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Figueroa C, Guillén V, Huenupán F, Vallejos C, Henríquez E, Urrutia F, Sanhueza F, Alarcón E. Comparison of Acoustic Parameters of Voice and Speech According to Vowel Type and Suicidal Risk in Adolescents. J Voice 2024:S0892-1997(24)00254-6. [PMID: 39217086 DOI: 10.1016/j.jvoice.2024.08.006] [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: 05/03/2024] [Revised: 08/03/2024] [Accepted: 08/05/2024] [Indexed: 09/04/2024]
Abstract
Globally, suicide prevention and understanding suicidal behavior represent significant health challenges. The predictive potential of voice, speech, and language appears as a promising solution to the difficulty in assessment. OBJECTIVE To analyze variations in acoustic parameters in voice and speech based on vowel types according to different levels of suicidal risk among adolescents in a text reading task. METHODOLOGY Cross-sectional analytical design using nonprobabilistic sampling. Our sample comprised 98 adolescents aged 14 to 19, undergoing voice acoustic assessment, along with suicidal ideation determination through the Okasha Suicidality Scale and Beck Depression Inventory. Acoustic analysis of recordings was conducted using Praat for phonetic research, Python program, Focusrite interface, and microphone to register voice and speech acoustic parameters such as Fundamental Frequency, Jitter, and Formants. Subsequently, data from adolescents with and without suicidal risk were compared. RESULTS Significant differences were observed between suicidal and nonsuicidal adolescents in several acoustic aspects, especially in females in fundamental frequency (F0), signal-to-noise ratio (HNRdB), and temporal variability measured by jitter and standard deviation. In men, differences were found in F0 and HNRdB (P < 0.05). CONCLUSION This study demonstrated statistically significant variations in various voice acoustic parameters among adolescents with and without suicidal risk. These findings underscore the potential relevance of voice and speech as markers for suicidal risk.
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Affiliation(s)
- Carla Figueroa
- Academic Unit of Speech-Language Pathology, Faculty of Health Sciences, Autonomous University of Chile, Chile; Department of Neurosciences, Faculty of Medicine and Nursing, University of the Basque Country (UPV/EHU), Leioa, Spain.
| | - Virginia Guillén
- Department of Neurosciences, Faculty of Medicine and Nursing, University of the Basque Country (UPV/EHU), Leioa, Spain
| | - Fernando Huenupán
- Department of Electrical Engineering, Faculty of Engineering and Sciences, Universidad de La Frontera, Temuco, Chile
| | - Carla Vallejos
- Speech-Language Pathology Program Students, Faculty of Health Sciences, Autonomous University of Chile, Temuco, Chile
| | - Emanuel Henríquez
- Speech-Language Pathology Program Students, Faculty of Health Sciences, Autonomous University of Chile, Temuco, Chile
| | - Felipe Urrutia
- Speech-Language Pathology Program Students, Faculty of Health Sciences, Autonomous University of Chile, Temuco, Chile
| | - Francisca Sanhueza
- Speech-Language Pathology Program Students, Faculty of Health Sciences, Autonomous University of Chile, Temuco, Chile
| | - Enzo Alarcón
- Academic Unit of Speech-Language Pathology, Faculty of Health Sciences, Autonomous University of Chile, Chile
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Kuhlemeier A, Willging CE. A Multigroup Structural Equation Modeling Approach for Analyzing Differences Among Sexually Diverse Youth. JOURNAL OF HOMOSEXUALITY 2024:1-25. [PMID: 39186323 DOI: 10.1080/00918369.2024.2389903] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 08/27/2024]
Abstract
High rates of negative behavioral health outcomes among sexually diverse (SD) youth are consistently documented, but population-level trends obscure within-group differences. Social dynamics intersect in youths' lives in ways that cannot be accounted for by summing their independent effects. An intersectional perspective is essential to understanding the behavioral health outcomes of SD youth. We performed multigroup structural equation modeling using an SD subset of New Mexico Youth Risk and Resiliency Survey (N = 10,037) respondents to examine the moderating role of supportive adult relationships for lesbian, gay, and bisexual youth across 12 intersecting (sexual orientation by race/ethnicity by sex) identity categories. Standardized estimates show that supportive relationships are associated with moderate reductions in psychological distress among lesbians (β = -0.459 for Native, β = -0.303 for Hispanic, and β = -0.421 for white) and female bisexual youth (β = -0.352 for Native, β = -0.376 for Hispanic, and β = -0.393 for white). Among male youth, supportive relationships are associated with reduced likelihood of substance use for gay (β = -0.330 for Native, β = -0.464 for Latinx and β = -0.591 for white) and bisexual youth (β = -0.442 for Native, β = -0.306 for Latinx and β = -0.290 for white). This study challenges monolithic characterizations of SD youth, illustrating that the health-promotive benefits of support differ based on sexual orientation, race/ethnicity, and sex.
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Affiliation(s)
- Alena Kuhlemeier
- College of Population Health, University of New Mexico Health Sciences Center, Albuquerque, NM, USA
| | - Cathleen E Willging
- Pacific Institute for Research and Evaluation-Southwest Center, Albuquerque, NM, USA
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Wright LE, Savage B, Watts SJ. Sexuality Minority Status, Victimization, Mental Health, and Substance Use. Subst Use Misuse 2024:1-13. [PMID: 39177190 DOI: 10.1080/10826084.2024.2392522] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 08/24/2024]
Abstract
Background: Prior research suggests that sexual minority status is related to victimization, mental health issues, and substance use. However, few studies have sought to connect these relationships in a way supported by theory, and fewer have utilized probability and/or nationally representative samples. Objective: The current study seeks to test the relationships among these variables, guided by general strain theory (GST). Methods: One wave of the National Longitudinal Study of Adolescent to Adult Health dataset (Add Health) (N = 14,121) and path modeling in Mplus are utilized. Results: Models run separately by race/ethnicity suggest that the relationship among these variables largely support expectations from GST, but with some notable differences by race/ethnicity. Conclusion: Results suggest a relationship among these variables that concurs with criminological theorizing. Implications and limitations are discussed.
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Affiliation(s)
- Lauren E Wright
- Department of Sociology and Political Science, Tennessee Tech University, Cookeville, Tennessee, USA
| | - Brenda Savage
- School of History and Social Science, LA Tech University, Ruston, Louisiana, USA
| | - Stephen J Watts
- Department of Criminology and Criminal Justice, University of Memphis, Memphis, Tennessee, USA
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Marion L, Newnham EA, Morgan H, Perry Y, Cook A, Lin A, Strauss P. An Exploration of LGBTQA+ Young People's Coping Strategies When Navigating Suicidal Thoughts and Behaviors. JOURNAL OF HOMOSEXUALITY 2024:1-25. [PMID: 39146055 DOI: 10.1080/00918369.2024.2382811] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 08/17/2024]
Abstract
LGBTQA+ young people experience suicidal thoughts and behaviors at a much greater rate than their heterosexual and cisgender peers. This study explored firsthand accounts of the coping strategies employed by LGBTQA+ young people when experiencing suicidal thoughts and behaviors. LGBTQA+ young people (N = 27; ages 14-25) in Australia with a history of suicidal thoughts and/or attempts participated in semi-structured interviews. Using reflexive thematic analysis, four major themes were developed: (1) It's about the journey, not the destination, (2) Connecting with others, (3) When I knew better, I coped better, and (4) Doing the best I can with what I have. LGBTQA+ young people reported utilizing a range of coping strategies, however these were limited by a lack of knowledge around mental health, gender and sexuality diversity, and available resources. Experiences of discrimination within support settings and limited access to clinicians with knowledge of sexuality and gender diversity were cited as significant barriers. Interventions to increase mental health literacy in LGBTQA+ young people and improvements to clinician knowledge of sexuality and gender diversity are needed to enhance LGBTQA+ young people's access to effective coping strategies when experiencing suicidal thoughts and behaviors.
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Affiliation(s)
- Larissa Marion
- School of Population Health, Curtin University, Perth, Western Australia, Australia
- School of Psychological Science, The University of Western Australia, Perth, Western Australia
- Youth Mental Health, Telethon Kids Institute, Perth, Western Australia, Australia
| | - Elizabeth A Newnham
- School of Population Health, Curtin University, Perth, Western Australia, Australia
- Curtin Enable Institute, Curtin University, Perth, Western Australia, Australia
- FXB Center for Health and Human Rights, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA
| | - Helen Morgan
- Youth Mental Health, Telethon Kids Institute, Perth, Western Australia, Australia
| | - Yael Perry
- Youth Mental Health, Telethon Kids Institute, Perth, Western Australia, Australia
- UWA Medical School, The University of Western Australia, Perth, Western Australia, Australia
| | - Angus Cook
- The School of Population and Global Health, The University of Western Australia, Perth, Western Australia, Australia
| | - Ashleigh Lin
- UWA Medical School, The University of Western Australia, Perth, Western Australia, Australia
- The School of Population and Global Health, The University of Western Australia, Perth, Western Australia, Australia
| | - Penelope Strauss
- Youth Mental Health, Telethon Kids Institute, Perth, Western Australia, Australia
- The School of Population and Global Health, The University of Western Australia, Perth, Western Australia, Australia
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5
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O'Shea J, Jenkins R, Nicholls D, Downs J, Hudson LD. Prevalence, severity and risk factors for mental disorders among sexual and gender minority young people: a systematic review of systematic reviews and meta-analyses. Eur Child Adolesc Psychiatry 2024:10.1007/s00787-024-02552-1. [PMID: 39141104 DOI: 10.1007/s00787-024-02552-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/09/2024] [Accepted: 08/01/2024] [Indexed: 08/15/2024]
Abstract
Evidence suggests heightened prevalence and severity of mental disorders among sexual minority (SM) and gender minority (GM) young people. Several risk factors have been associated with these disparities. A systematic review of systematic reviews and meta-analysis was conducted to provide a comprehensive overview of the literature and to determine the field's current position. MEDLINE, PsycInfo, Scopus and Web of Science were searched in March 2022 and updated January 2024. Eligibility criteria were systematic reviews or meta-analyses assessing contemporaneous prevalence, severity and/or risk factors of mental disorders among SM or GM young people aged 25 and under. 42 reviews were included, all of which were low quality. The prevalence of depression among SM was 26% (95% CI 21-32%), and among GM was 46% (95% CI 36-56%). Greater depression severity was found among SM compared to heterosexual young people, with a significant albeit small effect size (Hedges' g = 0.38, 95% CI = 0.25 to 0.50); effect sizes were similar when separating by gender. GM also reported greater symptom severity compared to cisgender young people. Other mental disorders were more prevalent compared to those reported in the general population, and of greater severity compared to heterosexual/cisgender young people. Several proximal and distal risk factors were focused upon within the systematic reviews identified. Past systematic reviews consistently indicate a heightened risk of mental disorders among SM and GM young people. Services need to be aware of these disparities and adapt their care accordingly.
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Affiliation(s)
- Jonathan O'Shea
- Population, Policy and Practice Department, Great Ormond Street UCL Institute of Child Health, London, UK. jonathan.o'
| | - Rebecca Jenkins
- Hull York Medical School, University of York, University Road, Heslington, York, UK
| | - Dasha Nicholls
- Division of Psychiatry, Department of Brain Sciences, Imperial College London, London, UK
| | - James Downs
- Independent Researcher and Expert by Experience, Cardiff, UK
| | - Lee D Hudson
- Population, Policy and Practice Department, Great Ormond Street UCL Institute of Child Health, London, UK
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6
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Wallace ER, O'Neill S, Lagdon S. Risk and protective factors for suicidality among lesbian, gay, bisexual, transgender, and queer (LGBTQ+) young people, from countries with a high global acceptance index (GAI), within the context of the socio-ecological model: A scoping review. J Adolesc 2024; 96:897-924. [PMID: 38372179 DOI: 10.1002/jad.12308] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2023] [Revised: 01/31/2024] [Accepted: 02/03/2024] [Indexed: 02/20/2024]
Abstract
INTRODUCTION Lesbian, gay, bisexual, transgender, and queer (LGBTQ+) young people experience higher prevalence rates of suicidality than their heterosexual and/or cisgender peers. However, there is limited research that can inform suicide prevention efforts. Our aim was to synthesize quantitative, qualitative, and mixed methods research on risk and protective factors among LGBTQ+ young people, from countries with a high Global Acceptance Index. METHODS A scoping review guided by Arksey and O'Malley's five-stage framework, using the Preferred Reporting Items for Systematic Reviews and Meta-analysis Extension for Scoping Reviews protocol. Five databases and grey literature were searched for relevant studies. Identified factors were clustered by thematic type, according to the socio-ecological model to identify empirical trends and knowledge gaps. The mixed methods appraisal tool was used for quality assessment of studies. RESULTS Sixty-six studies met our inclusion criteria. Overall, 59 unique risk factors and 37 unique protective factors were identified. Key risk factors include past suicidality, adverse childhood experiences, internalized queerphobia, minority stress, interpersonal violence, bullying, familial conflict, and anti-LGBTQ+ policies/legislation. Key protective factors include self-affirming strategies, adult/peer support, at-school safety, access to inclusive healthcare, family connectedness, positive coming out experiences, gender-affirming services and LGBTQ+ inclusive policies and legislation. CONCLUSIONS Overall, our findings affirm that multiple risk and protective factors, at all levels of the socio-ecological model, interact in complex, unique and diverse ways upon suicidality among LGBTQ+ young people. Implications for suicide prevention are discussed. Further empirical studies are required, particularly at the communities, policies, and societal levels of the socio-ecological model, and these studies should include a focus on protective factors and significant within-group differences.
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Affiliation(s)
| | - Siobhan O'Neill
- School of Psychology, Ulster University, Coleraine, Northern Ireland
| | - Susan Lagdon
- School of Psychology, Ulster University, Coleraine, Northern Ireland
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7
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O’Shea J, James R, Nicholls D, Downs J, Hudson LD. Prevalence, severity and risk factors of psychiatric disorders amongst sexual and gender diverse young people during the COVID-19 pandemic: A systematic review. Clin Child Psychol Psychiatry 2024; 29:1213-1227. [PMID: 38290723 PMCID: PMC11188558 DOI: 10.1177/13591045241229751] [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: 02/01/2024]
Abstract
Before the COVID-19 pandemic, the prevalence and severity of psychiatric disorders among sexual and gender diverse (SGD) young people was greater than in their heterosexual/cisgender peers. We systematically reviewed literature examining the prevalence, severity, and risk factors for psychiatric disorders among SGD young people aged 25 and under during the pandemic. Four databases (MEDLINE, PsycInfo, Scopus and Web of Science) were searched. Eligibility criteria were studies assessing prevalence rates, mean symptomology scores and risk factors of psychiatric disorders using contemporaneous screening measures or diagnosis. Thirteen studies of mixed quality were identified. Most studies indicated SGD young people were at high risk of experiencing several psychiatric disorders including depressive and generalised anxiety disorder compared to the general population. This group also experienced more severe symptomology of various psychiatric disorders compared to their heterosexual/cisgender peers. Risk factors included those specific to the pandemic along with factors that led to greater risk before the pandemic. This systematic review has indicated evidence of heightened risk of psychiatric disorders among SGD young people during the COVID-19 pandemic. It is important for clinicians to acknowledge the needs of SGD young people, working with them to co-develop more inclusive care as they deal with the pandemic's fallout.
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Affiliation(s)
- Jonathan O’Shea
- Population, Policy and Practice Department, UCL GOS Institute of Child Health, UK
| | - Rachel James
- Population, Policy and Practice Department, UCL GOS Institute of Child Health, UK
| | - Dasha Nicholls
- Department of Brain Sciences, Imperial College London, UK
| | - James Downs
- Faculty of Eating Disorders, Royal College of Psychiatrists, UK
| | - Lee D Hudson
- Population, Policy and Practice Department, UCL GOS Institute of Child Health, UK
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8
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Richardson R, Connell T, Foster M, Blamires J, Keshoor S, Moir C, Zeng IS. Risk and Protective Factors of Self-harm and Suicidality in Adolescents: An Umbrella Review with Meta-Analysis. J Youth Adolesc 2024; 53:1301-1322. [PMID: 38564099 PMCID: PMC11045640 DOI: 10.1007/s10964-024-01969-w] [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: 08/28/2023] [Accepted: 03/02/2024] [Indexed: 04/04/2024]
Abstract
Suicide remains the second most common cause of death in young people aged 10-24 years and is a growing concern globally. The literature reports a vast number of factors that can predispose an adolescent to suicidality at an individual, relational, community, or societal level. There is limited high-level research identifying and understanding these risk and protective factors of adolescent suicidality. The present study used an umbrella review and meta-analysis to synthesize evidence from the review literature in the past 20 years on risk and protective factors of self-harm and suicidality (behavior and ideation) in adolescents. The umbrella review included 33 quantitative reviews with 1149 individual studies on suicidality and self-harm. Based on the data synthesis, it compared the public health impact of exposure on the population of the identified exposure. Bullying victimization was the most attributed environmental exposure for suicidality. The other identified significant school and individual factors were sleeping disturbance, school absenteeism, and exposure to antidepressants. Several significant vulnerable young populations were identified with significantly higher prevalence of suicidality, including lesbian, gay, bisexual, transgender, queer (or questioning) youth and those with mental health disorders, problem behaviors, previous suicidality, self-harm, and gender (female). A person-centered approach emphasizing connectedness and bully-free school environments should be a priority focus for schools, health professionals, and public health policymakers.
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Affiliation(s)
- Rebecca Richardson
- Faculty of Health and Environmental Science, Research Office, Department of Biostatistics and Epidemiology, Auckland University of Technology, Auckland, New Zealand
- Faculty of Culture and Society, School of Social Sciences and Public Policy, Auckland University of Technology, Auckland, New Zealand
| | - Tanya Connell
- Faculty of Health and Environmental Science, School of Nursing, Auckland University of Technology, Auckland, New Zealand
| | - Mandie Foster
- Faculty of Health and Environmental Science, School of Nursing, Auckland University of Technology, Auckland, New Zealand
- School of Midwifery and Nursing, Edith Cowan University, Perth, WA, Australia
| | - Julie Blamires
- Faculty of Health and Environmental Science, School of Nursing, Auckland University of Technology, Auckland, New Zealand
| | - Smita Keshoor
- Faculty of Health and Environmental Science, School of Oral Health, Auckland University of Technology, Auckland, New Zealand
| | - Chris Moir
- Centre for Postgraduate Nursing Studies, University of Otago, Christchurch, New Zealand
| | - Irene Suilan Zeng
- Faculty of Health and Environmental Science, Research Office, Department of Biostatistics and Epidemiology, Auckland University of Technology, Auckland, New Zealand.
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Alacreu-Crespo A, Sebti E, Moret RM, Courtet P. From Social Stress and Isolation to Autonomic Nervous System Dysregulation in Suicidal Behavior. Curr Psychiatry Rep 2024; 26:312-322. [PMID: 38717659 PMCID: PMC11147891 DOI: 10.1007/s11920-024-01503-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 04/11/2024] [Indexed: 06/04/2024]
Abstract
PURPOSE OF REVIEW In this narrative review we wanted to describe the relationship of autonomic nervous system activity with social environment and suicidal spectrum behaviors. RECENT FINDINGS Patients with suicidal ideation/suicide attempt have higher sympathetic nervous system (SNS) and lower parasympathetic nervous system (PNS) activity in resting conditions and during acute stress tasks compared with patients without suicidal ideation/suicide attempt. Death by suicide and violent suicide attempt also are related to SNS hyperactivation. Similarly, a SNS/PNS imbalance has been observed in people with childhood trauma, stressful life events or feelings of loneliness and isolation. Social support seems to increase PNS control and resilience. Due to the importance of the social context and stressful life events in suicidal behavior, SNS/PNS imbalance could act as a mediator in this relationship and be a source of relevant biomarkers. Childhood trauma and stressful life events may impair the autonomic nervous system response in suicidal patients. Loneliness, isolation and social support may act as moderators in acute stress situations.
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Affiliation(s)
- Adrián Alacreu-Crespo
- Department of Psychology and Sociology, University of Zaragoza, C/Atarazana 4, Aragon, Teruel, 44003, Spain.
- FondaMental Foundation, Créteil, France.
| | - Emma Sebti
- IGF, Univ. Montpellier, CNRS, INSERM, Montpellier, France
- Department of Emergency Psychiatry and Acute Care, Lapeyronie Hospital, CHU Montpellier, Montpellier, France
| | - Rosa María Moret
- Department of Psychology and Sociology, University of Zaragoza, C/Atarazana 4, Aragon, Teruel, 44003, Spain
| | - Philippe Courtet
- FondaMental Foundation, Créteil, France
- IGF, Univ. Montpellier, CNRS, INSERM, Montpellier, France
- Department of Emergency Psychiatry and Acute Care, Lapeyronie Hospital, CHU Montpellier, Montpellier, France
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Fowler JA, Buckley L, Viskovich S, Muir M, Dean JA. Healthcare providers perspectives on digital, self-guided mental health programs for LGBTQIA+ individuals: A cross-sectional online survey. Psychiatry Res 2024; 335:115873. [PMID: 38555827 DOI: 10.1016/j.psychres.2024.115873] [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] [Received: 07/27/2023] [Revised: 03/07/2024] [Accepted: 03/24/2024] [Indexed: 04/02/2024]
Abstract
Digital, self-guided mental health programs are a promising avenue for mental health support for LGBTQIA+ (lesbian, gay, bisexual, trans, Queer, intersex, asexual plus additional sexuality, gender, and romantic identities) people - however, healthcare providers (HCPs) perspectives on programs are largely unknown. The aim of this study was to explore these perspectives. A cross-sectional online survey was distributed across Australia, with a final sample of 540 HCPs from a range of disciplines. Most respondents (419, 81.2 %), reported that digital, self-guided mental health programs would be useful, but 74.5 % (n = 380) also reported that they had concerns. Thematic analysis of open-text responses showed that HCPs believe programs may help overcome access barriers and could be useful as part of a wider care journey. Others were concerned about patient safety, and whether programs could be appropriately tailored to LGBTQIA+ experiences. Content analysis of open-text responses showed affirming language and imagery, content on LGBTQIA+ people's unique challenges, wider health information, and connections to community were important to include in programs. HCPs advocated for programs that offered broad and sub-population specific information. These findings show that HCPs are enthusiastic about digital, self-guided mental health programs, but care should be taken to address key concerns to facilitate future implementation.
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Affiliation(s)
- James A Fowler
- The University of Queensland, Faculty of Medicine, School of Public Health, Herston, Brisbane, QLD 4006, Australia.
| | - Lisa Buckley
- The University of Queensland, Faculty of Medicine, School of Public Health, Herston, Brisbane, QLD 4006, Australia
| | - Shelley Viskovich
- The University of Queensland, Faculty of Health and Behavioral Sciences, School of Psychology, St Lucia, Brisbane, QLD 4027, Australia
| | - Miranda Muir
- The University of Queensland, Faculty of Health and Behavioral Sciences, School of Psychology, St Lucia, Brisbane, QLD 4027, Australia
| | - Judith A Dean
- The University of Queensland, Faculty of Medicine, School of Public Health, Herston, Brisbane, QLD 4006, Australia
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Tepman A, Wong ML. The role of victimisation and sleep quality in self-harm and depression among sexual minority adolescents. A prospective cohort study. Eur Child Adolesc Psychiatry 2024:10.1007/s00787-024-02444-4. [PMID: 38671245 DOI: 10.1007/s00787-024-02444-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/20/2023] [Accepted: 04/19/2024] [Indexed: 04/28/2024]
Abstract
Sexual minority adolescents (SMA) have a disproportionately high prevalence of victimisation, self-harm, and depressed mood, relative to the general population. Yet, the contributing and mechanistic factors are unclear. We aim to explore the directional relationship between victimisation and self-harm and depressed mood, with poor sleep quality as a possible mediator. A secondary data analysis was conducted using a nationally representative birth cohort in the United Kingdom, where participants self-identified as sexual minority (N = 1922, aged 11-13, 67.1% female) and their parents completed questionnaires and interviews when the participants were aged 11, 14 and 17. Logistic and linear regression were used to test whether victimisation prospectively predicted self-harm and depressed mood with mediation analyses conducted to assess if sleep onset latency and nocturnal awakening mediated their relationships. After adjusting for demographic factors and baseline self-harm and depressed mood, victimisation at age 11 significantly predicted self-harm (OR = 1.40, p < .01) and depressed mood (B = 0.024, SE = 0.01, p < .05) at age 17. In the mediation analyses, frequent nocturnal awakening at age 14, but not sleep onset latency, significantly mediated the effect of victimisation at age 11 on self-harm (indirect effect B = 0.008, SE = 0.004, 95%CI = 0.001-0.017) and depressed mood (indirect effect B = 0.005, SE = 0.002 95%CI = 0.001-0.010) at age 17. Our findings supported that victimisation contributed to negative mental health among SMA. Poor sleep quality could be an indicator of maladjustment with victimisation, which further increased vulnerability to negative mental health. Victimisation and sleep quality could be important assessment targets in mental health campaign among sexual minority adolescents.
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Affiliation(s)
| | - Mark Lawrence Wong
- Department of Social and Behavioural Sciences, City University of Hong Kong, Tat Chee Avenue, Kowloon, Hong Kong.
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12
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Gómez-Chica P, Rueda-Ruzafa L, Aparicio-Mota A, Rodriguez-Arrastia M, Ropero-Padilla C, Rodriguez-Valbuena C, Román P. Examining suicide risk in sexual and gender minority youth: A descriptive observational study on depressive symptoms, social support and self-esteem. J Clin Nurs 2024. [PMID: 38533544 DOI: 10.1111/jocn.17147] [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: 09/28/2023] [Accepted: 03/19/2024] [Indexed: 03/28/2024]
Abstract
AIM To understand the factors that contribute to the risk of suicide among lesbian, gay, bisexual, transgender, queer, intersex and asexual (sexual minorities) youth. BACKGROUND The increase in the likelihood of suicide has made it an urgent issue in public health, particularly among young people, where it now ranks as the fourth leading cause of death. This issue becomes even more significant when focusing on sexual minorities. METHODS A cross-sectional study was performed in targeted young individuals (15-29 years). Several variables were assessed, including suicide risk, self-esteem, presence and severity of depressive symptoms, perceived social support and self-reported levels of anxiety and depression. RESULTS Statistically significant disparities were observed in suicide risk, presence of depressive symptoms and self-reported levels of anxiety and depression, all of which were more pronounced in sexual minority youth compared to heterosexual cisgender individuals. Likewise, statistically significant differences were noted concerning self-esteem and family support, both of which were lower in sexual minority youth. CONCLUSION This study has identified risk factors, such as anxiety, depression and limited social support, as well as protective factors, like higher self-esteem and self-concept. Understanding and addressing all these factors are essential in reducing the elevated rates of suicide among sexual minority youth. Consequently, evidence-based interventions such as Gender and Sexuality Alliances, which empower and create safe spaces for sexual minority youth, possess substantial potential for effectively addressing this issue. IMPLICATIONS FOR THE PROFESSION Given sexual minorities vulnerability, healthcare pros, especially nurses, must grasp suicide risk factors. They can help by educating, offering care, assessing risk and fighting stigma. This guarantees safety and access to mental health services for at-risk individuals from sexual minorities. REPORTING METHOD The reporting follows the STROBE checklist. PATIENT CONTRIBUTION People who were invited to participate voluntarily completed a range of questionnaires.
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Affiliation(s)
| | - Lola Rueda-Ruzafa
- Research Group CTS-1114 Advances and Innovation in Health, University of Almería, Almería, Andalusía, Spain
- Faculty of Health Sciences, Department of Nursing Science, Physiotherapy and Medicine, University of Almería, Almería, Andalusía, Spain
| | - Adrián Aparicio-Mota
- Research Group CTS-1114 Advances and Innovation in Health, University of Almería, Almería, Andalusía, Spain
- Andalusian Public Foundation for Biomedical Research in Eastern Andalusia (FIBAO), University Hospital Torrecárdenas, Almería, Andalusía, Spain
| | - Miguel Rodriguez-Arrastia
- Research Group CTS-1114 Advances and Innovation in Health, University of Almería, Almería, Andalusía, Spain
- Faculty of Health Sciences, Department of Nursing Science, Physiotherapy and Medicine, University of Almería, Almería, Andalusía, Spain
| | - Carmen Ropero-Padilla
- Research Group CTS-1114 Advances and Innovation in Health, University of Almería, Almería, Andalusía, Spain
- Faculty of Health Sciences, Department of Nursing Science, Physiotherapy and Medicine, University of Almería, Almería, Andalusía, Spain
| | - Cristian Rodriguez-Valbuena
- Faculty of Health Sciences, Department of Nursing Science, Physiotherapy and Medicine, University of Almería, Almería, Andalusía, Spain
| | - Pablo Román
- Research Group CTS-1114 Advances and Innovation in Health, University of Almería, Almería, Andalusía, Spain
- Faculty of Health Sciences, Department of Nursing Science, Physiotherapy and Medicine, University of Almería, Almería, Andalusía, Spain
- Health Research Center CEINSA, University of Almería, Almería, Andalusía, Spain
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13
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Díaz Videla M, Delgado Rodríguez R, Martos-Montes R, Ordóñez Pérez D, Calvo P. The LGBTQ+ People-Animal Bond: A Systematic Review of the Effects of Companion Animals on LGBTQ+ People. JOURNAL OF HOMOSEXUALITY 2024; 71:934-957. [PMID: 36625558 DOI: 10.1080/00918369.2022.2150920] [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: 06/17/2023]
Abstract
LGBTQ+ people tend to experience prejudice, stigma, and discrimination, which increases their risk of developing mental health difficulties. Support networks, including companion animals, can be used to cope with these challenges. We performed a systematic review of studies related to the effects of human-animal interactions on the LGBTQ+ population. The review included 18 empirical studies; the findings showed that participants tended to view companion animals as family members, as well as providers of love, acceptance, and social support. Thus, companion animals could alleviate stress and increase resilience. However, certain costs were also cited and, under some circumstances, poorer health was observed. The results are discussed considering three unique aspects of the "LGBTQ+ people-animal bond": (1) it promotes self-acceptance, (2) provides a sense of protection against sexuality-based stigma and social acts of aggression based on sex or gender, and (3) exposes animal guardians requesting animal care services to potential discrimination. By characterizing the LGBTQ+ people-animal bond, more effective responses to meet their needs and promote inclusion may be achieved.
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Affiliation(s)
- Marcos Díaz Videla
- Iberoamerican Institute of Anthrozoology. University of Flores, Buenos Aires, Argentina
| | | | | | | | - Paula Calvo
- Iberoamerican Institute of Anthrozoology, Cátedra Animales y Sociedad. Rey Juan Carlos University, Móstoles, Spain
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14
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Bird K, Arcelus J, Matsagoura L, O'Shea B, Townsend E. Risk and protective factors for self-harm thoughts and behaviours in transgender and gender diverse people: A systematic review. Heliyon 2024; 10:e26074. [PMID: 38468947 PMCID: PMC10925986 DOI: 10.1016/j.heliyon.2024.e26074] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2023] [Revised: 01/17/2024] [Accepted: 02/07/2024] [Indexed: 03/13/2024] Open
Abstract
Background Self-harm (any self-injury or -poisoning regardless of intent) is highly prevalent in transgender and gender diverse (TGD) populations. It is strongly associated with various adverse health and wellbeing outcomes, including suicide. Despite increased risk, TGD individuals' unique self-harm pathways are not well understood. Following PRISMA guidelines we conducted the first systematic review of risk and protective factors for self-harm in TGD people to identify targets for prevention and intervention. Methods We searched five electronic databases (PubMed, PsychInfo, Scopus, MEDLINE, and Web of Science) published from database inception to November 2023 for primary and secondary studies of risk and/or protective factors for self-harm thoughts and behaviours in TGD people. Data was extracted and study quality assessed using Newcastle-Ottawa Scales. Findings Overall, 78 studies published between 2007 and 2023 from 16 countries (N = 322,144) were eligible for inclusion. Narrative analysis identified six key risk factors for self-harm in TGD people (aged 7-98years) were identified. These are younger age, being assigned female at birth, illicit drug and alcohol use, sexual and physical assault, gender minority stressors (especially discrimination and victimisation), and depression or depressive symptomology. Three important protective factors were identified: social support, connectedness, and school safety. Other possible unique TGD protective factors against self-harm included: chosen name use, gender-identity concordant documentation, and protective state policies. Some evidence of publication bias regarding sample size, non-responders, and confounding variables was identified. Interpretation This systematic review indicates TGD people may experience a unique self-harm pathway. Importantly, the risk and protective factors we identified provide meaningful targets for intervention. TGD youth and those assigned female at birth are at increased risk. Encouraging TGD people to utilise and foster existing support networks, family/parent and peer support groups, and creating safe, supportive school environments may be critical for self-harm and suicide prevention strategies. Efforts to reduce drug and alcohol use and experiences of gender-based victimisation and discrimination are recommended to reduce self-harm in this high-risk group. Addressing depressive symptoms may reduce gender dysphoria and self-harm. The new evidence presented in this systematic review also indicates TGD people may experience unique pathways to self-harm related to the lack of social acceptance of their gender identity. However, robust longitudinal research which examines gender-specific factors is now necessary to establish this pathway.
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Affiliation(s)
- K. Bird
- School of Psychology, University of Nottingham, Nottingham, UK
| | - J. Arcelus
- Institute of Mental Health, University of Nottingham, Nottingham, UK
- Bellvitge Biomedical Research Institute (IDIBELL), Barcelona, Spain
| | - L. Matsagoura
- School of Psychology, University of Nottingham, Nottingham, UK
| | - B.A. O'Shea
- School of Psychology, University of Nottingham, Nottingham, UK
- Department of Psychology, Harvard University, Cambridge, MA, USA
- The Centre for the Experimental-Philosophical Study of Discrimination, Aarhus University, Denmark
| | - E. Townsend
- School of Psychology, University of Nottingham, Nottingham, UK
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15
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Joyce DW, Kormilitzin A, Hamer-Hunt J, McKee KR, Tomasev N. Defining acceptable data collection and reuse standards for queer artificial intelligence research in mental health: protocol for the online PARQAIR-MH Delphi study. BMJ Open 2024; 14:e079105. [PMID: 38490661 PMCID: PMC10946350 DOI: 10.1136/bmjopen-2023-079105] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/08/2023] [Accepted: 02/29/2024] [Indexed: 03/17/2024] Open
Abstract
INTRODUCTION For artificial intelligence (AI) to help improve mental healthcare, the design of data-driven technologies needs to be fair, safe, and inclusive. Participatory design can play a critical role in empowering marginalised communities to take an active role in constructing research agendas and outputs. Given the unmet needs of the LGBTQI+ (Lesbian, Gay, Bisexual, Transgender, Queer and Intersex) community in mental healthcare, there is a pressing need for participatory research to include a range of diverse queer perspectives on issues of data collection and use (in routine clinical care as well as for research) as well as AI design. Here we propose a protocol for a Delphi consensus process for the development of PARticipatory Queer AI Research for Mental Health (PARQAIR-MH) practices, aimed at informing digital health practices and policy. METHODS AND ANALYSIS The development of PARQAIR-MH is comprised of four stages. In stage 1, a review of recent literature and fact-finding consultation with stakeholder organisations will be conducted to define a terms-of-reference for stage 2, the Delphi process. Our Delphi process consists of three rounds, where the first two rounds will iterate and identify items to be included in the final Delphi survey for consensus ratings. Stage 3 consists of consensus meetings to review and aggregate the Delphi survey responses, leading to stage 4 where we will produce a reusable toolkit to facilitate participatory development of future bespoke LGBTQI+-adapted data collection, harmonisation, and use for data-driven AI applications specifically in mental healthcare settings. ETHICS AND DISSEMINATION PARQAIR-MH aims to deliver a toolkit that will help to ensure that the specific needs of LGBTQI+ communities are accounted for in mental health applications of data-driven technologies. The study is expected to run from June 2024 through January 2025, with the final outputs delivered in mid-2025. Participants in the Delphi process will be recruited by snowball and opportunistic sampling via professional networks and social media (but not by direct approach to healthcare service users, patients, specific clinical services, or via clinicians' caseloads). Participants will not be required to share personal narratives and experiences of healthcare or treatment for any condition. Before agreeing to participate, people will be given information about the issues considered to be in-scope for the Delphi (eg, developing best practices and methods for collecting and harmonising sensitive characteristics data; developing guidelines for data use/reuse) alongside specific risks of unintended harm from participating that can be reasonably anticipated. Outputs will be made available in open-access peer-reviewed publications, blogs, social media, and on a dedicated project website for future reuse.
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Affiliation(s)
- Dan W Joyce
- Department of Primary Care and Mental Health and the Civic Health Information Laboratory, University of Liverpool, Liverpool, UK
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16
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Alam I, Khayri E, Podger TAB, Aspinall C, Fuhrmann D, Lau JYF. A call for better research and resources for understanding and combatting youth loneliness: integrating the perspectives of young people and researchers. Eur Child Adolesc Psychiatry 2024; 33:939-942. [PMID: 36577906 PMCID: PMC9797107 DOI: 10.1007/s00787-022-02125-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/20/2022] [Accepted: 12/10/2022] [Indexed: 12/29/2022]
Affiliation(s)
- Iqra Alam
- Psychology Department, King's College London, London, UK
| | - Ezekiel Khayri
- Psychology Department, King's College London, London, UK
| | | | - Caitlin Aspinall
- Youth Resilience Unit, Centre for Psychiatry and Mental Health, Wolfson Institute of Population Health, Queen Mary University of London, London, UK
| | - Delia Fuhrmann
- Psychology Department, King's College London, London, UK
| | - Jennifer Y F Lau
- Youth Resilience Unit, Centre for Psychiatry and Mental Health, Wolfson Institute of Population Health, Queen Mary University of London, London, UK.
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17
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Logie CH, Newman PA, Admassu Z, MacKenzie F, Chakrapani V, Tepjan S, Shunmugam M, Akkakanjanasupar P. Associations between water insecurity and mental health outcomes among lesbian, gay, bisexual, transgender and queer persons in Bangkok, Thailand and Mumbai, India: Cross-sectional survey findings. Glob Ment Health (Camb) 2024; 11:e31. [PMID: 38572259 PMCID: PMC10988155 DOI: 10.1017/gmh.2024.27] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/15/2023] [Revised: 12/29/2023] [Accepted: 02/20/2024] [Indexed: 04/05/2024] Open
Abstract
Background Water insecurity disproportionally affects socially marginalized populations and may harm mental health. Lesbian, gay, bisexual, transgender and queer (LGBTQ) persons are at the nexus of social marginalization and mental health disparities; however, they are understudied in water insecurity research. Yet LGBTQ persons likely have distinct water needs. We explored associations between water insecurity and mental health outcomes among LGBTQ adults in Mumbai, India and Bangkok, Thailand. Methods This cross-sectional survey with a sample of LGBTQ adults in Mumbai and Bangkok assessed associations between water insecurity and mental health outcomes, including anxiety symptoms, depression symptoms, loneliness, alcohol misuse, COVID-19 stress and resilience. We conducted multivariable logistic and linear regression analyses to examine associations between water insecurity and mental health outcomes. Results Water insecurity prevalence was 28.9% in Mumbai and 18.6% in Bangkok samples. In adjusted analyses, in both sites, water insecurity was associated with higher likelihood of depression symptoms, anxiety symptoms, COVID-19 stress, alcohol misuse and loneliness. In Mumbai, water insecurity was also associated with reduced resilience. Conclusion Water insecurity was common among LGBTQ participants in Bangkok and Mumbai and associated with poorer well-being. Findings signal the importance of assessing water security as a stressor harmful to LGBTQ mental health.
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Affiliation(s)
- Carmen H. Logie
- Factor Inwentash Faculty of Social Work, University of Toronto, Toronto, ON, Canada
- United Nations University Institute for Water, Environment, and Health, Hamilton, ON, Canada
- Women’s College Research Institute, Women’s College Hospital, Toronto, ON, Canada
- Centre for Gender & Sexual Health Equity, Vancouver, BC, Canada
| | - Peter A. Newman
- Factor Inwentash Faculty of Social Work, University of Toronto, Toronto, ON, Canada
| | - Zerihun Admassu
- Factor Inwentash Faculty of Social Work, University of Toronto, Toronto, ON, Canada
| | - Frannie MacKenzie
- Factor Inwentash Faculty of Social Work, University of Toronto, Toronto, ON, Canada
| | | | | | - Murali Shunmugam
- Centre for Sexuality and Health Research and Policy (C-SHaRP), Chennai, India
| | - Pakorn Akkakanjanasupar
- Department of Educational Policy, Management, and Leadership, Faculty of Education, Chulalongkorn University, Bangkok, Thailand
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18
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Krisnanda VD, Setyosari P, Ramli M, Setiyowati AJ. Cultivating self-love applying mindfulness-based cognitive therapy to overcome self-harm and suicidal intentions in LGBTQ adolescents. J Public Health (Oxf) 2024; 46:e169-e170. [PMID: 37533206 DOI: 10.1093/pubmed/fdad140] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2023] [Revised: 06/29/2023] [Accepted: 07/18/2023] [Indexed: 08/04/2023] Open
Affiliation(s)
- Veno Dwi Krisnanda
- Malang State University, Indonesia
- Indraprasta University PGRI, Indonesia
| | | | - M Ramli
- Malang State University, Indonesia
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19
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Keum BT, Maurin-Waters E, Chong ESK. The Mental Health Costs of Online Heterosexism Among LGBTQ+ Individuals: Development and Initial Validation of the Perceived Online Heterosexism Scale. ARCHIVES OF SEXUAL BEHAVIOR 2024; 53:525-541. [PMID: 37943472 DOI: 10.1007/s10508-023-02733-0] [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: 04/29/2023] [Revised: 10/18/2023] [Accepted: 10/19/2023] [Indexed: 11/10/2023]
Abstract
Experiences of heterosexism are rampant online, where bias and harassment against LGBTQ+ individuals spread conveniently and widely. Yet, research has been limited in understanding the exposure to online heterosexism among LGBTQ+ individuals partly due to the lack of a quantitative measure to advance this research. Thus, the current study developed and examined the psychometric properties of the Perceived Online Heterosexism Scale (POHS). Items were developed via a literature review, a survey of social media platforms, and an expert review. Exploratory (N = 288) and confirmatory (N = 653) factor analyses yielded a 4-factor structure and produced a 20-item scale with the following subscales: (1) Heterosexist Cyberaggression (4 items), (2) Online Heterosexist Stereotyping (4 items), (3) Online Exposure to Systemic Heterosexism (8 items), and (4) Heterosexist Online Media (four items). Internal consistency estimates ranged from .91 to .96, and the POHS accounted for 65.9% of the variance. Examination of a second-order model suggested that a total scale score can also be used. Initial construct validity was evidenced as POHS scores were associated with an existing heterosexism measure, anxiety and depressive symptoms, internalized heterosexism, and LGBTQ+ community connectedness in line with theory and empirical evidence. Implications for research practice are discussed.
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Affiliation(s)
- Brian TaeHyuk Keum
- Department of Counseling, Developmental & Educational Psychology, Lynch School of Education and Human Development, Boston College, 140 Commonwealth Ave., Chestnut Hill, MA, 02467, USA.
| | - Emily Maurin-Waters
- Department of Social Welfare, University of California Los Angeles, Los Angeles, CA, USA
| | - Eddie S K Chong
- Department of Social Work and Social Administration, The University of Hong Kong, Hong Kong, China
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20
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Lamontagne E, Leroy V, Yakusik A, Parker W, Howell S, Ventelou B. Assessment and determinants of depression and anxiety on a global sample of sexual and gender diverse people at high risk of HIV: a public health approach. BMC Public Health 2024; 24:215. [PMID: 38238673 PMCID: PMC10795213 DOI: 10.1186/s12889-023-17493-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2022] [Accepted: 12/14/2023] [Indexed: 01/22/2024] Open
Abstract
BACKGROUND Sexual and gender diverse people face intersecting factors affecting their well-being and livelihood. These include homophobic reactions, stigma or discrimination at the workplace and in healthcare facilities, economic vulnerability, lack of social support, and HIV. This study aimed to examine the association between such factors and symptoms of anxiety and depression among sexual and gender diverse people. METHODS This study is based on a sample of 108,389 gay, bisexual, queer and questioning men, and transfeminine people from 161 countries collected through a cross-sectional internet survey. We developed a multinomial logistic regression for each group to study the associations of the above factors at different severity scores for anxiety and depression symptoms. RESULTS Almost a third (30.3%) of the participants reported experiencing moderate to severe symptoms of anxiety and depression. Higher severity scores were found for transfeminine people (39%), and queer or questioning people (34.8%). Severe symptoms of anxiety and depression were strongly correlated with economic hardship for all groups. Compared to those who are HIV-negative, those living with HIV were more likely to report severe symptoms of anxiety and depression, and the highest score was among those who do not know their HIV status. Transfeminine people were the most exposed group, with more than 80% higher risk for those living with HIV suffering from anxiety and depression. Finally, homophobic reactions were strongly associated with anxiety and depression. The relative risk of severe anxiety and depression was 3.47 times higher for transfeminine people facing transphobic reactions than those with no symptoms. Moreover, anxiety and depression correlate with stigma or discrimination in the workplace and healthcare facilities. CONCLUSIONS The strong association between the severity of anxiety and depression, and socioeconomic inequality and HIV status highlights the need for concrete actions to meet the United Nations' pledge to end inequalities faced by communities and people affected by HIV. Moreover, the association between stigma or discrimination and anxiety and depression among sexual and gender diverse people is alarming. There is a need for bold structural public health interventions, particularly for transfeminine, queer and questioning people who represent three communities under the radar of national HIV programmes.
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Affiliation(s)
- Erik Lamontagne
- UNAIDS, 20 Ave Appia, 1211, Geneva, Switzerland.
- Aix-Marseille University, CNRS, EHESS, Centrale Marseille, Aix-Marseille School of Economics, 5-9 Boulevard Maurice Bourdet 13205, Marseille, France.
| | - Vincent Leroy
- Aix Marseille Univ, Inserm, IRD, SESSTIM, Sciences Economiques & Sociales de La Santé & Traitement de L'Information Médicale, ISSPAM, Marseille, France
| | - Anna Yakusik
- UNAIDS, 20 Ave Appia, 1211, Geneva, Switzerland
- Imperial College London, Faculty of Medicine, School of Public Health, London, SW7 2AZ, England
| | | | | | - Bruno Ventelou
- Aix-Marseille University, CNRS, EHESS, Centrale Marseille, Aix-Marseille School of Economics, 5-9 Boulevard Maurice Bourdet 13205, Marseille, France
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21
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Lopes B, Jaspal R. Identity Processes and Psychological Wellbeing Upon Recall of a Significant "Coming Out" Experience in Lesbian, Gay and Bisexual People. JOURNAL OF HOMOSEXUALITY 2024; 71:207-231. [PMID: 36041082 DOI: 10.1080/00918369.2022.2111536] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
This study focuses on the relations between minority stressors, protective factors and psychological wellbeing among lesbian, gay and bisexual (LGB) people. Experimental data based on a sample of 156 showed that participants asked to recall a negative coming out experience to somebody significant reported more identity threat and distress and less positive affect compared to those recalling a neutral coming out experience. In the negative recall condition, the effects of the stressors of discrimination and rejection on the variance of distress through the mediation of identity threat were statistically significant but not in the neutral recall condition and the two conditions statistically significantly differed in regards to the relationship between discrimination and distress. Identity resilience-continuity was associated with less identity threat and distress in the negative recall condition only, while social support was negatively associated and LGB stigma sensitivity was positively associated with distress in both conditions. Degree of outness (operating as a coping strategy) was associated with increased positive affect in both the neutral and negative recall conditions. When recalling a negative coming out experience, LGB people may be more susceptible to distress associated with minority stressors but also capitalize on available coping strategies.
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Affiliation(s)
- Barbara Lopes
- Center for Research in Neuropsychology and Cognitive and Behavioral Intervention (CINEICC), Universidade de Coimbra, Coimbra, Portugal
| | - Rusi Jaspal
- Vice-Chancellor's Office, University of Brighton, Brighton, UK
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22
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Cooley CC, Zhang ZM, Denney JT. Sexual Orientation and Age-Related Patterns of Suicidal Ideation Among U.S. Adults. LGBT Health 2024; 11:38-46. [PMID: 37486708 DOI: 10.1089/lgbt.2021.0428] [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] [Indexed: 07/25/2023] Open
Abstract
Purpose: We aimed to explore whether and how suicidal ideation differs according to specific sexual orientations (i.e., heterosexual, gay/lesbian, bisexual orientation) and age groups in gender-stratified analyses. Methods: We identified state health departments from nine U.S. states that collected Behavioral Risk Factor Surveillance System data on both sexual orientation and suicidal ideation from 2011 to 2018 for adults aged 18 and older (n = 113,337). Logistic regression and average marginal effects (AME) were used to examine the likelihood of suicidal ideation by sexual orientation, gender, and age. Results: We found that after important sociodemographic and socioeconomic controls, sexual minority adult men and women experienced significantly higher odds of suicidal ideation than their same-gender heterosexual counterparts. After all adjustments, lesbian women had more than three times higher odds and bisexual women had almost four times higher odds than heterosexual women. Compared with heterosexual men, gay men reported twice higher odds and bisexual men exhibited 3.67 times higher odds of suicidal ideation. Analysis of the AME revealed age-specific disparities. The likelihood of suicidal ideation for bisexual men aged 18-24 years was significantly higher than that for gay and heterosexual men of the same age. Among women, bisexual women closer to middle age (35-44 years) experienced a higher likelihood of suicidal ideation than heterosexual or lesbian women of the same age. Conclusion: The elevated risk of suicidal ideation among sexual minority people throughout different stages of adulthood has important implications for policies and support services.
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Affiliation(s)
- Caleb C Cooley
- Department of Sociology, Washington State University, Pullman, Washington, USA
| | | | - Justin T Denney
- Department of Sociology, Washington State University, Pullman, Washington, USA
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23
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Hughes TL, Bochicchio L, Drabble L, Muntinga M, Jukema JS, Veldhuis CB, Bruck S, Bos H. 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. BMC Public Health 2023; 23:2533. [PMID: 38110908 PMCID: PMC10729573 DOI: 10.1186/s12889-023-17466-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2023] [Accepted: 12/12/2023] [Indexed: 12/20/2023] Open
Abstract
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.
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Affiliation(s)
- Tonda L Hughes
- School of Nursing, Department of Psychiatry, Columbia University Irving Medical School, Center for Sexual and Gender Minority Health Research, 560 West 168 Street, New York, NY, USA.
| | - Lauren Bochicchio
- Columbia University School of Nursing Center for Sexual and Gender Minority Health Research, 560 West 168th Street, New York, NY, USA
| | - Laurie Drabble
- College of Health and Human Sciences, San Jose State University, One Washington Square, San Jose, CA, USA
| | - Maaike Muntinga
- Department of Ethics, Law and Humanities, Amsterdam UMC location VUmc, De Boelelaan 1118, Amsterdam, 1081 HZ, Netherlands
| | - Jan S Jukema
- School of Health, Saxion University of Applied Sciences, M. H. Tromplaan 28, Enschede, 7513 AB, Netherlands
| | - Cindy B Veldhuis
- Departments of Medical Social Sciences, Psychology, Psychiatry, and Obstetrics & Gynecology, Northwestern University, 625 N. Michigan Ave., 14th Floor, Chicago, IL, USA
| | - Sunčica Bruck
- Kohnstamm Instituut, Keizer Karelplein 1, Amstelveen, 1185 HL, Netherlands
| | - Henny Bos
- Research Institute Child Development and Education, Faculty of Social and Behavioural Sciences, University of Amsterdam, Amsterdam, 1012 WX, Netherlands
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24
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Kuhlemeier A, Shattuck D, Willging C, Ramos MM. Associations Between Nonsuicidal Self-Injury and School-Based Health-Promotive Factors for Sexual and Gender Minority Youth and Their Peers. LGBT Health 2023; 10:617-628. [PMID: 37358568 PMCID: PMC10734899 DOI: 10.1089/lgbt.2021.0404] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/27/2023] Open
Abstract
Purpose: The purpose of this study was to identify associations between school-based, health-promotive factors and nonsuicidal self-injury (NSSI) for sexual and gender minority youth and their heterosexual and cisgender peers. Methods: Using data from the 2019 New Mexico Youth Risk and Resiliency Survey (N = 17,811) and multilevel logistic regression to account for school-based clustering, we compared the effect of four school-based health-promotive factors on NSSI for stratified samples of lesbian/gay, bisexual, and gender-diverse (hereafter, gender minority [GM]) youth. Interactions were examined to evaluate the impact of school-based factors on NSSI for lesbian/gay, bisexual, (compared with heterosexual) and GM (compared with cisgender) youth. Results: Stratified analyses showed that three school-based factors (adult at school who listens, adult at school who believes they will be successful, clear school rules) were associated with lower odds of reporting NSSI for lesbian/gay and bisexual youth, but not GM youth. Interaction effects showed that lesbian/gay youth demonstrated greater reductions in odds of NSSI when reporting school-based supports compared with heterosexual youth. Associations between school-based factors and NSSI were not significantly different for bisexual compared with heterosexual youth. GM youth appear to experience no health-promotive effect on NSSI of school-based factors. Conclusions: Our findings underscore the potential of schools to provide supportive resources that reduce the odds of NSSI for most youth (i.e., heterosexual and bisexual youth), but are particularly effective in reducing NSSI among lesbian/gay youth. However, more study is needed to understand the potential impact of school-based health-promotive factors on NSSI for GM youth.
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Affiliation(s)
- Alena Kuhlemeier
- Southwest Center, Pacific Institute for Research and Evaluation, Albuquerque, New Mexico, USA
| | - Daniel Shattuck
- Southwest Center, Pacific Institute for Research and Evaluation, Albuquerque, New Mexico, USA
| | - Cathleen Willging
- Southwest Center, Pacific Institute for Research and Evaluation, Albuquerque, New Mexico, USA
| | - Mary M. Ramos
- Division of Adolescent Medicine, Department of Pediatrics, University of New Mexico, Albuquerque, New Mexico, USA
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25
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Marzetti H, Chandler A, Jordan A, Oaten A. The politics of LGBT+ suicide and suicide prevention in the UK: risk, responsibility and rhetoric. CULTURE, HEALTH & SEXUALITY 2023; 25:1559-1576. [PMID: 36780346 DOI: 10.1080/13691058.2023.2172614] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/22/2022] [Accepted: 01/21/2023] [Indexed: 06/18/2023]
Abstract
Suicide is a major public health concern, patterned by systematic inequalities, with lesbian, gay, bisexual and trans (LGBT+) people being one example of a minoritised group that is more likely to think about and attempt suicide worldwide. To address this, UK national suicide prevention policies have suggested that LGBT+ people should be prioritised in prevention activities. However, there is little research seeking to understand how LGBT+ suicide is re/presented in political and policy spheres. In this article, we critically analyse all mentions of LGBT+ suicide in UK parliamentary debates between 2009 and 2019 and in the eight suicide prevention policies in use during this period. We argue that LGBT+ suicide is understood in two contrasting ways: firstly, as a pathological 'problem', positioning LGBT+ people either as risks or as at risk and in need of mental health support. Alternatively, suicide can be seen as externally attributable to perpetrators of homophobic, biphobic and transphobic hate, requiring anti-hate activities as part of suicide prevention. In response, we argue that although these explanations may appear oppositional; they both draw on reductive explanations of LGBT+ suicide, failing to consider the complexity of suicidal distress, thus constraining understandings of suicide and suicide prevention.
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Affiliation(s)
- Hazel Marzetti
- School of Health in Social Science, University of Edinburgh, Edinburgh, UK
| | - Amy Chandler
- School of Health in Social Science, University of Edinburgh, Edinburgh, UK
| | - Ana Jordan
- School of Social and Political Sciences, University of Lincoln, Lincoln, UK
| | - Alexander Oaten
- School of Social and Political Sciences, University of Lincoln, Lincoln, UK
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26
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Hacker D, Jones CA, Yasin E, Preece S, Davies H, Hawkins A, Belli A, Paton E. Cognitive Outcome After Complicated Mild Traumatic Brain Injury: A Literature Review and Meta-Analysis. J Neurotrauma 2023; 40:1995-2014. [PMID: 36964755 DOI: 10.1089/neu.2023.0020] [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] [Indexed: 03/26/2023] Open
Abstract
Cognitive outcome for mild traumatic brain injury (mTBI) with positive brain imaging (complicated mTBI) was compared with that for mTBI with normal imaging (uncomplicated mTBI) and with moderate to severe TBI, using meta-analysis. Twenty-three studies utilizing objective neurocognitive tests were included in the analysis. At less than 3 months post-injury, complicated mTBI was associated with poorer cognitive outcomes than uncomplicated mTBI, but deficits were not comparable to those with moderate-severe TBI. After 3 months post-injury, a similar pattern was detected. Beyond 3 months, deficits in complicated mTBI relative to those with uncomplicated mTBI were present in processing speed, memory, executive function, and language, although the latter may be the result of reduced semantic fluency. The effect size of deficits in these domains was more marked in moderate-severe TBI. The available data support the use of complicated mTBI as a distinct classification in the prediction of cognitive outcome. The extent of cognitive deficit in complicated mTBI was small and unlikely to cause significant disability. However, patients with complicated mTBI constitute a broad category encompassing individuals who may differ markedly in the nature and extent of intracranial imaging abnormality, and further studies are warranted. Limitations of the available studies include small, selected samples; variations in TBI severity classification; absence of validity ("effort") testing; differing imaging methodology; and lack of long-term follow-up.
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Affiliation(s)
- David Hacker
- Clinical Neuropsychology Department, and University Hospitals Birmingham NHS Foundation Trust, Birmingham, United Kingdom
| | - Christopher A Jones
- School of Psychology, The University of Birmingham, Birmingham, United Kingdom
| | - Eyrsa Yasin
- Clinical Neuropsychology Department, and University Hospitals Birmingham NHS Foundation Trust, Birmingham, United Kingdom
| | - Sophie Preece
- Clinical Neuropsychology Department, and University Hospitals Birmingham NHS Foundation Trust, Birmingham, United Kingdom
| | - Holly Davies
- Clinical Neuropsychology Department, and University Hospitals Birmingham NHS Foundation Trust, Birmingham, United Kingdom
| | - Andrew Hawkins
- Clinical Neuropsychology Department, and University Hospitals Birmingham NHS Foundation Trust, Birmingham, United Kingdom
| | - Antonio Belli
- Department of Neurosurgery, University Hospitals Birmingham NHS Foundation Trust, Birmingham, United Kingdom
| | - Emily Paton
- Clinical Neuropsychology Department, and University Hospitals Birmingham NHS Foundation Trust, Birmingham, United Kingdom
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27
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Gomez J, Barnes LA, Yost JM, Gordon J, Ginsberg BA, Aleshin M. Hidradenitis suppurativa in sexual and gender minorities: A review and considerations for providers. J Am Acad Dermatol 2023; 89:795-801. [PMID: 35283243 DOI: 10.1016/j.jaad.2022.03.008] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2021] [Revised: 01/26/2022] [Accepted: 03/01/2022] [Indexed: 02/05/2023]
Abstract
The literature on hidradenitis suppurativa in sexual and gender minorities remains sparse. This review article aims to discuss critical factors for providers to consider in lesbian, gay, bisexual, transgender, queer, intersex, and asexual patients with hidradenitis suppurativa, including associated comorbidities, gender-affirming hormonal therapy, squamous cell carcinoma, infections in HIV-positive patients, and creating a welcoming clinic for sexual and gender minority patients.
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Affiliation(s)
- Jason Gomez
- Stanford School of Medicine, Stanford, California; Stanford Graduate School of Business, Stanford, California
| | - Leandra A Barnes
- Department of Dermatology, Stanford University School of Medicine, Stanford, California
| | - John Montgomery Yost
- Department of Dermatology, Stanford University School of Medicine, Stanford, California; Crossover Health, Menlo Park, California
| | - Justin Gordon
- Department of Dermatology, Stanford University School of Medicine, Stanford, California
| | | | - Maria Aleshin
- Department of Dermatology, Stanford University School of Medicine, Stanford, California.
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28
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Abboud S, Seal DW, Pachankis JE, Khoshnood K, Khouri D, Fouad FM, Heimer R. Experiences of stigma, mental health, and coping strategies in Lebanon among Lebanese and displaced Syrian men who have sex with men: A qualitative study. Soc Sci Med 2023; 335:116248. [PMID: 37742387 DOI: 10.1016/j.socscimed.2023.116248] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2022] [Revised: 09/11/2023] [Accepted: 09/12/2023] [Indexed: 09/26/2023]
Abstract
BACKGROUND In Lebanon, men who have sex with men (MSM) face high rates of stigma, discrimination, and violence. Minority stress, or the unique stressors related to anti-MSM stigma and discrimination, negatively impacts the mental health of MSM. These stressors are heightened for those with intersectional minority identities such as displaced Syrian MSM in Lebanon. METHODS In this qualitative study conducted in 2020-21, part of a larger study focused on the mental and sexual health risks among MSM, we collected qualitative data from Lebanese and displaced Syrian MSM living in Lebanon and analyzed reports of their experiences with stigma, mental health, and coping strategies. We conducted semi-structured, in-depth interviews with 12 displaced Syrian MSM and 13 Lebanese MSM. RESULTS Our findings highlight how MSM in Lebanon navigate stigma and the mental health risks that result. Common stressors among Lebanese and displaced Syrian MSM were related to finances, sexual orientation discrimination, and social isolation. Comparing the two groups, we found that stressors specific to displaced Syrian MSM were related to adverse childhood experiences, recent exposure to the Syrian war, displacement, and discrimination in Lebanon based on their intersectional identities as MSM and Syrians. For Lebanese participants, the most common stigma coping strategies were avoidance, drinking alcohol, using drugs, or having sex. As for displaced Syrian MSM, the most common stigma coping strategy was seeking the freely available mental health services offered to them through non-governmental organizations. CONCLUSION Our findings suggest that increased targeted mental health and social support interventions, informed by the unique experiences of Lebanese and displaced Syrian MSM, are highly needed to improve the coping and mental health resources of all MSM in Lebanon.
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Affiliation(s)
- Sarah Abboud
- University of Illinois Chicago College of Nursing, 845 S. Damen Ave, Chicago, IL, 60612, USA
| | - David W Seal
- Tulane University School of Public Health & Tropical Medicine, 1440 Canal St, New Orleans, LA, 70112, USA.
| | - John E Pachankis
- Yale School of Public Health, Department of Epidemiology of Microbial Diseases, 60 College St, New Haven, CT, 06510, USA
| | - Kaveh Khoshnood
- Yale School of Public Health, Department of Epidemiology of Microbial Diseases, 60 College St, New Haven, CT, 06510, USA
| | - Danielle Khouri
- American University of Beirut, Faculty of Health Sciences, Bliss Street, Beirut, Lebanon
| | - Fouad M Fouad
- American University of Beirut, Faculty of Health Sciences, Bliss Street, Beirut, Lebanon
| | - Robert Heimer
- Yale School of Public Health, Department of Epidemiology of Microbial Diseases, 60 College St, New Haven, CT, 06510, USA
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29
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Kaufman EA, Meddaoui B, Seymour NE, Victor SE. The Roles of Minority Stress and Thwarted Belongingness in Suicidal Ideation among Cisgender and Transgender/Nonbinary LGBTQ+ Individuals. Arch Suicide Res 2023; 27:1296-1311. [PMID: 36214309 DOI: 10.1080/13811118.2022.2127385] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/02/2022]
Abstract
Rates of suicidal ideation (SI), attempts, and death by suicide are consistently elevated among persons from sexual and gender minority groups relative to the general population. Experiences of minority stress and thwarted belongingness may contribute to elevated risk, and be most pernicious among persons with multiple marginalized identities. AIM The present study sought to examine the relation between gender identity (cisgender vs. transgender and nonbinary individuals [TNB]) and recent SI among a convenience sample of lesbian, gay, bisexual, questioning, and queer adults. METHODS Participants (N = 807) completed an online survey with measures of minority stress, SI, and thwarted belongingness. RESULTS We tested a mediation model in which TNB identity was indirectly associated with SI via minority stress (β = 1.94, SE = 0.30, Bootstrap 95% CI = [1.39, 2.58]). We also investigated thwarted belongingness as a moderator between minority stress and SI, and found evidence of a two-way interaction (β = 0.01, SE = 0.001, p < .001). The conditional indirect effect of gender identity on SI through minority stress was higher for individuals with higher levels of thwarted belongingness (β = 0.07, SE = 0.02, Bootstrap 95% CI = [0.04, 0.11]). CONCLUSION Gender identity was indirectly associated with SI through minority stress and elevations in minority stress were associated with more frequent SI. The minority stress and SI association was strongest for participants reporting higher thwarted belongingness. Building and maintaining strong social support networks may be especially important for persons with intersecting gender and sexual minority identities who face minority stress. HIGHLIGHTSTNB gender identity was indirectly associated with SI via minority stressThwarted belongingness moderated the relation between minority stress and SIThe minority stress SI relation was strongest at higher thwarted belongingness.
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30
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Razai MS, Berry-Hart T, Tawakoli AR, Ahmad A, Hargreaves S. Silent suffering of Afghanistan's LGBT+ community. Lancet Glob Health 2023; 11:e1331-e1332. [PMID: 37591575 DOI: 10.1016/s2214-109x(23)00316-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2023] [Accepted: 06/30/2023] [Indexed: 08/19/2023]
Affiliation(s)
- Mohammad S Razai
- Population Health Research Institute, St George's University of London, London SW17 0RE, UK.
| | | | | | - Ayesha Ahmad
- Institute of Medical and Biomedical Education, St George's University of London, London, UK
| | - Sally Hargreaves
- Population Health Research Institute, St George's University of London, London SW17 0RE, UK; The Migrant Health Research Group, Institute for Infection and Immunity, St George's University of London, London, UK
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31
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Frances C, Garnsey C, DeMulder J. Neglected gaps in improving the health, wellbeing, and care for sexual and gender minority young people living in low- and lower-middle- income countries: a scoping review. BMC Public Health 2023; 23:1664. [PMID: 37648963 PMCID: PMC10466764 DOI: 10.1186/s12889-023-16443-8] [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: 08/02/2022] [Accepted: 08/02/2023] [Indexed: 09/01/2023] Open
Abstract
BACKGROUND There is a lack of reliable data on the size, characteristics, and experiences of sexual and gender minority (SGM) young people (ages 10-24) in low- and lower-middle- income countries (LMICs). This review examines the research conducted in the last thirteen years with and about SGM young people living in low-income settings and seeks to answer the question: What is known about the mental and physical health needs, safety, and wellbeing of SGM young people living in LMICs? METHODS We conducted a scoping review informed by the methodological frameworks put forth by Arksey and O'Malley and the Joanna Briggs Institute. We systematically searched two general social science databases and one topic-specific database for peer-reviewed papers, of any research design, that included SGM young people or explored attitudes toward SGM young people in LMICs. We included papers that reported on factors influencing the health and wellbeing of SGM populations, including physical and mental health, healthcare-seeking behaviors, substance use, experiences of discrimination and/or stigma, experiences of violence and abuse (emotional, physical, and/or sexual), economically motivated paid sex practices, housing or economic security, and attitudes of others toward SGM populations. RESULTS Of the 5,409 unique records identified, 79 papers drawing from data collected from 74 unique studies met the inclusion criteria. Only 50 of the 79 papers included SGM young people as participants, with just 13 focusing exclusively on SGM young people ages 10-24. The included papers were classified into three thematic groupings: attitudes toward SGM populations (n = 26), risks to health (n = 40), and experiences of stigma and discrimination (n = 13). CONCLUSION The findings indicate that the health and wellbeing of SGM young people in LMICs has been historically under-researched. While SGM young people have received more attention from researchers in recent years, the body of literature as a whole is disjointed and sparse, and often studies are about SGM young people, rather than with and for them. Our review highlights the need for more and better research, more accurate and disaggregated demographic data, and leadership and participation of SGM-led community-based organizations in the co-design of studies that focus on SGM young people.
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Affiliation(s)
| | - Camille Garnsey
- Department of Psychological Sciences, University of Connecticut, Storrs, CT, USA
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32
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Firk C, Großheinrich N, Scherbaum N, Deimel D. The impact of social connectedness on mental health in LGBTQ + identifying individuals during the COVID-19 pandemic in Germany. BMC Psychol 2023; 11:252. [PMID: 37644578 PMCID: PMC10466739 DOI: 10.1186/s40359-023-01265-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2023] [Accepted: 07/26/2023] [Indexed: 08/31/2023] Open
Abstract
BACKGROUND Recent studies report that LGBTQ + people have experienced high levels of mental health problems during COVID-19-related social distancing. Given the well-established association between social isolation and mental health, the main aim of the current study was to investigate differences in mental health and (perceived) social isolation and social support in LGBTQ + individuals compared to heterosexual, cisgender people and to explore whether the hypothesized higher mental health burden in LGBTQ + individuals is (partly) mediated by (perceived) social isolation or social support. METHODS N = 531 participants indicating belonging to the LGBTQ + community and N = 1826 not identifying as LGBTQ + participated in a cross-sectional online survey during the initial COVID-19-related lockdown in Germany. Standardized questionnaires were used to assess depression, anxiety, suicidality, loneliness and social support. Further, perceived social isolation and face-to-face communication during the lockdown were assessed. RESULTS LGBTQ + people had higher levels of depression, anxiety and suicidal thought, were lonelier and experienced less social support than non-LGBTQ + identifying individuals. Mediation analysis showed that the higher levels of mental health burden in LGBTQ + people were (partly) mediated by reduced social connectedness. Further face-to-face contact positively affected mental health by reducing feelings of loneliness. CONCLUSION Given the high impact of loneliness on mental health, governmental actions should be taken to promote social connectedness particularly among LGBTQ + identifying individuals to ensure that the COVID-19 pandemic does not exacerbate the health inequalities that already exist between LGBTQ+-identifying and heterosexual, cisgender people.
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Affiliation(s)
- Christine Firk
- Catholic University of Applied Sciences North Rhine-Westphalia, Robert-Schuman- Str. 25, 52066, Aachen, Germany.
- Institute of Health Research and Social Psychiatry, Catholic University of Applied Sciences North Rhine-Westphalia, Robert-Schuman-Str. 25, 52066, Aachen, Germany.
| | - Nicola Großheinrich
- Institute of Health Research and Social Psychiatry, Catholic University of Applied Sciences North Rhine-Westphalia, Robert-Schuman-Str. 25, 52066, Aachen, Germany
- Catholic University of Applied Sciences of North Rhine-Westphalia, Wörthstraße 10, 50668, Cologne, Germany
| | - Norbert Scherbaum
- Department of Psychiatry and Psychotherapy, Medical Faculty, LVR-University Hospital Essen, University of Duisburg-Essen, Essen, Germany
| | - Daniel Deimel
- Catholic University of Applied Sciences North Rhine-Westphalia, Robert-Schuman- Str. 25, 52066, Aachen, Germany
- Department of Psychiatry and Psychotherapy, Medical Faculty, LVR-University Hospital Essen, University of Duisburg-Essen, Essen, Germany
- German Institute for Addiction and Prevention Research, Catholic University of Applied Sciences North Rhine-Westphalia, Konrad-Adenauer-Ufer 79-81, 50668, Cologne, Germany
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Torregosa MB, Ynalvez MA, Benavides MDR, Chaudhuri N, Craddock C. Perceived stress among Hispanic young adults: Impact of the coping with work and family stress program. JOURNAL OF AMERICAN COLLEGE HEALTH : J OF ACH 2023; 71:1342-1347. [PMID: 34152940 DOI: 10.1080/07448481.2021.1926260] [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: 04/16/2020] [Revised: 04/26/2021] [Accepted: 05/02/2021] [Indexed: 06/13/2023]
Abstract
Objective: To examine the effect of an evidence-based curriculum on stress perceptions across time. Participants: Hispanic college students from a Hispanic-serving institution in a U.S. southern border city. Methods: A permuted block design with repeated measures was used. Participants were randomly assigned to treatment and control groups. The treatment group received the Coping with Work and Family Stress (CWFS) evidence-based curriculum while the control group did not receive any programming. Data were collected from both the groups at baseline, exit, and at 3-month follow-up. Results: Stress reduction was observed among program participants however an unintended negative consequence of the intervention was found among those who experience intimate partner violence. Conclusion: The CWFS evidence-based intervention may be appropriate to use in reducing general types of stress but perhaps not stress resulting from intimate partner violence.
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Affiliation(s)
- Marivic B Torregosa
- Collegeof Nursing and Health Sciences, Texas A&M International University, Laredo, Texas, USA
| | | | | | - Nandita Chaudhuri
- Public Policy Research Institute, Texas A and M University College Station, College Station, Texas, USA
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Wang XX, Cosquer M, Zhuang M, Ali A, Falissard B, Corruble E, Gressier F, Jousselme C. The role of parents' and friends' support in preventing suicide attempts among French sexual minority adolescents. Rev Epidemiol Sante Publique 2023; 71:101594. [PMID: 36966599 DOI: 10.1016/j.respe.2023.101594] [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: 04/20/2022] [Revised: 12/27/2022] [Accepted: 02/14/2023] [Indexed: 05/16/2023] Open
Abstract
OBJECTIVES French sexual minority adolescents are at higher risk for suicide attempts than their heterosexual peers. However, little is known about the role of parents' and friends' support among French lesbian, gay and bisexual (LGB) youth. This study aimed to research the role of their support in preventing suicide attempts among LGB adolescents in France. MATERIALS AND METHODS Data were drawn from a French cross-sectional study entitled "Portraits d'adolescents". Parental support was defined by satisfactory relations between participants and their parents. Friends' support was defined by satisfactory relations between participants and their friends. Chi-square and multiple logistic regression analyses were used to estimate and identify associated factors of suicide attempts in LGB as opposed to heterosexual youth. RESULTS Data from a sample of 14,265 French adolescents aged 13 to 20 were analyzed. Among them, 637 (4.47%) identified as LGB. Attempted suicide was independently associated with sexual orientation (30.7% vs 10.6%; OR = 2.59 [2.11-3.18]; p < 0.0001). Both parents' and friends' support appeared to be protective factors in suicide attempts among heterosexuals (adjusted ORs = 0.40 [0.35-0.46] and 0.61 [0.51-0.75], respectively), whereas in the LGB group, only parental support was significant (adjusted OR = 0.42 [0.27-0.65]), independently of other variables. DISCUSSION Prevention efforts might be carried out by identifying within-group differences among French adolescents with different sexual orientations. The supportive role of family members should be strengthened. Positive resources and salutary support systems may effectively prevent suicide attempts. CONCLUSIONS French LGB adolescents have a higher risk for suicide attempts than their heterosexual peers. Parental support was reconfirmed as a major protective factor against suicide attempts in sexual minority adolescents.
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Affiliation(s)
- Xavier Xu Wang
- CESP, U1018, Moods Team, Paris-Saclay University, Bicêtre University Hospital, Le Kremlin Bicêtre, France; Centre Hospitalier Fondation Vallée, Gentilly, France.
| | - Mireille Cosquer
- CESP, U1018, Moods Team, Paris-Saclay University, Bicêtre University Hospital, Le Kremlin Bicêtre, France; Centre Hospitalier Fondation Vallée, Gentilly, France
| | - Min Zhuang
- Saint Louis University, 1 N. Grand Blvd. St. Louis, MO 63103, USA
| | - Aminata Ali
- CESP, U1018, Moods Team, Paris-Saclay University, Bicêtre University Hospital, Le Kremlin Bicêtre, France; Fondation Santé des Etudiants de France (FSEF), 75014, Paris, France
| | - Bruno Falissard
- CESP, U1018, Moods Team, Paris-Saclay University, Bicêtre University Hospital, Le Kremlin Bicêtre, France
| | - Emmanuelle Corruble
- CESP, U1018, Moods Team, Paris-Saclay University, Bicêtre University Hospital, Le Kremlin Bicêtre, France; Department of Psychiatry, Bicêtre University Hospital, Assistance Publique-Hôpitaux de Paris, Hôpitaux Universitaires Paris Saclay, Le Kremlin-Bicêtre, France
| | - Florence Gressier
- CESP, U1018, Moods Team, Paris-Saclay University, Bicêtre University Hospital, Le Kremlin Bicêtre, France; Department of Psychiatry, Bicêtre University Hospital, Assistance Publique-Hôpitaux de Paris, Hôpitaux Universitaires Paris Saclay, Le Kremlin-Bicêtre, France
| | - Catherine Jousselme
- CESP, U1018, Moods Team, Paris-Saclay University, Bicêtre University Hospital, Le Kremlin Bicêtre, France; Centre Hospitalier Fondation Vallée, Gentilly, France
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Díaz-Faes DA, Pereda N, Gámez-Guadix M. The role of adverse childhood experiences in suicide among sexual minority undergraduate students. DEATH STUDIES 2023; 48:219-227. [PMID: 37203223 DOI: 10.1080/07481187.2023.2214892] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/20/2023]
Abstract
This study explores the rates and odds of adverse childhood experiences (ACEs) and their relationship to suicide attempts in a sample of undergraduate students (n = 924, 71.6% women), comparing lesbian, gay and bisexual (LGB) youth to their heterosexual counterparts. Using propensity score matching, we matched 231 sexual minority and 603 heterosexual participants at a ratio of 1:3, based on gender, age, socioeconomic status, and religious beliefs. Sexual minority participants reported a significantly higher ACE score (M = 2.70 vs. 1.85; t = 4.93; p <.001; d = .391) and higher rates of all but one type of ACEs than their heterosexual counterparts. They also reported a higher prevalence and risk of suicide attempts (33.3% vs. 11.8% respectively, odds ratio = 3.73; p < .001). In logistic regression analysis, sexual minority status, emotional abuse and neglect, bias attack, having a household member with mental health problems, bullying and cyberbullying were significantly associated with suicide attempts.
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Affiliation(s)
- Diego A Díaz-Faes
- Department of Clinical Psychology and Psychobiology, Faculty of Psychology, Universitat de Barcelona, Barcelona, Spain
- Institute of Neurosciences (UBNeuro), Universitat de Barcelona, Barcelona, Spain
| | - Noemí Pereda
- Department of Clinical Psychology and Psychobiology, Faculty of Psychology, Universitat de Barcelona, Barcelona, Spain
- Institute of Neurosciences (UBNeuro), Universitat de Barcelona, Barcelona, Spain
| | - Manuel Gámez-Guadix
- Department of Biological and Health Psychology, Universidad Autónoma de Madrid, Madrid, Spain
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Alam I, Khayri E, Podger TAB, Aspinall C, Fuhrmann D, Lau JYF. A call for better research and resources for understanding and combatting youth loneliness: integrating the perspectives of young people and researchers. Eur Child Adolesc Psychiatry 2023; 32:371-374. [PMID: 36652017 PMCID: PMC9846658 DOI: 10.1007/s00787-022-02127-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Affiliation(s)
- Iqra Alam
- Psychology Department, King's College London, London, England
| | - Ezekiel Khayri
- Psychology Department, King's College London, London, England
| | | | - Caitlin Aspinall
- Youth Resilience Unit, Queen Mary University of London, London, England
| | - Delia Fuhrmann
- Psychology Department, King's College London, London, England
| | - Jennifer Y F Lau
- Youth Resilience Unit, Queen Mary University of London, London, England.
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Waller G, Newbury-Birch D, Simpson D, Armstrong E, James B, Chapman L, Ahmed F, Ferguson J. The barriers and facilitators to the reporting and recording of self-harm in young people aged 18 and under: a systematic review. BMC Public Health 2023; 23:158. [PMID: 36694149 PMCID: PMC9871435 DOI: 10.1186/s12889-023-15046-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2022] [Accepted: 01/13/2023] [Indexed: 01/25/2023] Open
Abstract
BACKGROUND AND AIMS This systematic review sought to identify, explain and interpret the prominent or recurring themes relating to the barriers and facilitators of reporting and recording of self-harm in young people across different settings, such as the healthcare setting, schools and the criminal justice setting. METHODS A search strategy was developed to ensure all relevant literature around the reporting and recording of self-harm in young people was obtained. Literature searches were conducted in six databases and a grey literature search of policy documents and relevant material was also conducted. Due to the range of available literature, both quantitative and qualitative methodologies were considered for inclusion. RESULTS Following the completion of the literature searches and sifting, nineteen papers were eligible for inclusion. Facilitators to reporting self-harm across the different settings were found to be recognising self-harm behaviours, using passive screening, training and experience, positive communication, and safe, private information sharing. Barriers to reporting self-harm included confidentiality concerns, negative perceptions of young people, communication difficulties, stigma, staff lacking knowledge around self-harm, and a lack of time, money and resources. Facilitators to recording self-harm across the different settings included being open to discussing what is recorded, services working together and co-ordinated help. Barriers to recording self-harm were mainly around stigma, the information being recorded and the ability of staff being able to do so, and their length of professional experience. CONCLUSION Following the review of the current evidence, it was apparent that there was still progress to be made to improve the reporting and recording of self-harm in young people, across the different settings. Future work should concentrate on better understanding the facilitators, whilst aiming to ameliorate the barriers.
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Affiliation(s)
- Gillian Waller
- NHS Business Services Authority, Stella House, Newburn, Newcastle, NE15 8NY, UK.
| | - Dorothy Newbury-Birch
- grid.26597.3f0000 0001 2325 1783School of Social Sciences, Humanities and Law, Teesside University, Middlesbrough, TS1 3BA UK
| | - Diane Simpson
- grid.7110.70000000105559901Faculty of Education and Society, University of Sunderland, Sunderland, SR6 0DD UK
| | - Emma Armstrong
- grid.26597.3f0000 0001 2325 1783School of Social Sciences, Humanities and Law, Teesside University, Middlesbrough, TS1 3BA UK
| | - Becky James
- Department of Health and Social Care, Office for Health Improvement & Disparities, Newburn, Newcastle, NE15 8NY UK
| | - Lucy Chapman
- grid.433912.e0000 0001 0150 9675Durham County Council, County Hall, Durham, DH1 5UJ UK
| | - Farhin Ahmed
- grid.26597.3f0000 0001 2325 1783School of Social Sciences, Humanities and Law, Teesside University, Middlesbrough, TS1 3BA UK
| | - Jennifer Ferguson
- grid.26597.3f0000 0001 2325 1783School of Social Sciences, Humanities and Law, Teesside University, Middlesbrough, TS1 3BA UK
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Bravo-Sanzana M, Miranda R, Oriol X. Adolescent Victimization during COVID-19 Lockdowns and Its Influence on Mental Health Problems in Seven Countries: The Mediation Effect of Resilience. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:1958. [PMID: 36767323 PMCID: PMC9915164 DOI: 10.3390/ijerph20031958] [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: 11/21/2022] [Revised: 01/11/2023] [Accepted: 01/17/2023] [Indexed: 06/18/2023]
Abstract
The objective of this study was to test the differences between the mean scores of victimization, an indicator of depression, stress, and anxiety (DASS), across seven countries (Australia, Chile, India, Indonesia, Mexico, Poland, and the Russian Federation) during the COVID-19 lockdowns. In addition, this study sought to analyze the mediator role of resilience in these relationships in the different countries. To this end, a structural equation model (SEM) was tested and differences across countries were considered through a multigroup analysis. Data for adolescent students from seven countries (n = 7241) collected by the Global Research Alliance showed that levels of anxiety, depression, and stress among adolescents were different in the countries assessed; all of them presented values above the mean of the indicator, with Chile and Russia having the highest values. Regarding the prevalence of exposure to violence, the mean across all countries studied was 34%, with the highest prevalence in Russia and India. At the global level, an adequate adjustment was observed in the SEM mediation model considering all countries. However, a mediator effect of resilience was only observed in the relationship between victimization and the indicator of DASS in Chile, Indonesia, and Russia. The results are discussed, analyzing the relevance of resilience as a protective factor for mental health during COVID-19 lockdowns.
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Affiliation(s)
- Mónica Bravo-Sanzana
- Núcleo Científico-Tecnológico en Ciencias Sociales y Humanidades, Universidad de La Frontera, Temuco 4811230, Chile
| | - Rafael Miranda
- Department of Psychology, Universidad Continental, Huancayo 12000, Peru
| | - Xavier Oriol
- Department of Psychology, Universidad de Girona, 17004 Girona, Spain
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Wilson E, Crudgington H, Morgan C, Hirsch C, Prina M, Gayer-Anderson C. The longitudinal course of childhood bullying victimization and associations with self-injurious thoughts and behaviors in children and young people: A systematic review of the literature. J Adolesc 2023; 95:5-33. [PMID: 36210652 PMCID: PMC10092090 DOI: 10.1002/jad.12097] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2022] [Revised: 09/09/2022] [Accepted: 09/14/2022] [Indexed: 11/07/2022]
Abstract
INTRODUCTION Bullying victimization has consistently been highlighted as a risk factor for self-injurious thoughts and behaviors (SITBs) in young people. This systematic review of prospective, community-based studies explored associations between bullying victimization (traditional/face-to-face and cyber) across the full spectrum of self-harm and suicidality, in children and young people aged up to (and including) 25 years. Importantly, associations by sex/gender were explored. METHODS MEDLINE, Embase, PsycINFO, CINAHL and Scopus were searched for articles meeting the inclusion criteria. Articles were screened by title, abstract and full text. Quality appraisal was performed using the Newcastle-Ottawa Scale for cohort studies. Data were synthesized narratively. The protocol is registered on PROSPERO (CRD42021261916) and followed PRISMA 2020 guidelines. RESULTS A total of 35 papers were included, across 17 countries. Results were presented by bullying type: traditional/face-to-face (n = 25), cyber (n = 7) and/or an aggregate of both types (n = 7). Outcomes included suicidal ideation (n = 17), self-harm (n = 10), suicide attempt (n = 4), NSSI (n = 4), other (n = 7). Studies measured outcomes in under 18s (n = 24), 18-25-year-olds (n = 8) and both under 18s and 18-25-year-olds (n = 3). Studies exploring the role of sex/gender (20%) found some interesting nuances. CONCLUSIONS Some weak to strong associations between bullying and SITBs were found yet conclusions are tentative due to study heterogeneity (e.g., methods used, conceptualizations and operationalisations of exposures/outcomes). Future research should address methodological issues raised in this review, and further explore gender differences in bullying, including by bullying sub-types (e.g., overt or relational) and victim status (e.g., victim or bully-victim).
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Affiliation(s)
- Emma Wilson
- Department of Health Service & Population Research, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
- ESRC Centre for Society and Mental Health, King's College London, London, UK
| | - Holly Crudgington
- Department of Health Service & Population Research, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
- ESRC Centre for Society and Mental Health, King's College London, London, UK
| | - Craig Morgan
- Department of Health Service & Population Research, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
- ESRC Centre for Society and Mental Health, King's College London, London, UK
| | - Colette Hirsch
- Department of Psychology, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
- South London and Maudsley NHS Foundation Trust, Bethlem Royal Hospital, Kent, UK
| | - Matthew Prina
- Department of Health Service & Population Research, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
| | - Charlotte Gayer-Anderson
- Department of Health Service & Population Research, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
- ESRC Centre for Society and Mental Health, King's College London, London, UK
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Wang XX, Gan Q, Zhou J, Cosquer M, Falissard B, Corruble E, Jousselme C, Gressier F. A systematic review of the factors associated with suicide attempts among sexual-minority youth. THE EUROPEAN JOURNAL OF PSYCHIATRY 2023. [DOI: 10.1016/j.ejpsy.2022.09.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
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de Lange J, Baams L, Bos H, Bosker R, Dumon E, Portzky G, Robinson J, van Bergen D. Moderating role of coping in the association between minority stress and suicidal ideation and suicide attempts among sexual and gender minority young adults. Suicide Life Threat Behav 2022; 52:1178-1192. [PMID: 36056550 PMCID: PMC10946947 DOI: 10.1111/sltb.12913] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/10/2021] [Revised: 04/11/2022] [Accepted: 08/09/2022] [Indexed: 12/14/2022]
Abstract
OBJECTIVE This study examined associations of minority stressors (i.e., victimization, internalized homonegativity, and stigma consciousness), and coping styles (i.e., active, avoidant, and passive) with suicidal ideation and suicide attempts (suicidality) among sexual and gender minority (SGM) young adults, and whether coping style moderated these associations. METHODS Logistic regression analyses examined these associations among 1432 SGM young adults (ages 18-29). RESULTS Minority stressors and passive coping were associated with a higher likelihood of suicidality. Avoidant coping was associated with a lower likelihood of lifetime suicidal ideation and attempts among sexual minority participants, and active coping with a lower likelihood of past-year suicidal ideation among sexual minority participants. Moderation analyses among sexual minority participants showed that when avoidant coping was high, associations between low victimization (compared with no victimization) and lifetime suicide attempts, and stigma consciousness and lifetime suicide attempts became non-significant, and the association between internalized homonegativity and lifetime suicide attempts became significant. Among gender minority participants, when passive coping was high the association between low victimization and lifetime suicidal ideation became significant. CONCLUSION This study underlines the importance of minority stress and coping for suicidality among SGM young adults and the need for more research regarding the role of coping.
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Affiliation(s)
- Jennifer de Lange
- Department of Pedagogy and Educational SciencesUniversity of GroningenGroningenThe Netherlands
| | - Laura Baams
- Department of Pedagogy and Educational SciencesUniversity of GroningenGroningenThe Netherlands
| | - Henny Bos
- Department of Child Development and EducationUniversity of AmsterdamAmsterdamThe Netherlands
| | - Roel Bosker
- Department of Pedagogy and Educational SciencesUniversity of GroningenGroningenThe Netherlands
| | - Eva Dumon
- Department of Head and Skin, Flemish Centre of Expertise in Suicide PreventionGhent UniversityGhentBelgium
| | - Gwendolyn Portzky
- Department of Head and Skin, Flemish Centre of Expertise in Suicide PreventionGhent UniversityGhentBelgium
| | - Jo Robinson
- OrygenParkvilleVictoriaAustralia
- Centre for Youth Mental HealthUniversity of MelbourneParkvilleVictoriaAustralia
| | - Diana van Bergen
- Department of Pedagogy and Educational SciencesUniversity of GroningenGroningenThe Netherlands
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Abboud S, Veldhuis C, Ballout S, Nadeem F, Nyhan K, Hughes T. Sexual and gender minority health in the Middle East and North Africa Region: A scoping review. INTERNATIONAL JOURNAL OF NURSING STUDIES ADVANCES 2022; 4:100085. [PMID: 38745607 PMCID: PMC11080540 DOI: 10.1016/j.ijnsa.2022.100085] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2022] [Revised: 06/18/2022] [Accepted: 06/25/2022] [Indexed: 01/05/2023] Open
Abstract
Background Researchers in studies from multiple countries suggest that sexual and gender minority people experience high rates of violence, stigma, and discrimination, as well as mistrust of health care providers and systems. Despite growing evidence related to sexual and gender minority health in North America and Europe, we know little about the health of this population in the Middle East and North Africa. Objectives We aimed to comprehensively examine the literature related to the health of sexual and gender minority people in the Middle East and North Africa and to identify research gaps and priorities. Design We conducted a scoping review informed by the framework recommended by Arksey and O'Malley and the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR) tool. Data sources We searched the following databases: PubMed (using Medline All on the Ovid platform), PsycINFO (Ovid), CINAHL (Ebsco), and Embase (Ovid). The search strategy combined terms for the geographic region of interest (Middle East and North Africa) and the population of interest (sexual and gender minority). Each was operationalized using multiple search terms and, where available, controlled vocabulary terms. Review Methods Research articles were identified and assessed for inclusion using an explicit strategy. Relevant information was extracted and synthesized to present a descriptive summary of existing evidence. Results Research designs of the 98 articles we reviewed included quantitative (n = 73), qualitative (n = 20), and mixed methods (n = 5). Most studies were conducted in Lebanon (n = 33), Pakistan (n = 32), and Iran (n = 23) and focused mainly on gender minority individuals (n = 46) and men who have sex with men (n = 32). Five themes emerged from the review: sexual health (52; 53%); mental health (20; 20%); gender identity (17; 17%); violence and discrimination (7; 7%); and experiences with the healthcare system (2; 2%). Although researchers focused on multiple health outcomes in some studies, we included them under the theme most closely aligned with the main objective of the study. Conclusion Although our study is limited to few countries in the Middle East and North Africa region, we found that sexual and gender minority individuals face multiple adverse sexual and mental health outcomes and experience high rates of stigma, discrimination, and violence. More research is needed from countries outside of Lebanon, Pakistan, and Iran, including community-based participatory approaches and multi-level intervention development. Nurses and other healthcare providers in the region need training in providing inclusive care for this population.
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Affiliation(s)
- Sarah Abboud
- University of Illinois Chicago, College of Nursing, Chicago, IL, United States of America
| | - Cindy Veldhuis
- Columbia University, School of Nursing, New York, New York, United States of America
| | - Suha Ballout
- University of Massachusetts Boston, College of Nursing and Health Sciences, Boston, Massachusetts, United States of America
| | | | - Kate Nyhan
- Yale University Cushing/Whitney Medical Library, New Haven, Connecticut, United States of America
| | - Tonda Hughes
- Columbia University, School of Nursing, New York, New York, United States of America
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Kundu A, Fu R, Grace D, Logie CH, Abramovich A, Baskerville B, Yager C, Schwartz R, Mitsakakis N, Planinac L, Chaiton M. Correlates of wanting to seek help for mental health and substance use concerns by sexual and gender minority young adults during the COVID-19 pandemic: A machine learning analysis. PLoS One 2022; 17:e0277438. [PMID: 36383536 PMCID: PMC9668172 DOI: 10.1371/journal.pone.0277438] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2022] [Accepted: 10/26/2022] [Indexed: 11/17/2022] Open
Abstract
The COVID-19 pandemic has worsened the mental health and substance use challenges among many people who are Two Spirit, lesbian, gay, bisexual, transgender, queer, questioning, and intersex (2SLGBTQI+). We aimed to identify the important correlates and their effects on the predicted likelihood of wanting to seek help among 2SLGBTQI+ young adults for mental health or substance use concerns during the pandemic. A cross-sectional survey was conducted in 2020-2021 among 2SLGBTQI+ young adults aged 16-29 living in two Canadian provinces (Ontario and Quebec). Among 1414 participants, 77% (n = 1089) wanted to seek help for their mental health or substance use concerns during the pandemic, out of these, 69.8% (n = 760) reported delay in accessing care. We built a random forest (RF) model to predict the status of wanting to seek help, which achieved moderately high performance with an area under the receiver operating characteristic curve (AUC) of 0.85. The top 10 correlates of wanting to seek help were worsening mental health, age, stigma and discrimination, and adverse childhood experiences. The interactions of adequate housing with certain sexual orientations, gender identities and mental health challenges were found to increase the likelihood of wanting to seek help. We built another RF model for predicting risk of delay in accessing care among participants who wanted to seek help (n = 1089). The model identified a similar set of top 10 correlates of delay in accessing care but lacked adequate performance (AUC 0.61). These findings can direct future research and targeted prevention measures to reduce health disparities for 2SLGBTQI+ young adults.
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Affiliation(s)
- Anasua Kundu
- Institute of Medical Science, University of Toronto, Toronto, Canada
- Centre for Addiction and Mental Health, Toronto, Canada
- Ontario Tobacco Research Unit, University of Toronto, Toronto, Canada
| | - Rui Fu
- Department of Otolaryngology—Head and Neck Surgery, Sunnybrook Research Institute, University of Toronto, Toronto, Canada
- Dalla Lana School of Public Health, University of Toronto, Toronto, Canada
| | - Daniel Grace
- Dalla Lana School of Public Health, University of Toronto, Toronto, Canada
| | - Carmen H. Logie
- Factor-Inwentash Faculty of Social Work, University of Toronto, Toronto, Canada
- United Nations University Institute for Water, Environment & Health, Hamilton, Canada
| | - Alex Abramovich
- Centre for Addiction and Mental Health, Toronto, Canada
- Dalla Lana School of Public Health, University of Toronto, Toronto, Canada
- Department of Psychiatry, University of Toronto, Toronto, Canada
| | - Bruce Baskerville
- Canadian Institutes of Health Research, Ottawa, Canada
- School of Pharmacy, Faculty of Science, University of Waterloo, Kitchener, Canada
| | | | - Robert Schwartz
- Centre for Addiction and Mental Health, Toronto, Canada
- Ontario Tobacco Research Unit, University of Toronto, Toronto, Canada
- Dalla Lana School of Public Health, University of Toronto, Toronto, Canada
| | - Nicholas Mitsakakis
- Dalla Lana School of Public Health, University of Toronto, Toronto, Canada
- Children’s Hospital of Eastern Ontario Research Institute, Ottawa, Canada
| | - Lynn Planinac
- Ontario Tobacco Research Unit, University of Toronto, Toronto, Canada
| | - Michael Chaiton
- Institute of Medical Science, University of Toronto, Toronto, Canada
- Centre for Addiction and Mental Health, Toronto, Canada
- Ontario Tobacco Research Unit, University of Toronto, Toronto, Canada
- Dalla Lana School of Public Health, University of Toronto, Toronto, Canada
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Fowler JA, Buckley L. A socioecological review of LGBTQI+ adolescent bias-based bullying: What characterizes a bystander, and where do we go from here? JOURNAL OF GAY & LESBIAN MENTAL HEALTH 2022. [DOI: 10.1080/19359705.2022.2138669] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Affiliation(s)
- James A. Fowler
- School of Public Health, The University of Queensland, Herston Campus, Herston, Australia
| | - Lisa Buckley
- School of Public Health, The University of Queensland, Herston Campus, Herston, Australia
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Townsend E, Ness J, Waters K, Rehman M, Kapur N, Clements C, Geulayov G, Bale E, Casey D, Hawton K. Life problems in children and adolescents who self-harm: findings from the multicentre study of self-harm in England. Child Adolesc Ment Health 2022; 27:352-360. [PMID: 35042280 PMCID: PMC9786245 DOI: 10.1111/camh.12544] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 12/09/2021] [Indexed: 12/30/2022]
Abstract
BACKGROUND Self-harm, a significant and increasing global problem in children and adolescents, is often repeated and is associated with risk of future suicide. To identify potential interventions, we need to understand the life problems faced by children and adolescents, and by sub-groups of younger people who self-harm. Our aims were to include the following: (a) investigate the type and frequency of life problems in a large sample of children and adolescents who self-harmed. (b) Examine whether problems differ between those who repeat self-harm and those who do not. METHODS We analysed data for 2000 to 2013 (follow up until 2014) from the Multicentre Study of Self-harm in England on individuals aged 11 to 18 years who presented to one of the five study hospitals following self-harm and received a psychosocial assessment including questions about problems, which precipitated self-harm. RESULTS In 5648 patients (12,261 self-harm episodes), (75.5% female, mean age 16.1 years) the most frequently reported problems at first episode of self-harm were family problems. Problems around study/employment/study and relationships with friends also featured prominently. The types of problems that precede self-harm differed between late childhood/early adolescence. Abuse, mental health problems and legal problems significantly predicted repeat self-harm for females. CONCLUSION The most common problems reported by both genders were social/interpersonal in nature, indicating the need for relevant services embedded in the community (e.g. in schools/colleges). Self-harm assessment and treatment choices for children and adolescents must take age and gender into account. To prevent future self-harm, individualised supports and services are particularly needed for abuse, mental health and legal problems.
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Affiliation(s)
- Ellen Townsend
- Self-Harm Research Group, School of Psychology, University of Nottingham, Nottingham, UK
| | - Jennifer Ness
- Centre for Self-harm and Suicide Prevention Research, Research and Development Centre, Derbyshire Healthcare NHS Foundation Trust, Kingsway Hospital, Derby, UK
| | - Keith Waters
- Centre for Self-harm and Suicide Prevention Research, Research and Development Centre, Derbyshire Healthcare NHS Foundation Trust, Kingsway Hospital, Derby, UK
| | - Muzamal Rehman
- Centre for Self-harm and Suicide Prevention Research, Research and Development Centre, Derbyshire Healthcare NHS Foundation Trust, Kingsway Hospital, Derby, UK
| | - Navneet Kapur
- Centre for Mental Health and Safety, Manchester Academic Health Sciences Centre, University of Manchester, Manchester, UK
| | - Caroline Clements
- Centre for Mental Health and Safety, Manchester Academic Health Sciences Centre, University of Manchester, Manchester, UK
| | - Galit Geulayov
- Centre for Suicide Research, University Department of Psychiatry, University of Oxford and Oxford Health NHS Foundation Trust, Warneford Hospital, Oxford, UK
| | - Elizabeth Bale
- Centre for Suicide Research, University Department of Psychiatry, University of Oxford and Oxford Health NHS Foundation Trust, Warneford Hospital, Oxford, UK
| | - Deborah Casey
- Centre for Suicide Research, University Department of Psychiatry, University of Oxford and Oxford Health NHS Foundation Trust, Warneford Hospital, Oxford, UK
| | - Keith Hawton
- Centre for Suicide Research, University Department of Psychiatry, University of Oxford and Oxford Health NHS Foundation Trust, Warneford Hospital, Oxford, UK
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Morales-Arjona I, Pastor-Moreno G, Ruiz-Pérez I, Sordo L, Henares-Montiel J. Characterization of Cyberbullying Victimization and Perpetration Before and During the COVID-19 Pandemic in Spain. CYBERPSYCHOLOGY, BEHAVIOR AND SOCIAL NETWORKING 2022; 25:733-743. [PMID: 36125383 DOI: 10.1089/cyber.2022.0041] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
Cyberbullying is an extremely damaging form of interpersonal violence. Little is yet known about cyberbullying behaviors in the child and youth population during the COVID-19 pandemic and what effect this reduction in face-to-face social interactions has had on an increase in socialization via the Internet and cyberbullying. The present study is a cross-sectional descriptive study conducted in young people between the ages of 12 and 27 years attending two secondary schools in southern Spain (N = 733) to examine differences regarding sociodemographic characteristics, academic performance, and digital device use (independent variables) in the experiences of cybervictimization, cyberperpetration, and adverse psychological effects (dependent variables). Logistic regression models were constructed for each of the dependent variables including the independent variables mentioned above. More than 50 percent of the sample were victims of cyberbullying. Females and the LGBTIQ+ Community were at greater risk of being cybervictims and suffer adverse psychological effects. A total of 22.8 percent of the students reported having been victims and 26.5 percent perpetrators of cyberbullying for the first time during the COVID-19 pandemic, but no other major differences were observed. These findings point out that cyberbullying must be prioritized in public policy as part of an overall strategy for combating violence in childhood and adolescence, as well as gender-based and discriminatory violence.
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Affiliation(s)
- Irene Morales-Arjona
- Escuela Andaluza de Salud Pública, Granada, Spain
- Servicio de Medicina Preventiva y Salud Pública, Hospital Virgen de la Victoria, Málaga, Spain
| | - Guadalupe Pastor-Moreno
- Escuela Andaluza de Salud Pública, Granada, Spain
- Consorcio de Investigación Biomédica en Red de Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
- Instituto de Investigación Biosanitaria de Granada (ibs.GRANADA), Granada, Spain
| | - Isabel Ruiz-Pérez
- Escuela Andaluza de Salud Pública, Granada, Spain
- Consorcio de Investigación Biomédica en Red de Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
- Instituto de Investigación Biosanitaria de Granada (ibs.GRANADA), Granada, Spain
| | - Luis Sordo
- Consorcio de Investigación Biomédica en Red de Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
- Departamente de Salud Pública y Materno Infantil, Facultad de Medicina de la Universidad Complutense de Madrid, Madrid, Spain
| | - Jesús Henares-Montiel
- Escuela Andaluza de Salud Pública, Granada, Spain
- Consorcio de Investigación Biomédica en Red de Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
- Instituto de Investigación Biosanitaria de Granada (ibs.GRANADA), Granada, Spain
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De Silva DA, Diduk-Smith RM. Comparison of Suicides Among Younger and Older Adolescents in Virginia, 2008-2017. Arch Suicide Res 2022; 26:1958-1965. [PMID: 34425060 DOI: 10.1080/13811118.2021.1965929] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
Objective: Suicide is the second leading cause of death in youth and is of public health importance. Characteristics and precipitating circumstances may differ by adolescent age groups. Understanding these differences may inform prevention efforts that are population-specific. Therefore, we sought to compare suicides between younger and older adolescents in Virginia from 2008 to 2017.Methods: We used data from the Virginia Violent Death Reporting System (VVDRS), part of the National Violent Death Reporting System (NVDRS). We included suicides of all adolescents aged 10-17 who were residents of Virginia from 2008 to 2017. Descriptive statistics and unadjusted logistic regression were used to compare characteristics and circumstances between younger (10-14) and older (15-17) adolescents.Results: Three hundred and 24 (324) adolescents died by suicide between 2008 and 2017 in Virginia, of which 20% were younger adolescents, and 80% were older adolescents. Suicides of younger adolescents increased significantly over the 10-year period. Younger adolescent suicides seemed to occur after a crisis, while suicides among older adolescents occurred due to intimate partner problems and substance use. Mental health issues were common in both.Conclusions: Suicides may be more impulsive among younger adolescents and warrants further attention, while strategies to cope with intimate partner problems and substance use may be important for older adolescents and should be considered when implementing services and interventions. HIGHLIGHTSImpulsivity may be an issue among younger adolescents.Strategies for relationship and substance use issues may benefit older adolescents.Targeted interventions may be necessary for younger and older adolescents.
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Zhou C, Fruitman K, Szwed S, Wickersham M, Spellun J, Zonana J. Weill Cornell Medicine Wellness Qlinic: Adapting the Student-Run Clinic Model to Expand Mental Health Services and Medical Education. Community Ment Health J 2022; 58:1244-1251. [PMID: 35084635 PMCID: PMC8792141 DOI: 10.1007/s10597-022-00943-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/29/2021] [Accepted: 01/10/2022] [Indexed: 11/30/2022]
Abstract
The Weill Cornell Medicine Wellness Qlinic (Wellness Qlinic) is a student-run mental health clinic serving the lesbian, gay, bisexual, transgender, and queer (LGBTQ +) community in New York City. Student-run clinics have successfully provided primary care to underserved communities experiencing barriers to accessing health care. Psychiatric evaluation and medication management have also been implemented in several student-run clinics, but providing sustainable psychotherapy services has been a challenge. In this paper, we present a student-run mental health program incorporating interdisciplinary trainees to provide robust short-term psychiatric treatment, including individual psychotherapy, medication management, and group therapy. Results of a chart-review study to evaluate patient engagement and treatment outcomes are presented. The Wellness Qlinic's treatment model resulted in 90% patient retention and positive clinical outcomes for patients while addressing an education and training gap in LGBTQ + mental health for multidisciplinary mental health care providers.
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Affiliation(s)
- Constance Zhou
- Weill-Cornell/Rockefeller/Sloan-Kettering Tri-Institutional MD-PhD Program, 1300 York Ave, Room C-103, New York, NY, 10065, USA.
| | - Kate Fruitman
- Weill Cornell Medicine, 1300 York Ave, Room C-118, New York, NY, 10065, USA
| | - Sarah Szwed
- Weill-Cornell/Rockefeller/Sloan-Kettering Tri-Institutional MD-PhD Program, 1300 York Ave, Room C-103, New York, NY, 10065, USA
| | - Matthew Wickersham
- Weill-Cornell/Rockefeller/Sloan-Kettering Tri-Institutional MD-PhD Program, 1300 York Ave, Room C-103, New York, NY, 10065, USA
| | - Jessica Spellun
- Weill Cornell Medicine, 525 East 68th Street, Box 140, New York, NY, 10065, USA
| | - Jess Zonana
- Weill Cornell Medicine, 525 East 68th Street, Box 140, New York, NY, 10065, USA
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O'Connor J, Jeanes R, Denison E, Lambert K, Bevan N. Examining Pride Cups as a health promotion resource to address homophobia in Australian men's sport. Health Promot Int 2022; 37:6722676. [PMID: 36166266 DOI: 10.1093/heapro/daac093] [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: 11/13/2022] Open
Abstract
Effective interventions are needed to stop homophobic behaviours in sport settings as these behaviours are associated with negative health and social outcomes for individuals who identify as Lesbian, Gay, Bisexual, Transgender, Queer or other diverse genders and sexualities. This paper reports the results of a quasi-experimental study commissioned by a public health agency to explore the benefits of a novel intervention that has been widely adopted by Australian community sport clubs. The 'Pride Cup' intervention includes education for club leaders, sport participants and the hosting of a rainbow-themed 'pride game'. Survey responses of male participants from six randomly selected sport clubs which had received the intervention (n = 148) were compared to responses (n = 137) from six randomly selected comparison clubs (Australian Football, cricket, field hockey, roller derby). Employing a post-test-only design, the study explored differences in homophobic attitudes, behaviours and individual efficacy to react negatively to homophobic behaviours. The study found significant differences (p < 0.001) in self-reported use of homophobic slurs (e.g. fag) in the last 2 weeks by participants in the treatment (11%) versus comparison (31.8%) clubs, and significant differences in the perceived use of these slurs by teammates (25.9% vs. 56.6%) or coaches (7.8% vs. 23.3%). There were also significant differences in efficacy scores, but no differences in homophobic attitudes. These results, combined with evidence of community-driven adoption, support the allocation of public health resources to conduct larger scale trials using pre/post designs to confirm these findings.
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Affiliation(s)
- Justen O'Connor
- Faculty of Education, Monash University, Clayton, Victoria 3800, Australia
| | - Ruth Jeanes
- Faculty of Education, Monash University, Clayton, Victoria 3800, Australia
| | - Erik Denison
- Faculty of Arts, Monash University, Clayton, Victoria 3800, Australia
| | - Karen Lambert
- Faculty of Education, Monash University, Clayton, Victoria 3800, Australia
| | - Nadia Bevan
- Faculty of Arts, Monash University, Clayton, Victoria 3800, Australia
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50
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Coleman E, Radix AE, Bouman WP, Brown GR, de Vries ALC, Deutsch MB, Ettner R, Fraser L, Goodman M, Green J, Hancock AB, Johnson TW, Karasic DH, Knudson GA, Leibowitz SF, Meyer-Bahlburg HFL, Monstrey SJ, Motmans J, Nahata L, Nieder TO, Reisner SL, Richards C, Schechter LS, Tangpricha V, Tishelman AC, Van Trotsenburg MAA, Winter S, Ducheny K, Adams NJ, Adrián TM, Allen LR, Azul D, Bagga H, Başar K, Bathory DS, Belinky JJ, Berg DR, Berli JU, Bluebond-Langner RO, Bouman MB, Bowers ML, Brassard PJ, Byrne J, Capitán L, Cargill CJ, Carswell JM, Chang SC, Chelvakumar G, Corneil T, Dalke KB, De Cuypere G, de Vries E, Den Heijer M, Devor AH, Dhejne C, D'Marco A, Edmiston EK, Edwards-Leeper L, Ehrbar R, Ehrensaft D, Eisfeld J, Elaut E, Erickson-Schroth L, Feldman JL, Fisher AD, Garcia MM, Gijs L, Green SE, Hall BP, Hardy TLD, Irwig MS, Jacobs LA, Janssen AC, Johnson K, Klink DT, Kreukels BPC, Kuper LE, Kvach EJ, Malouf MA, Massey R, Mazur T, McLachlan C, Morrison SD, Mosser SW, Neira PM, Nygren U, Oates JM, Obedin-Maliver J, Pagkalos G, Patton J, Phanuphak N, Rachlin K, Reed T, Rider GN, Ristori J, Robbins-Cherry S, Roberts SA, Rodriguez-Wallberg KA, Rosenthal SM, Sabir K, Safer JD, Scheim AI, Seal LJ, Sehoole TJ, Spencer K, St Amand C, Steensma TD, Strang JF, Taylor GB, Tilleman K, T'Sjoen GG, Vala LN, Van Mello NM, Veale JF, Vencill JA, Vincent B, Wesp LM, West MA, Arcelus J. Standards of Care for the Health of Transgender and Gender Diverse People, Version 8. INTERNATIONAL JOURNAL OF TRANSGENDER HEALTH 2022; 23:S1-S259. [PMID: 36238954 PMCID: PMC9553112 DOI: 10.1080/26895269.2022.2100644] [Citation(s) in RCA: 648] [Impact Index Per Article: 324.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/15/2023]
Abstract
Background: Transgender healthcare is a rapidly evolving interdisciplinary field. In the last decade, there has been an unprecedented increase in the number and visibility of transgender and gender diverse (TGD) people seeking support and gender-affirming medical treatment in parallel with a significant rise in the scientific literature in this area. The World Professional Association for Transgender Health (WPATH) is an international, multidisciplinary, professional association whose mission is to promote evidence-based care, education, research, public policy, and respect in transgender health. One of the main functions of WPATH is to promote the highest standards of health care for TGD people through the Standards of Care (SOC). The SOC was initially developed in 1979 and the last version (SOC-7) was published in 2012. In view of the increasing scientific evidence, WPATH commissioned a new version of the Standards of Care, the SOC-8. Aim: The overall goal of SOC-8 is to provide health care professionals (HCPs) with clinical guidance to assist TGD people in accessing safe and effective pathways to achieving lasting personal comfort with their gendered selves with the aim of optimizing their overall physical health, psychological well-being, and self-fulfillment. Methods: The SOC-8 is based on the best available science and expert professional consensus in transgender health. International professionals and stakeholders were selected to serve on the SOC-8 committee. Recommendation statements were developed based on data derived from independent systematic literature reviews, where available, background reviews and expert opinions. Grading of recommendations was based on the available evidence supporting interventions, a discussion of risks and harms, as well as the feasibility and acceptability within different contexts and country settings. Results: A total of 18 chapters were developed as part of the SOC-8. They contain recommendations for health care professionals who provide care and treatment for TGD people. Each of the recommendations is followed by explanatory text with relevant references. General areas related to transgender health are covered in the chapters Terminology, Global Applicability, Population Estimates, and Education. The chapters developed for the diverse population of TGD people include Assessment of Adults, Adolescents, Children, Nonbinary, Eunuchs, and Intersex Individuals, and people living in Institutional Environments. Finally, the chapters related to gender-affirming treatment are Hormone Therapy, Surgery and Postoperative Care, Voice and Communication, Primary Care, Reproductive Health, Sexual Health, and Mental Health. Conclusions: The SOC-8 guidelines are intended to be flexible to meet the diverse health care needs of TGD people globally. While adaptable, they offer standards for promoting optimal health care and guidance for the treatment of people experiencing gender incongruence. As in all previous versions of the SOC, the criteria set forth in this document for gender-affirming medical interventions are clinical guidelines; individual health care professionals and programs may modify these in consultation with the TGD person.
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Affiliation(s)
- E Coleman
- Institute for Sexual and Gender Health, Department of Family Medicine and Community Health, University of Minnesota Medical School, Minneapolis, MN, USA
| | - A E Radix
- Callen-Lorde Community Health Center, New York, NY, USA
- Department of Medicine, NYU Grossman School of Medicine, New York, NY, USA
| | - W P Bouman
- Nottingham Centre for Transgender Health, Nottingham, UK
- School of Medicine, University of Nottingham, Nottingham, UK
| | - G R Brown
- James H. Quillen College of Medicine, East Tennessee State University, Johnson City, TN, USA
- James H. Quillen VAMC, Johnson City, TN, USA
| | - A L C de Vries
- Department of Child and Adolescent Psychiatry, Amsterdam UMC Location Vrije Universiteit Amsterdam, Amsterdam, Netherlands
- Center of Expertise on Gender Dysphoria, Amsterdam UMC Location Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - M B Deutsch
- Department of Family & Community Medicine, University of California-San Francisco, San Francisco, CA, USA
- UCSF Gender Affirming Health Program, San Francisco, CA, USA
| | - R Ettner
- New Health Foundation Worldwide, Evanston, IL, USA
- Weiss Memorial Hospital, Chicago, IL, USA
| | - L Fraser
- Independent Practice, San Francisco, CA, USA
| | - M Goodman
- Emory University Rollins School of Public Health, Atlanta, GA, USA
| | - J Green
- Independent Scholar, Vancouver, WA, USA
| | - A B Hancock
- The George Washington University, Washington, DC, USA
| | - T W Johnson
- Department of Anthropology, California State University, Chico, CA, USA
| | - D H Karasic
- University of California San Francisco, San Francisco, CA, USA
- Independent Practice at dankarasic.com
| | - G A Knudson
- University of British Columbia, Vancouver, Canada
- Vancouver Coastal Health, Vancouver, Canada
| | - S F Leibowitz
- Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, IL, USA
| | - H F L Meyer-Bahlburg
- New York State Psychiatric Institute, New York, NY, USA
- Department of Psychiatry, Columbia University, New York, NY, USA
| | | | - J Motmans
- Transgender Infopunt, Ghent University Hospital, Gent, Belgium
- Centre for Research on Culture and Gender, Ghent University, Gent, Belgium
| | - L Nahata
- Department of Pediatrics, The Ohio State University College of Medicine, Columbus, OH, USA
- Endocrinology and Center for Biobehavioral Health, The Abigail Wexner Research Institute at Nationwide Children's Hospital, Columbus, OH, USA
| | - T O Nieder
- University Medical Center Hamburg-Eppendorf, Interdisciplinary Transgender Health Care Center Hamburg, Institute for Sex Research, Sexual Medicine and Forensic Psychiatry, Hamburg, Germany
| | - S L Reisner
- Harvard Medical School, Boston, MA, USA
- Harvard T. H. Chan School of Public Health, Boston, MA, USA
| | - C Richards
- Regents University London, UK
- Tavistock and Portman NHS Foundation Trust, London, UK
| | | | - V Tangpricha
- Division of Endocrinology, Metabolism & Lipids, Department of Medicine, Emory University School of Medicine, Atlanta, GA, USA
- Atlanta VA Medical Center, Decatur, GA, USA
| | - A C Tishelman
- Boston College, Department of Psychology and Neuroscience, Chestnut Hill, MA, USA
| | - M A A Van Trotsenburg
- Bureau GenderPRO, Vienna, Austria
- University Hospital Lilienfeld-St. Pölten, St. Pölten, Austria
| | - S Winter
- School of Population Health, Curtin University, Perth, WA, Australia
| | - K Ducheny
- Howard Brown Health, Chicago, IL, USA
| | - N J Adams
- University of Toronto, Ontario Institute for Studies in Education, Toronto, Canada
- Transgender Professional Association for Transgender Health (TPATH)
| | - T M Adrián
- Asamblea Nacional de Venezuela, Caracas, Venezuela
- Diverlex Diversidad e Igualdad a Través de la Ley, Caracas, Venezuela
| | - L R Allen
- University of Nevada, Las Vegas, NV, USA
| | - D Azul
- La Trobe Rural Health School, La Trobe University, Bendigo, Australia
| | - H Bagga
- Monash Health Gender Clinic, Melbourne, Victoria, Australia
- Monash University, Melbourne, Victoria, Australia
| | - K Başar
- Department of Psychiatry, Hacettepe University, Ankara, Turkey
| | - D S Bathory
- Independent Practice at Bathory International PLLC, Winston-Salem, NC, USA
| | - J J Belinky
- Durand Hospital, Guemes Clinic and Urological Center, Buenos Aires, Argentina
| | - D R Berg
- National Center for Gender Spectrum Health, Institute for Sexual and Gender Health, Department of Family Medicine and Community Health, University of Minnesota Medical School, Minneapolis, MN, USA
| | - J U Berli
- Oregon Health & Science University, Portland, OR, USA
| | - R O Bluebond-Langner
- NYU Langone Health, New York, NY, USA
- Hansjörg Wyss Department of Plastic Surgery, New York, NY, USA
| | - M-B Bouman
- Center of Expertise on Gender Dysphoria, Amsterdam UMC Location Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
- Department of Plastic Surgery, Amsterdam UMC Location Vrije Universiteit Amsterdam, , Amsterdam, Netherlands
| | - M L Bowers
- Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Mills-Peninsula Medical Center, Burlingame, CA, USA
| | - P J Brassard
- GrS Montreal, Complexe CMC, Montreal, Quebec, Canada
- Université de Montreal, Quebec, Canada
| | - J Byrne
- University of Waikato/Te Whare Wānanga o Waikato, Hamilton/Kirikiriroa, New Zealand/Aotearoa
| | - L Capitán
- The Facialteam Group, Marbella International Hospital, Marbella, Spain
| | | | - J M Carswell
- Harvard Medical School, Boston, MA, USA
- Boston's Children's Hospital, Boston, MA, USA
| | - S C Chang
- Independent Practice, Oakland, CA, USA
| | - G Chelvakumar
- Nationwide Children's Hospital, Columbus, OH, USA
- The Ohio State University, College of Medicine, Columbus, OH, USA
| | - T Corneil
- School of Population & Public Health, University of British Columbia, Vancouver, BC, Canada
| | - K B Dalke
- Penn State Health, PA, USA
- Penn State College of Medicine, Hershey, PA, USA
| | - G De Cuypere
- Center for Sexology and Gender, Ghent University Hospital, Gent, Belgium
| | - E de Vries
- Nelson Mandela University, Gqeberha, South Africa
- University of Cape Town, Cape Town, South Africa
| | - M Den Heijer
- Center of Expertise on Gender Dysphoria, Amsterdam UMC Location Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
- Department of Endocrinology, Amsterdam UMC Location Vrije Universiteit Amsterdam, , Amsterdam, Netherlands
| | - A H Devor
- University of Victoria, Victoria, BC, Canada
| | - C Dhejne
- ANOVA, Karolinska University Hospital, Stockholm, Sweden
- Department of Medicine Huddinge, Karolinska Institutet, Stockholm, Sweden
| | - A D'Marco
- UCTRANS-United Caribbean Trans Network, Nassau, The Bahamas
- D M A R C O Organization, Nassau, The Bahamas
| | - E K Edmiston
- University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
| | - L Edwards-Leeper
- Pacific University, Hillsboro, OR, USA
- Independent Practice, Beaverton, OR, USA
| | - R Ehrbar
- Whitman Walker Health, Washington, DC, USA
- Independent Practice, Maryland, USA
| | - D Ehrensaft
- University of California San Francisco, San Francisco, CA, USA
| | - J Eisfeld
- Transvisie, Utrecht, The Netherlands
| | - E Elaut
- Center for Sexology and Gender, Ghent University Hospital, Gent, Belgium
- Department of Clinical Experimental and Health Psychology, Ghent University, Gent, Belgium
| | - L Erickson-Schroth
- The Jed Foundation, New York, NY, USA
- Hetrick-Martin Institute, New York, NY, USA
| | - J L Feldman
- Institute for Sexual and Gender Health, Institute for Sexual and Gender Health, Department of Family Medicine and Community Health, University of Minnesota Medical School, Minneapolis, MN, USA
| | - A D Fisher
- Andrology, Women Endocrinology and Gender Incongruence, Careggi University Hospital, Florence, Italy
| | - M M Garcia
- Department of Urology, Cedars-Sinai Medical Center, Los Angeles, CA, USA
- Departments of Urology and Anatomy, University of California San Francisco, San Francisco, CA, USA
| | - L Gijs
- Institute of Family and Sexuality Studies, Department of Neurosciences, KU Leuven, Leuven, Belgium
| | | | - B P Hall
- Duke University Medical Center, Durham, NC, USA
- Duke Adult Gender Medicine Clinic, Durham, NC, USA
| | - T L D Hardy
- Alberta Health Services, Edmonton, Alberta, Canada
- MacEwan University, Edmonton, Alberta, Canada
| | - M S Irwig
- Harvard Medical School, Boston, MA, USA
- Beth Israel Deaconess Medical Center, Boston, MA, USA
| | | | - A C Janssen
- Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, IL, USA
- Northwestern Feinberg School of Medicine, Chicago, IL, USA
| | - K Johnson
- RMIT University, Melbourne, Australia
- University of Brighton, Brighton, UK
| | - D T Klink
- Department of Pediatrics, Division of Pediatric Endocrinology, Ghent University Hospital, Gent, Belgium
- Division of Pediatric Endocrinology and Diabetes, ZNA Queen Paola Children's Hospital, Antwerp, Belgium
| | - B P C Kreukels
- Center of Expertise on Gender Dysphoria, Amsterdam UMC Location Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
- Department of Medical Psychology, Amsterdam UMC Location Vrije Universiteit Amsterdam, , Amsterdam, Netherlands
| | - L E Kuper
- Department of Psychiatry, Southwestern Medical Center, University of Texas, Dallas, TX, USA
- Department of Endocrinology, Children's Health, Dallas, TX, USA
| | - E J Kvach
- Denver Health, Denver, CO, USA
- University of Colorado School of Medicine, Aurora, CO, USA
| | - M A Malouf
- Malouf Counseling and Consulting, Baltimore, MD, USA
| | - R Massey
- WPATH Global Education Institute
- Department of Psychiatry & Behavioral Sciences, Emory University School of Medicine, Atlanta, GA, USA
| | - T Mazur
- Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, Buffalo, NY, USA
- John R. Oishei Children's Hospital, Buffalo, NY, USA
| | - C McLachlan
- Professional Association for Transgender Health, South Africa
- Gender DynamiX, Cape Town, South Africa
| | - S D Morrison
- Division of Plastic Surgery, Seattle Children's Hospital, Seattle, WA, USA
- Division of Plastic Surgery, Department of Surgery, University of Washington Medical Center, Seattle, WA, USA
| | - S W Mosser
- Gender Confirmation Center, San Francisco, CA, USA
- Saint Francis Memorial Hospital, San Francisco, CA, USA
| | - P M Neira
- Johns Hopkins Center for Transgender Health, Baltimore, MD, USA
- Johns Hopkins Medicine Office of Diversity, Inclusion and Health Equity, Baltimore, MD, USA
| | - U Nygren
- Division of Speech and Language Pathology, Department of Clinical Science, Intervention and Technology, Karolinska Institutet, Stockholm, Sweden
- Speech and Language Pathology, Medical Unit, Karolinska University Hospital, Stockholm, Sweden
| | - J M Oates
- La Trobe University, Melbourne, Australia
- Melbourne Voice Analysis Centre, East Melbourne, Australia
| | - J Obedin-Maliver
- Stanford University School of Medicine, Department of Obstetrics and Gynecology, Palo Alto, CA, USA
- Department of Epidemiology and Population Health, Stanford, CA, USA
| | - G Pagkalos
- Independent PracticeThessaloniki, Greece
- Military Community Mental Health Center, 424 General Military Training Hospital, Thessaloniki, Greece
| | - J Patton
- Talkspace, New York, NY, USA
- CytiPsychological LLC, San Diego, CA, USA
| | - N Phanuphak
- Institute of HIV Research and Innovation, Bangkok, Thailand
| | - K Rachlin
- Independent Practice, New York, NY, USA
| | - T Reed
- Gender Identity Research and Education Society, Leatherhead, UK
| | - G N Rider
- National Center for Gender Spectrum Health, Institute for Sexual and Gender Health, Department of Family Medicine and Community Health, University of Minnesota Medical School, Minneapolis, MN, USA
| | - J Ristori
- Andrology, Women Endocrinology and Gender Incongruence, Careggi University Hospital, Florence, Italy
| | | | - S A Roberts
- Harvard Medical School, Boston, MA, USA
- Division of Endocrinology, Boston's Children's Hospital, Boston, MA, USA
| | - K A Rodriguez-Wallberg
- Department of Reproductive Medicine, Karolinska University Hospital, Stockholm, Sweden
- Department of Oncology-Pathology, Karolinska Institute, Stockholm, Sweden
| | - S M Rosenthal
- Division of Pediatric Endocrinology, UCSF, San Francisco, CA, USA
- UCSF Child and Adolescent Gender Center
| | - K Sabir
- FtM Phoenix Group, Krasnodar Krai, Russia
| | - J D Safer
- Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Mount Sinai Center for Transgender Medicine and Surgery, New York, NY, USA
| | - A I Scheim
- Epidemiology and Biostatistics, Dornsife School of Public Health, Drexel University, Philadelphia, PA, USA
- Epidemiology and Biostatistics, Schulich School of Medicine and Dentistry, Western University, Ontario, Canada
| | - L J Seal
- Tavistock and Portman NHS Foundation Trust, London, UK
- St George's University Hospitals NHS Foundation Trust, London, UK
| | | | - K Spencer
- National Center for Gender Spectrum Health, Institute for Sexual and Gender Health, Department of Family Medicine and Community Health, University of Minnesota Medical School, Minneapolis, MN, USA
| | - C St Amand
- University of Houston, Houston, TX, USA
- Mayo Clinic, Rochester, MN, USA
| | - T D Steensma
- Center of Expertise on Gender Dysphoria, Amsterdam UMC Location Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
- Department of Medical Psychology, Amsterdam UMC Location Vrije Universiteit Amsterdam, , Amsterdam, Netherlands
| | - J F Strang
- Children's National Hospital, Washington, DC, USA
- George Washington University School of Medicine, Washington, DC, USA
| | - G B Taylor
- Atrium Health Department of Obstetrics and Gynecology, Division of Female Pelvic Medicine and Reconstructive Surgery, Charlotte, NC, USA
| | - K Tilleman
- Department for Reproductive Medicine, Ghent University Hospital, Gent, Belgium
| | - G G T'Sjoen
- Center for Sexology and Gender, Ghent University Hospital, Gent, Belgium
- Department of Endocrinology, Ghent University Hospital, Gent, Belgium
| | - L N Vala
- Independent Practice, Campbell, CA, USA
| | - N M Van Mello
- Center of Expertise on Gender Dysphoria, Amsterdam UMC Location Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
- Department of Obstetrics and Gynaecology, Amsterdam UMC Location Vrije Universiteit Amsterdam, Amsterdam, Netherlands
| | - J F Veale
- School of Psychology, University of Waikato/Te Whare Wānanga o Waikato, Hamilton/Kirikiriroa, New Zealand/Aotearoa
| | - J A Vencill
- Department of Psychiatry & Psychology, Mayo Clinic, Rochester, MN, USA
- Division of General Internal Medicine, Mayo Clinic, Rochester, MN, USA
| | - B Vincent
- Trans Learning Partnership at https://spectra-london.org.uk/trans-learning-partnership, UK
| | - L M Wesp
- College of Nursing, University of Wisconsin MilwaukeeMilwaukee, WI, USA
- Health Connections Inc., Glendale, WI, USA
| | - M A West
- North Memorial Health Hospital, Robbinsdale, MN, USA
- University of Minnesota, Minneapolis, MN, USA
| | - J Arcelus
- School of Medicine, University of Nottingham, Nottingham, UK
- Bellvitge Biomedical Research Institute (IDIBELL), L'Hospitalet de Llobregat, Barcelona, Spain
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