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DeMaio DM, Barerra EP, Post J, Boskey ER, Guss CE. Understanding Gaps of HIV Knowledge Among Transgender Young Adults: A Pilot Interview Study. AIDS EDUCATION AND PREVENTION : OFFICIAL PUBLICATION OF THE INTERNATIONAL SOCIETY FOR AIDS EDUCATION 2024; 36:229-243. [PMID: 39189961 DOI: 10.1521/aeap.2024.36.4.229] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 08/28/2024]
Abstract
Many transgender young adults are unaware of the role of pre-exposure prophylaxis (PrEP) in HIV prevention. Our aim was to understand where transgender and gender-diverse young adults receive health information about HIV and PrEP and their preferences for future learning. Semistructured, qualitative individual and group interviews were done with 14 transgender and gender-diverse young adults. Interviews were transcribed verbatim and analyzed using thematic analysis. Four themes emerged from the interviews related to (1) making trustworthy education materials, (2) the importance of communities, (3) knowledge needed about PrEP, and (4) a lack of early and diverse classroom education. Transgender and genderdiverse persons are at higher risk for HIV than their cisgender peers, yet they have information gaps and hold misconceptions about preventative measures like PrEP. Such misconceptions may be addressed by early, inclusive conversations about HIV transmission and prevention.
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Affiliation(s)
- Danielle M DeMaio
- Division of Adolescent/Young Adult Medicine, Boston Children's Hospital
| | - Ellis P Barerra
- Division of Adolescent/Young Adult Medicine, Boston Children's Hospital
| | - Julian Post
- Division of Adolescent/Young Adult Medicine, Boston Children's Hospital
| | - Elizabeth R Boskey
- Division of Gynecology, Boston Children's Hospital, Harvard Medical School, and the Harvard T.H. Chan School of Public Health
| | - Carly E Guss
- Division of Adolescent/Young Adult Medicine, Boston Children's Hospital
- Harvard Medical School
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2
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O’Kane KMK, Goldberg SY, Bouchard KN, Dawson SJ. Busting MisconSEXions: evaluation of a social media knowledge translation initiative addressing myths about sex. Front Psychol 2024; 15:1347493. [PMID: 39006551 PMCID: PMC11241140 DOI: 10.3389/fpsyg.2024.1347493] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2023] [Accepted: 06/10/2024] [Indexed: 07/16/2024] Open
Abstract
There is a critical gap in sex education such that many people lack access to evidence-based and accessible information about sexuality, putting them at risk for endorsing myths about sex and in turn having poorer sexual wellbeing. To address this gap, we developed a novel social media knowledge translation initiative-MisconSEXions-to debunk common myths about sexuality. The goal of this study was twofold. First, to examine whether exposure to MisconSEXions is effective for reducing sexuality myth endorsement. Second, to evaluate the acceptability (participants' satisfaction with the content), appropriateness (the perceived fit of the content with participants), adoption (participants' intention to engage with the initiative), and penetration (participants' perception of the content's impact on their lives) of MisconSEXions among study participants. We also examined possible group differences in our observed effects by assigned sex, gender modality, and sexual orientation. A large and diverse sample (N = 2,356) of adults completed an online survey and reported on their demographics, sexuality myth endorsement before and after exposure to MisconSEXions content, and the acceptability, appropriateness, adoption, and penetration of the MisconSEXions content. We found that participants' sexuality myth endorsement was significantly lower following exposure to MisconSEXions content, and this effect held across assigned sex, gender modality, and sexual orientation groups. Regardless of participants' assigned sex, gender modality, or sexual orientation, MisconSEXions content was reported to be both acceptable and appropriate to people's lives. Participants reported relatively low levels of adoption, such that they reported reluctance to engage with the content on social media. Additionally, participants reported mixed feelings regarding the impact of the content on their lives (i.e., penetration). Overall, the findings have implications for how sexuality social media knowledge translation initiatives can fill important gaps in providing inclusive and accessible sex education.
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Affiliation(s)
- Kiarah M. K. O’Kane
- Department of Psychology, The University of British Columbia, Vancouver, BC, Canada
| | - Simone Y. Goldberg
- Department of Psychology, The University of British Columbia, Vancouver, BC, Canada
| | - Katrina N. Bouchard
- Department of Obstetrics and Gynaecology, The University of British Columbia, Vancouver, BC, Canada
| | - Samantha J. Dawson
- Department of Psychology, The University of British Columbia, Vancouver, BC, Canada
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3
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Chang KK, Rogge RD, Starr LR. Characterizing Life Stress Exposure Among Sexual Minority Adolescents: Temporality, Content, And Mediating Role in Mental Health Disparities. Res Child Adolesc Psychopathol 2024; 52:851-863. [PMID: 38214850 DOI: 10.1007/s10802-023-01165-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/20/2023] [Indexed: 01/13/2024]
Abstract
Though sexual minority adolescents face a wide array of deleterious stressors, few studies have examined the role of specific types of stress exposure (i.e., chronic vs. episodic, interpersonal vs. non-interpersonal) on mental health disparities. This study utilizes a contextual threat-based assessment to (a) compare levels of stress exposure types between sexual minority and non-sexual minority adolescents, and (b) examine stress type as a mediator between sexual orientation and two outcomes: depressive symptoms and emotion dysregulation. Data comes from a longitudinal sample (14-17 years-old, N = 241; 17.6% sexual minority; 54% assigned female at birth; 73.9% White), with two time-points (T1 and T2) utilized. Sexual minority adolescents reported higher chronic interpersonal stress, but no differences in non-interpersonal chronic or episodic stress, relative to non-sexual minority adolescents. Chronic interpersonal stress exposure mediated the link between membership in an oppressed group (i.e., sexual minority teens) and the primary outcomes (emotion dysregulation and depressive symptoms) at both T1 and T2. Findings demonstrate the utility of contextual threat-based assessments within sexual minority research.
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Affiliation(s)
- Katharine K Chang
- Department of Psychology, University of Rochester, Rochester, NY, USA.
| | - Ronald D Rogge
- Department of Psychology, University of Rochester, Rochester, NY, USA
| | - Lisa R Starr
- Department of Psychology, University of Rochester, Rochester, NY, USA
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Jayne PE, Szucs LE, Lesesne CA, Grose RG, Johns MM. "I wouldn't have felt so alone": The sexual health education experiences of transgender and gender diverse youth living in the southeastern United States. PERSPECTIVES ON SEXUAL AND REPRODUCTIVE HEALTH 2024; 56:158-170. [PMID: 38623631 PMCID: PMC11304134 DOI: 10.1111/psrh.12258] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 04/17/2024]
Abstract
BACKGROUND Transgender and gender diverse youth experience multiple disproportionate adverse sexual health outcomes. Sexual health education teaches knowledge, attitudes, and skills for promoting sexual health, including reducing risk for sexually transmitted infection, HIV acquisition, and unintended pregnancy. Provision of sexual health education may be protective, but research remains scarce. METHODS We conducted a multi-stage thematic analysis of 33 in-depth interviews among transgender and gender diverse youth (ages 15-24) living in the southeastern United States on their sexual health education experiences. RESULTS Our study participants described school-based sexual health education as unhelpful due to a lack of relevant information, inadequately prepared teachers, and a perceived negative tone toward sexuality. They reported relying on online sources of sexual health information, finding relevant content and community despite some limitations. Participants desired content and pedagogy that expands beyond binary and white-centric presentations of sexuality and gender and sought resources that provide relevant, accurate, and judgment-free information while holding positive framing around sexuality and gender. CONCLUSION There is much work needed to improve the breadth, quality, and relevance of school-based sexual health education. Sexual health education can improve by strengthening critical media literacy skills of youth; raising staff cultural competency on gender, race, and sexual identity through training and supports; using culturally relevant and inclusive curricula; and partnering with community-based organizations. Transgender and gender diverse youth would benefit from sexual health education from multiple sources which is queer-friendly, affirms their existence, and provides information on gender, race, and sexuality in positive and expansive ways.
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Affiliation(s)
- Paula E. Jayne
- U.S. Centers for Disease Control and Prevention’s Division of Adolescent and School Health, Atlanta, Georgia, USA
| | - Leigh E. Szucs
- U.S. Centers for Disease Control and Prevention’s Division of Adolescent and School Health, Chamblee, Georgia, USA
| | | | - Rose Grace Grose
- Colorado School of Public Health, Community Health Education, University of Northern Colorado, Greeley, Colorado, USA
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Joyce E, Pratt D, Lea J. " Where Is My Place?" A Qualitative Study of Gay Men's Experiences of Social Support, Relationships and Community in Relation to Psychological Wellbeing and Distress. JOURNAL OF HOMOSEXUALITY 2024:1-27. [PMID: 38787790 DOI: 10.1080/00918369.2024.2354408] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/26/2024]
Abstract
This study aimed to understand young gay men's experiences of social support, relationships, community networks, talking about psychological distress, and their impact on distress and wellbeing. Eight verbatim transcriptions from semi-structured interviews with gay men aged 18-35 years were analyzed using Interpretative Phenomenological Analysis. Three super-ordinate themes were developed; 1) Growing up gay in a straight world: Developmental traumas, regarding men's experiences of homophobic abuse and exclusion and the internalized impact on their identities and identity concealment. 2) Belonging and not belonging within LGBTQ+ communities, encompassing men's varied experiences of LGBTQ+ communities and the corresponding impacts upon their wellbeing. 3) Relational responses to rejection, describing how men made sense of and managed their relationships within the context of the developmental traumas they had experienced growing up as gay men. These findings illuminate the psychological impact of experiencing multiple developmental traumas related to one's identity as a gay man, and how this influences lifelong relational behavior; and how experiences of social support, relationships and LGBTQ+ communities influence men's mental health. They provide a strong rationale for psychological interventions to acknowledge and address gay men's unique and adverse social experiences within their relationships, communities and societies.
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Affiliation(s)
- Emmeline Joyce
- Division of Psychology and Mental Health, School of Health Sciences, Faculty of Biology, Medicine and Health, The University of Manchester, Manchester, UK
- The Psychosis Research Unit, Greater Manchester Mental Health NHS Foundation Trust, Manchester, UK
| | - Daniel Pratt
- Division of Psychology and Mental Health, School of Health Sciences, Faculty of Biology, Medicine and Health, The University of Manchester, Manchester, UK
- The Suicide Risk and Safety Research Unit, Greater Manchester Mental Health NHS Foundation Trust, Manchester, UK
| | - James Lea
- Division of Psychology and Mental Health, School of Health Sciences, Faculty of Biology, Medicine and Health, The University of Manchester, Manchester, UK
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Espino E, Jiménez-Díaz O, Del Rey R, Elipe P. Outlining Individual and Contextual Factors Related to LGBTQ+ Bullying: A Systematic Review of Two Decades of Research. TRAUMA, VIOLENCE & ABUSE 2024; 25:898-917. [PMID: 37078578 DOI: 10.1177/15248380231165724] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/03/2023]
Abstract
Scientific interest in lesbian, gay, bisexual, transgender, queer and any other sexual orientation, gender identity and/or expression (LGBTQ+) bullying in educational settings has grown exponentially in recent years. However, the varied ways of measuring its occurrence and associated factors have made it difficult to achieve a holistic understanding of this problem. Therefore, this systematic review aimed to provide an updated overview of individual and contextual factors related to LGBTQ+ bullying over the past two decades, based on the measurement approach to this phenomenon. Studies published from 2000 to 2020 were analyzed following the Preferred Reporting Items for Systematic reviews and Meta-Analyses strategy. Inclusion and exclusion criteria were applied in a staggered process, and 111 articles met all the criteria. Studies focusing on LGBTQ+ bullying victimization or aggression were eligible for inclusion. Our analysis revealed LGBTQ+ bullying is usually examined by measures of general aggressions (47.8%) from the victims' perspective (87.3%). The best-represented factors across studies were individual characteristics (63.1%; n = 70), especially participants' sexual orientation and gender identity and expression (68.5%). Boys/males, from a binary gender perspective, and sexual and gender minority youth in general, were more at risk of being targeted for LGBTQ+ bullying. Although contextual factors were far less well-represented, the results revealed that gay-straight alliances, anti-homophobia policies, and social support act as protective factors. This review highlights the need to analyze LGBTQ+ bullying considering the full spectrum of sexual and gender diversity, to examine in more detail its contextual risk/protective factors, and to design public policies and psychoeducational programs in order to address the low effectiveness of generic interventions. Implications for future research and practice are discussed.
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Brecht A, Bos S, Ries L, Hübner K, Widenka PM, Winter SM, Calvano C. Analyzing body dissatisfaction and gender dysphoria in the context of minority stress among transgender adolescents. Child Adolesc Psychiatry Ment Health 2024; 18:30. [PMID: 38431595 PMCID: PMC10909265 DOI: 10.1186/s13034-024-00718-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/17/2023] [Accepted: 02/05/2024] [Indexed: 03/05/2024] Open
Abstract
BACKGROUND Gender dysphoria among transgender adolescents has predominantly been examined in relation to body dissatisfaction. While in adult transgender samples, body dissatisfaction is higher than in cisgender controls, this has so far rarely been investigated for adolescents. In the context of a cisnormative society, the impact of influences from the social environment on body dissatisfaction and gender dysphoria has been neglected in research. Therefore, this study aimed to (1) provide a detailed analysis of body dissatisfaction among young transgender people and (2) investigate whether body dissatisfaction and gender dysphoria are associated with experiences of minority stress such as trans hostility and poor peer relations (PPR). METHODS The paper presents a cross-sectional study among a sample of transgender adolescents, presenting at a specialized outpatient counseling clinic (N = 99; age M = 15.36, SD = 1.85). First, body dissatisfaction (assessed by the Body-Image-Scale; BIS), was explored and compared to data from a population-based control group of cisgender peers (N = 527; age M = 14.43, SD = 0.97). Second, within a clinic-referred transgender subsample (n = 74), associations between body dissatisfaction and gender dysphoria (measured by Utrecht Gender Dysphoria Scale; UGDS), PPR (measured by the Youth-Self-Report; YSR-R), and trans hostile experiences (assessed in clinical interview) were examined by correlations, t-tests and multivariate regression. RESULTS Transgender adolescents reported more body dissatisfaction than cisgender peers. The dissatisfaction with sex characteristics, non-hormonal reactive body regions and the total score for body dissatisfaction were positively related with gender dysphoria. The majority had experienced trans hostility in the present and/or past (54.1%) and PPR (63.5%). More body dissatisfaction was correlated with more PPR regarding visible body parts i.e., hair, overall appearance and muscles, whilst PPR and gender dysphoria were not associated. Transgender adolescents who experienced trans hostility showed higher gender dysphoria and PPR, but not more body dissatisfaction. In multiple regression, trans hostility predicted gender dysphoria, whilst age and PPR predicted body dissatisfaction. DISCUSSION Experiences of minority-stress differentially interact with body dissatisfaction and gender dysphoria among transgender adolescents. Social correlates of body dissatisfaction and gender dysphoria must be considered when working with young transgender people.
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Affiliation(s)
- Alexandra Brecht
- Department of Education and Psychology, Clinical Child and Adolescent Psychology and Psychotherapy, Freie Universität Berlin, 14195, Berlin, Germany.
- Department of Child and Adolescent Psychiatry, Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt Universität zu Berlin and Berlin Insitute of Health, 13353, Berlin, Germany.
| | - Sascha Bos
- Department of Child and Adolescent Psychiatry, Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt Universität zu Berlin and Berlin Insitute of Health, 13353, Berlin, Germany
| | - Laura Ries
- Department of Child and Adolescent Psychiatry, Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt Universität zu Berlin and Berlin Insitute of Health, 13353, Berlin, Germany
| | - Kerstin Hübner
- Department of Child and Adolescent Psychiatry, Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt Universität zu Berlin and Berlin Insitute of Health, 13353, Berlin, Germany
| | - Pia-Marie Widenka
- Klinik für Kinder- und Jugendmedizin, Universität zu Lübeck, Ratzeburger Allee 160, 23562, Lübeck, Germany
| | - Sibylle Maria Winter
- Department of Child and Adolescent Psychiatry, Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt Universität zu Berlin and Berlin Insitute of Health, 13353, Berlin, Germany
| | - Claudia Calvano
- Department of Education and Psychology, Clinical Child and Adolescent Psychology and Psychotherapy, Freie Universität Berlin, 14195, Berlin, Germany
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Huang E, Zhang A, Yan J. Effects of Delivering an Animation-Based Inclusive Sex Education Curriculum for Adolescents in China. JOURNAL OF HOMOSEXUALITY 2024; 71:414-431. [PMID: 37018285 DOI: 10.1080/00918369.2022.2122360] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/19/2023]
Abstract
Evidence suggests that tailored inclusive sex education can be an effective response to prevent gender-based violence and promote an inclusive educational environment. This study examined the effects of an age-appropriate and animation-based inclusive sex education curriculum among Chinese adolescents. A total of 243 students from one comprehensive vocational high school participated in the study. Attitudes toward homosexuality and relevant knowledge were assessed using Attitudes Toward Lesbians and Gays Scale and researcher-made questionnaires at the preintervention and postintervention. Results indicated that adolescents' attitudes and knowledge showed improvement after intervention; female students showed more positive attitudes toward homosexuals; and the animation-based inclusive sex education was welcomed by most participants. Implications of the findings and directions for future research were also discussed.
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Affiliation(s)
- Er Huang
- Xiangya Nursing School, Central South University, Changsha, P. R. China
| | - Aidi Zhang
- Department of Critical Care Medicine, The Third Xiangya Hospital, Central South University, Changsha, P. R. China
| | - Jin Yan
- Department of Nursing, The Third Xiangya Hospital of Central South University, Changsha, P. R. China
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Kesler K, Gerber A, Laris BA, Anderson P, Baumler E, Coyle K. High School FLASH Sexual Health Education Curriculum: LGBTQ Inclusivity Strategies Reduce Homophobia and Transphobia. PREVENTION SCIENCE : THE OFFICIAL JOURNAL OF THE SOCIETY FOR PREVENTION RESEARCH 2023; 24:272-282. [PMID: 36930403 PMCID: PMC10764373 DOI: 10.1007/s11121-023-01517-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/26/2023] [Indexed: 03/18/2023]
Abstract
Homophobic and transphobic beliefs that lead to bias-based harassment remain a critical concern for young people in the USA. The aim of the present study was to examine the impact of an inclusive comprehensive sex education program (High School FLASH) on homophobic and transphobic beliefs. Data from this study come from a randomized controlled trial that evaluated the impact of High School FLASH on students' sexual behaviors and related outcomes with 20 schools in two U.S. regions (Midwest and South). Following the baseline survey, the 20 schools were randomly assigned to receive FLASH or a comparison curriculum. Ninth and 10th grade students completed follow-up surveys 3 and 12 months after the instructional period. We examined changes in homophobic beliefs using multilevel linear regression models in the full sample and two sub-groups: straight cisgender young people versus those who identified as not straight or cisgender. Mean scores on the homophobic and transphobic beliefs scale were statistically significantly lower among young people receiving FLASH relative to the comparison at both the 3- and 12-month timepoints (p-values for adjusted mean differences were < 0.01, n = 1357 and 1275, respectively). Specifically, FLASH's positive impact on reducing homophobic and transphobic beliefs was statistically significant for straight and cisgender youth at both survey follow-ups (p < 0.01, n = 1144 and p = 0.05, n = 1078, respectively); the effects for the LGBTQ sub-group reached statistical significance at only the final follow-up (p = 0.01, n = 197). Our results show that carefully designed, inclusive comprehensive sexual health education programs like High School FLASH can play a role in promoting better school climates for all youth by reducing beliefs that may lead to bullying, violence, and victimization.
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Affiliation(s)
- Kari Kesler
- Public Health-Seattle & King County, Seattle, WA, USA.
| | - Andrea Gerber
- Public Health-Seattle & King County, Seattle, WA, USA
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Schuler A, Wedel A, Kelsey SW, Wang X, Quiballo K, Beatrice Floresca Y, Phillips G, Beach LB. Suicidality by Sexual Identity and Correlates Among American Indian and Alaska Native High School Students. J Adolesc Health 2023; 73:1030-1037. [PMID: 37737757 PMCID: PMC10840863 DOI: 10.1016/j.jadohealth.2023.07.020] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/16/2022] [Revised: 07/04/2023] [Accepted: 07/12/2023] [Indexed: 09/23/2023]
Abstract
PURPOSE This study aims to determine the prevalence of suicidality among American Indian and Alaskan Native (AI/AN) adolescents. Additionally, we measured suicidality, stratified by sex, and its association with sexual identity, sexual violence, and binge drinking. METHODS We pooled data from the Youth Risk Behavior Survey from 2005 to 2019 to analyze the prevalence of sexual minorities, forced sex, and binge drinking, and their association with suicidality using basic descriptive statistics followed by adjusted odds ratios stratified by sex among AI/AN youth. RESULTS 19% of AI/AN participants reported having suicidal thoughts and 14% reported having a previous suicide attempt. More than 17% of AI/AN participants identified as sexual minority youth (SMY). Compared to AI/AN heterosexual youth, AI/AN bisexual youth had significantly higher odds of reporting suicidal thoughts (aOR = 16.01), planning (aOR = 12.4), and previous attempts (aOR = 7.73). This pattern was also significantly demonstrated for AI/AN gay/lesbian youth. 43% of all AI/AN participants reported being forced into sexual intercourse. The presence of binge drinking was associated with higher odds of suicidal thoughts for both females and males compared to those who did not binge drink. DISCUSSION At the intersection of multiple marginalization, AI/AN SMY have a high mental health burden, demonstrating the need for culturally informed, community-led, and targeted mental health support focused on SMY AI/AN. Though this study fails to capture the heterogeneity within the AI/AN community, as nuances exist at the tribal level, these results demonstrate work needs to be done to support the health burden that AI/AN youth carry.
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Affiliation(s)
- Adrienne Schuler
- Northwestern University Feinberg School of Medicine, Chicago, Illinois
| | - Anneliese Wedel
- Northwestern University Feinberg School of Medicine, Chicago, Illinois
| | - Scar Winter Kelsey
- Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, Chicago, Illinois
| | - Xinzi Wang
- Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, Chicago, Illinois
| | - Kay Quiballo
- Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, Chicago, Illinois
| | - Ysabel Beatrice Floresca
- Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, Chicago, Illinois
| | - Gregory Phillips
- Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, Chicago, Illinois.
| | - Lauren B Beach
- Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, Chicago, Illinois
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Johnson B, Szilagyi N. Supporting Transgender Youth Across Psychosocial Systems. Child Adolesc Psychiatr Clin N Am 2023; 32:815-837. [PMID: 37739637 DOI: 10.1016/j.chc.2023.05.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 09/24/2023]
Abstract
Transgender children and adolescents are at an elevated risk for negative mental health outcomes due to exposure to stigma and discrimination regarding their identity. While various environments may perpetuate this stigma, many supports also exist that can bolster safety, affirmation, and resilience in this population. Opportunities for support exist within schools, broader communities, religious organizations, and with medical professionals who practice gender-affirming care. Clinicians who are familiar with resources in their communities can effectively guide transgender youth and their families to these affirming spaces.
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Affiliation(s)
- Brandon Johnson
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, 1090 Amsterdam Avenue 16th Floor, New York, NY 10025, USA.
| | - Nathalie Szilagyi
- Yale Child Study Center, Yale School of Medicine, New Haven, CT, USA; Aurora Psychiatric Associates, Greenwich, CT, USA
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Cruz TH, Ross-Reed DE, FitzGerald CA, Overton K, Landrau-Cribbs E, Schiff M. Effects of School Policies and Programs on Violence Among All High School Students and Sexual and Gender Minority Students. THE JOURNAL OF SCHOOL HEALTH 2023; 93:679-689. [PMID: 37408512 DOI: 10.1111/josh.13297] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/16/2022] [Revised: 12/08/2022] [Accepted: 02/05/2023] [Indexed: 07/07/2023]
Abstract
BACKGROUND Youth identifying as lesbian, gay, bisexual (LGB) and/or transgender/gender nonconforming (TGNC) are at increased risk of violence. School policies and practices may mitigate this risk. METHODS Researchers merged data from the 2016 New Mexico School Health Profiles and the 2017 New Mexico Youth Risk and Resiliency Survey. Researchers employed multivariable logistic regression to test the associations between school-level measures and violence outcomes. RESULTS Genders and sexualities alliances (GSAs) were associated with reduced odds of lifetime forced sex among all, heterosexual cisgender, and LGB students, reduced odds of sexual violence among heterosexual cisgender students, and reduced odds of dating violence among LGB students. Inclusive sexual health education was associated with reduced odds of lifetime forced sex among LGB and TGNC students, reduced odds of sexual violence among LGB students, and increased odds of dating violence among heterosexual cisgender students. Inclusive teacher training was associated with increased odds of lifetime forced sex among TGNC students. IMPLICATIONS FOR SCHOOL HEALTH POLICY, PRACTICE, AND EQUITY Inclusive sexual health education and the presence of active GSAs may have the greatest potential for reducing violence, especially among LGB and TGNC students. CONCLUSIONS Findings highlight the important role of school policies and practices in addressing violence.
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Affiliation(s)
- Theresa H Cruz
- Research Associate Professor, , Department of Pediatrics, Division of Prevention and Population Sciences, Deputy Director, UNM Prevention Research Center, University of New Mexico, MSC 11 61451, University of New Mexico, Albuquerque, NM, 87131, USA
| | - Danielle E Ross-Reed
- Evaluation Consultant, , Department of Pediatrics, Division of Prevention and Population Sciences, University of New Mexico, MSC 11 6145, 1 University of New Mexico, Albuquerque, NM, 87131, USA
| | - Courtney A FitzGerald
- Sr. Research Scientist 2, , Department of Pediatrics, UNM Prevention Research Center, MSC 11 6145, 1 University of New Mexico, Albuquerque, NM, 87131, USA
| | - Kathryn Overton
- Doctoral Student, , Department of Political Science, MSC 05-3070, 1 University of New Mexico, Albuquerque, NM, 87131-0001, USA
| | - Erica Landrau-Cribbs
- Associate Scientist 2, , Department of Pediatrics, UNM Prevention Research Center, MSC 11 6145, 1 University of New Mexico, Albuquerque, NM, 87131, USA
| | - Melissa Schiff
- Professor Emerita, , Department of Internal Medicine, Division of Epidemiology, Biostats, and Preventive Medicine, MSC10 5550, 1 University of New Mexico, Albuquerque, NM, 87131, USA
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Fernandes T, Alves B, Gato J. Between Resilience and Agency: A Systematic Review of Protective Factors and Positive Experiences of LGBTQ+ Students. Healthcare (Basel) 2023; 11:2098. [PMID: 37510539 PMCID: PMC10379181 DOI: 10.3390/healthcare11142098] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2023] [Revised: 07/16/2023] [Accepted: 07/21/2023] [Indexed: 07/30/2023] Open
Abstract
A negative school climate resulting from homophobic and transphobic bias and discrimination is associated with poor well-being and mental health among LGBTQ+ youth. However, protective factors and mechanisms may buffer against the impact of stigmatization. Drawing on the socio-ecological model, minority stress theory, and positive youth development and agency perspectives, we carried out a systematic review of research focusing on factors that can promote the well-being of LGBTQ+ students in educational settings, outlining the primary outcomes from studies published between 2012 and 2022. The PRISMA protocol was used for this review, and 64 articles were scrutinized. The results of the thematic analysis revealed that both external factors (school-inclusive policies and extracurricular activities; social support from school, family, and the community; and school connectedness) and internal factors (psychosocial characteristics and personal agency) promote positive school experiences, such as the exploration of sexual and gender identities in a safe environment. The present findings highlight the need for inclusive school policies and strategies and individual-level interventions that target the well-being and positive mental health outcomes of sexual and gender minority students.
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Affiliation(s)
- Telmo Fernandes
- Centre for Psychology, University of Porto, 4099-002 Porto, Portugal
| | - Beatriz Alves
- Faculty of Psychology and Education Sciences, University of Porto, 4099-002 Porto, Portugal
| | - Jorge Gato
- Centre for Psychology, University of Porto, 4099-002 Porto, Portugal
- Faculty of Psychology and Education Sciences, University of Porto, 4099-002 Porto, Portugal
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14
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Valdez ES, Valdez L, Gorry E, Chan J, Dixon S, Fisher T, Simoun A, Weil M, Collins-Lovell C, Egan J, Gubrium A. Mind the Gaps: The Need for Inclusion of Male-Identified Voices in Adolescent Sexual and Reproductive Health. Am J Mens Health 2023; 17:15579883231181570. [PMID: 37334894 DOI: 10.1177/15579883231181570] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/21/2023] Open
Abstract
Adolescent sexual and reproductive health (ASRH) inequities are well documented for historically excluded youth (i.e., youth of color, LGBTQIA+ youth, youth with disabilities, recently im/migrated youth) living in the U.S. Northeast. However, the lived experience of male-identifying young people from historically excluded backgrounds in ASRH remains largely unexamined. The purpose of this paper is to present findings related to male-identified perspectives on social constructions of sexuality, sexual and reproductive health, and sexuality education. A research team composed of two local youth-serving organizations, eight youth researchers, and university researchers, used Youth Participatory Action Research (YPAR) methods to examine how structural violence contributes to inequitable ASRH outcomes for historically excluded youth. Photovoice and community mapping were used as YPAR methods. We also completed individual interviews on the same topic with the youth and with 17 key stakeholders that either provide services to youth or are emerging adult service recipients. Community-driven data reveal two major themes around the silencing of male-identified voices in ASRH: lack of culture-centered and gender-expansive approaches for ASRH, and the subsequent toll of sexism and (cis)gendered social and educational norms on young people. Our findings highlight that sexuality education, cisgender hetero culture, and social norms have put the onus of responsibility on people identifying as women for sexual and reproductive health. An unintended consequence of that is that young people identifying as men may feel powerless and uninformed around their own SRH. Our findings illustrate the importance of using culture-centered and gender-transformative approaches to ASRH to address inequity.
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Affiliation(s)
- Elizabeth Salerno Valdez
- Community Health and Prevention, Dornsife School of Public Health, Drexel University, Philadelphia, PA, USA
| | - Luis Valdez
- Community Health and Prevention, Dornsife School of Public Health, Drexel University, Philadelphia, PA, USA
| | - Eddie Gorry
- Department of Health Promotion and Policy, School of Public Health and Health Sciences, University of Massachusetts Amherst, Amherst, MA, USA
| | - Jazmine Chan
- Department of Health Promotion and Policy, School of Public Health and Health Sciences, University of Massachusetts Amherst, Amherst, MA, USA
| | - Saharra Dixon
- Department of Health Promotion and Policy, School of Public Health and Health Sciences, University of Massachusetts Amherst, Amherst, MA, USA
| | - Tiarra Fisher
- Department of Health Promotion and Policy, School of Public Health and Health Sciences, University of Massachusetts Amherst, Amherst, MA, USA
| | - Alya Simoun
- Department of Health Promotion and Policy, School of Public Health and Health Sciences, University of Massachusetts Amherst, Amherst, MA, USA
| | - Mira Weil
- Department of Health Promotion and Policy, School of Public Health and Health Sciences, University of Massachusetts Amherst, Amherst, MA, USA
| | - Camille Collins-Lovell
- Department of Health Promotion and Policy, School of Public Health and Health Sciences, University of Massachusetts Amherst, Amherst, MA, USA
| | - Justine Egan
- Massachusetts Department of Public Health, Boston, MA, USA
| | - Aline Gubrium
- Department of Health Promotion and Policy, School of Public Health and Health Sciences, University of Massachusetts Amherst, Amherst, MA, USA
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15
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Woolweaver AB, Drescher A, Medina C, Espelage DL. Leveraging Comprehensive Sexuality Education as a Tool for Knowledge, Equity, and Inclusion. THE JOURNAL OF SCHOOL HEALTH 2023; 93:340-348. [PMID: 36404494 DOI: 10.1111/josh.13276] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/03/2022] [Revised: 09/21/2022] [Accepted: 11/02/2022] [Indexed: 06/16/2023]
Abstract
BACKGROUND Sexual education programs in the United States are rooted in inequitable structures and are often inadequate at educating marginalized student groups such as students of color, Lesbian, Gay, Bisexual, Transgender, Queer (LGBTQ+), women, and disabled students. CONTRIBUTIONS TO THEORY Current sexual education is irregularly implemented and often excludes or misrepresents the experiences of students with marginalized identities. This theoretical paper specifically discusses ways that sexual education has been harmful or exclusionary for marginalized student groups and how a shift toward making sexual education inclusive and equitable will improve outcomes for students of all identities. IMPLICATIONS FOR SCHOOL HEALTH POLICY, PRACTICE, AND EQUITY This paper discusses several recommendations on improving access to equitable sexual health education for all students including reviewing and improving sexual education curriculum and delivery, as well as the need for additional research focused on this topic. CONCLUSIONS This article provides an overview on the current sexual education system, its inadequacies, and how comprehensive sexuality education programs can be leveraged as a tool for equity for students of all backgrounds, but particularly those who are underrepresented in sexual education curricula.
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Affiliation(s)
- Ashley B Woolweaver
- School of Education, University of North Carolina at Chapel Hill, 100 East Cameron Avenue, Chapel Hill, NC 7514-3916, USA
| | - Anne Drescher
- University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Courtney Medina
- University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
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16
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Rabbitte M, Enriquez M. Factors that impact assigned female sexual minority individuals health care experiences: A qualitative descriptive study. AMERICAN JOURNAL OF SEXUALITY EDUCATION 2023; 19:97-120. [PMID: 38576876 PMCID: PMC10989845 DOI: 10.1080/15546128.2023.2187502] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 04/06/2024]
Abstract
This qualitative descriptive study identified factors that impact assigned female at birth (AFAB) cisgender and non-binary sexual minority individuals' decision to engage, or not engage, in health-seeking behaviors and receive preventative health care services. AFAB sexual minority individuals were asked to describe their health care experiences to determine modifiable factors that could improve their intention to seek care and improve their health care experiences. Purposive sampling was used to recruit AFAB sexual minority individuals between 18-30 years of age in the Chicago metropolitan area. Three main themes emerged from data acquired through individual interviews: (1) "ask the right questions"; main themes (2 lack of trust in health professionals; (3 the need for better sexual health education. An important finding was participants wanted to be asked about their sexual orientation, sexual behavior, and gender identity. Participants wanted to be able to share their sexual orientation and gender identity with health care professionals so they could receive appropriate care, accurate information, and feel comfortable sharing aspects about their life. Additionally, the results suggested that general and health sciences curricula should include content about diverse sexual and gender minority populations. Findings have important implications for health education and clinical practice.
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17
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Crehan ET, Rocha J, Sclar J, Ward O, Donaghue A. Topics and timing of sexuality and relationship education for autistic and non-autistic adults in the United States. Disabil Health J 2023:101466. [PMID: 37062650 DOI: 10.1016/j.dhjo.2023.101466] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2022] [Revised: 03/16/2023] [Accepted: 03/16/2023] [Indexed: 04/05/2023]
Abstract
INTRODUCTION Sexuality and relationship education is a learning area that historically has been overlooked, especially for autistic individuals. To inform future programming, we are in need of evidence-based reasoning to guide program design, such as what to cover and when. In particular, the social aspects of sexuality and relationship education, which are less commonly addressed, need further scrutiny. OBJECTIVE To identify sexuality and relationship education priorities and timelines based on feedback from autistic and non-autistic adults. METHODS An online anonymous survey of adults in the United States posed questions about sexuality and relationship education, sexual and relationship experiences, and autistic traits. RESULTS Comparisons by diagnostic group (autistic and non-autistic) revealed no significant differences in the timing of sexual experiences. Autistic individuals were significantly more likely to indicate that they wanted to learn more about gender identity, sexual orientation, consent, and assertiveness than non-autistic peers. However, the majority of all participants across diagnostic groups wanted more information across all surveyed topics. CONCLUSIONS Lack of differences in timing of sexuality-related experiences highlights the importance of beginning sexuality and relationship education early for all learners. Important diagnostic group differences highlight critical areas of development for sexuality and relationship education programming. The importance of incorporating needs of autistic learners into program design is highlighted for future work. Overall findings support the idea that more sexuality and relationship education across the lifespan would best meet the learning needs of all people.
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18
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Torres-Cortés B, Leiva L, Canenguez K, Olhaberry M, Méndez E. Shared Components of Worldwide Successful Sexuality Education Interventions for Adolescents: A Systematic Review of Randomized Trials. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:4170. [PMID: 36901181 PMCID: PMC10002383 DOI: 10.3390/ijerph20054170] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 01/23/2023] [Revised: 02/17/2023] [Accepted: 02/21/2023] [Indexed: 06/18/2023]
Abstract
A crucial aspect of human development is sexuality which has implications for health, particularly in adolescence, since unfavorable sexual experiences may result in physical and mental problems. Sexuality education interventions (SEI) are one of the most used actions to promote sexual health in adolescents. Nevertheless, there is variability across their components; therefore, key elements for an effective SEI targeted at adolescents (A-SEI) are not well known. Based on this background, this study aims to identify the shared components of successful A-SEI through a systematic review of randomized controlled trials (RCT). This study followed the preferred reporting items for systematic reviews and meta-analyses statement. A search was conducted in CINAHL, PsycInfo, PubMed, and Web of Science between November and December 2021. A total of 21 studies passed the inclusion test after the review of 8318 reports. A total of 18 A-SEIs were identified in these studies. The components analyzed were the intervention's approach, dose, type of intervention, theoretical framework, facilitators' training, and intervention methodology. The results established that components that should be present in the design of an effective A-SEI are behavior change theoretical models, the use of participatory methodology, be targeted at mixed-sex groups, facilitators' training, and at least ten hours of weekly intervention.
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Affiliation(s)
- Betzabé Torres-Cortés
- Department of Psychology, Faculty of Social Sciences, Pontificia Universidad Católica de Chile, Av. Vicuña Mackenna 4860, Macul 7820436, Chile
- Department of Psychology, Faculty of Social Sciences, Universidad de Chile, Avenida Capitán Ignacio Carrera Pinto 1045, Ñuñoa 7800284, Chile
- Millennium Institute for Research on Depression and Personality (MIDAP), Av. Vicuña Mackenna 4860, Macul 7820436, Chile
| | - Loreto Leiva
- Department of Psychology, Faculty of Social Sciences, Universidad de Chile, Avenida Capitán Ignacio Carrera Pinto 1045, Ñuñoa 7800284, Chile
| | - Katia Canenguez
- Department of Psychiatry, Massachusetts General Hospital, Yawkey 6A, 55 Fruit Street, Boston, MA 02114, USA
- Department of Psychiatry, Harvard Medical School, 25 Shattuck St, Boston, MA 02115, USA
| | - Marcia Olhaberry
- Department of Psychology, Faculty of Social Sciences, Pontificia Universidad Católica de Chile, Av. Vicuña Mackenna 4860, Macul 7820436, Chile
- Millennium Institute for Research on Depression and Personality (MIDAP), Av. Vicuña Mackenna 4860, Macul 7820436, Chile
| | - Emmanuel Méndez
- Department of Psychology, Faculty of Social Sciences, Pontificia Universidad Católica de Chile, Av. Vicuña Mackenna 4860, Macul 7820436, Chile
- Department of Psychiatry, Faculty of Medicine, Universidad de Chile, Gran Av. José Miguel Carrera 3100, San Miguel 8900085, Chile
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19
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López González UA, Legaz Sánchez EM, Cárcamo Ibarra PM, Lluch Rodrigo JA. [Descriptive study about non-formal sex education resources available in Spain.]. Rev Esp Salud Publica 2023; 97:e202302014. [PMID: 36815205 PMCID: PMC10558103] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2022] [Accepted: 12/24/2022] [Indexed: 02/24/2023] Open
Abstract
OBJECTIVE Sex education (SE) is a fundamental element of a fulfilling and safe life. Currently, education is understood beyond what happens inside the classroom. The aim of this research was to describe and to compare sex education resources available in official webs of Autonomous Communities of Spain (ACS) that to could be used in non-formal educational context. METHODS A review of the ACS official web pages related to healthcare, education, youth, family and equality was made. Finally, 216 resources were selected for descriptive analysis. The resources were classified based on United Nations Educational, Scientific and Cultural Organization's (UNESCO) Technical Guidelines. RESULTS 64% of resources were targeted at young people/adolescents. 80% dealt some specific issues, the most frequent being Reproductive Health, Violence and Gender. Values and Rights related to sexuality, Skills for Health and Well-being and Sexual behaviour are issues rarely addressed. Only 6 ACS were a social network profile related to SE. ACS with the widest diversity of issues addressed were Andalusia, Asturias and the Canary Islands. CONCLUSIONS Homogeneity in the kind of resources and issues disparity reveals potential inequities in SE access in Spain. To enhance out-of-school environments learning can provide better successful health promotion. UNESCO's guidelines can be used to classify educational resource content and to identify the institutions that have best integrated actual SE paradigm.
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Affiliation(s)
| | - Eva María Legaz Sánchez
- Servicio de Promoción de la Salud y Prevención en Etapas de la Vida, Subdirección General de Promoción de la Salud y Prevención, Dirección General de Salud Pública y Adicciones, Consejería de Sanidad Universal y Salud Pública de la Comunidad Valenciana. Valencia. España
| | | | - José Antonio Lluch Rodrigo
- Servicio de Promoción de la Salud y Prevención en Etapas de la Vida, Subdirección General de Promoción de la Salud y Prevención, Dirección General de Salud Pública y Adicciones, Consejería de Sanidad Universal y Salud Pública de la Comunidad Valenciana. Valencia. España
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20
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Chan ASW, Lo IPY, Yan E. Health and Social Inclusion: The Impact of Psychological Well-Being and Suicide Attempts Among Older Men Who Have Sex With Men. Am J Mens Health 2022; 16:15579883221120985. [PMID: 36082415 PMCID: PMC9465597 DOI: 10.1177/15579883221120985] [Citation(s) in RCA: 15] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2022] [Revised: 08/01/2022] [Accepted: 08/04/2022] [Indexed: 01/26/2023] Open
Abstract
Older adults' mental health and suicidal tendencies have garnered much attention because of their vulnerability. Few studies have examined the impact of psychological well-being and suicide attempts among older men who have sex with men (OMSM). This study examines the levels of depression and suicidal tendencies among OMSM, factors impacting their mental health, and their likelihood of committing suicide. Descriptive statistics are used to analyze the correlation between depression and suicidal tendencies among OMSM in the United States. We constructed a regression model using relevant data, and scales were selected based on a literature review. The validity and relevance of the control variables were considered. Depression and suicidal tendencies were dependent variables. Data were obtained from the U.S. General Social Survey and analyzed with an ordinary least squares model. There were significant differences between MSM and general groups in depression and suicidal tendency scores (t = 67.084, 58.193, p < .01). Compared with general groups, MSM scored significantly higher on depression and suicidal tendencies. The regression analysis revealed that sex with men was associated with depression and suicidal tendencies (p < .01) among older men. This indicates that OMSM generally have higher levels of depression and suicidal tendencies than the general population. Finally, in the intermediary test, the level of depression had a significant mediating effect on the relationship between homosexuality and suicidal tendencies (p < .01). This suggests that depression intervention can help reduce suicidal tendencies among OMSM.
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Affiliation(s)
- Alex Siu Wing Chan
- Department of Applied Social Sciences,
Faculty of Health and Social Sciences, The Hong Kong Polytechnic University, Hong
Kong, China
| | - Iris Po Yee Lo
- Department of Applied Social Sciences,
Faculty of Health and Social Sciences, The Hong Kong Polytechnic University, Hong
Kong, China
| | - Elsie Yan
- Department of Applied Social Sciences,
Faculty of Health and Social Sciences, The Hong Kong Polytechnic University, Hong
Kong, China
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21
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Diamond LM, Alley J. Rethinking minority stress: A social safety perspective on the health effects of stigma in sexually-diverse and gender-diverse populations. Neurosci Biobehav Rev 2022; 138:104720. [PMID: 35662651 DOI: 10.1016/j.neubiorev.2022.104720] [Citation(s) in RCA: 83] [Impact Index Per Article: 41.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2021] [Revised: 04/25/2022] [Accepted: 05/30/2022] [Indexed: 12/13/2022]
Abstract
For over two decades, the minority stress model has guided research on the health of sexually-diverse individuals (those who are not exclusively heterosexual) and gender-diverse individuals (those whose gender identity/expression differs from their birth-assigned sex/gender). According to this model, the cumulative stress caused by stigma and social marginalization fosters stress-related health problems. Yet studies linking minority stress to physical health outcomes have yielded mixed results, suggesting that something is missing from our understanding of stigma and health. Social safety may be the missing piece. Social safety refers to reliable social connection, inclusion, and protection, which are core human needs that are imperiled by stigma. The absence of social safety is just as health-consequential for stigmatized individuals as the presence of minority stress, because the chronic threat-vigilance fostered by insufficient safety has negative long-term effects on cognitive, emotional, and immunological functioning, even when exposure to minority stress is low. We argue that insufficient social safety is a primary cause of stigma-related health disparities and a key target for intervention.
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Affiliation(s)
- Lisa M Diamond
- Department of Psychology, University of Utah, Salt Lake City, UT, USA.
| | - Jenna Alley
- Department of Psychology, University of Utah, Salt Lake City, UT, USA
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22
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Henderson ER, Sang JM, Louth-Marquez W, Egan JE, Espelage D, Friedman M, Coulter RWS. "Words Aren't Supposed to Hurt, But They Do": Sexual and Gender Minority Youth's Bullying Experiences. JOURNAL OF INTERPERSONAL VIOLENCE 2022; 37:NP8747-NP8766. [PMID: 33300412 PMCID: PMC10910491 DOI: 10.1177/0886260520978199] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/28/2023]
Abstract
Sexual and gender minority youth (SGMY) are more likely to experience bullying and violence compared to the youth who do not identify as SGMY, leading to increased risk of poor mental and physical health outcomes, and poor academic performance. Few studies explore the entire range of bullying experienced by sexual and gender minority youth (SGMY). The purpose of this study was to qualitatively describe the ways in which SGMY experience bullying victimization. We conducted semi-structured interviews with a diverse sample of 20 SGMY aged 14-18 years (median age 16 years) recruited from online social media. The sample included 10 participants who identified as cisgender girls, 4 who identified as cisgender boys, 2 who identified as transgender, and 4 who identified as another gender identity. Ten participants identified as bisexual, six identified as lesbian, and four identified as gay. Findings indicated six common experiences of bullying among the participants: (a) verbal harassment; (b) gender policing; (c) physical violence; (d) sexual harassment; (e) treated as sexual perpetrators and deviants; and (f) and social exclusion. SGMY described how bullying victimization ranged from overt to concealed attitudes and behaviors, and they articulated how several forms of bullying are likely not experienced by heterosexual and cisgender youth. These results support findings from prior qualitative studies and suggest that efforts to address school-based bullying may benefit from a more complete awareness of the range of bullying victimization experienced by SGMY. Development of multi-item scales of bullying that reflect the six common experiences of bullying presented in this study would allow researchers to quantitatively explore the range of bullying behaviors experienced by SGMY, and would aid in the conceptualization and successful implementation of anti-bullying interventions.
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23
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Zhao J. Social Intervention and Governance of Youth School Bullying-Based on Computer Medical Data Analysis. Front Public Health 2022; 10:881124. [PMID: 35669742 PMCID: PMC9163334 DOI: 10.3389/fpubh.2022.881124] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2022] [Accepted: 04/12/2022] [Indexed: 12/02/2022] Open
Abstract
The rise of computational social science provides a new method for campus bullying research based on large-scale data collection, calculation and analysis. Governing the bullying behavior of a middle school through social intervention, and closely observe the service needs and existing problems of the school youth group. This paper analyzes the characteristics, inducements and negative effects of school bullying. Combine drama courses and working group education methods to intervene in school bullying. Intervention work includes making teenagers aware of bullying behavior and identifying bullying types. To achieve the purpose of empathy through role play, bullies can effectively control irrational thoughts, understand their own cognitive biases, and reconcile their own emotions and behaviors. So that the victims can identify the bullying behavior around them in time, and cultivate their resistance and self-protection awareness in the event of bullying. Based on the empirical analysis of social work to intervene in the practical dilemma, and put forward the corresponding countermeasures to reduce the negative impact of school bullying on all aspects of youth, so as to reduce the various social risks brought by school bullying.
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Affiliation(s)
- Jiahui Zhao
- School of Government, Shanghai University of Political Science and Law, Shanghai, China
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24
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Marchi M, Arcolin E, Fiore G, Travascio A, Uberti D, Amaddeo F, Converti M, Fiorillo A, Mirandola M, Pinna F, Ventriglio A, Galeazzi GM. Self-harm and suicidality among LGBTIQ people: a systematic review and meta-analysis. Int Rev Psychiatry 2022; 34:240-256. [PMID: 36151841 DOI: 10.1080/09540261.2022.2053070] [Citation(s) in RCA: 22] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
Research evidence has consistently documented a higher risk of suicidality in the Lesbian, Gay, Bisexual, Transgender, Intersex, and Queer (LGBTIQ) population. This systematic review and meta-analysis aimed to report a detailed description of research data regarding the risk of Attempted Suicide (SA), Suicide Ideation (SI), and Non-Suicidal Self-Injury (NSSI) behaviours for LGBTIQ people and their subgroups. Medline, Scopus, PsycINFO, and EMBASE were searched for studies reporting a comparative estimation of SA, SI, and NSSI rates among LGBTIQ population and the general population (i.e. heterosexual/cisgender), without restrictions on participants' age and setting for the enrolment. Pooled analyses were based on odds ratios (ORs, with 95% CIs), estimated through inverse variance models with random effects. Fifty studies were selected for the quantitative synthesis and included fifty samples involving 3.735.601 controls and 87.252 LGBTIQ people. LGBTIQ people reported an increased risk of SA (OR:4.36[95%CI:3.32;5.71]), SI (OR:3.76[95%CI:3.02;4.69]), and NSSI (OR:4.24[95%CI:3.23;5.55]). Among LGBTIQ subgroups, the Bisexual group has shown the highest risk of suicidality (SA, OR:6.71; SI, OR:5.04; NSSI, OR: 5.03), followed by the Lesbian-Gay for attempted suicide (SA, OR:6.03), and the Transgender-Intersex-Queer for suicide ideation and non-suicidal self-injury (SI and NSSI, OR:3.42). The quality of the evidence ranged from low to moderate. Our findings have shown that LGBTIQ people report a higher risk of suicidality compared with their cisgender/heterosexual peers. This evidence may contribute to the public awareness on LGBTQI mental health needs and suggest supportive strategies as well as preventive interventions (e.g. supportive programs, counselling, and destigmatizing efforts) as parts of a tailored health-care planning aimed to reduce psychiatric morbidity and mortality in this at-risk population.
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Affiliation(s)
- Mattia Marchi
- Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Modena, Italy.,Department of Mental Health and Drug Abuse, Azienda USL-IRCCS di Reggio Emilia, Reggio Emilia, Italy
| | - Elisa Arcolin
- Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Modena, Italy
| | - Gianluca Fiore
- Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Modena, Italy
| | - Antonio Travascio
- Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Modena, Italy
| | - Daniele Uberti
- Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Modena, Italy
| | - Francesco Amaddeo
- Department of Neurosciences, Biomedicine and Movement Sciences, University of Verona, Verona, Italy
| | | | - Andrea Fiorillo
- Department of Psychiatry, University of Campania "Luigi Vanvitelli", Naples, Italy
| | - Massimo Mirandola
- Department of Diagnostics and Public Health, Infectious Diseases Section, University of Verona, Verona, Italy.,School of Health Sciences, University of Brighton, Brighton, UK
| | - Federica Pinna
- Department of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy
| | - Antonio Ventriglio
- Department of Clinical and Experimental Medicine, University of Foggia, Foggia, Italy
| | - Gian Maria Galeazzi
- Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Modena, Italy.,Department of Mental Health and Drug Abuse, Azienda USL-IRCCS di Reggio Emilia, Reggio Emilia, Italy
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25
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Chan ASW, Wu D, Lo IPY, Ho JMC, Yan E. Diversity and Inclusion: Impacts on Psychological Wellbeing Among Lesbian, Gay, Bisexual, Transgender, and Queer Communities. Front Psychol 2022; 13:726343. [PMID: 35572280 PMCID: PMC9105225 DOI: 10.3389/fpsyg.2022.726343] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2021] [Accepted: 01/05/2022] [Indexed: 11/13/2022] Open
Abstract
For scholars, practitioners, and legislators concerned about sexual minority adolescents, one of the main goals is to create more positive and inclusive learning environments for this minority group. Numerous factors, such as repeated patterns of homophobic bullying by classmates and others in school, have been a significant barrier to achieving this goal. In addition, lesbian, gay, bisexual, transgender, and queer (LGBTQ) adolescents encounter substantial inequality across a broad spectrum of wellbeing and education consequences. Compared with their heterosexual counterparts, LGBTQ adolescents experience more anxiety, depression, suicidal thoughts, antisocial behavior, poorer academic performance, less school attachment and protection, and a weaker desire to finish their studies. Such discrepancies based on gender and sexuality were linked to more maltreatment encountered by LGBTQ adolescents. It is crucial to recognize the backgrounds and expectations of LGBTQ adolescents to offer them the best resources. To overcome the inequality and obstacles faced by these LGBTQ adolescents, it is essential to examine tools and techniques that can be utilized. This study examined the literature that explains why society fails to provide enough support to LGBTQ students. Specifically, mechanisms explaining how LGBTQ adolescents interact with others in the learning environment and how such discrepancies arise will be examined. Following that, violence and prejudice, which are fundamental causes of psychological problems among LGBTQ adolescents, will be explored. This review paper thus provides supportive strategies for schools to develop more inclusive learning environments for LGBTQ adolescents.
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Affiliation(s)
- Alex Siu Wing Chan
- Department of Applied Social Sciences, The Hong Kong Polytechnic University, Kowloon, Hong Kong SAR, China
| | - Dan Wu
- Department of Applied Social Sciences, The Hong Kong Polytechnic University, Kowloon, Hong Kong SAR, China
| | - Iris Po Yee Lo
- Department of Applied Social Sciences, The Hong Kong Polytechnic University, Kowloon, Hong Kong SAR, China
| | - Jacqueline Mei Chi Ho
- School of Nursing, The Hong Kong Polytechnic University, Kowloon, Hong Kong SAR, China
| | - Elsie Yan
- Department of Applied Social Sciences, The Hong Kong Polytechnic University, Kowloon, Hong Kong SAR, China
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Marraccini ME, Ingram KM, Naser SC, Grapin SL, Toole EN, O'Neill JC, Chin AJ, Martinez RR, Griffin D. The roles of school in supporting LGBTQ+ youth: A systematic review and ecological framework for understanding risk for suicide-related thoughts and behaviors. J Sch Psychol 2022; 91:27-49. [PMID: 35190078 PMCID: PMC8906061 DOI: 10.1016/j.jsp.2021.11.006] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2021] [Revised: 06/25/2021] [Accepted: 11/30/2021] [Indexed: 01/20/2023]
Abstract
The extant literature on suicide-related thoughts and behaviors (STB) has highlighted increased patterns of risk among specific minoritized populations, including lesbian, gay, bisexual, transgender, questioning, intersex, two spirit, and queer (LGBTQ+) youth. Compared to their heterosexual and cisgender peers, LGBTQ+ youth are at increased risk for having STB. Identity-specific stressors such as homonegativity and anti-queerness are among the unique factors posited to contribute to this risk and inhibit factors that protect against suicide. The school setting has been a focal point for suicide prevention and intervention and may also play a key role in linking students to care; however, schools also hold the potential to provide supports and experiences that may buffer against risk factors for STB in LGBTQ+ students. This systematic literature review presents findings from 44 studies examining school-related correlates of STB in LGBTQ+ students, informing an ecological approach to suicide prevention for school settings. Findings underscore the importance of school context for preventing STB in LGBTQ+ youth. Approaches that prioritize safety and acceptance of LGBTQ+ youth should span multiple layers of a student's ecology, including district and state level policies and school programs and interventions, such as Gender and Sexuality Alliances and universal bullying prevention programs. Beyond their role as a primary access point for behavioral health services, schools offer a unique opportunity to support suicide prevention by combating minority stressors through promoting positive social relationships and a safe community for LGBTQ+ students.
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Affiliation(s)
- Marisa E Marraccini
- School of Education, University of North Carolina at Chapel Hill, United States of America.
| | - Katherine M Ingram
- School of Education, University of North Carolina at Chapel Hill, United States of America
| | - Shereen C Naser
- College of Sciences and Health Professions, Cleveland State University, United States of America
| | - Sally L Grapin
- Psychology Department, Montclair State University, United States of America
| | - Emily N Toole
- School of Education, University of North Carolina at Chapel Hill, United States of America
| | - J Conor O'Neill
- Department of Psychiatry and Behavioral Sciences, Duke University School of Medicine, United States of America
| | - Andrew J Chin
- School of Education, University of North Carolina at Chapel Hill, United States of America
| | - Robert R Martinez
- School of Education, University of North Carolina at Chapel Hill, United States of America
| | - Dana Griffin
- School of Education, University of North Carolina at Chapel Hill, United States of America
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Esteban Mora J, Morales Rodríguez FM, Martínez Ramón JP. Attitudes toward Transsexuality, Empathy, and Bullying in Young Population. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19073849. [PMID: 35409533 PMCID: PMC8997397 DOI: 10.3390/ijerph19073849] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 01/07/2022] [Revised: 03/15/2022] [Accepted: 03/20/2022] [Indexed: 12/10/2022]
Abstract
Affective-sexual and gender diversity is an increasingly distinctive and extended reality and should be acknowledged and respected. From a psychosocial and educational point of view, it is appropriate to review young people’s attitudes and knowledge regarding this, relating them to aspects such as empathy, violence, or bullying, to implement quality education in the early stages of primary education. The main objective of this study was to analyze the relationship between empathy levels, attitudes toward transsexuality, and bullying among Spanish university students. The sample consisted of 247 students. Instruments were administered to evaluate negative attitudes toward transsexual people, gender ideology, transphobia, bullying, and empathy. Inverse relationships were found between transphobia and empathy. Regression analysis demonstrated the predictive ability of empathy on attitudes toward transsexual people. The results of this study are expected to increase awareness in society and encourage appropriate, satisfactory, or tolerable coexistence, in which all individuals can be free to live and express themselves. While the results indicated that the quality of life of transgender people has comparatively improved, there is still a long way to go.
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Affiliation(s)
- Jesús Esteban Mora
- Department of Educational and Developmental Psychology, Faculty of Psychology, Campus Universitario de Cartuja, University of Granada, 18071 Granada, Spain;
| | - Francisco Manuel Morales Rodríguez
- Department of Educational and Developmental Psychology, Faculty of Psychology, Campus Universitario de Cartuja, University of Granada, 18071 Granada, Spain;
- Correspondence: ; Tel.: +34-68-097-6924
| | - Juan Pedro Martínez Ramón
- Departament of Evolutionary and Educational Psychology, Faculty of Psychology, Mare Nostrum Campus, University of Murcia, 30100 Murcia, Spain;
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Kraus A, Moskowitz DA, Ma J, Macapagal K. Cigarette Use and Vaping Among Sexual and Gender Minority (SGM) Adolescents Assigned Male at Birth: Patterns of Use and Associations with Demographic and Psychosocial Factors. Int J Behav Med 2022; 29:685-690. [PMID: 35217994 DOI: 10.1007/s12529-021-10037-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/17/2021] [Indexed: 11/28/2022]
Abstract
BACKGROUND This study described cigarette and electronic nicotine delivery systems (ENDs) use and their demographic and psychosocial correlates in a sample of sexual and gender minority (SGM) adolescents assigned male at birth. METHODS One-way ANOVA, multivariate linear regression, and correlation analyses were conducted to examine correlates of cigarettes/ENDs use on 159 SGM adolescent users, ages 15-18. RESULTS Fifty-three percent of the sample used cigarettes/ENDs, with differences based on sexual orientation: bisexual, pansexual, and queer adolescents used ENDs more than gay adolescents. White adolescents smoked more cigarettes than adolescents of color, independent of ENDs use. Regarding psychosocial correlates, alcohol use and depression were associated with greater daily cigarette use, while sexual orientation identity was associated with greater daily ENDs use. CONCLUSIONS This study characterized frequency and psychosocial correlates of cigarettes/ENDs use among SGM adolescents. Findings highlighted several risk factors for tobacco use and will inform future interventions for SGM adolescents.
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Affiliation(s)
- Ashley Kraus
- Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, 625 N. Michigan Avenue, Suite 1400, Chicago, IL, 60611, USA. .,Institute for Sexual and Gender Minority Health and Wellbeing, Northwestern University, 625 N. Michigan Avenue, Suite 1400, Chicago, IL, 60611, USA.
| | - David A Moskowitz
- Associate Instructional Professor Department of Public Health Sciences, The University of Chicago, Biological Sciences Division, 5841 S. Maryland Ave., MC2000, Chicago, IL, 60637, USA
| | - Junye Ma
- SDSU/UC San Diego Joint Doctoral Program in Clinical Psychology, 6363 Alvarado Court, Suite 103, San Diego, CA, 92120, USA
| | - Kathryn Macapagal
- Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, 625 N. Michigan Avenue, Suite 1400, Chicago, IL, 60611, USA.,Institute for Sexual and Gender Minority Health and Wellbeing, Northwestern University, 625 N. Michigan Avenue, Suite 1400, Chicago, IL, 60611, USA.,Department of Psychiatry and Behavioral Sciences, Northwestern University Feinberg School of Medicine, 710 N. Lake Shore Drive, Chicago, IL, 60611, USA
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Chilean University Teachers’ Social Representations and Attitudes about Students’ Sexual Diversity. SUSTAINABILITY 2022. [DOI: 10.3390/su14031722] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
This study seeks to explore social representations and attitudes of university teachers in relation to sexual diversity. The study has a qualitative approach through content analysis. The research was collected through 62 critical incidents with university professors, with at least one year of experience in undergraduate teaching, in five universities located in the northern macro zone of Chile. The results highlight that there are teachers who take on three different types of roles when faced with situations of gender diversity.. Some are in favour of the inclusion of the sexual minority community, others are more like external observers and a third group, with little interest in inclusion, practice for the students belonging to sexual minorities, within the diversity of the university classrooms. Many teachers tend to contain and compensate for the scarce support that sexually diverse young people have within their families. Teachers demand more training than they currently have in order to be able to carry out adequate interventions in the classroom. Finally, the number of feelings and emotions described by teachers in the face of events and experiences related to sexual diversity in their university institutions is highly significant.
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Szucs LE, Barrios LC, Young E, Robin L, Hunt P, Jayne PE. The CDC's Division of Adolescent and School Health Approach to Sexual Health Education in Schools: 3 Decades in Review. THE JOURNAL OF SCHOOL HEALTH 2022; 92:223-234. [PMID: 34964130 PMCID: PMC10924689 DOI: 10.1111/josh.13115] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/02/2021] [Accepted: 08/22/2021] [Indexed: 06/14/2023]
Abstract
BACKGROUND School health education, including sexual health education, plays a crucial role in shaping adolescents' protective health behaviors, experiences, and outcomes. Adolescents need functional knowledge and skills to practice, adopt, and maintain healthy behaviors for preventing sexually transmitted infections (STIs), including human immunodeficiency virus (HIV), and unintended pregnancy. METHODS The US Centers for Disease Control and Prevention's Division of Adolescent and School Health (CDC/DASH) has advanced school-based approaches to STI/HIV and pregnancy prevention through surveillance, research and evaluation, and program partnership and collaboration for over 3 decades. RESULTS CDC/DASH uses systematic and innovative strategies to identify the breadth of adolescent sexual health evidence; characterize key elements of effective educational curricula; and provide practical guidance to support school-based delivery. CDC/DASH's approach to effective health and sexual health education in schools has changed dramatically over the past 30 years and must continue to progress. CONCLUSION This paper describes how and why that approach has evolved and outlines directions for the future.
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Affiliation(s)
- Leigh E. Szucs
- Research Application and Evaluation Branch, Division of Adolescent and School Health, The US Centers for Disease Control and Prevention, 1600 Clifton Rd NE, US8-1, Atlanta, GA, 30329-4027
| | - Lisa C. Barrios
- Research Application and Evaluation Branch, Division of Adolescent and School Health, The US Centers for Disease Control and Prevention, 1600 Clifton Rd NE, US8-1, Atlanta, GA, 30329-4027
| | - Emily Young
- Research Application and Evaluation Branch, Division of Adolescent and School Health, The US Centers for Disease Control and Prevention, 1600 Clifton Rd NE, US8-1, Atlanta, GA 30329-4027; Oak Ridge Institute of Science and Education, 1299 Bethel Valley Road, TN, Oak Ridge, TN, 37830
| | - Leah Robin
- Research Application and Evaluation Branch, Division of Adolescent and School Health, The US Centers for Disease Control and Prevention, 1600 Clifton Rd NE, US8-1, Atlanta, GA 30329-4027
| | - Pete Hunt
- Research Application and Evaluation Branch, Division of Adolescent and School Health (Retired), The US Centers for Disease Control and Prevention, 1600 Clifton Rd, NE, US8-1, Atlanta, GA, 30329-4027
| | - Paula E. Jayne
- Research Application and Evaluation Branch, Division of Adolescent and School Health (Retired); ICF, The US Centers for Disease Control and Prevention, 1600 Clifton Rd NE, US8-1; ICF, 2635 Corporate Blvd NE Suite 1000, Atlanta, GA, 30345
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Smith DM, Johns NE, Raj A. Do Sexual Minorities Face Greater Risk for Sexual Harassment, Ever and at School, in Adolescence? : Findings From a 2019 Cross-Sectional Study of U.S. Adults. JOURNAL OF INTERPERSONAL VIOLENCE 2022; 37:NP1963-NP1987. [PMID: 32571176 PMCID: PMC8574207 DOI: 10.1177/0886260520926315] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
Bullying of sexual minorities in the United States is common and often begins in middle and high school, yet research that examines sexual harassment of sexual minorities is limited. This study examines whether sexual minorities are more likely than straight people to (a) report sexual harassment and (b) report sexual harassment as adolescents at middle or high school. We analyzed survey data from a cross-sectional study of sexual harassment and assault, conducted with nationally representative samples of adults in 2019 (N = 2,205). Sexual harassment was categorized as non-physically aggressive sexual harassment only (NPSH; e.g., verbal or cyber harassment), physically aggressive sexual harassment (PSH; e.g., stalking, rubbing up against you; with or without NPSH), sexual assault (SA; i.e., forced sex; with or without NPSH or PSH), or no sexual harassment (none). In total, 6% of female and male respondents identified as a sexual minority. A history of sexual harassment or assault was reported by 95.0% of sexual minority women and 80.3% of straight women (p = .001), and by 77.3% of sexual minority men and 41.3% of straight men (p = .001). Multivariable multinomial models demonstrate that sexual minorities were more likely than straight individuals to report NPSH (Adjusted Odds Ratio [AOR] = 2.88, 95% [Confidence Interval] CI = [1.33, 6.20]), PSH (AOR = 4.15, 95% CI: [1.77, 9.77]), and SA (AOR = 5.48, 95% CI = [2.56, 11.73]; reference group: no harassment), as well as to report PSH (AOR = 2.67, 95% CI = [1.30, 5.47]) at school in middle or high school. These abuses demonstrate increased risk for sexual harassment among sexual minorities, including increased risk for physically aggressive sexual harassment when in middle and high school.
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Affiliation(s)
| | - Nicole E. Johns
- Center on Gender Equity and Health, Department of Medicine, University of California San Diego
| | - Anita Raj
- Center on Gender Equity and Health, Department of Medicine, University of California San Diego
- Department of Education Studies, Division of Social Sciences, University of California San Diego
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Madireddy S, Madireddy S. Supportive model for the improvement of mental health and prevention of suicide among LGBTQ+ youth. INTERNATIONAL JOURNAL OF ADOLESCENCE AND YOUTH 2022. [DOI: 10.1080/02673843.2022.2025872] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/19/2022] Open
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Sex education and self-poisoning in Sri Lanka: an explorative analysis. BMC Public Health 2022; 22:26. [PMID: 34991547 PMCID: PMC8740467 DOI: 10.1186/s12889-021-12374-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2021] [Accepted: 11/30/2021] [Indexed: 11/25/2022] Open
Abstract
Background Self-harm and suicide are important causes of morbidity and mortality in Sri Lanka, but our understanding of these behaviours is limited. Qualitative studies have implicated familial and societal expectations around sex and relationships. We conducted an explorative analysis using case-control data to investigate the association between sex education and self-poisoning in Sri Lanka. Methods Cases (N=298) were self-poisoning inpatients on a toxicology ward, Teaching Hospital Peradeniya. Controls (N=500) were sex and age frequency matched to cases and were outpatients/visitors to the same hospital. Participants were asked whether they had received sex education, and to rate the quality and usefulness of any sex education received. Logistic regression models adjusted for age, sex, and religion quantified the association between receipt, quality and usefulness of sex education and self-poisoning. We tested whether the associations differed by sex. Results Roughly 1-in-3 cases and 1-in-5 controls reported having not received sex education. Individuals who did not receive sex education were nearly twice as likely to have self-poisoned than those who did (OR 1.68 (95% CI 1.11-2.55)). Those who reported the sex education they received as not useful were more likely to have self-poisoned compared to those who reported it useful (OR 1.95 (95% CI 1.04-3.65)). We found no evidence of an association between self-poisoning and the self-rated quality of sex education, or that associations differed by participant sex. Conclusion As sex education is potentially modifiable at the population-level, further research should aim to explore this association in more depth, using qualitative methods and validated measurement tools. Supplementary Information The online version contains supplementary material available at 10.1186/s12889-021-12374-4.
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Powell TW, Jo M, Smith AD, Marshall BD, Thigpen S, Offiong A, Geffen SR. Supplementing Substance Use Prevention With Sexual Health Education: A Partner-Informed Approach to Intervention Development. Health Promot Pract 2022; 23:109-117. [DOI: 10.1177/1524839920947683] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Supplementing substance use prevention with sexual health education would allow educators to address the risk and protective factors that influence both health issues. This streamlined approach may minimize the inefficiencies of multisession, single-purpose interventions. Our team developed a supplemental sexual and reproductive health (SRH) unit to align with an existing evidence-based intervention, LifeSkills Training (LST). This goal of this article is to describe our process, final product, lessons learned, and future directions. Our partner-informed approach took place across three key phases: (1) formative insights, (2) unit development, and (3) pilot implementation. The final supplemental SRH unit is ten, 45-minute sessions offered to seventh- and eighth-grade students and includes a set of learning objectives that are aligned with individual sessions. The supplemental SRH unit also mirrors existing LST modules in length, flow, layout, facilitator instructions, focus on prevention, and utilization of a student workbook. Lessons learned include strategies to effectively incorporate a wide range of ongoing feedback from multiple sources and quickly respond to staff turnover. This partnership approach serves as a model for researchers and practitioners aiming to extend the reach of existing evidence-based programs.
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Affiliation(s)
| | - Meghan Jo
- Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Anne D. Smith
- Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Beth D. Marshall
- Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Santha Thigpen
- Maree G. Farring Elementary/Middle School, Baltimore, MD, USA
| | - Asari Offiong
- Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
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35
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Kaufman TML, Baams L. Disparities in Perpetrators, Locations, and Reports of Victimization for Sexual and Gender Minority Adolescents. J Adolesc Health 2022; 70:99-107. [PMID: 34446345 PMCID: PMC7612809 DOI: 10.1016/j.jadohealth.2021.06.024] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/19/2021] [Revised: 06/15/2021] [Accepted: 06/18/2021] [Indexed: 11/20/2022]
Abstract
PURPOSE Sexual and gender minority (SGM) adolescents are more likely to become victims of bullying and harassment than heterosexual, cisgender adolescents, but little is known about the contextual details of these victimization experiences. This study aims to examine by whom and where adolescents are bullied or harassed, to whom adolescents report such victimization, and whether these experiences differ between SGM and heterosexual, cisgender adolescents. METHODS Participants in this nationally representative study were 29,879 students (mean age = 14.1) from 136 Dutch middle/high schools across grades 7-12 (14.5% sexual minority, 2.7% gender minority) who completed a survey about their school-based experiences. RESULTS Perpetrators of victimization of SGM students were more often teachers and school staff compared with heterosexual, cisgender adolescents. Furthermore, SGM students experienced victimization in private locations (in the rest- or changing rooms/parking lots, at home), more often than heterosexual, cisgender students. Finally, SGM students felt less safe than their heterosexual, cisgender peers to report these experiences to teachers or parents, and were more likely to report their experiences to the police or the school janitor. SGM students who reported victimization experiences were less likely to receive support: the problems were less often acted on and persisted more often than those of heterosexual, cisgender students. CONCLUSIONS SGM adolescents are not only victimized more often, but also by different perpetrators (teachers, other school staff) and in more private places. Their victimization is also less likely to be recognized or acted on by those responsible for adolescent's safety: teachers or parents.
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Affiliation(s)
- Tessa M L Kaufman
- Department of Sociology, University of Groningen, Groningen, The Netherlands; Department of Education and Pedagogy, Utrecht University, Utrecht, The Netherlands.
| | - Laura Baams
- Department of Pedagogy and Educational Sciences, University of Groningen, Groningen, The Netherlands
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McDermott E, Eastham R, Hughes E, Pattinson E, Johnson K, Davis S, Pryjmachuk S, Mateus C, Jenzen O. Explaining effective mental health support for LGBTQ+ youth: A meta-narrative review. SSM - MENTAL HEALTH 2021; 1:None. [PMID: 34957424 PMCID: PMC8654681 DOI: 10.1016/j.ssmmh.2021.100004] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2021] [Revised: 05/24/2021] [Accepted: 05/25/2021] [Indexed: 12/02/2022] Open
Abstract
This meta-narrative review on mental health early intervention support for LGBTQ+ youth aimed to develop a theoretical framework to explain effective mental health support. Using the RAMESES standards for meta-narrative reviews, we identified studies from database searches and citation-tracking. Data extraction and synthesis was conducted through conceptual coding in Atlas.ti. in two stages: 1) conceptual mapping of the meta-narratives; 2) comparing the key concepts across the meta-narratives to produce a theoretical framework. In total, 2951 titles and abstracts were screened and 200 full papers reviewed. 88 studies were included in the final review. Stage 1 synthesis identified three meta-narratives - psychological, psycho-social, and social/youth work. Stage 2 synthesis resulted in a non-pathological theoretical framework for mental health support that acknowledged the intersectional aspects of LGBTQ+ youth lives, and placed youth at the centre of their own mental health care. The study of LGBTQ+ youth mental health has largely occurred independently across a range of disciplines such as psychology, sociology, public health, social work and youth studies. The interdisciplinary theoretical framework produced indicates that effective early intervention mental health support for LGBTQ+ youth must prioritise addressing normative environments that marginalises youth, LGBTQ+ identities and mental health problems. Despite elevated rates of poor mental health, LGBTQ + youth underutilize mental health services and often experience inadequate support. There is a limited evidence-base examining LGBTQ + youth early intervention mental health support needs. Early intervention services for LGBTQ + youth mental health must de-pathologize emotional distress, difficult thoughts and behaviours. Early intervention support must address normative environments that marginalises youth, intersectional LGBTQ + identities and mental health. Mental health support providers must understand individual lives, connect with LGBTQ+ youth, facilitate their autonomy and encourage agency.
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Affiliation(s)
- Elizabeth McDermott
- Lancaster University, Lancaster, UK
- Corresponding author. Department of Health Research, University of Lancaster, Lancaster, LA1 4YW, UK.
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Sava LM, Earnshaw VA, Menino DD, Perrotti J, Reisner SL. LGBTQ Student Health: A Mixed-Methods Study of Unmet Needs in Massachusetts Schools. THE JOURNAL OF SCHOOL HEALTH 2021; 91:894-905. [PMID: 34553384 DOI: 10.1111/josh.13082] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/24/2021] [Revised: 07/09/2021] [Accepted: 07/10/2021] [Indexed: 06/13/2023]
Abstract
BACKGROUND Lesbian, gay, bisexual, transgender, and queer and questioning (LGBTQ) youth experience poor physical and mental health outcomes relative to their non-LGBTQ peers. School health professionals (SHPs), such as school nurses, play a key role in addressing LGBTQ student health needs. However, few studies examine school health needs of LGBTQ students from both the youth and SHP perspective. METHODS From August 2017 to July 2018, 28 LGBTQ youth and 19 SHPs (N = 47) in Massachusetts participated in online focus groups and a brief survey on school health needs and experiences. Qualitative themes were coded using Rapid Qualitative Inquiry principles and NVIVO. RESULTS Both LGBTQ students and SHPs identified an urgent need for inclusive sexual education and mental health services. LGBTQ students raised access to safer bathrooms, information, and guidance on gender transitioning, and access to safe spaces as school-based needs. Missing from SHPs' perspectives, students also discussed sexual violence/harassment of transgender students and racism impacting youth of color. CONCLUSIONS LGBTQ students, especially transgender students and LGBTQ youth of color, have unmet health needs that need to be addressed. Recognizing these needs is the first step towards inclusive health services and support for all students in schools. Next, interventions to increase the capacity of SHPs to address LGBTQ student health are necessary.
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Affiliation(s)
- Lauren M Sava
- The Fenway Institute at Fenway Health, Boston, MA, 02215
| | | | - David D Menino
- Boston Children's Hospital, 21 Autumn Street, Boston, MA, 02215
| | - Jeff Perrotti
- The Massachusetts Commission on LGBTQ Youth, 250 Washington Street 4th Floor, Boston, MA, 02108
| | - Sari L Reisner
- Director of Transgender Research, Brigham and Women's Hospital, Assistant Professor of Medicine, Harvard Medical School, Assistant Professor of Epidemiology, Harvard T.H. Chan School of Public Health, Director of Transgender Health Research and Affiliated Research Scientist, The Fenway Institute at Fenway Health, 221 Longwood Ave, Boston, MA, 02215
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Mark K, Corona-Vargas E, Cruz M. Integrating Sexual Pleasure for Quality & Inclusive Comprehensive Sexuality Education. INTERNATIONAL JOURNAL OF SEXUAL HEALTH : OFFICIAL JOURNAL OF THE WORLD ASSOCIATION FOR SEXUAL HEALTH 2021; 33:555-564. [PMID: 38595784 PMCID: PMC10903684 DOI: 10.1080/19317611.2021.1921894] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/05/2021] [Revised: 04/15/2021] [Accepted: 04/20/2021] [Indexed: 04/11/2024]
Abstract
The lack of inclusion of sexual pleasure in comprehensive sexuality education (CSE) could be detrimental to sexual development, misses opportunities for inclusive education, and may have a long-term impact on sexual well-being. The WAS' Declaration on Sexual Pleasure provides the opportunity to advocate for pleasure as an indispensable part of CSE. Specifically, the inclusion of pleasure in CSE will positively impact six outcomes: traditional risk-reduction, cultivating healthy relationships, celebration of sexual diversity, exercise of sexual rights, empowerment, and consent, and prevention of gender-based sexual violence. Messages of sexual pleasure are crucial for sexuality education to be comprehensive, effective, and inclusive.
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Affiliation(s)
- Kristen Mark
- Department of Family Medicine & Community Health, University of Minnesota Medical School, Minneapolis, Minnesota, USA
| | | | - Mariana Cruz
- International Planned Parenthood Federation Western Hemisphere Region, London, UK
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Brown JM, Naser SC, Brown Griffin C, Grapin SL, Proctor SL. A multicultural, gender, and sexually diverse affirming school‐based consultation framework. PSYCHOLOGY IN THE SCHOOLS 2021. [DOI: 10.1002/pits.22593] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Affiliation(s)
- Jeffrey M. Brown
- Department of Counseling and School Psychology San Diego State University San Diego California USA
| | - Shereen C. Naser
- Department of Psychology Cleveland State University Cleveland Ohio USA
| | - Charity Brown Griffin
- Department of Psychological Sciences Winston‐Salem State University Winston‐Salem North Carolina USA
| | - Sally L. Grapin
- Department of Psychology Montclair State University Montclair New Jersey USA
| | - Sherrie L. Proctor
- Department of Educational Psychology Queens College of the City University of New York New York City New York USA
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Brecht A, Bos S, Ries L, Winter SM, Calvano C. Assessment of Psychological Distress and Peer Relations among Trans Adolescents-An Examination of the Use of Gender Norms and Parent-Child Congruence of the YSR-R/CBCL-R among a Treatment-Seeking Sample. CHILDREN-BASEL 2021; 8:children8100864. [PMID: 34682130 PMCID: PMC8535001 DOI: 10.3390/children8100864] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 08/20/2021] [Revised: 09/23/2021] [Accepted: 09/23/2021] [Indexed: 11/16/2022]
Abstract
Among trans adolescents, increased psychological distress is reported in the literature. The goal of this study was to examine psychological distress, associated peer relations and parent report congruence among the treatment-seeking sample of the Gender Identity Special Consultation (GISC) for youth at the Charité Berlin. Further, differences between the instruments' binary gender norms were investigated. Retrospectively, we analyzed clinical data derived from the GISC. By initial interviews and using the Youth Self-Report and Child Behavior Checklist, n = 50 trans adolescents aged 12-18 years (M = 15.5) were examined for psychological problems and peer relations. Congruence between self and parent report was analyzed by correlations. Half of the sample reported suicidality, self-harm and bullying. Trans adolescents showed significantly higher internalizing and total problems than the German norm population. The congruence between self and parent report proved to be moderate to high. The level of congruence and poor peer relations were identified as predictors of internalizing problems. Significant differences between the female vs. male gender norms emerged regarding mean scores and the number of clinically significant cases. Data provide valuable implications for intervention on a peer and family level. There are limitations to the suitability of questionnaires that use binary gender norms, and further research on adequate instruments and assessment is needed.
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Affiliation(s)
- Alexandra Brecht
- Department of Child and Adolescent Psychiatry, Charité—Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt Universität zu Berlin and Berlin Insitute of Health, 13353 Berlin, Germany; (S.B.); (L.R.); (S.M.W.); (C.C.)
- Correspondence: ; Tel.: +49-30-450-566-653
| | - Sascha Bos
- Department of Child and Adolescent Psychiatry, Charité—Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt Universität zu Berlin and Berlin Insitute of Health, 13353 Berlin, Germany; (S.B.); (L.R.); (S.M.W.); (C.C.)
| | - Laura Ries
- Department of Child and Adolescent Psychiatry, Charité—Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt Universität zu Berlin and Berlin Insitute of Health, 13353 Berlin, Germany; (S.B.); (L.R.); (S.M.W.); (C.C.)
| | - Sibylle M. Winter
- Department of Child and Adolescent Psychiatry, Charité—Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt Universität zu Berlin and Berlin Insitute of Health, 13353 Berlin, Germany; (S.B.); (L.R.); (S.M.W.); (C.C.)
| | - Claudia Calvano
- Department of Child and Adolescent Psychiatry, Charité—Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt Universität zu Berlin and Berlin Insitute of Health, 13353 Berlin, Germany; (S.B.); (L.R.); (S.M.W.); (C.C.)
- Department of Education and Psychology, Clinical Child and Adolescent Psychology and Psychotherapy, Freie Universität Berlin, 14195 Berlin, Germany
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Batchelder AW, Stanton AM, Kirakosian N, King D, Grasso C, Potter J, Mayer KH, O'Cleirigh C. Mental Health and Substance Use Diagnoses and Treatment Disparities by Sexual Orientation and Gender in a Community Health Center Sample. LGBT Health 2021; 8:290-299. [PMID: 34080895 DOI: 10.1089/lgbt.2020.0293] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022] Open
Abstract
Purpose: This study assessed disparities in screener- and provider-identified mental health and substance use diagnoses and treatment attendance by sexual orientation and gender in an urban community health center focused on sexual and gender minority individuals. Methods: Using an electronic data query (October 2015 to October 2018), computerized screening results assessing likely depression, anxiety, alcohol use disorder (AUD), and substance use disorder (SUDs); provider diagnoses; and treatment initiation related to mental health and substance use were compared across sexual orientation (heterosexual, gay/lesbian, bisexual, and other) and gender categories (men and women, inclusive of cisgender and transgender individuals; N = 24,325). Results: Bisexual and other-identified individuals were more likely to screen positive for depression and anxiety, followed by gay/lesbian women, compared with heterosexual individuals and gay men (χ2 = 463.22, p < 0.001 and χ2 = 263.36, p < 0.001, respectively). Of those who screened positive for AUDs, women were less likely to be diagnosed by a professional (χ2 = 63.79, p < 0.001) and of those who screened positive for either alcohol or other SUDs, women were less likely to attend one or more substance use-related behavioral health appointments, regardless of sexual orientation (contingency coefficient = 0.14, p < 0.001). Conclusion: This community health center study identified a need for increased mental health services for bisexual and other-identified individuals and increased assessment and initiation of substance use treatment for women, including sexual minority women.
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Affiliation(s)
- Abigail W Batchelder
- Department of Psychiatry, Massachusetts General Hospital, Boston, Massachusetts, USA.,Department of Psychiatry, Harvard Medical School, Boston, Massachusetts, USA.,The Fenway Institute, Fenway Health, Boston, Massachusetts, USA
| | - Amelia M Stanton
- Department of Psychiatry, Massachusetts General Hospital, Boston, Massachusetts, USA.,Department of Psychiatry, Harvard Medical School, Boston, Massachusetts, USA.,The Fenway Institute, Fenway Health, Boston, Massachusetts, USA
| | - Norik Kirakosian
- Department of Psychiatry, Massachusetts General Hospital, Boston, Massachusetts, USA.,Department of Psychiatry, Harvard Medical School, Boston, Massachusetts, USA
| | - Dana King
- The Fenway Institute, Fenway Health, Boston, Massachusetts, USA
| | - Chris Grasso
- The Fenway Institute, Fenway Health, Boston, Massachusetts, USA
| | - Jennifer Potter
- The Fenway Institute, Fenway Health, Boston, Massachusetts, USA
| | - Kenneth H Mayer
- The Fenway Institute, Fenway Health, Boston, Massachusetts, USA
| | - Conall O'Cleirigh
- Department of Psychiatry, Massachusetts General Hospital, Boston, Massachusetts, USA.,Department of Psychiatry, Harvard Medical School, Boston, Massachusetts, USA.,The Fenway Institute, Fenway Health, Boston, Massachusetts, USA
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Santos CDFBF, Godoy F, de Menezes VA, Colares V, de Araújo Zarzar PMP, Ferreira RC, Kawachi I. LGB prevalence in schools is associated with unhealthy weight-control behaviors in lesbian, gay, and bisexual youth: a multilevel analysis. BMC Public Health 2021; 21:1256. [PMID: 34187426 PMCID: PMC8244205 DOI: 10.1186/s12889-021-11260-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2020] [Accepted: 06/10/2021] [Indexed: 11/10/2022] Open
Abstract
Background Previous studies have found that a school climate of more heteronormativity is associated with adverse effects on the mental health of LGB students. Accordingly, our aim was to assess the association between lower LGB prevalence in schools and unhealthy weight-control behaviors among LGB youth. Methods A cross-sectional, multilevel study based in public high schools in the city of Olinda, Northeast Brazil. A multilevel logistic regression was performed, including 2500 adolescents enrolled in 27 schools. The contextual variable was the prevalence of LGB youth in each school (as a proxy for heteronormativity in schools), while the outcome was unhealthy weight-control behaviors (fasting, purging, and taking diet pills). We controlled for socioeconomic characteristics (age, sex, receiving a family allowance), obesity, and self-reported happiness. Results Lower LGB prevalence in schools was associated with higher odds of engaging in unhealthy weight-control behaviors (OR: 1.5, 95%CI: 1.0, 2.2) among all youth, regardless of sexual orientation. No cross-level interactions between school context and individual characteristics were statistically significant. Conclusion Lower LGB prevalence in schools was associated with a higher risk of unhealthy weight-control behaviors in youth regardless of sexual orientation, which may reflect either the contextual influence of school climate, or may be due to residual confounding.
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Affiliation(s)
| | - Fabiana Godoy
- Graduate Program in Hebiatrics - School of Dentistry, University of Pernambuco, Av. Gov. Agamenon Magalhães - Santo Amaro, Recife, PE, 50100-010, Brazil
| | - Valdenice Aparecida de Menezes
- Graduate Program in Hebiatrics - School of Dentistry, University of Pernambuco, Av. Gov. Agamenon Magalhães - Santo Amaro, Recife, PE, 50100-010, Brazil
| | - Viviane Colares
- Graduate Program in Hebiatrics - School of Dentistry, University of Pernambuco, Av. Gov. Agamenon Magalhães - Santo Amaro, Recife, PE, 50100-010, Brazil
| | - Patrícia Maria Pereira de Araújo Zarzar
- Pediatric Dentistry and Orthodontics, School of Dentistry, Federal University of Minas Gerais, R. Prof. Moacir Gomes de Freitas, 688 - Pampulha, Belo Horizonte, MG, 31270-901, Brazil
| | - Raquel C Ferreira
- Social and Preventive Dentistry, School of Dentistry, Federal University of Minas Gerais, R. Prof. Moacir Gomes de Freitas, 688 - Pampulha, Belo Horizonte, MG, 31270-901, Brazil
| | - Ichiro Kawachi
- Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, 677 Huntington Ave, Boston, MA, 02115, USA
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Pampati S, Johns MM, Szucs LE, Bishop MD, Mallory AB, Barrios LC, Russell ST. Sexual and Gender Minority Youth and Sexual Health Education: A Systematic Mapping Review of the Literature. J Adolesc Health 2021; 68:1040-1052. [PMID: 33162290 PMCID: PMC8121450 DOI: 10.1016/j.jadohealth.2020.09.032] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/29/2020] [Revised: 08/09/2020] [Accepted: 09/22/2020] [Indexed: 10/23/2022]
Abstract
PURPOSE To synthesize the diverse body of literature on sexual and gender minority youth (SGMY) and sexual health education. METHODS We conducted a systematic search of the literature on SGMY and sexual health education, including SGMY perspectives on sexual health education, the acceptability or effectiveness of programs designed for SGMY, and SGMY-specific results of sexual health education programs delivered to general youth populations. RESULTS A total of 32 articles were included. Sixteen qualitative studies with SGMY highlight key perspectives underscoring how youth gained inadequate knowledge from sexual health education experiences and received content that excluded their identities and behaviors. Thirteen studies examined the acceptability or effectiveness of sexual health interventions designed for SGMY from which key characteristics of inclusive sexual health education relating to development, content, and delivery emerged. One study found a sexual health education program delivered to a general population of youth was also acceptable for a subsample of sexual minority girls. CONCLUSIONS Future research on SGMY experiences should incorporate populations understudied, including younger adolescents, sexual minority girls, and transgender persons. Further, the effectiveness of inclusive sexual health education in general population settings requires further study.
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Affiliation(s)
- Sanjana Pampati
- Oak Ridge Institute for Science and Education (ORISE), Oak Ridge, Tennessee.
| | - Michelle M Johns
- Division of Adolescent and School Health, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Leigh E Szucs
- Division of Adolescent and School Health, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Meg D Bishop
- Department of Human Development and Family Sciences, University of Texas at Austin, Austin, Texas; University of Texas Population Research Center, Austin, Texas
| | - Allen B Mallory
- Department of Human Development and Family Sciences, University of Texas at Austin, Austin, Texas; University of Texas Population Research Center, Austin, Texas
| | - Lisa C Barrios
- Division of Adolescent and School Health, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Stephen T Russell
- Department of Human Development and Family Sciences, University of Texas at Austin, Austin, Texas; University of Texas Population Research Center, Austin, Texas
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Philbin MM, Wang X, Feaster DJ, LaBossier NJ, Phillips G. LGB-Affirming School Climates and Sexual Health Outcomes Among U.S. High School Students 2015-2017: Differences by Sex and Sexual Identity. J Adolesc Health 2021; 68:1121-1128. [PMID: 33419621 PMCID: PMC8686698 DOI: 10.1016/j.jadohealth.2020.11.006] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/08/2020] [Revised: 11/05/2020] [Accepted: 11/05/2020] [Indexed: 12/28/2022]
Abstract
PURPOSE Lesbian, gay, and bisexual (LGB) adolescents face disparities in sexual health outcomes compared to their heterosexual peers, which has implications for health outcomes and developmental trajectories. We examined whether adolescents living in jurisdictions with school climates that were more exclusionary toward LGB individuals engaged in higher risk sexual behaviors than those in jurisdictions with more inclusive school climates. METHODS Data on sexual identity, age at first sex, condom use at last sex and the number of lifetime partners came from the 2015 (20 jurisdictions) and 2017 (19 jurisdictions) Youth Risk Behavior Surveillance Surveys. Data on LGB climates in schools, aggregated to the state level, came from the School Health Profile Survey of the Centers for Disease Control and Prevention. Multilevel multivariable regressions examined the association between LGB school climate and sexual behaviors, including effect modification. RESULTS Overall, living in jurisdictions with more exclusionary LGB school climates was significantly associated with a lower age at first sex (β = -.04[-.07, -.02]) and a lower likelihood of condom use (OR = .94[.90, .98]), but not the number of lifetime partners. Associations differed by subgroup: sexual identity modified the relationship between school climate and age at first sex (β = -.09[-.15, -.03]) for bisexual adolescents, and school climate and condom use for bisexual (OR = .86[.76, .98]) and gay adolescents (OR = .66[.64, .68]). CONCLUSIONS Exclusionary LGB school climates are associated with a lower age at first sex and a lower likelihood of condom use for all adolescents, and particularly bisexual individuals. Additional research and practice should address school-level climates to support adolescents' healthy sexual development.
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Affiliation(s)
- Morgan M Philbin
- Department of Sociomedical Sciences, Columbia University Mailman School of Public Health, New York, New York.
| | - Xinzi Wang
- Department of Medical Social Sciences, Feinberg School of Medicine, Northwestern University, Chicago, Illinois; Institute for Sexual and Gender Minority Health and Wellbeing, Northwestern University, Chicago, Illinois
| | - Daniel J Feaster
- Department of Public Health Sciences, University of Miami Miller School of Medicine, Miami, Florida
| | | | - Gregory Phillips
- Department of Medical Social Sciences, Feinberg School of Medicine, Northwestern University, Chicago, Illinois; Institute for Sexual and Gender Minority Health and Wellbeing, Northwestern University, Chicago, Illinois
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Coulter RWS, Paglisotti T, Montano G, Bodnar K, Bersamin M, Russell ST, Hill AV, Mair C, Miller E. Intersectional Differences in Protective School Assets by Sexuality, Gender, Race/Ethnicity, and Socioeconomic Status. THE JOURNAL OF SCHOOL HEALTH 2021; 91:318-330. [PMID: 33740272 PMCID: PMC8432425 DOI: 10.1111/josh.13005] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/01/2020] [Revised: 11/03/2020] [Accepted: 11/25/2020] [Indexed: 06/12/2023]
Abstract
BACKGROUND School assets-such as connectedness, caring relationships with adults, high behavioral expectations from adults, and meaningful participation-are associated with positive outcomes for adolescents. However, little is known about how school assets differ among adolescents with intersecting marginalized identities. METHODS We used the 2013-2014 California Healthy Kids Survey (N = 320,462 students) to examine differences in school assets with respect to sexuality, gender, race/ethnicity, and socioeconomic status using adjusted multilevel linear regression models. RESULTS Sexual minority, gender minority, racial/ethnic minority, and low socioeconomic status adolescents had significantly lower protective school assets. For all outcomes, the differences between sexual minority and heterosexual adolescents were more pronounced among nontransgender girls than nontransgender boys; however, these differences were not consistently present among racial/ethnic minority students. For school connectedness and meaningful participation, differences for racial/ethnic minorities versus white adolescents were more pronounced among nontransgender girls than nontransgender boys. Differences between transgender adolescents and nontransgender boys were more pronounced for white adolescents compared to some other racial/ethnic minority students. Overall, adolescents with certain multiple marginalized identities had lower school assets. CONCLUSIONS Interventions are needed to strengthen school assets among marginalized students, thereby helping mitigate health and education inequities.
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Affiliation(s)
- Robert W S Coulter
- Assistant Professor, , Department of Behavioral and Community Health Sciences, Graduate School of Public Health, University of Pittsburgh, 6129 Public Health Building, 130 De Soto Street, Pittsburgh, PA, 15261., USA
| | - Taylor Paglisotti
- Data Analyst Coordinator, , Department of Pediatrics, School of Medicine, University of Pittsburgh, 120 Lytton Avenue, Pittsburgh, PA, 15213-1444., USA
| | - Gerald Montano
- Assistant Professor of Pediatrics, , Department of Pediatrics, School of Medicine, University of Pittsburgh, University Center, Suite 225, 120 Lytton Avenue, Pittsburgh, PA, 15213-1481., USA
| | - Kaitlin Bodnar
- Research Assistant, , University of Pittsburgh, Graduate School of Public Health, P.O. Box 7319, Pittsburgh, PA, 15213., USA
| | - Melina Bersamin
- Senior Research Scientist, , Prevention Research Center, 1516 East Franklin Street, Chapel Hill, NC, 27514., USA
| | - Stephen T Russell
- Professor, , Department of Human Development and Family Sciences, Population Research Center, University of Texas at Austin, 108 E Dean Keeton Street, Austin, TX, 78712., USA
| | - Ashley V Hill
- Postdoctoral Researcher, , Division of Adolescent and Young Adult Medicine, UPMC Children's Hospital of Pittsburgh, University Center, Suite 302.4, 120 Lytton Avenue, Pittsburgh, PA, 15213-1481., USA
| | - Christina Mair
- Associate Professor, , Department of Behavioral and Community Health Sciences, Graduate School of Public Health, University of Pittsburgh, 6136 Public Health Building, 130 De Soto Street, Pittsburgh, PA, 15261., USA
| | - Elizabeth Miller
- Professor, , Department of Pediatrics, School of Medicine, University of Pittsburgh, University Center, Suite 302.2, 120 Lytton Avenue, Pittsburgh, PA, 15213-1481., USA
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Jackman KB, Caceres BA, Kreuze EJ, Bockting WO. Suicidality among Gender Minority Youth: Analysis of 2017 Youth Risk Behavior Survey Data. Arch Suicide Res 2021; 25:208-223. [PMID: 31642392 PMCID: PMC7176535 DOI: 10.1080/13811118.2019.1678539] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
We examined differences in suicidality based on gender identity while adjusting for known suicide risk factors in a sample of United States adolescents. Using data from the 2017 Youth Risk Behavior Survey we used logistic regression models to examine three suicide-related outcomes. Youth were categorized as transgender (1.3%), gender-questioning (1.4%), or cisgender (97.3%). In fully adjusted models, compared to cisgender youth, transgender youth had 2.71 (95% CI 1.50-4.92) higher odds of past-year suicide attempts and 2.54 (95% CI 1.05-6.15) higher odds of past-year suicide attempts requiring treatment. Gender-questioning youth had 2.31 (95% CI 1.48-3.60) higher odds of past-year suicidal ideation compared to cisgender youth. Policies and interventions are needed to reduce suicidality among gender minority youth, improve access to mental healthcare, and reduce peer victimization and substance use.
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Giano Z, O'Neil AM, Stowe M, Hubach RD. Examining Profiles of Latinx Sexual Minority Adolescents Associated with Suicide Risk. J Immigr Minor Health 2021; 23:452-462. [PMID: 33389392 DOI: 10.1007/s10903-020-01128-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/17/2020] [Indexed: 11/28/2022]
Abstract
Few studies have focused on within-group heterogeneity about specific factors that make lesbian, gay, or bisexual (LGB) Latinx adolescents at greater odds than other LGB adolescents for suicide We take a unique mixture-modeling approach by creating profiles of Latinx LGB adolescents based on suicide risk factors used in previous investigations (bullying, alcohol, sleep, social media, and poor grades). We use these profiles in a logistic regression to investigate suicidality A sample of 686 LGB, Latinx adolescents were used in a latent profile analysis yielding four distinct profiles. Class 4 represented the highest risk, with high rates of bullying, alcohol, poor grades, and use of electronics, while class 3 represented the lowest risk with low rates of bullying and alcohol Results speak to the need to address suicidal ideation through multiple factors, noting the strong association that both bullying and alcohol have with suicidal ideation.
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Affiliation(s)
- Zachary Giano
- Center for Rural Health, Oklahoma State University-Center for Health Sciences, 1111 W 17th Street, Tulsa, OK, 74107, USA.
| | - Andrew M O'Neil
- Center for Rural Health, Oklahoma State University-Center for Health Sciences, 1111 W 17th Street, Tulsa, OK, 74107, USA
| | - Mollie Stowe
- Center for Rural Health, Oklahoma State University-Center for Health Sciences, 1111 W 17th Street, Tulsa, OK, 74107, USA
| | - Randolph D Hubach
- Center for Rural Health, Oklahoma State University-Center for Health Sciences, 1111 W 17th Street, Tulsa, OK, 74107, USA
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Goldfarb ES, Lieberman LD. Three Decades of Research: The Case for Comprehensive Sex Education. J Adolesc Health 2021; 68:13-27. [PMID: 33059958 DOI: 10.1016/j.jadohealth.2020.07.036] [Citation(s) in RCA: 142] [Impact Index Per Article: 47.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/03/2020] [Revised: 07/21/2020] [Accepted: 07/22/2020] [Indexed: 11/25/2022]
Abstract
PURPOSE School-based sex education plays a vital role in the sexual health and well-being of young people. Little is known, however, about the effectiveness of efforts beyond pregnancy and sexually transmitted disease prevention. The authors conducted a systematic literature review of three decades of research on school-based programs to find evidence for the effectiveness of comprehensive sex education. METHODS Researchers searched the ERIC, PsycINFO, and MEDLINE. The research team identified papers meeting the systematic literature review criteria. Of 8,058 relevant articles, 218 met specific review criteria. More than 80% focused solely on pregnancy and disease prevention and were excluded, leaving 39. In the next phase, researchers expanded criteria to studies outside the U.S. to identify evidence reflecting the full range of topic areas. Eighty articles constituted the final review. RESULTS Outcomes include appreciation of sexual diversity, dating and intimate partner violence prevention, development of healthy relationships, prevention of child sex abuse, improved social/emotional learning, and increased media literacy. Substantial evidence supports sex education beginning in elementary school, that is scaffolded and of longer duration, as well as LGBTQ-inclusive education across the school curriculum and a social justice approach to healthy sexuality. CONCLUSIONS Review of the literature of the past three decades provides strong support for comprehensive sex education across a range of topics and grade levels. Results provide evidence for the effectiveness of approaches that address a broad definition of sexual health and take positive, affirming, inclusive approaches to human sexuality. Findings strengthen justification for the widespread adoption of the National Sex Education Standards.
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Affiliation(s)
- Eva S Goldfarb
- Department of Public Health, Montclair State University, Montclair, New Jersey.
| | - Lisa D Lieberman
- Department of Public Health, Montclair State University, Montclair, New Jersey
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Naser SC, Clonan‐Roy K, Fuller KA, Goncy EA, Wolf N. Exploring the experiences and responses of LGBTQ+ adolescents to school‐based sexuality education. PSYCHOLOGY IN THE SCHOOLS 2020. [DOI: 10.1002/pits.22471] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Affiliation(s)
| | | | | | | | - Nicole Wolf
- Cleveland State University Cleveland Ohio USA
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Self-Injurious Thoughts and Behaviors Among Sexual and Gender Minority Youth: a Systematic Review of Recent Research. CURRENT SEXUAL HEALTH REPORTS 2020. [DOI: 10.1007/s11930-020-00295-z] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
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