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Ancín-Nicolás RA, Pastor Y, López-Sáez MÁ, Platero L. Protective Factors in the LGBTIQ+ Adolescent Experience: A Systematic Review. Healthcare (Basel) 2024; 12:1865. [PMID: 39337206 PMCID: PMC11431086 DOI: 10.3390/healthcare12181865] [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: 07/10/2024] [Revised: 09/12/2024] [Accepted: 09/13/2024] [Indexed: 09/30/2024] Open
Abstract
Background: LGBTIQ+ adolescents face multiple forms of violence due to minority stress, putting their mental health at risk. These adolescents, particularly trans and gender-diverse youth, face significant challenges, including family violence, bullying, and limited access to health services. This article investigates the factors that protect their mental health. Method: A systematic review of articles published between 2019 and 2024 was conducted using the PRISMA method. Results: The study identifies family and school support, peer relationships, and individual resilience as key protective factors to reduce depression, anxiety, and suicidal behavior, as well as increase self-esteem and well-being. Conclusions: This review calls for further research into protective factors related to the microsystem, exosystem, and macrosystem and the impact of intervention programs with adolescents and their families.
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Affiliation(s)
- Ruth A. Ancín-Nicolás
- Department of Psychology, Rey Juan Carlos University, Avda/Atenas, s/n, 28922 Alcorcón, Madrid, Spain; (Y.P.); (M.Á.L.-S.); (L.P.)
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Lachaud J, Yusuf AA, Maelzer F, Perri M, Gogosis E, Ziegler C, Mejia-Lancheros C, Hwang SW. Social isolation and loneliness among people living with experience of homelessness: a scoping review. BMC Public Health 2024; 24:2515. [PMID: 39285399 PMCID: PMC11403937 DOI: 10.1186/s12889-024-19850-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2024] [Accepted: 08/22/2024] [Indexed: 09/20/2024] Open
Abstract
Social isolation and loneliness (SIL) are public health challenges that disproportionally affect individuals who experience structural and socio-economic exclusion. The social and health outcomes of SIL for people with experiences of being unhoused have largely remained unexplored. Yet, there is limited synthesis of literature focused on SIL to appropriately inform policy and targeted social interventions for people with homelessness experience. The aim of this scoping review is to synthesize evidence on SIL among people with lived experience of homelessness and explore how it negatively impacts their wellbeing. We carried out a comprehensive literature search from Medline, Embase, Cochrane Library, PsycINFO, CINAHL, Sociological Abstracts, and Web of Science's Social Sciences Citation Index and Science Citation Index for peer-reviewed studies published between January 1st, 2000 to January 3rd, 2023. Studies went through title, abstract and full-text screening conducted independently by at least two reviewers. Included studies were then analyzed and synthesized to identify the conceptualizations of SIL, measurement tools and approaches, prevalence characterization, and relationship with social and health outcomes. The literature search yielded 5,294 papers after removing duplicate records. Following screening, we retained 27 qualitative studies, 23 quantitative studies and two mixed method studies. SIL was not the primary objective of most of the included articles. The prevalence of SIL among people with homelessness experience varied from 25 to 90% across studies. A range of measurement tools were used to measure SIL making it difficult to compare results across studies. Though the studies reported associations between SIL, health, wellbeing, and substance use, we found substantial gaps in the literature. Most of the quantitative studies were cross-sectional, and only one study used health administrative data to ascertain health outcomes. More studies are needed to better understand SIL among this population and to build evidence for actionable strategies and policies to address its social and health impacts.
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Affiliation(s)
- James Lachaud
- College of Social Work, The Ohio State University, 1947 College Rd, Columbus, OH, 43210, USA.
- MAP Centre for Urban Health Solutions, Unity Health Toronto, Toronto, ON, Canada.
| | - Ayan A Yusuf
- MAP Centre for Urban Health Solutions, Unity Health Toronto, Toronto, ON, Canada
| | - Faith Maelzer
- MAP Centre for Urban Health Solutions, Unity Health Toronto, Toronto, ON, Canada
- Health Sciences Department, McMaster University, Hamilton, ON, Canada
| | - Melissa Perri
- MAP Centre for Urban Health Solutions, Unity Health Toronto, Toronto, ON, Canada
- Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada
| | - Evie Gogosis
- MAP Centre for Urban Health Solutions, Unity Health Toronto, Toronto, ON, Canada
| | - Carolyn Ziegler
- Library Services, Unity Health, Toronto, Toronto, ON, Canada
| | - Cilia Mejia-Lancheros
- MAP Centre for Urban Health Solutions, Unity Health Toronto, Toronto, ON, Canada
- Family Child Health Initiative, Institute for Better Health, Trillium, Health Partners, Mississauga, ON, Canada
| | - Stephen W Hwang
- MAP Centre for Urban Health Solutions, Unity Health Toronto, Toronto, ON, Canada
- Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada
- Division of General Internal Medicine, University of Toronto, Toronto, ON, Canada
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Poskin M, Turk M, Nolfi D, Klotzbaugh R, Dietz C. The beliefs and practices used to promote physical and mental health in youth who identify as lesbian, gay, bisexual, transgender, intersex, or queer plus (LGBTIQ+) experiencing housing insecurity: An integrative review. Public Health Nurs 2024. [PMID: 39105479 DOI: 10.1111/phn.13381] [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: 02/17/2024] [Revised: 06/09/2024] [Accepted: 07/11/2024] [Indexed: 08/07/2024]
Abstract
PURPOSE The purpose of this integrative review was to explore the beliefs and practices used to promote physical and mental health among youth ages 18-25 years, identifying as LGBTIQ+ experiencing housing insecurity. METHOD The approach used strategies described by Whittemore and Knafl. Peer-reviewed, published research articles in English were identified using eight electronic databases. Eighteen research reports using qualitative, quantitative, and mixed methods were identified. Articles were evaluated for quality using the American Association of Critical Care Nurses Evidenced-Level Hierarchy evaluation tool. Data were analyzed and synthesized using Braun and Clarke's method. FINDINGS Four themes related to the purpose were extracted: pervasive experiences of stigma and discrimination, constantly attuned to navigating risks, inconsistent engagement in health information and care, and inner strength developed through personal and community experiences. DISCUSSION There are strong implications for future research, public health nursing practice, and health policy. Public health nurses should incorporate social determinants of health (addressing harmful social processes such as homophobia and racism) as well as a strength-based upstream approach in research, education, and health care practices. More research must also be done to assess engagement in physical and mental health information and care.
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Affiliation(s)
- Mary Poskin
- School of Nursing, Duquesne University, Pittsburgh, Pennsylvania, USA
| | - Melanie Turk
- School of Nursing, Duquesne University, Pittsburgh, Pennsylvania, USA
| | - David Nolfi
- Research Engagement, Gumberg Library, Duquesne University, Pittsburgh, Pennsylvania, USA
| | - Ralph Klotzbaugh
- School of Nursing, Duquesne University, Pittsburgh, Pennsylvania, USA
| | - Craig Dietz
- KC Care Federally Qualified Health Center, Kansas City, Missouri, USA
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Wanta JW, Gianakakos G, Nguy A, Balsamo DN. Systems-Involved Transgender and Gender-Diverse Youth: Homelessness, Juvenile Legal Systems, and Child Welfare and Foster Care. Child Adolesc Psychiatr Clin N Am 2023; 32:839-848. [PMID: 37739638 DOI: 10.1016/j.chc.2023.04.003] [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 and gender-diverse (TGD) youth are overrepresented in legal and social support systems intended to protect and support youth along their developmental journeys. However, these systems often fall short for TGD youth and further stigmatize an already vulnerable population. This article provides an overview of the experience, care, and treatment of systems-involved TGD youth. Working with systems-involved transgender and gender-diverse youth necessitates a high level of compassion and advocacy in pursuit of more equitable care and access.
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Affiliation(s)
- Jonathon W Wanta
- Pritzker Department of Psychiatry and Behavioral Health, Ann and Robert H. Lurie Children's Hospital of Chicago, 225 East Chicago Avenue, Box 10, Chicago, IL 60611, USA.
| | - George Gianakakos
- Pritzker Department of Psychiatry and Behavioral Health, Ann and Robert H. Lurie Children's Hospital of Chicago, 225 East Chicago Avenue, Box 10, Chicago, IL 60611, USA
| | - Austin Nguy
- University of California, Riverside, School of Medicine, 900 University Avenue, Riverside, CA 92521, USA
| | - Dalia N Balsamo
- Department of Psychiatry and Neuroscience, University of California, Riverside, School of Medicine, 900 University Avenue, Riverside, CA 92521, USA
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King WM, Jadwin-Cakmak L, Trammell R, Gamarel KE. Structural vulnerability as a conceptual framework for transgender health research: findings from a community needs assessment of transgender women of colour in Detroit. CULTURE, HEALTH & SEXUALITY 2023; 25:681-697. [PMID: 35736653 PMCID: PMC9780405 DOI: 10.1080/13691058.2022.2086709] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/21/2022] [Accepted: 06/02/2022] [Indexed: 06/02/2023]
Abstract
The concept of structural vulnerability explains how systems of oppression drive health inequities by reducing access to survival resources (e.g. food, housing) for marginalised populations. Indicators of structural vulnerability such as housing instability, violent victimisation and poverty are often interconnected and result from intersectional oppression. We sought to demonstrate the utility of the structural vulnerability framework for transgender health research by examining patterns of structural vulnerability indicators among transgender women of colour in Detroit. We conducted latent class analysis and tested associations between classes and mental health and substance use outcomes. Membership to the Lowest Vulnerability class was negatively associated with post-traumatic stress disorder (PTSD) (aOR = 0.10, 95% CI: 0.02-0.59). High Economic Vulnerability membership was associated with daily marijuana use (aOR = 4.61, 95% CI: 1.31-16.16). Complex Multi-Vulnerability membership was associated with PTSD (aOR = 9.75, 95% CI: 2.55-37.29), anxiety (aOR = 4.12, 95% CI: 1.22-13.97), suicidality (aOR = 6.20, 95% CI: 1.39-27.70), and club drug use (aOR = 4.75, 95% CI: 1.31-17.29). Substantively different findings emerged when testing relationships between each indicator and each outcome, highlighting the value of theoretically grounded quantitative approaches to understanding health inequities. Community-driven interventions and policy changes that reduce structural vulnerability may improve mental health and substance use outcomes among structurally vulnerable trans women of colour.
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Affiliation(s)
- Wesley M King
- Department of Health Behavior and Health Education, University of Michigan, Ann Arbor, MI, USA
| | - Laura Jadwin-Cakmak
- Department of Health Behavior and Health Education, University of Michigan, Ann Arbor, MI, USA
| | - Racquelle Trammell
- Department of Health Behavior and Health Education, University of Michigan, Ann Arbor, MI, USA
- Trans Sistas of Colour Project, Detroit, MI, USA
| | - Kristi E Gamarel
- Department of Health Behavior and Health Education, University of Michigan, Ann Arbor, MI, USA
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Philbin MM, Wurtz HM, McCrimmon T, Kelly E, Homan P, Guta A. How social policies shape the health and well-being of sexual- and gender-minority youth: Pathways of influence, social side effects and implications for life course trajectories. Soc Sci Med 2023; 317:115624. [PMID: 36566607 PMCID: PMC9839642 DOI: 10.1016/j.socscimed.2022.115624] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2022] [Revised: 10/17/2022] [Accepted: 12/16/2022] [Indexed: 12/23/2022]
Abstract
Recent research has documented the harmful health consequences of structural-level stigma that targets sexual and gender minority (SGM) individuals. In the case of sexual and gender minority youth (SGMY), life trajectories are shaped not only by targeted, SGM-focused policies, but also by social policies more broadly which may have unique impacts on SGMY given their social position. However, little work has explored the pathways that connect both targeted and universal social policies and the health and well-being of SGMY. In this study, we conducted 68 qualitative interviews with SGMY in New York City (n = 30) and community stakeholders across the US (n = 38) and used the constant comparative method to identify the pathways through which social policies affect SGMY health and well-being. We propose three pathways that are shaped by specific inter-related social policies in ways that contribute to health inequities among SGMY: 1) access to social inclusion in educational settings; 2) housing-related regulations and subsequent (in)stability; and 3) access to material resources through labor market participation. We also highlight ways that SGMY, and organizations that support them, engage in agency and resistance to promote inclusion and wellbeing. Drawing on ecosocial theory, we demonstrate how policies work across multiple domains and levels to influence cycles of vulnerability and risk for SGMY. We close by discussing the implications of our findings for future research and policy.
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Affiliation(s)
- Morgan M Philbin
- Columbia University Mailman School of Public Health, Department of Sociomedical Sciences, New York City, NY, USA.
| | - Heather M Wurtz
- Columbia University Mailman School of Public Health, Department of Sociomedical Sciences, New York City, NY, USA
| | - Tara McCrimmon
- Columbia University Mailman School of Public Health, Department of Sociomedical Sciences, New York City, NY, USA
| | - Erin Kelly
- Columbia University Mailman School of Public Health, Department of Sociomedical Sciences, New York City, NY, USA
| | - Patricia Homan
- Florida State University, Department of Sociology, Tallahassee, FL, USA
| | - Adrian Guta
- University of Windsor, School of Social Work, Windsor,ON, Canada
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