Disparities in Persistent Victimization and Associated Internalizing Symptoms for Heterosexual Versus Sexual Minority Youth

Peer Bullying Victimization Trajectories for Sexually and Gender Diverse Youth from Early Childhood to Late Adolescence

Sexually and gender diverse (SGD) youth experience more peer bullying victimization than heterosexual, cisgender youth during adolescence, yet the emergence and persistence of these disparities remain underexplored. Also, it is unclear which factors are associated with these disparities across development, and how these disparities are linked to late adolescent health discrepancies. This study utilized the sample from the Millennium Cohort Study in Britain (N = 10,080; 51.3% assigned female at birth; Mage = 2.28, SDage = 0.46 at Wave 2), in which 23.74% of youth reported non-heterosexual attraction, 21.59% reported non-heterosexual identity, and 1.08% reported gender identity not in line with the sex assigned at birth. Using latent class growth modeling, four peer bullying victimization trajectories were identified, with early peak (7.2%), late childhood peak (6.3%), adolescence onset (12.8%), and low (73.6%) rates of victimization. SGD youth, compared to heterosexual and cisgender youth, were found to have increased odds of being in the victimization-involved classes, especially the adolescence onset class. The study further revealed that SGD youth reported more mental health and relational difficulties in childhood, which were linked to their heightened risk of longer-lasting victimization. Further, long-term victimization was found to partially account for the disparities in health and well-being for SGD youth in late adolescence. In conclusion, SGD youth were more likely to experience longer-lasting bullying victimization during childhood and adolescence, its related mental and relational vulnerabilities were already established in childhood, and such victimization disparities were further linked to their detrimental health and well-being in late adolescence. The design, hypotheses, and target analyses of the current study were preregistered on 21st April 2023 at https://osf.io/f2zxy .

A Latent Profile Analysis of Social Support, Online Contacts, and Preference for Online Communication Among Same- and Both-Sex Attracted and Other-Sex Attracted Adolescents

This study aimed to assess differences between other-sex attracted and same- and both-sex attracted adolescents in profiles of peer and family social support, online contacts, and preferences for online communication. Data stem from the 2017 Dutch "Health and Behavior in School-Aged Children" (HBSC) survey (N = 6,823; 4.0% same- and both-sex attracted; M age=14.73, SD = 1.59, range = 12-18). We conducted latent profile analyses to estimate profiles in peer and family social support, online contacts, and preferences for online communication. Then we assessed the association between sexual attraction and profile membership. A five-profile solution fitted the data best. Profiles were characterized as high support, online contact, and average online communication preference (35.6%); high support, low online contact, and weak online communication preference (42.9%); average support, high online contact, and strong online communication preference (9.9%); low support, low online contact, and average online communication preference (6.9%); and low support, average online contact, and average online communication preference (5.0%). Same- and both-sex attracted adolescents had higher odds than other-sex attracted adolescents of being in the latter three profiles than in the first profile. Thus, same- and both-sex attracted adolescents were more likely to report average to low rates of peer and family social support, high to low frequency of online contact, and an average to strong preference for online communication than other-sex attracted adolescents. The average to low levels of support especially influenced these sexual orientation-based differences in profile membership.

Health disparities in one of the world's most progressive countries: a scoping review of mental health and substance use among sexual and gender minority people in the Netherlands

BACKGROUND

Evidence from many parts of the world shows that sexual and gender minority (SGM) people have poorer health than their cisgender heterosexual counterparts. Minority stressors, particularly stigma and discrimination, have been identified as major contributors to sexual orientation- and gender identity-related health disparities, particularly negative mental health and behavioral health outcomes. To better understand factors that contribute to these disparities, we conducted a scoping review of SGM mental health and substance use research in the Netherlands-a country with a long-standing reputation as a pioneer in SGM equality.

METHODS

Using Joanna Briggs Institute guidelines and the PRISMA-ScR protocol, we searched seven databases to identify studies published between 2010 and 2022 that focused on substance use and/or mental health of SGM youth and adults in the Netherlands.

RESULTS

Although there was some evidence that SGM people in the Netherlands report fewer substance use and mental health concerns than those in less progressive countries, with very few exceptions studies found poorer outcomes among SGM participants than cisgender, heterosexual participants. However, this observation must be considered cautiously given major gaps in the literature. For example, only one study focused exclusively on adult sexual minority women, two focused on older SGM adults, and very little attention was given to nonbinary individuals. Most studies used non-probability samples that were quite homogenous. Many studies, especially those with youth, assessed sexual orientation based on sexual attraction; some studies of adults operationalized SGM status as having a same-sex partner. Importantly, we found no studies that directly assessed associations between structural-level stigma and health outcomes. Studies were mostly focused at the individual level and on health problems; very little attention was given to strengths or resilience.

CONCLUSIONS

Findings of persistent health disparities-despite the relatively long history of SGM supportive policies in the Netherlands-highlight the need for more research and greater attention to population groups that have been underrepresented. Such research would not only provide guidance on strategies to improve the health of SGM people in the Netherlands, but also in other countries that are seeking to reduce health inequities. Addressing SGM health disparities in the Netherlands and elsewhere is complex and requires a multifaceted approach that addresses individual, interpersonal and structural factors.

Explaining behavioral health differences in urban and rural sexual minority adolescents: A longitudinal investigation of minority stress in a diverse national sample of sexual minority adolescents: A longitudinal investigation of minority stress in a diverse national sample of sexual minority adolescents

PURPOSE

Experiences of sexuality-based discrimination (ie, minority stressors) against youth who identify as nonheterosexual (ie, sexual minority) have been associated with increased symptoms of anxiety, depression, and post-traumatic stress disorder (PTSD) for sexual minority adolescents (SMA; ages 14-17). However, little is known about the experiences of SMA living in rural communities across the United States. Thus, the present study sought to examine differences in mental health patterns between urban and rural dwelling SMA, and to see whether these differences are, at least in part, explained by experiences of lifetime minority stress.

METHODS

A nationwide sample of SMA residing in the United States (N = 2,558; aged 14-17, M = 15.90 years, SD = 0.98) was recruited through purposive social media and respondent-driven sampling methods to complete a cross-sectional survey online. Measures included those of minority stress, urbanicity, and symptoms of anxiety, depression, and PTSD. Parallel multiple mediation (PMM) analysis was employed to test whether urbanicity was associated with anxiety, depressive, and PTSD symptoms through reported lifetime minority stress.

FINDINGS

On average, SMA living in rural areas significantly reported more lifetime minority stress, depressive, and PTSD symptoms than SMA living in urban settings. Results from our PMM analysis indicated that heightened experiences of lifetime minority stress indirectly linked the effects of living in rural areas on anxiety (b = -0.288, 95% CI = [-0.491, -0.085]), depressive (b = -0.158, 95% CI = [-0.270, -0.047), and PTSD symptoms PTSD (b = -0.349, 95% CI = [-0.596, -0.105]). The model accounted for 16.8%, 18%, and 24.1% of the variability in anxiety symptoms, depressive symptoms, and PTSD symptoms, respectively.

CONCLUSIONS

SMA in our study who reside in rural areas reported elevated minority stress, depressive, and PTSD symptoms as compared to their urban dwelling peers. Our study found that lifetime experiences of minority stress fully mediated the relationship between urbanicity and both depressive and PTSD symptoms, and partially mediated the relationship between urbanicity and anxiety. These findings highlight the need to increase support for rural youth who are growing into adulthood and may find continuing challenges in their family, peer, and community relationships.

Disparities in Perpetrators, Locations, and Reports of Victimization for Sexual and Gender Minority Adolescents

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.

Longitudinal associations between peer factors and suicidal thoughts and behaviors among sexual minority women

OBJECTIVE

Sexual minority young women endorse higher rates of suicidal thoughts and behaviors than heterosexual women, but the reasons for these disparities remain unclear. One hypothesis is that the two groups of women share peer-related risk factors, but the magnitude of effect is stronger for sexual minority women.

METHOD

We utilized 6 years of data drawn from a community sample of women (N = 2078; 26% sexual minority) to examine rates of suicidality in early adulthood, adolescent peer influences on later suicidal ideation and behavior, and whether sexual minority status moderated the impact of peer influences on suicidality.

RESULTS

Across the study period, rates of suicidality were higher among sexual minority women compared to heterosexual women. In prospective analyses, peer victimization increased risk for future suicidality whereas peer connectedness attenuated risk for the entire sample. Additionally, sexual minority status moderated the magnitude of these relationships for suicidal ideation and behavior. Specifically, the effect of peer connectedness on suicidal ideation was stronger for heterosexual women than sexual minority women, whereas the effect of peer connectedness on suicidal attempts was stronger for sexual minority than for heterosexual women. In addition, peer victimization increased risk for suicide attempts among sexual minority women.

CONCLUSIONS

This study highlights the importance of peer experiences in late adolescence for suicidality during the transition to young adulthood, and how such relations vary by sexual minority status.

Confirming the Reliability and Validity of the Sexual Minority Adolescent Stress Inventory in a National Sample of Sexual Minority Adolescents

Objective: Sexual minority adolescents (SMA) experience numerous behavioral health disparities, including depression, anxiety, substance use, non-suicidal self-injury, and suicidality. The primary framework to understand these disparities is minority stress theory, which frames this disproportionate burden as the result of discrimination, violence, and victimization in a homophobic culture. Empirical examinations of minority stress among SMA have been limited by lack of diverse samples or validated measures. This study engaged a national community sample of SMA to confirm reliability and validity of the Sexual Minority Adolescent Stress Inventory (SMASI). Method: A national sample of 2,310 SMA aged 14-17 was recruited in the United States through a hybrid social media and respondent-driven sampling approach. Item response theory and confirmatory factor analysis established the psychometric properties of the SMASI in this sample; minority stress was modeled as a latent variable in several regression models to verify criterion and divergent validity. Results: In this national sample (M age = 15.9; 64% female and 60% White), the factor structure of the SMASI and its 11 subscales was confirmed and shown to be invariant by demographic characteristics. Minority stress as measured by the SMASI was significantly associated with all mental and behavioral health outcomes. Conclusions: This study provides evidence that SMASI is a reliable, valid, and important tool for better understanding minority stress and subsequent health and mental health consequences among SMA.

Bullying Victimization and Sexual Wellbeing in Sexually Active Heterosexual, Cisgender and Sexual/Gender Minority Adolescents: The Mediating Role of Emotion Regulation

Bullying victimization is prevalent in adolescence and associated with adverse consequences on physical and psychological wellbeing, paricularly in sexual and gender minority youth. However, little is known about its associations with sexual wellbeing and the underlying mechanisms that could explain this association. The present study assessed the associations between bullying victimization and sexual wellbeing (sexual satisfaction, sexual desire/arousal and orgasmic function difficulties, sexual distress) via the mediating role of emotion regulation difficulties, considering potential sexual/gender minority status-based differences. Self-report online surveys were completed by 1036 sexually active (49.7% were girls) high school students (M_age = 14.6 years, SD_age = 0.6). Bullying victimization was directly and negatively associated with sexual desire/arousal difficulties and positively with sexual distress. Higher emotion regulation difficulties mediated the associations between higher bullying victimization and higher orgasmic function difficulties, as well as higher bullying victimization and higher sexual distress. No significant association was observed between bullying victimization and sexual satisfaction. No significant differences were observed between heterosexual, cisgender and sexual and gender minority youth in any of the associations. The findings suggest that bullying victimization is associated with adolescents' sexual wellbeing. The cross-sectional design and small effect sizes support the need for further prospective cohort studies.

Differences in Adolescent Experiences of Polyvictimization and Suicide Risk by Sexual Minority Status

Sexual minority adolescents (SMA) report more suicide risk behaviors than heterosexual adolescents. Polyvictimization (co-occurrence of multiple types of victimization) may be an important, underresearched correlate of this disparity. With the 2017 national Youth Risk Behavior Survey (N = 13,179), national estimates of polyvictimization and suicide risk were assessed among high school students by sexual minority status (SM vs. heterosexual), and multivariate relationships between sexual minority status, polyvictimization, and suicide risk were tested. Additionally, risk profiles of those who experienced polyvictimization (2 + types of victimization; n = 1,932) were compared across sexual minority status. Results confirm that SMA are more likely to experience polyvictimization than heterosexual adolescents (31.8% v. 12.9%, respectively); however, also indicate that polyvictimization does not fully explain elevated suicide risk among SMA.

Explaining Health Disparities between Heterosexual and LGB Adolescents by Integrating the Minority Stress and Psychological Mediation Frameworks: Findings from the TRAILS Study

Lesbian, gay, and bisexual (LGB) adolescents experience elevated levels of internalizing problems and use more substances than heterosexual adolescents. The minority stress and psychological mediation framework are complementary theoretical frameworks that were developed to explain these disparities. However, limited empirical research has integrated both frameworks to study health disparities between heterosexual and LGB adolescents. This study attempts such an integration, using data from the first five waves (participant age 11-22) of the TRacking Adolescents' Individual Lives Survey (TRAILS), a cohort study of Dutch adolescents (N = 1738; 151 LGB; 54.8% girls). It was tested whether an LGB identity was linked to internalizing problems and substance use through a serial mediation process, in which sexual identity would be associated with peer victimization and negative relationships with parents (first set of mediators, in keeping with the minority stress framework), which in turn would be associated with fear of negative social evaluation and a lack of social support (second set of mediators, in keeping with the psychological mediation framework), and eventually increasing the risk for internalizing problems and elevated levels of substance use. Moreover, it was tested whether the link between minority stress and substance use was mediated by peers' substance use levels, as hypothesized by the psychological mediation framework. Compared to heterosexual participants, LGB participants reported more internalizing problems, smoked more cigarettes, and used more marijuana, but did not consume more alcohol. The relation between sexual identity and internalizing problems was mediated by peer victimization and parental rejection, which is in line with the minority stress framework. No statistically significant support was found for the psychological mediation framework. These findings provide a better understanding of the pathways through which sexual identity disparities in mental wellbeing and substance use come about.