if substance use was associated with TDVV disparities between SMY and heterosexual high school students who dated 12 months prior to the survey (n = 18,704). Sex-stratified logistic regression models generated prevalence ratios adjusted for demographic characteristics and substance use behaviors to determine if substance use mediated the relationship between sexual identity and TDVV. Compared with their heterosexual peers, SMY experienced higher rates of TDVV and were more likely to report using most types of substances, although differences were more pronounced among female students compared with male students. Disparities in TDVV were reduced for male gay and bisexual students as well as for female bisexual students once substance use was entered into the model, suggesting that there is a relationship between substance use and some of gay and bisexual students' risk for experiences of TDVV. Comprehensive efforts for violence prevention among sexual minority students may benefit from incorporating substance use prevention, given its relationship to disparities in TDVV.

Generating Intervention Concepts for Reducing Adolescent Relationship Abuse Inequities Among Sexual and Gender Minority Youth: Protocol for a Web-Based, Longitudinal, Human-Centered Design Study

Background

Sexual and gender minority youth (SGMY; eg, lesbian, gay, bisexual, and transgender youth) are at greater risk than their cisgender heterosexual peers for adolescent relationship abuse (ARA; physical, sexual, or psychological abuse in a romantic relationship). However, there is a dearth of efficacious interventions for reducing ARA among SGMY. To address this intervention gap, we designed a novel web-based methodology leveraging the field of human-centered design to generate multiple ARA intervention concepts with SGMY.

Objective

This paper aims to describe study procedures for a pilot study to rigorously test the feasibility, acceptability, and appropriateness of using web-based human-centered design methods with SGMY to create novel, stakeholder-driven ARA intervention concepts.

Methods

We are conducting a longitudinal, web-based human-centered design study with 45-60 SGMY (aged between 14 and 18 years) recruited via social media from across the United States. Using MURAL (a collaborative, visual web-based workspace) and Zoom (a videoconferencing platform), the SGMY will participate in four group-based sessions (1.5 hours each). In session 1, the SGMY will use rose-thorn-bud to individually document their ideas about healthy and unhealthy relationship characteristics and then use affinity clustering as a group to categorize their self-reported ideas based on similarities and differences. In session 2, the SGMY will use rose-thorn-bud to individually critique a universal evidence-based intervention to reduce ARA and affinity clustering to aggregate their ideas as a group. In session 3, the SGMY will use a creative matrix to generate intervention ideas for reducing ARA among them and force-rank the intervention ideas based on their potential ease of implementation and potential impact using an importance-difficulty matrix. In session 4, the SGMY will generate and refine intervention concepts (from session 3 ideations) to reduce ARA using round robin (for rapid iteration) and concept poster (for fleshing out ideas more fully). We will use content analyses to document the intervention concepts. In a follow-up survey, the SGMY will complete validated measures about the feasibility, acceptability, and appropriateness of the web-based human-centered design methods (a priori benchmarks for success: means >3.75 on each 5-point scale).

Results

This study was funded in February 2020. Data collection began in August 2020 and will be completed by April 2021.

Conclusions

Through rigorous testing of the feasibility of our web-based human-centered design methodology, our study may help demonstrate the use of human-centered design methods to engage harder-to-reach stakeholders and actively involve them in the co-creation of relevant interventions. Successful completion of this project also has the potential to catalyze intervention research to address ARA inequities for SGMY. Finally, our approach may be transferable to other populations and health topics, thereby advancing prevention science and health equity.

International Registered Report Identifier (IRRID)

DERR1-10.2196/26554

School Bullying and Dating Violence in Adolescents: A Systematic Review and Meta-Analysis

Involvement in bullying perpetration or victimization could be risk factors for perpetration or victimization in early romantic relationships that emerge within an evolving peer group. Nevertheless, research on this topic is still in its early stages. This study was conducted to fill these gaps in knowledge through a comprehensive research synthesis. After systematic searches and application of inclusion and exclusion criteria, 23 projects that reported relations between bullying (perpetration and victimization) and dating violence (perpetration and victimization) were included in this meta-analysis. Bullying perpetration was related to dating violence perpetration (odds ratio [OR] = 1.98), and this relation held after adjusting for covariates (OR = 1.29). Moderator analyses showed that this effect was significant for males and females and stronger in cross-sectional studies. There was also a significant relation between bullying perpetration and dating violence victimization (OR = 2.59), but this was much weaker after controlling for covariates (OR = 1.09) and stronger for males and in longitudinal studies. Bullying victimization was related to dating violence victimization (OR = 2.51), also after adjusting for covariates (OR = 1.96), stronger for females and longitudinal projects. The relation between bullying victimization and dating violence perpetration was not statistically significant (unadjusted OR = 1.43, adjusted OR = 1.01). More research is needed to confirm these results, but this meta-analysis suggests that bullying and dating violence could be different behavioral manifestations, in different evolutionary moments and in different contexts, of the same underlying antisocial or violent dispositions, although longitudinal studies are needed to confirm this. Tailored and comprehensive interventions could be useful to tackle both problem behaviors.

Mediating Factors Explaining the Association Between Sexual Minority Status and Dating Violence

Dating violence presents a serious threat for individual health and well-being. A growing body of literature suggests that starting in adolescence, individuals with sexual minority identities (e.g., individuals who identify as gay, lesbian, or bisexual) may be at an increased risk for dating violence compared with heterosexuals. Research has not, however, identified the mechanisms that explain this vulnerability. Using a diverse sample of young adults (n = 2,474), the current study explored how minority stress theory, revictimization theory, sex of sexual partners, and risky sexual behavior explained differences in dating violence between sexual minority and heterosexual young adults. Initial analyses suggested higher rates of dating violence among individuals who identified as bisexual, and individuals who identified as gay or lesbian when compared with heterosexuals, and further found that these associations failed to differ across gender. When mediating and control variables were included in the analyses, however, the association between both sexual minority identities and higher levels of dating violence became nonsignificant. Of particular interest was the role of discrimination, which mediated the association between bisexual identity and dating violence. Other factors, including sex and number of sexual partners, alcohol use, and childhood maltreatment, were associated with higher rates of dating violence but did not significantly explain vulnerability among sexual minority individuals compared with their heterosexual peers. These findings suggest the importance of minority stress theory in explaining vulnerability to dating violence victimization among bisexuals in particular, and generally support the importance of sexual-minority specific variables in understanding risk for dating violence within this vulnerable population.

Sexual Violence and Chemsex among Substance-Using Sexual and Gender Minorities in Texas

Chemsex is the use of methamphetamine or other substances to enhance sexual experiences, and is most often associated with sexual minority men. Within the chemsex literature, questions of sexual violence emerge due, in part, to ambiguity about what constitutes consent within sexualized environments with co-occurring substance use. To understand the context in which sexual violence occurs, data from an online survey of sexual and gender minority Texans were analyzed using bivariate and logistic regression (N = 1273), and qualitative interviews with substance-using sexual minority men from a separate sample were thematically analyzed (N = 22). Among survey participants, 12.8% experienced a form of sexual violence (10.1% experienced intimate partner violence and 7.6% experienced sexual assault). When participants were categorized based on past year substance use and sex party attendance, 48.0% of participants who used drugs and attended sex parties (a proxy for chemsex) experienced sexual violence (41.6% experienced intimate partner violence and 41.0% experienced sexual assault). When variables statistically significant at the bivariate-level were entered into logistic regression models, participants in the chemsex category were 12.5 [95% CI: 6.9, 22.8] times more likely to experience sexual violence. Substance-using sexual minority men experiencing sexual violence describe situations in which consent is difficult to revoke and sexual exploitation is likely to occur. Studies which more deeply explore the relationship between sexual and relationship violence and chemsex among sexual and gender minorities are needed. Particularly, the notion of consent needs further conceptualization in the context of drug use and sex parties.

HIGHLIGHTS

Measures of recent substance use and sex party attendance were combined to create a proxy measure for chemsex, which is the use of substances to enhance sexual experiences.Substance-using sexual and gender minorities engaging in chemsex were at increased risk of sexual violence.In addition to engaging in chemsex, variables associated with an increased odds of sexual violence among sexual and gender minorities were younger age, having a non-monosexual sexual identity, and receiving a mental health diagnoses.Studies on sexual and gender minorities engaging in chemsex should be developed to further explore sexual exploitation.

Developing an inclusive Safe Dates program for sexual and gender minority adolescents: A pilot study

INTRODUCTION

Despite the prevalence and negative consequences of dating violence among sexual and gender minority (SGM) adolescents, few prevention programs address dating violence for these groups. We describe the adaptation of the evidence-based Safe Dates dating violence prevention program to be inclusive of SGM adolescents and the outcome of a pilot trial of the expanded curriculum implemented in mixed settings serving both SGM and cisgender, heterosexual youth.

METHODS

Following a published framework of curriculum adaptation, we gathered information on SGM adolescents' needs and adapted Safe Dates materials to address SGM-specific risk factors for, and manifestations of, dating violence. We piloted the adapted program in 11 US schools and organizations serving SGM and cisgender, heterosexual youth (N = 156). The average age of participants was 15.11 years (SD = 2.76) at baseline. Participants were diverse with respect to race/ethnicity (26% Black/African American, 24% Hispanic/Latino, 21% White, 7% American Indian/Native Alaskan, 5% Asian/Pacific Islander), gender (56% female), and SGM status (35% SGM). Multi-level models measured change in scores on a written measure of dating violence knowledge from pre-test to post-test.

RESULTS

Dating violence knowledge increased significantly. Improvements did not differ by gender (female-identified versus not female-identified) or SGM status.

CONCLUSIONS

Results support initial feasibility and efficacy of dating violence prevention programs that include both SGM and cisgender, heterosexual adolescents. The program normalizes diverse SGM identities and encourages participation of youth who are questioning or choosing not to disclose their gender or sexual identities. Larger-scale research should examine effects on dating violence experiences.

Associations Between LGBTQ-Affirming School Climate and Intimate Partner Violence Victimization Among Adolescents

Intimate partner violence (IPV) impacts sexual minority adolescents at rates equal to or greater than the rate it impacts heterosexual adolescents. We investigated whether reports of physical and sexual IPV were less frequent in school jurisdictions with more affirming climates for lesbian, gay, bisexual, transgender, and queer (LGBTQ) students; and whether these associations varied for sexual orientation subgroups. We combined student-level data from the 2015 Youth Risk Behavior Surveys on demographics and experiences with physical and sexual IPV with jurisdiction-level data from the 2014 School Health Profiles on LGBTQ-affirming school climate. Multilevel logistic regression models examined associations between LGBTQ-affirming school climates and IPV. We stratified our data by sex and examined whether these associations differed by sexual orientation subgroups using cross-level interaction terms between school climate and sexual orientation (assessed via sexual identity and behavior). Sexual minority youth were more likely to report experiencing past-year physical and sexual IPV than their heterosexual counterparts. Attending schools with more LGBTQ-affirming climates reduced the likelihood of reporting physical IPV, but not sexual IPV, for female students. More LGBTQ-affirming school climates increased risk for sexual IPV among gay male students. Establishing LGBTQ-affirming school climates may reduce physical IPV for female students, but may have unintended consequences on sexual IPV prevalence for gay male students. More work is necessary to ensure that these climates are affirming for all sexual minority students and to address sexual violence prevention.

Teen Dating Violence and Suicide Risk Among Bisexual Adolescents

PURPOSE

Suicide is a public health problem that disproportionately affects bisexual youth more than heterosexual, lesbian/gay, and other sexual minority youth. Teen dating violence (TDV) consists of physically, emotionally, and/or psychologically aggressive behavior in adolescent relationships and has been linked to increased suicidality among sexual minority youth. Although biological sex differences in suicide and TDV have been noted, limited research currently exists regarding the importance of these differences in bisexual youth.

METHODS

This study employed a cross-sectional descriptive design to investigate the relationship between biological sex, TDV, and suicide risk among bisexual youth in grades 9-12. This study used structural equation modeling to conduct a secondary analysis of pooled 2015 and 2017 national Youth Risk Behavior Surveillance Survey data that examined whether TDV mediated the relationship between biological sex and suicide risk among bisexual youth.

RESULTS

Results indicated that TDV did not mediate the relationship between biological sex and suicide risk among bisexual youth. Biological sex was a significant predictor of suicide risk with male youth reporting lower suicide risk than female youth, when controlling for dating history, TDV, age, and race. TDV predicted suicide risk, with youth reporting TDV having higher suicide risk, when controlling for dating history, biological sex, age, and race. In addition, black and Hispanic youth reported lower suicide risk compared to white youth.

CONCLUSION

There is a dire need for research that addresses issues of TDV and suicide among bisexual youth. Understanding factors influencing suicide risk following TDV experiences among bisexual youth will inform interventions to mitigate negative mental health outcomes.

Physical and Sexual Teen Dating Violence Victimization and Sexual Identity Among U.S. High School Students, 2015

Lesbian, gay, and bisexual (LGB) youth are at risk for many negative behaviors associated with teen dating violence victimization (TDVV). This study describes the prevalence of physical and sexual TDVV by sexual identity and quantifies the increased risk for TDVV among LGB youth compared with heterosexual youth. The participants for this study were students in Grades 9 to 12 participating in the 2015 national Youth Risk Behavior Survey (YRBS) who responded to questions ascertaining sexual identity and both physical and sexual TDVV. Data were analyzed by sexual identity, stratified by sex, and controlled for race/ethnicity and grade in school. Frequencies of physical and sexual TDVV and prevalence of TDVV from a combined TDVV measure were calculated. Associations between these behaviors and sexual identity were identified. Generally, LGB youth had greater prevalence and frequency of TDVV compared with heterosexual youth. Prevalence of TDVV within sexual identity subgroups further differed by sex. Students who were not sure of their sexual identity had the highest risk of most categories of TDVV when adjusting for sex, race/ethnicity, and grade in school. These results are the first to use a nationally representative sample to describe frequency of TDVV and to determine prevalence of a combined physical and sexual TDVV measure by sexual identity among youth. Schools, communities, and families can help prevent teen dating violence and ameliorate the potential impacts of these victimizations.

Evaluation of sexual minority identity as a moderator of the association between intimate partner violence and suicidal ideation and attempts among a national sample of youth

Sexual minority (SM) youth are at high risk for intimate partner violence (IPV) and suicidal ideation/attempts compared to their heterosexual peers. We examined whether SM identity enhanced the relationship between experiences of IPV and suicidal ideation/attempts. Weighted logistic regression models were run using the 2017 Youth Risk Behavior Survey. All main effects were significant; each SM identity and both physical and sexual IPV were significantly associated with suicidal ideation and suicide attempts. The interaction between bisexual identity and physical IPV was significant for suicidal ideation; as physical IPV experiences increased, the difference between bisexual identity and heterosexual youth was non-significant. Findings suggest exploring trauma and suicidal ideation by aggregate groups and increasing support for SM youth in schools and communities.

Prospective associations among relationship abuse, sexual harassment and bullying in a community sample of sexual minority and exclusively heterosexual youth

INTRODUCTION

Sexual minority youth (SMY) are at significantly greater risk for experiencing adolescent relationship abuse (ARA) than exclusively heterosexual youth, yet little is known about the factors that elevate their risks for such abuse. Peer victimization (i.e., bullying, sexual harassment) has been associated with ARA among heterosexual youth. SMY experience higher rates of peer victimization than heterosexual youth, suggesting that it may be a risk factor for ARA among these youth. Using longitudinal data from a community sample of adolescents recruited from the northeastern US, we examined whether sexual identity was associated prospectively with ARA, and whether that relationship would be indirect, and mediated via bullying and sexual harassment at a 12-month follow-up. We expected to find higher rates of peer victimization and ARA among SMY than heterosexual youth, and we expected that sexual harassment and bullying would predict subsequent relationship abuse.

METHODS

Adolescents (N = 800; 58% female; 81% European-American; 19% SMY) between 13 and 15 years (M = 14.45, SD = 0.85) completed a web survey at baseline, 6-months and 12-months.

RESULTS

Consistent with prior studies, SMY reported higher rates of bullying, sexual harassment, and relationship abuse than heterosexual youth. SMY who reported sexual harassment at baseline were more likely to report relationship abuse over time. Contrary to our expectations, however, bully victimization did not predict subsequent relationship abuse.

CONCLUSIONS

Sexual harassment can be particularly harmful for SMY because it targets gender and sexual identity at a formative developmental period and puts youth at risk for relationship abuse.

Dimensions of Sexual Orientation and Rates of Intimate Partner Violence among Young Sexual Minority Individuals Assigned Female at Birth: The Role of Perceived Partner Jealousy

OBJECTIVE

Sexual minorities assigned female at birth are at increased risk for experiencing intimate partner violence (IPV) compared to heterosexual individuals, and bisexual individuals assigned female at birth appear to be at greatest risk. However, few studies have examined potential explanatory factors. Partner jealousy may contribute to bisexual individuals' increased risk for experiencing IPV, given stereotypes that they are promiscuous and evidence that people anticipate being jealous of a bisexual partner.

METHODS

This study examined the role of perceived partner jealousy in cross-sectional associations between self-reported dimensions of sexual orientation (identity, attractions, behavior) and IPV victimization among 368 young sexual minorities assigned female at birth (77.4% cisgender women).

RESULTS

Sexual behavior was associated with IPV, but sexual identity and attractions were not. Those with both male and female sexual partners in their lifetime were at increased risk for many forms of IPV compared to those with only male partners and those who never had sex, and these associations were partially explained by their higher perceived partner jealousy. Those with male and female partners were only at increased risk for two types of IPV compared to those with only female partners and these differences were not explained by perceived partner jealousy.

CONCLUSIONS

Jealousy may contribute to behaviorally bisexual individuals' increased risk for many forms of IPV compared to those with only male partners or never had sex. This highlights the importance of considering multiple dimensions of sexual orientation and has implications for the development of interventions to reduce IPV in this population.

Examining the intersection of race/ethnicity and sexual orientation on suicidal ideation and suicide attempt among adolescents: Findings from the 2017 Youth Risk Behavior Survey

Although some studies have examined factors associated with suicidal behaviors, few studies have examined the intersection of sexual orientation and race/ethnicity on suicidal behaviors among adolescents. The objective of this study is to examine the intersection of sexual orientation and race/ethnicity on suicidal ideation and suicide attempt. We hypothesized that controlling for the effects of known risk factors for suicidal behaviors, there will be an interaction effect between sexual orientation and race/ethnicity on suicidal behaviors. Data for this study came from the 2017 Youth Risk Behavior Surveillance System. A sample of 13,697 adolescents aged 14-18 years (51.8% female) was analyzed using binary logistic regression. Of the 13,697 adolescents, 17.7% reported suicidal ideation and 7.7% made at least one suicide attempt during the past 12 months. In the multivariate logistic regression models, non-White sexual minority adolescents are less likely to report suicidal ideation. However, Hispanic lesbian/gay adolescents had 1.71 times higher odds of making a suicide attempt. Odds of suicide attempt are 1.2 times higher for Black or African American bisexual adolescents and American Indian/Native Hawaiian/Pacific Islander bisexual adolescents had 2.44 times higher odds of making a suicide attempt. Other significant predictors of suicidal behaviors include a history of sexual assault, a victim of bullying, depression, cigarette smoking, misuse of prescription pain medication, and illicit drug use. The findings of the present study extend past research on the intersection of sexual orientation and race/ethnicity on mental health problems among adolescents including suicidal behaviors.