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

Online Human-Centered Design Methods are Acceptable, Appropriate, and Feasible for Generating Adolescent Relationship Abuse Intervention Ideas With Sexual and Gender Diverse Youth

PURPOSE

Sexual and gender diverse youth (SGDY) are at greater risk for adolescent relationship abuse (ARA) than cisgender heterosexual youth, but there are not enough evidence-based interventions for reducing ARA among SGDY. We piloted online human-centered design (HCD) methodology to engage SGDY in generating ARA intervention ideas. This study evaluated the acceptability, appropriateness, and feasibility of the online methods and identified SGDY-derived intervention ideas for reducing ARA.

METHODS

From August 2020 through March 2021, we conducted a longitudinal online HCD study with 46 SGDY (aged 14-18 years) recruited via social media from across the United States. SGDY completed HCD activities using MURAL (collaborative digital whiteboard) in four group-based sessions (1.5 hours each) and a follow-up survey with validated measures of acceptability, appropriateness, and feasibility (a priori success benchmarks: means > 3.75 on each five-point scale).

RESULTS

SGDY in the sample were 41% racial/ethnic minorities. SGDY rated the online HCD methods as highly acceptable, appropriate, and feasible (means ≥ 4.29). SGDY co-created a breadth of ARA intervention concepts across all social-ecological levels, including commonplace ideas (e.g., curriculum for schools) and novel ideas, such as social media-based interventions to foster healthy relationships, incentivization interventions for performing social justice work, and school plays with SGDY storylines.

DISCUSSION

Online HCD methods are acceptable, appropriate, and feasible for designing ARA intervention ideas. The intervention ideas generated in this study can help catalyze ARA intervention research for SGDY. Our method can be transported to other populations and health topics to help advance adolescent health and equity.

Associations Among Plurisexual Identity, Intimate Partner Violence, Reproductive Coercion, and Parental Monitoring in a Sample of Adolescent and Young Adult Pregnant People

Purpose: The goal of this study was to examine plurisexual identity, intimate partner violence (IPV), reproductive coercion, and parental monitoring among pregnant 13-21-year-olds. Methods: We conducted a cross-sectional analysis of data collected from a cohort of pregnant adolescents and young adults between October 2019 and May 2023 (n = 398). Logistic regression was completed to assess IPV and reproductive coercion as a function of plurisexual identity. Next, we assessed potential interactions between parental monitoring and plurisexual identity and examined IPV and reproductive coercion as a function of parental monitoring for the full sample and stratified by plurisexuality. Results: Plurisexual identity was associated with IPV (adjusted odds ratio [aOR] = 2.3; confidence interval [CI]: 1.4-4.0). IPV was inversely related to parental monitoring among plurisexual participants (aOR: 0.51; CI: 0.32-0.82), but this association was not significant for heterosexual participants (aOR: 1.1; CI: 0.75-1.6). Conclusions: This work demonstrates the importance of parental monitoring in supporting young plurisexual pregnant people.

Substance use prevalence, patterns, and correlates in transgender and gender diverse youth: A scoping review

Transgender and gender diverse (TGD) adults are at elevated risk of problematic substance use. While understanding substance use disparities in TGD youth is crucial for informing early preventions, there is no known synthesis of prevalence and correlates of substance use in TGD youth. The objectives of this study were to: 1) describe the prevalence and patterns of substance use in TGD youth, 2) identify and evaluate potential correlates of substance use, and 3) report the strengths and limitations of the current literature in recommendation of future steps. A PRISMA-guided systematic search was conducted to identify 55 studies that reported prevalence, patterns, or correlates of substance use in TGD youth aged 10-24 years; were published in the English language; and followed a quantitative design. Fifty-four (98.18%) studies examined prevalence and patterns, 23 (41.82%) examined correlates, and 12 (21.82%) examined moderators and mediators of substance use in TGD youth. Findings suggest TGD youth exhibit a moderate-to-high prevalence of recent substance use, including alcohol (23-31%), binge drinking (11-59%), cigarettes (10-59%), e-cigarettes (17-27%), and marijuana (17-46%). Additionally, results supported that greater victimization experiences, including those related and unrelated to being a gender minority, were associated with increased substance use risk. Few studies examined polysubstance use, resilience, and protective factors, or considered TGD subgroup differences, which we recommend in future research. Further, we recommend improving population-based surveys to better capture gender identity and related experiences.

Interventional Effects Analysis of Dating Violence and Sexual Assault Victimization in LGBTQ + Adolescents: Quantifying the Roles of Inequities in School and Family Factors

Lesbian, gay, bisexual, transgender/nonbinary, and queer (LGBTQ +) adolescents experience considerable disparities in dating violence and sexual assault victimization relative to heterosexual and cisgender peers. These disparities may be driven in part by the disruptive effects of heterosexism and cissexism on school-based and family relationships. To quantify the potential roles of these processes and identify priorities for prevention efforts, we estimated the extent to which dating violence and sexual assault victimization in LGBTQ + adolescents could be reduced by eliminating sexual orientation and gender modality inequities in school adult support, bullying victimization, and family adversity. We analyzed data from a cross-sectional, population-based survey of high school students in Dane County, Wisconsin (N = 15,467; 13% sexual minority; 4% transgender/nonbinary; 72% White) using interventional effects analysis, adjusting for grade, race/ethnicity, and family financial status. We found that eliminating inequities in bullying victimization and family adversity could significantly reduce dating violence and sexual assault victimization in LGBTQ + adolescents, particularly sexual minority cisgender girls and transgender/nonbinary adolescents. For instance, eliminating gender modality inequities in family adversity could reduce sexual assault victimization in transgender/nonbinary adolescents by 2.4 percentage points, representing 27% of the existing sexual assault victimization disparity between transgender/nonbinary and cisgender adolescents (P < 0.001). Results suggest that dating violence and sexual assault victimization in LGBTQ + adolescents could be meaningfully reduced by policies and practices addressing anti-LGBTQ + bullying as well as heterosexism- and cissexism-related stress in LGBTQ + adolescents' families.

Youth Characteristics Associated With Sexual Violence Perpetration Among Transgender Boys and Girls, Cisgender Boys and Girls, and Nonbinary Youth

IMPORTANCE

Gender minority adults experience higher rates of sexual violence (SV) than cisgender adults. How this disparity extends to youths, including perpetration rates, is unknown.

OBJECTIVE

To compare rates of experience and perpetration of SV by gender identity and investigate characteristics associated with odds of perpetration within gender identity categories.

DESIGN, SETTING, AND PARTICIPANTS

This cross-sectional study used baseline data from a national online longitudinal survey collected in 2018 to 2020. Eligible participants were youths ages 14 to 16 years who read English and had internet access. Data were analyzed in November 2021 and March 2022.

EXPOSURES

Youth characteristics included stressors associated with being marginalized (eg, internalized transphobia), general stressors (eg, trauma not associated with experiencing SV), other marginalized statuses (eg, identifying as a girl), factors associated with protection (eg, social support), environmental characteristics (eg, community violence exposure), and risk factors associated with SV (eg, consumption of violent pornography).

MAIN OUTCOMES AND MEASURES

Self-reported rates of experiencing and perpetrating SV, defined as sexual assault, rape, attempted rape, and coercive sex, among cisgender, transgender, and nonbinary youths.

RESULTS

Among 4193 youths in the sample (mean [SD] age, 14.8 [0.7] years), 3282 participants (78.3%) were cisgender, 329 participants (7.9%) were transgender, and 582 participants (13.9%) were nonbinary. The odds of SV perpetration were not statistically significantly different for transgender boys and girls (odds ratio [OR], 0.90; 95% CI, 0.57-1.41; P = .64) or nonbinary youths (OR, 0.78; 95% CI, 0.54-1.12; P = .18) compared with cisgender boys and girls. By contrast, transgender boys and girls (OR, 2.31; 95% CI, 1.83-2.91; P < .001) and nonbinary youths (OR, 2.37; 95% CI, 1.98-2.83; P < .001) were more than 2-fold as likely as cisgender boys and girls to report experiencing SV. Aggressive behavior was associated with higher odds of SV perpetration for transgender boys and girls (adjusted OR [aOR], 1.87; 95% CI, 0.75-4.65; P = .18) and nonbinary youths (aOR, 1.61; 95% CI, 0.78-3.32; P = .20). Indications of hostile masculinity were associated with higher odds of SV perpetration among cisgender youths (ie, positive attitudes for boys to engage in rape behaviors: aOR per unit increase in score, 1.15; 95% CI, 1.07-1.25; P < .001; sexual dominance: aOR per unit increase in score, 1.03; 95% CI, 1.01-1.04; P < .001) but not among transgender or nonbinary youths.

CONCLUSION AND RELEVANCE

These findings may suggest an important foundation for the development of inclusive, research-based SV prevention programs and methods for incorporating gender identity effectively into SV research.