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Ching THW, Finkelstein-Fox L, Lee SY, Watson RJ. Effects of sexual and gender minority stress on depressive symptoms among adolescents of color in the United States. CULTURAL DIVERSITY & ETHNIC MINORITY PSYCHOLOGY 2024; 30:309-318. [PMID: 36048116 PMCID: PMC9975117 DOI: 10.1037/cdp0000562] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
OBJECTIVE There is a need for more research on minority stress theory (MST) with sexual and gender minority (SGM) adolescents of color, because of their disproportionate risk for depression. METHOD We recruited 1,627 SGM adolescents of color in the United States to complete measures assessing lesbian, gay, bisexual, transgender, and queer (LGBTQ) climate, LGBTQ microaggressions within one's ethnoracial community, internalized LGBTQ stigma, stress management ability, and depressive symptoms. Using structural equation modeling, a hybrid measurement-structural model was tested, indicating good model fit. RESULTS Multiple significant indirect pathways linking LGBTQ climate and depressive symptoms emerged. A less positive LGBTQ climate was associated with more microaggression-related stress, more internalized LGBTQ stigma, and worse stress management ability, all of which were associated with greater depressive symptoms. A serial mediation with more microaggression-related stress being associated with greater internalized LGBTQ stigma approached significance. CONCLUSIONS Our findings generally support MST processes in terms of depressive symptoms in SGM adolescents of color, suggesting that psychosocial interventions targeting these processes may have meaningful implications for the mental health of this vulnerable group. (PsycInfo Database Record (c) 2024 APA, all rights reserved).
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Affiliation(s)
| | | | - Sharon Y. Lee
- Warren Alpert Medical School of Brown University, Providence, RI
| | - Ryan J. Watson
- Department of Human Development and Family Sciences, University of Connecticut, Storrs, CT
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Ferbežar N, Kopinič A, Gavriloski Tretjak M. Elements of Minority Stress and Resilience in LGBTQ+ Students' Experience of Education. JOURNAL OF HOMOSEXUALITY 2024:1-24. [PMID: 38470515 DOI: 10.1080/00918369.2024.2326473] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 03/14/2024]
Abstract
This study investigates the experiences of minority stress and resilience among LGBTQ+ students in educational settings and identifies critical contributors to their well-being. To highlight the unique educational experiences of LGBTQ+ participants a qualitative research strategy was employed. We conducted narrative interviews with 27 LGBTQ+ people aged 17 to 41 who are or have been enrolled in primary, secondary or tertiary education in Slovenia. The results indicate that minority stress is a significant in their educational experiences, with various deleterious effects. The testimonies of our respondents indicate, albeit to a lesser extent, that the education system can enhance the resilience of LGBTQ+ youth and mitigate the negative impacts of minority stress. This study confirms prior research on minority stress effects on LGBTQ+ individuals. It asserts that LGBTQ+ youth experience minority stress within the education system, while emphasizing that certain aspects of resilience can significantly mitigate these negative effects. As social support emerged as a significant factor in our study, it would be reasonable to investigate how school personnel can enhance LGBT youths' resilience in the future. Additionally, it would be beneficial to investigate how the support of peers and (chosen) families influences the school experiences of LGBTQ+ students.
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Affiliation(s)
- Nika Ferbežar
- Department of Social Pedagogy, University of Primorska, Koper, Slovenia
| | - Alja Kopinič
- Adult Mental Health Department, Health Center, Sevnica, Slovenia
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Panken E, Frydenlund N, Mistry N, Prabhu R, Wong J, Kundu S, Victorson D, Amarasekera C. Heteronormative biases and distinctive experiences with prostate cancer among men who have sex with men: a qualitative focus group study. BMC Urol 2024; 24:10. [PMID: 38184578 PMCID: PMC10771696 DOI: 10.1186/s12894-023-01398-0] [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] [Received: 05/21/2023] [Accepted: 12/28/2023] [Indexed: 01/08/2024] Open
Abstract
BACKGROUND Men who have sex with men (MSM) face many challenges and biases in healthcare. Within urology there is a need to better understand how prostate cancer impacts MSM given the unique ways in which side effects that accompany treatment may affect this population. The goal of this study is to explore the experience of MSM with prostate cancer to advance the existing literature in this area and inform implementation and delivery of clinical practice and policy guidelines. METHODS Four focus groups were conducted with a semi-structured interview guide. Using a phenomenological qualitative approach consistent with grounded theory [1] and naturalistic inquiry principles we sought to better understand the direct experiences of MSM with prostate cancer. Audio transcriptions were thematically analyzed to identify themes that impact MSM throughout their prostate cancer journey. An iterative, team-wide classification process was used to identify, organize, and group common codes into higher-order categories and themes. RESULTS Patient's choice of provider and their interactions with the healthcare system were strongly impacted by their sexual identities. Participants commented on navigating the heteronormative healthcare environment and the impact of assumptions they encountered. MSM experienced the sexual side effects of prostate cancer treatment in unique ways. Issues with erectile dysfunction and ejaculatory dysfunction had significant impacts on patient's sexual experience, with some describing being forced to explore new modes of sexual expression. Anejaculation was a theme that was distressing for many participants. The emotional impact of a prostate cancer diagnosis was significant in the men interviewed. Common themes included loss of identity and fear for future relationships. CONCLUSIONS MSM have unique concerns after prostate cancer treatment that differ from men who don't identify as MSM. It is critical that providers familiarize themselves with the concerns of this patient population regarding prostate cancer treatment. An important step toward reducing heteronormative bias in prostate cancer care is to better understand the goals, identity, and sexual practices of MSM and to provide informed anticipatory guidance.
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Affiliation(s)
- Evan Panken
- Department of Urology, Northwestern University, 675 N. St. Clair St, Chicago, IL, 60611, USA.
| | - Noah Frydenlund
- Department of Urology, Northwestern University, 675 N. St. Clair St, Chicago, IL, 60611, USA
| | - Neil Mistry
- Department of Urology, Northwestern University, 675 N. St. Clair St, Chicago, IL, 60611, USA
| | - Rahul Prabhu
- Department of Urology, Northwestern University, 675 N. St. Clair St, Chicago, IL, 60611, USA
| | - Jeffrey Wong
- University of Colorado School of Medicine, Aurora, CO, USA
| | - Shilajit Kundu
- Department of Urology, Northwestern University, 675 N. St. Clair St, Chicago, IL, 60611, USA
| | - David Victorson
- Department of Urology, Northwestern University, 675 N. St. Clair St, Chicago, IL, 60611, USA
- Department of Medical Social Sciences, Northwestern University, Chicago, IL, USA
| | - Channa Amarasekera
- Department of Urology, Northwestern University, 675 N. St. Clair St, Chicago, IL, 60611, USA
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Heiden-Rootes K, Meyer D, Sledge R, Davis BK, Drallmeier T, Linsenmeyer W, Levine S, Dalton MR. Seeking gender-affirming medical care: A phenomenological inquiry on skillful coping with transgender and non-binary adults in the United States Midwest. QUALITATIVE RESEARCH IN MEDICINE & HEALTHCARE 2023; 7:11485. [PMID: 38213669 PMCID: PMC10782890 DOI: 10.4081/qrmh.2023.11485] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2023] [Accepted: 11/19/2023] [Indexed: 01/13/2024] Open
Abstract
This study sought to understand how transgender and gender non-binary (TGNB) individuals skillfully cope with healthcare services and to explore how childhood experiences impact expectations, habits, and meaning-making when utilizing healthcare services. Using an interpretive phenomenological approach, we sampled 17, White TGNB adults in the United States, ages 19 to 57, using semi-structed interviews about childhood experiences with healthcare utilization and adult experiences seeking genderaffirming healthcare. Analysis identified one main theme-Anticipate the worst in healthcare and be pleasantly surprised-and three subthemes: i) contrast between positive childhood and negative adulthood experiences in medical care; ii) coping practices for the worst; and iii) finding your unicorn doctor and medical staff for pleasant experiences. Results indicate participants experienced a disruption and acquisition of new coping practices in healthcare settings and the cultivation of a radical imagination for a more liberated medical world for TGNB people. Implications for providers and medical offices for empowering TGNB adults are described.
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Affiliation(s)
- Katie Heiden-Rootes
- Department of Family & Community Medicine, Saint Louis University, St. Louis, Missouri
| | - Dixie Meyer
- Department of Family & Community Medicine, Saint Louis University, St. Louis, Missouri
| | - Renata Sledge
- Department of Family & Community Medicine, Saint Louis University, St. Louis, Missouri
| | - Bryce K. Davis
- Clinical Psychology Program, Department of Psychology, Saint Louis University, St. Louis, Missouri
| | - Theresa Drallmeier
- Department of Family & Community Medicine, Saint Louis University, St. Louis, Missouri
| | - Whitney Linsenmeyer
- Doisy College of Health Science, Department of Nutrition and Dietetics, Saint Louis University, St. Louis, Missouri, United States
| | - Samantha Levine
- Department of Family & Community Medicine, Saint Louis University, St. Louis, Missouri
| | - Michelle R. Dalton
- Department of Family & Community Medicine, Saint Louis University, St. Louis, Missouri
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Sorrell SA, Lefevor GT, Bell JH, Berg CO, Skidmore SJ. "You're not gay; You're a child of god": Microaggressions experienced by LGBTQ+ teens and their parents in the Church of Jesus Christ of Latter-day saints. FAMILY PROCESS 2023. [PMID: 36725693 DOI: 10.1111/famp.12863] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/06/2022] [Revised: 01/02/2023] [Accepted: 01/03/2023] [Indexed: 06/18/2023]
Abstract
Like other teens in conservative religious environments, LGBTQ+ teens raised in the Church of Jesus Christ of Latter-day Saints (CJCLDS) likely experience unique microaggressions. Furthermore, like other conservatively religious parents of LGBTQ+ teens, active Latter-day Saint (LDS) parents who openly support their LGBTQ+ teens likely both witness microaggressions toward their teens and may personally experience microaggressions. The present study sought to understand parents' and teens' experiences of microaggressions in conservative religious contexts by focusing specifically on the microaggressions experienced by (a) LGBTQ+ teens raised in the CJCLDS and (b) their active LDS parents. Thematic analysis of separate interviews with 19 dyads of LGBTQ+ teens and their active LDS parents (38 total interviews) revealed various ways in which they experienced verbal, nonverbal, and environmental microaggressions. We highlight parents' and teens' shared experiences of microaggressions that may be uniquely related to their religious contexts, such as assumptions that LGBTQ+ teens or their parents are not faithful and exclusionary Church policies. Additionally, we identified microaggressions that specifically targeted parents of LGBTQ+ teens, such as comments suggesting parents should limit their support for their teens. Finally, we found that parents had vicarious experiences with microaggressions through witnessing or learning about microaggressions that targeted their teens. Findings highlight the ways that the religious contexts in which microaggressions occur can influence the way that microaggressions are communicated to and experienced by LGBTQ+ teens - and their parents.
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Indirect contact and adolescents' intentions as bystanders to LGBTQ+ microaggressions. JOURNAL OF APPLIED DEVELOPMENTAL PSYCHOLOGY 2023. [DOI: 10.1016/j.appdev.2022.101485] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
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7
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Correro AN, Hinrichs KLM, Krishnan MC, Cottingham ME, Trittschuh EH, Parmenter BA, Kang J, Stelmokas J. Neuropsychological assessment with lesbian, gay, bisexual, transgender, and queer/questioning (LGBTQ+) individuals: Practice, education, and training survey. Clin Neuropsychol 2022:1-43. [PMID: 36458596 DOI: 10.1080/13854046.2022.2148379] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2022] [Accepted: 11/11/2022] [Indexed: 12/04/2022]
Abstract
Objective: We sought to describe the LGBTQ + related education, training, and clinical practice of independently licensed neuropsychologists in the United States and to identify factors that predict affirmative neuropsychological practices. We hypothesized that LGBTQ + identity, female gender, more recent training, and extent of LGBTQ + education/training would predict use of LGBTQ + practice guidelines. Method: A workgroup of clinical psychologists with experience in LGBTQ + psychology and neuropsychology developed a survey to identify personal and professional factors that predict affirmative neuropsychological testing practices. The survey was distributed through professional organizations and listservs between August and September 2021 with 118 responses meeting inclusionary criteria. Results: The majority of participants identified as heterosexual (70.3%) and cisgender (97.5%), and most (48-63%) received LGBTQ + training post-licensure. Between 19% and 32% of participants reported never completing LGBTQ + specific education. Consistent with our hypotheses, factors predicting affirmative clinical practice behaviors were LGBTQ + education/training, and personal background (sexual minority status, female/feminine gender, and years since degree). Other significant factors included prior experience with LGBTQ + patients and primary patient population (child vs. adult). Qualitative responses indicated varying values, attitudes, and knowledge regarding collection of LGBTQ + information and modification of clinical practice. Conclusions: Neuropsychologists underutilize affirming practices as evidenced by low rates of querying pronouns, knowing whether LGBTQ + health information is available at their institutions, and adjusting evaluation and feedback approaches. We provide specific training and education recommendations to increase knowledge and skills and to address beliefs about LGBTQ + health that can serve to promote affirmative neuropsychological practice.
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Affiliation(s)
- Anthony N Correro
- Mental Health Service, VA Ann Arbor Healthcare System, Ann Arbor, Michigan, USA
- Department of Psychiatry, Michigan Medicine, University of Michigan Health, Ann Arbor, Michigan, USA
| | - Kate L M Hinrichs
- Mental Health Service, VA Boston Healthcare System, Boston, Massachusetts, USA
- Department of Psychiatry, Harvard Medical School, Boston, Massachusetts, USA
| | - Mira C Krishnan
- Division of Psychiatry and Behavioral Medicine, Michigan State University College of Human Medicine, East Lansing, Michigan, USA
| | | | - Emily H Trittschuh
- Geriatric Research Education and Clinical Center (GRECC), VA Puget Sound Healthcare System, Seattle, Washington, USA
- Department of Psychiatry and Behavioral Sciences, University of Washington School of Medicine, Seattle, Washington, USA
| | - Brett A Parmenter
- Department of Psychiatry and Behavioral Sciences, University of Washington School of Medicine, Seattle, Washington, USA
- Mental Health Service, American Lake Division, VA Puget Sound Healthcare System, Tacoma, Washington, USA
- Olympic Psychology Services, Tacoma, Washington, USA
| | - Jinkyung Kang
- Department of Internal Medicine-Geriatric and Palliative Medicine, Michigan Medicine, University of Michigan Health, Ann Arbor, Michigan, USA
| | - Julija Stelmokas
- Mental Health Service, VA Ann Arbor Healthcare System, Ann Arbor, Michigan, USA
- Department of Psychiatry, Michigan Medicine, University of Michigan Health, Ann Arbor, Michigan, USA
- Mental Health Service, Brooklyn Campus, VA New York Harbor Healthcare System, Brooklyn, New York, USA
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Kiekens WJ, Kaufman TML, Baams L. Sexual and Gender Identity-Based Microaggressions: Differences by Sexual and Gender Identity, and Sex Assigned at Birth Among Dutch Youth. JOURNAL OF INTERPERSONAL VIOLENCE 2022; 37:NP21293-NP21319. [PMID: 34866474 PMCID: PMC7613687 DOI: 10.1177/08862605211056729] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
Research describes several sexual and gender identity-based microaggressions that sexual and gender minority (SGM) people might experience. We aimed to examine the occurrence of different sexual and gender identity-based microaggressions among SGM youth and to identify differences by sexual and gender identity, and sex assigned at birth. Open-ended questions about daily experiences were coded for 16 types of sexual and gender identity-based microaggressions in two daily diary studies among Dutch SGM youth (Study 1: N = 90, M age = 17.64 SD = 1.78; Study 2: N = 393, M age = 18.36 SD = 2.65). Several types of microaggressions were identified, and there was sizable variability in the reported frequency. Overall, lesbian women and bisexual youth were less likely to report microaggressions than gay youth. Bisexual youth were less likely to report use of heterosexist or transphobic terminology than gay youth and youth assigned male at birth were less likely to report invalidation of LGBTQ identity than youth assigned female at birth. Last, gender minority youth were more likely to report familial microaggressions, invalidation of LGBTQ identity, and threatening behaviors than cisgender youth. Overall, this study provides empirical support using mixed qualitative and quantitative methods for theorized typologies of microaggressions among Dutch SGM youth.
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Affiliation(s)
- Wouter J. Kiekens
- Department of Sociology/Interuniversity
Center for Social Science Theory and Methodology (ICS), University of Groningen, The Netherlands
| | - Tessa M. L. Kaufman
- Department of Sociology/Interuniversity
Center for Social Science Theory and Methodology (ICS), University of Groningen, The Netherlands
- Department of Education and Pedagogy, Utrecht University, The Netherlands
| | - Laura Baams
- Department of Pedagogy and Educational
Sciences, University of Groningen, The Netherlands
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Ropero-Padilla C, Rodríguez-Valbuena C, Rodriguez-Arrastia M, Ruiz-Fernández MD, Roman P, Sanchez-Labraca N. Exploring the microaggression experiences of LGBTQ+ community for a culturally safe care: A descriptive qualitative study. NURSE EDUCATION TODAY 2022; 115:105423. [PMID: 35661578 DOI: 10.1016/j.nedt.2022.105423] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/30/2021] [Revised: 05/03/2022] [Accepted: 05/25/2022] [Indexed: 06/15/2023]
Abstract
BACKGROUND Microaggressions, stigma and minority stress still occur among sexual and gender minorities on an individual, interpersonal, and structural level. Cultural immersion may therefore be an effective strategy in order to find potential healthcare approaches and foster more comprehensive, critical, intersectional, and inclusive care practices. OBJECTIVE The aim of this study was to develop insight into the experiences of LGBTQ+ community members to obtain in-depth perceptions of microaggressions and an understanding of their healthcare needs to provide a culturally safe and sensitive care. DESIGN A qualitative descriptive study was conducted between September to November 2021. SETTINGS This study was conducted at the University of Almeria with LGBTQ+ community members. PARTICIPANTS Twenty-one LGBTQ+ individual participated in this study, aged between 18 and 56 years old. METHODS Participants were recruited using a purposive sampling. Responses from semi-structured interviews were studied using a thematic analysis. Methods and findings are reported in line with Standards for Reporting Qualitative Research recommendations. RESULTS Three themes emerged from the qualitative analysis: (i) experiences to understand the impact of a heteronormative society, (ii) perceptions of engaging with health education and promotion, and (iii) healthcare access, use and experiences within the LGTBQ+ community. CONCLUSIONS This study yields findings about the difficulties that LGBTQ+ community members face in the healthcare system in order to ensure equal care for vulnerable communities and integrate a culturally safe care approach into nursing practice. Certain microaffirmation strategies against social determinants of health such as school-based nursing strategies can help to raise awareness and knowledge among heterosexual peers and reduce cultural invisibility, microaggressions, stigma and minority stress. In order to provide culturally safe care, educators might also explore the inclusion of gender and sexual minority care content in both in-faculty education and ongoing continuing education for nurse practitioners.
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Affiliation(s)
- Carmen Ropero-Padilla
- Faculty of Health Sciences, Pre-Department of Nursing, Jaume I University, Castello de la Plana, Spain.
| | - Cristian Rodríguez-Valbuena
- Faculty of Health Sciences, Department of Nursing Science, Physiotherapy and Medicine, University of Almeria, Almeria, Spain.
| | - Miguel Rodriguez-Arrastia
- Faculty of Health Sciences, Pre-Department of Nursing, Jaume I University, Castello de la Plana, Spain.
| | - María Dolores Ruiz-Fernández
- Faculty of Health Sciences, Department of Nursing Science, Physiotherapy and Medicine, University of Almeria, Almeria, Spain; Health Research Centre, University of Almeria, Almeria, Spain; Research Group CTS-451 Health Sciences, University of Almeria, Almeria, Spain.
| | - Pablo Roman
- Faculty of Health Sciences, Department of Nursing Science, Physiotherapy and Medicine, University of Almeria, Almeria, Spain; Health Research Centre, University of Almeria, Almeria, Spain; Research Group CTS-451 Health Sciences, University of Almeria, Almeria, Spain.
| | - Nuria Sanchez-Labraca
- Faculty of Health Sciences, Department of Nursing Science, Physiotherapy and Medicine, University of Almeria, Almeria, Spain; Health Research Centre, University of Almeria, Almeria, Spain.
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Matijczak A, Tomlinson C, Pham A, Corona R, McDonald S. Relations Between Interpersonal Microaggressions, Depressive Symptoms, and Pet Attachment in an LGBTQ+ Emerging Adult Sample. JOURNAL OF LGBT YOUTH 2022; 20:658-679. [PMID: 37554400 PMCID: PMC10406454 DOI: 10.1080/19361653.2022.2091078] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/10/2022] [Revised: 06/02/2022] [Accepted: 06/09/2022] [Indexed: 08/10/2023]
Abstract
Exposure to microaggressions can have detrimental impacts on the mental health of LGBTQ+ emerging adults. Positive social relationships are a well-documented protective factor that help to buffer the impact of adversity on mental health in this population. However, the role of social relationships with pets has received minimal attention in research on LGBTQ+ mental health, despite the high prevalence of pets in U.S. households. This cross-sectional study examined whether the association between interpersonal microaggressions and depressive symptoms among LGBTQ+ emerging adults varied as a function of attachment to pets across three domains: love, emotion regulation, and personal growth. We recruited 163 LGBTQ+ emerging adults (18-21 years) who lived with a cat and/or dog within the past year (98.8% sexual minority, 47.2% gender minority, 37.4% racial/ethnic minority). We found that love and emotion regulation significantly moderated the positive association between interpersonal microaggressions and depressive symptoms. Specifically, this association was only significant when love and emotion regulation were at moderate or high levels. These findings have important implications for practice with LGBTQ+ pet owners, as it suggests that high levels of pet attachment may amplify the relation between interpersonal microaggressions and depressive symptoms.
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Affiliation(s)
- Angela Matijczak
- School of Social Work, Virginia Commonwealth University, Richmond VA, USA
| | - Camie Tomlinson
- School of Social Work, Virginia Commonwealth University, Richmond VA, USA
| | - An Pham
- Children’s Hospital of Richmond, Virginia Commonwealth University, Richmond VA, USA
| | - Rosalie Corona
- Department of Psychology, Virginia Commonwealth University, Richmond VA, USA
| | - Shelby McDonald
- Department of Psychology, Virginia Commonwealth University, Richmond VA, USA
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Mereish EH, Parra LA, Watson RJ, Fish JN. Subtle and Intersectional Minority Stress and Depressive Symptoms Among Sexual and Gender Minority Adolescents of Color: Mediating Role of Self-Esteem and Sense of Mastery. PREVENTION SCIENCE : THE OFFICIAL JOURNAL OF THE SOCIETY FOR PREVENTION RESEARCH 2022; 23:142-153. [PMID: 34482516 PMCID: PMC9802675 DOI: 10.1007/s11121-021-01294-9] [Citation(s) in RCA: 15] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/14/2021] [Indexed: 01/03/2023]
Abstract
Little research has examined subtle, intersectional, and everyday minority stress, such as microaggressions specific to being a queer person of color, and its associations with depressive symptoms among sexual and gender minority adolescents (SGMA) of color. Moreover, research is needed to identify mechanisms that might explain the associations between minority stress and depression. This study examined the associations between subtle and intersectional minority stress (i.e., SGMA of color-specific microaggressions) and depressive symptoms among SGMA of color and tested self-concept factors (i.e., self-esteem and sense of mastery) as mediators of these associations. A large national US sample of SGMA of color (N = 3398; 31.8% transgender; 55.7% plurisexual) ages 13 to 17 years (M = 15.56, SD = 1.27) were recruited online. Participants' race/ethnicity were Asian/Pacific Islander (12.2%), Black/African American (13.2%), Hispanic/Latina(o)/x (30%), Native American/Alaska Native (1.2%), Middle Eastern (1.9%), Biracial or Multiracial (40%), and other racial/ethnic minority groups (1.7%). Over and above the effects of racism and SGM-based victimization, subtle intersectional minority stressors were associated with greater depressive symptoms and lower self-esteem and sense of mastery. Mediation analyses indicated that subtle intersectional minority stressors had indirect effects on depressive symptoms through lower self-esteem and sense of mastery for the aggregate sample of SGMA of color and most racial/ethnic groups in the sample. The results demonstrate that subtle and intersectional minority stress is a unique and significant form of minority stress that is a risk factor for depressive symptoms for SGMA of color. Moreover, our findings underscore self-concept mechanisms as targets for prevention and intervention.
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Affiliation(s)
- Ethan H Mereish
- Lavender Lab, Department of Health Studies, American University, 4400 Massachusetts Avenue NW, DC, Washington, USA.
| | - Luis A Parra
- Brown School of Social Work, Washington University in Saint Louis, Saint Louis, USA
| | - Ryan J Watson
- Human Development & Family Sciences, University of Connecticut, Storrs, USA
| | - Jessica N Fish
- Department of Family Science, University of Maryland, College Park, USA
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Hsieh MT, Chen JS, Lin CY, Yen CF, Griffiths MD, Huang YT. Measurement Invariance of the Sexual Orientation Microaggression Inventory across LGB Males and Females in Taiwan: Bifactor Structure Fits the Best. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:10668. [PMID: 34682410 PMCID: PMC8536138 DOI: 10.3390/ijerph182010668] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 09/24/2021] [Revised: 10/01/2021] [Accepted: 10/05/2021] [Indexed: 02/03/2023]
Abstract
The present study examined the factor structure and concurrent validity of the traditional Chinese version of the Sexual Orientation Microaggression Inventory (SOMI) among lesbian, gay, and bisexual (LGB) individuals in Taiwan. In total, 1000 self-identified LGB individuals completed the SOMI, HIV and Homosexuality Related Stigma Scale (HHRSS), and Acceptance and Action Questionnaire-II (AAQ). Different factor structures (including one-factor, four-factor, bifactor, and higher-order factor structures) were evaluated using confirmatory factor analysis. The bifactor structure significantly outperformed all others on the SOMI. The bifactor structure with one general factor and four trait factors was found to be measurement invariant across biological sex with satisfactory fit indices. The SOMI general factor was significantly associated with HHRSS-Homosexuality score and AAQ score. The findings indicate that the SOMI is a psychometrically sound instrument for Taiwan sexual minority groups. More specifically, SOMI can be used to accurately assess microaggression among LGB individuals. The measure on microaggression may also provide insights for healthcare providers about LGB individuals' sexuality-related stigma. Moreover, healthcare providers and relevant stakeholders can use the SOMI to understand how LGB individuals perceive and feel microaggression.
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Affiliation(s)
- Meng-Tsang Hsieh
- Stroke Center and Department of Neurology, E-Da Hospital, Kaohsiung 82445, Taiwan;
- School of Medicine for International Students, College of Medicine, I-Shou University, Kaohsiung 82445, Taiwan
- Institute of Clinical Medicine, College of Medicine, National Cheng Kung University, Tainan 70101, Taiwan
| | - Jung-Sheng Chen
- Department of Medical Research, E-Da Hospital, Kaohsiung 82445, Taiwan;
| | - Chung-Ying Lin
- Institute of Allied Health Sciences, College of Medicine, National Cheng Kung University, Tainan 70101, Taiwan
- Department of Occupational Therapy, College of Medicine, National Cheng Kung University, Tainan 70101, Taiwan
- Department of Public Health, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan 70101, Taiwan
- Biostatistics Consulting Center, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan 701, Taiwan
| | - Cheng-Fang Yen
- Department of Psychiatry, School of Medicine College of Medicine, Kaohsiung Medical University, Kaohsiung 80708, Taiwan
- Department of Psychiatry, Kaohsiung Medical University Hospital, Kaohsiung 80756, Taiwan
- College of Professional Studies, National Pingtung University of Science and Technology, Pingtung 91201, Taiwan
| | - Mark D. Griffiths
- International Gaming Research Unit, Psychology Department, Nottingham Trent University, Nottingham NG1 4FQ, UK;
| | - Yu-Te Huang
- Department of Social Work and Social Administration, The University of Hong Kong, Hong Kong RM543, China;
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Dimberg SK, Clark DA, Spanierman LB, VanDaalen RA. "School Shouldn't Be Something You Have to Survive": Queer Women's Experiences with Microaggressions at a Canadian University. JOURNAL OF HOMOSEXUALITY 2021; 68:709-732. [PMID: 31509095 DOI: 10.1080/00918369.2019.1661729] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
The authors used an interpretative phenomenological analysis of focus-group data provided by eight research participants to investigate microaggressions that target queer women at an urban Canadian university. Four themes emerged from the data that support and extend prior sexual orientation microaggressions typologies research: (a) facing skepticism as response to sexual orientation, (b) living with surveillance as response to gender presentation, (c) encountering heteronormative assumptions, and (d) experiencing vulnerability. The authors discuss these findings in the context of previous research, outline future research directions, and provide implications for campus life.
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Affiliation(s)
- Sierra K Dimberg
- Faculty of Counseling & Counseling Psychology, Arizona State University, Tempe, Arizona, USA
| | - D Anthony Clark
- Faculty of Interdisciplinary Humanities and Communication, Arizona State University, Tempe, Arizona, USA
| | - Lisa B Spanierman
- Faculty of Counseling & Counseling Psychology, Arizona State University, Tempe, Arizona, USA
| | - Rachel A VanDaalen
- Faculty of Counseling & Counseling Psychology, Arizona State University, Tempe, Arizona, USA
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14
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The Moderating Effect of Comfort from Companion Animals and Social Support on the Relationship between Microaggressions and Mental Health in LGBTQ+ Emerging Adults. Behav Sci (Basel) 2020; 11:bs11010001. [PMID: 33374678 PMCID: PMC7822483 DOI: 10.3390/bs11010001] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2020] [Revised: 12/12/2020] [Accepted: 12/19/2020] [Indexed: 11/17/2022] Open
Abstract
LGBTQ+ (lesbian, gay, bisexual, transgender, queer, and other sexual/gender minority identities) individuals frequently report exposure to microaggressions, which are associated with deleterious mental health outcomes. Social support from humans has been found to be an important protective factor for LGBTQ+ emerging adults. However, an underexplored area of research is the protective role of interactions with companion animals for this population. We conducted simple and multiple moderation analyses to explore whether and to what extent emotional comfort from companion animals and human social support moderated the relationship between LGBTQ-related microaggressions and depressive and anxiety symptoms. Our sample included 134 LGBTQ+ emerging adults (mean age of 19.31). We found that social support moderated the relationship between microaggressions and depressive symptoms. The relationship between microaggressions and depressive symptoms was not significant at high levels of social support, indicating the protective nature of human social support. Comfort from companion animals also moderated the relationship between interpersonal microaggressions and depressive symptoms. For participants with high or medium levels of emotional comfort from companion animals, interpersonal microaggressions were positively associated with depressive symptoms. Our results highlight the need to further investigate the complex role of relationships with companion animals on mental health outcomes for LGBTQ+ emerging adults.
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Progovac AM, Mullin BO, Creedon TB, McDowell A, Sanchez-Roman MJ, Hatfield LA, Schuster MA, Cook BL. Trends in Mental Health Care Use in Medicare from 2009 to 2014 by Gender Minority and Disability Status. LGBT Health 2019; 6:297-305. [PMID: 31436481 DOI: 10.1089/lgbt.2018.0221] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Purpose: This study examines trends in Medicare beneficiaries' mental health care use from 2009 to 2014 by gender minority and disability status. Methods: Using 2009 to 2014 Medicare claims, we modeled mental health care use (outpatient mental health care, inpatient mental health care, and psychotropic drugs) over time, adjusting for age and behavioral health diagnoses. We compared trends for gender minority beneficiaries (identified using diagnosis codes) to trends for a 5% random sample of other beneficiaries, stratified by original entitlement reason (age vs. disability). Results: Adjusted outpatient and inpatient mental health care use decreased and differences generally narrowed between gender minority and other beneficiaries over the study period. Among beneficiaries qualifying through disability, the gap in the number of outpatient and inpatient visits (among those with at least one visit in a given year) widened. Psychotropic drug use rose for all beneficiaries, but the proportion of gender minority beneficiaries in the aged cohort who had a psychotropic medication prescription rose faster than for other aged beneficiaries. Conclusions: Mental health care needs for Medicare beneficiaries may be met increasingly by using psychotropic medications rather than outpatient visits, and this pattern is more pronounced for identified gender minority (especially aged) beneficiaries. These trends may indicate a growing need for research and provider training in safe and effective psychotropic medication prescribing alongside gender-affirming treatments such as hormone therapy, especially for aged gender minority individuals who likely already experience polypharmacy.
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Affiliation(s)
- Ana M Progovac
- Department of Psychiatry, Harvard Medical School, Boston, Massachusetts.,Health Equity Research Lab, Department of Psychiatry, Cambridge Health Alliance, Cambridge, Massachusetts
| | - Brian O Mullin
- Health Equity Research Lab, Department of Psychiatry, Cambridge Health Alliance, Cambridge, Massachusetts
| | - Timothy B Creedon
- Health Equity Research Lab, Department of Psychiatry, Cambridge Health Alliance, Cambridge, Massachusetts
| | - Alex McDowell
- PhD Program in Health Policy, Harvard University, Cambridge, Massachusetts.,Department of Health Care Policy, Harvard Medical School, Boston, Massachusetts
| | - Maria Jose Sanchez-Roman
- Health Equity Research Lab, Department of Psychiatry, Cambridge Health Alliance, Cambridge, Massachusetts.,Department of Prevention and Community Health, Milken Institute School of Public Health, George Washington University, Washington, DC
| | - Laura A Hatfield
- Department of Health Care Policy, Harvard Medical School, Boston, Massachusetts
| | | | - Benjamin Lê Cook
- Department of Psychiatry, Harvard Medical School, Boston, Massachusetts.,Health Equity Research Lab, Department of Psychiatry, Cambridge Health Alliance, Cambridge, Massachusetts
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16
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Nadal KL. A Decade of Microaggression Research and LGBTQ Communities: An Introduction to the Special Issue. JOURNAL OF HOMOSEXUALITY 2018; 66:1309-1316. [PMID: 30403569 DOI: 10.1080/00918369.2018.1539582] [Citation(s) in RCA: 33] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
Though the Supreme Court of the U.S. legalized same-sex marriage in 2015, heterosexism and transphobia has continued to manifest through many systems in the US - from lack of federal protection in employment non-discrimination laws to polices that prohibit transgender people from using bathroom and public facilities that match their gender identities. Heterosexist and transphobic discrimination have also persisted through interpersonal interactions - ranging from more overt forms (e.g., hate crimes, bullying) to more subtle forms of discrimination, otherwise known as microaggressions. Since 2008, there have been hundreds of articles written on microaggressions, with dozens focusing specifically on experiences of lesbian, gay, bisexual, transgender, and queer (LGBTQ) people. Qualitative and quantitative studies have revealed that LGBTQ people who experience microaggressions have reported negative outcomes like depression, low self-esteem, and trauma. This special issue aims to further Microaggression Theory by providing theoretical and empirical papers that focus on the manifestation and impact of microaggressions on LGBTQ people. Using an interdisciplinary approach, articles range in topic from intersectional identities, to health and psychological outcomes, to advancing research methods. Future studies regarding microaggressions and LGBTQ people are discussed- highlighting the influence of the changing landscape of heterosexism and transphobia within general society, as well as new dynamics that have formed and developed within LGBTQ communities.
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Affiliation(s)
- Kevin L Nadal
- a John Jay College of Criminal Justice , City University , New York , New York, USA
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