Towards an integrative self: a digital photo elicitation study of resilience among key marginalized populations of sexual and gender minority youth

Capturing the HIV-related social exclusion practices experienced by key populations through photovoice: an interpretative phenomenological study

BACKGROUND

Key populations are defined as groups that are susceptible to HIV, including Men Sex with Men (MSM), Transgender (TG), Persons who Inject Drug (PID), and Female Sex Worker (FSW). These key populations groups are among the fastest-growing populations in Indonesia. These vulnerable groups are ostracized by society and health services, which makes it difficult to get treatment. This project was carried out to investigate the different experiences and perspectives of these key populations in facing and addressing social and spiritual exclusion.

METHODS

A qualitative phenomenological study using photovoice was carried out from July to December 2022. Key populations comprising MSM, TG, PID, and FSW were recruited from community-based peer groups in West Bandung Regency using snowball sampling. This was followed by the Photovoice stages, from workshops to focus group discussions and interviews with audio recordings. Furthermore, thematic data analysis was carried out by interpretative participant narratives and photographs supported by Atlas.ti software.

RESULT

Eighteen participants comprising four MSM, five TG, four PIDs, and five FSWs participated in this research. Among these eighteen participants, six were HIV-negative, including 3 PIDs and 3 FSWs, while the remaining were positive. The analysis of the collected data identified four main themes: 1) limited access like unequal treatment, disadvantage, and harassment, 2) social and spiritual impact, 3) coping mechanisms, and 4) self-reflection through photovoice. These results showed that social exclusion occurred in an environment where community values, beliefs, and norms dehumanised these key populations, and where removal of support and care was prominent. Despite these challenges, participant resilience was evidenced by using internal resources and peer support as coping mechanisms. The participants considered photovoice as a tool to foster self-confidence and self-awareness through a reflective process.

CONCLUSIONS

The findings of this study highlight the emphasis on participants' openness in sharing their experiences, which can build empathy and promote a more inclusive community in HIV prevention efforts. This research findings can be used to inform HIV policy and practice and inclusion of these key populations in the community. We advocate making the photovoice efforts accessible to a wider audience through exhibitions and various media.

Baby Boomer Gay Men's Experiences with Primary Healthcare

This research explored baby boomer gay men's experiences with primary healthcare and their perspectives of future long-term care. Baby boomer gay men's perspectives about primary healthcare remain understudied in the United States. A descriptive qualitative study was conducted with 30 baby boomer men in the Southwest USA. We used semi-structured interviews to assess participants' initiation and maintenance of primary healthcare, disclosure of sexual orientation to providers, and perspectives about future healthcare needs, including long-term care. Data were analyzed with a latent thematic analysis. We found baby boomer gay men anticipate discrimination because of their sexual orientation whenever they establish healthcare with new providers. Participants identified circumstantial comfort in the new healthcare setting as a key motivator to disclose their sexual orientation. Thus, baby boomer gay men specifically sought gay or gay-friendly healthcare providers to ease the burden of managing disclosure and to permit free discussion of their sexual orientation and healthcare needs. Participants faced recurring anticipation of rejection and discrimination from healthcare providers, which extends to their perceptions of current healthcare encounters and future long-term care placement. Healthcare providers would benefit from understanding the practice implications of this dynamic. Future research on primary healthcare inclusivity is needed.

Ethical and methodological challenges conducting participative research with transgender and gender-diverse young people: a systematic review

Introduction

Research with transgender and gender-diverse (TGD) young people is essential to understand their experiences and to be able to propose, implement and adapt 'services' in the broadest sense to meet their needs. However, research outside clinical settings on current experiences and needs of youth under the age of 18 is limited which hinders the development of knowledge on TGD, as well as the development of research informed support practices. Acquiring parental consent for participatory research may present ethical and logistical difficulties, as it could jeopardize the safety, well-being, or confidentiality of adolescent participants. This creates a tension between the adolescent's right to autonomy, privacy, freedom, and all aspects related to the consent of the underage on the one hand, and the parents' right to protect their child on the other hand. This review aims to identify the methodological and ethical challenges associated with participatory research with transgender and gender-diverse young people.

Methods

We systematically searched bibliometric databases for studies published between 2006 and 2022 and included 4 main conceptual groups: transgender and gender non-conforming, adolescence, qualitative research (including participatory research) and consent. This review was registered in PROSPERO (CRD42022368360) in November 2022.

Results

Of the 3,794 articles initially identified, 291 met the inclusion criteria and 48 were examined. The selected studies were analyzed in the light of four main ethical tensions: involving parents or a trusted person in the consent gathering process, ensuring the protection and safety of young people while respecting confidentiality, and ensuring that spaces are created for transgender and gender-diverse young people to express themselves freely as part of an empowering research process. At the same time, several methodological challenges concerning public and stakeholder participation and recruitment, data collection and analysis as well as research integrity emerged from the selected studies.

Conclusion & implications

The existing literature of participatory research involving young transgender and gender-diverse individuals underscores the intricate and conflicting aspects, especially concerning power dynamics, empowerment, and the researcher's role. The relevance of these findings extends across various legal frameworks and is applicable to multiple contexts and countries.

Protocol for a scoping review on technology use and sexual and gender minority youth and mental health

INTRODUCTION

Research indicates that sexual and gender minority youth [SGMY] may engage more with information communication technologies [ICTs] more than their non-SGMY counterparts Craig SL et al. 2020. While scholarship generally explores youth's use of ICTs, there are gaps in scholarship that connect SGMY, their ICT engagement and influences to mental health. This scoping review will synthesize the literature that connects these core concepts in order to better understand the influence ITCs have on the mental health of SGMY and to develop a more fulsome understanding of this emerging area of literature.

METHODS AND ANALYSIS

Following the scoping review framework of Arksey and O'Malley, the search will be conducted in the PsycINFO [Ovid interface, 1980-], MEDLINE [Ovid interface, 1948-], CINAHL [EBSCO interface, 1937-], Sociological Abstracts [ProQuest interface, 1952-], Social Services Abstracts [ProQuest interface, 1979-], and Scopus. Descriptive summaries and thematic analysis will summarize the articles that meet the inclusion criteria using an extraction table.

ETHICS AND DISSEMINATION

The review outlined in this paper provides an overview of information that exists on the technology use of SGMY, ICTs and the interconnection with mental health. Results will be disseminated through peer reviewed journals and national and international conferences. As information collected for this paper as is retrieved from publicly available sources, ethics approval is not required.

"Self-care is being attentive to yourself": using assemblages to examine discursive-material practices of self-care among Filipino university students

PURPOSE

Researchers have observed a rise in mental health issues among university students over the course of the pandemic, in part due to the closure of schools and public spaces for wellness. Thus, the purpose of this study is to explore how students creatively reassemble their self-care practices through different objects and spaces within their homes to care for their mental health.

METHODS

Photo-elicitation interviews were conducted with ten (10) female university students from the Philippines. Photographs and interview transcripts were analysed through map-making practices and an iterative process of crafting assemblages and their cofunctionings.

RESULTS

The work-home assemblage was identified as the site of self-care, delineated by boundary-making and place-making practices and the creation of time spaces. The two major cofunctionings of the work-home assemblage were (a) caring for the self as fostering different relationalities with the self, and (b) caring for the self as copresencing with human and nonhuman others.

CONCLUSION

Findings demonstrate the importance of material and spatial relationalities in facilitating caring relational encounters with the self. Theoretical and practical implications include attuning to the existing material and spatial resources in one's environment and integrating them into one's practices of caring for the self.

Processes and Manifestations of Digital Resilience: Video and Textual Insights From Sexual and Gender Minority Youth

Minority stressors harm sexual and gender minority youth (SGMY). This may be mitigated by promotive and protective factors and processes that manifest resilient coping. SGMY increasingly interact with information communication technologies (ICTs) to meet psychological needs, yet research often problematizes youths’ ICT use, inhibiting understanding about ICTs’ potential resilience-enhancing utilities. This study analyzes text and video responses of 609 SGMY aged 14 to 29 residing in Canada or the United States to an open-ended survey question about the benefits of using ICTs. Constructivist grounded theory integrating multimodal coding was used to analyze the data, producing a framework of digital resilience—digital processes and actions that generate positive growth—with four themes: Regulating Emotions and Curating Microsystems; Learning and Integrating; Advocating and Leading; and Cultivating Relationships and Communities of Care. Implications for clinical practice, survey innovation, and application of findings in fostering affirming digital microsystems for SGMY are discussed.