Social media use and health and wellbeing of LGBTQ youth: A systematic review (Preprint)

Effects of Substance Use on Condomless Anal Sex in a Large Sample of Adolescent Men Who Have Sex with Men: A Within and Between Relationship Design

Substance use is a significant risk factor for HIV infection among adolescent men who have sex with men (AMSM). Substance use may reduce the use of HIV prevention measures or increase the likelihood of engaging in activities with a higher risk of HIV transmission, but there is a lack of studies dedicated to analyzing these mechanisms in adolescents and young MSM. This study aimed to explore the impact of substance use on condomless anal sex (CAS) in a large, racially diverse sample of AMSM. Additionally, we investigated how an individual's general level of substance use moderated the association between substance use before sex and CAS at the partnership level. Baseline data for an HIV prevention intervention were collected through online surveys from April 2018 to June 2020. The sample consisted of 1624 AMSM (M age, 16.69 years) who reported at least one sexual partner in the previous 3 months. Participants provided information about their three most recent sexual partners, including their relationship to the partner, PrEP use, frequency of alcohol, marijuana, and non-prescription drug use before sex, and the number of CAS acts. Participants also completed measures of their substance use frequency. Multilevel modeling in Mplus was used for data analysis, accounting for sexual partnerships nested within participants. All models controlled for PrEP use and relationship status. Results revealed a significant positive association between the frequency of non-prescription drug use before sex and CAS at the partnership level. This indicates that higher non-prescription drug use frequency before sex was associated with a greater number of CAS acts with partners. Moreover, the cross-level interaction between alcohol frequency and non-prescription drug use before sex was statistically significant. Specifically, for participants with high alcohol frequency scores, there was a significant positive association between non-prescription drug use before sex and CAS at the partnership level. AMSM with higher average alcohol consumption were more likely to engage in CAS when using non-prescription drugs prior to sex with a partner, compared to those with lower alcohol consumption. This study's use of multilevel data analysis contributes innovatively to the field by shedding light on how substance use operates within sexual relationships and different partnership dynamics. Tailored interventions targeting substance use should be developed to reduce HIV risk among AMSM.

Digital self-presentation and adolescent mental health: Cross-sectional and longitudinal insights from the "LifeOnSoMe"-study

BACKGROUND

The intensive use of social media among adolescents has caused concern about its impact on their mental health, but studies show that social media use is linked to both better and worse mental health. These seemingly contradictory findings may result from the diverse motivations, interactions, and experiences related to social media use, and studies investigating specific facets of social media use in relation to mental health and well-being, beyond general usage metrics, have been called for. Aspects of self-presentation on social media, such as feedback-seeking and upwards social comparison have been linked to worse mental health, however, there is a need for more studies exploring the relationship between self-presentation on social media and adolescent mental health over time.

AIM

The aim of this study was to explore the cross-sectional and longitudinal relationship between aspects of self-presentation and depression, anxiety, and well-being among adolescents.

METHODS

This study utilised both cross-sectional and longitudinal datasets from the LifeOnSoMe-study, comprising 3,424 and 439 participants, respectively (OSF preregistration https://doi.org/10.17605/OSF.IO/BVPS8 ). Latent Class Analysis (LCA) was used to identify similar response patterns within the Self-Presentation and Upwards Social Comparison Inclination Scale (SPAUSCIS). Regression models and first differencing methods were applied to evaluate the cross-sectional and longitudinal associations between focus on self-presentation and mental health and well-being among adolescents.

RESULTS

A strong emphasis on self-presentation was linked to increased levels of depression and anxiety in both males and females, and reduced well-being in females when compared to those with lower or intermediate self-presentation focus. The effect sizes ranged from small to medium. Furthermore, an escalation in self-presentation focus over time was associated with a slight increase in symptoms of anxiety and depression; however, the association with well-being did not reach statistical significance.

CONCLUSION

The results of the present study suggest that a heightened focus on self-presentation, which includes behaviours such as seeking feedback, employing strategic self-presentation tactics, and engaging in upward social comparisons, is associated with an elevated risk of reduced mental health.

Benefits and Harms of Proposed Social Media Legislation

This Viewpoint identifies potential strategies to address issues in adolescents’ use of social media and cautions against the premature adoption of some strategies, such as parental permissions and age restrictions.

Exploring the relationship between media use and depressive symptoms among gender diverse youth: findings of the Mental Health Days Study

BACKGROUND

Over the past decades, media use has become a key aspect of young people's daily lives, significantly shaping their social interactions, learning processes, and recreational pursuits. At the same time, healthcare professionals and researchers are increasingly concerned about the impact of media use on young people's mental health. This concern is particularly relevant for gender diverse youth who may have distinct experiences with media that could impact their mental health uniquely compared to their peers, such as increased exposure to cyberbullying and negative content regarding their gender identity. This study aims to explore the associations between media use and depressive symptoms among youth and examine if gender moderates this association.

METHODS

This study utilized a cross-sectional design involving a school-based sample of 8158 participants (Mage = 14.05 years, SD = 2.45, Ndiverse = 144) from Austria. Participants completed a survey assessing their media use and depressive symptoms using the Patient Health Questionnaire-9 (PHQ-9). Media use was measured by asking participants to report their daily usage in hours and minutes across various categories, including smartphone use, streaming services, social networks, and other media types. Multiple regression analyses were conducted to examine relationships between different forms of media use and depressive symptoms. Moderation analyses were performed using the PROCESS macro for SPSS to explore the role of gender.

RESULTS

For gender diverse youth, multiple regression analysis identified streaming services (β = 0.265, p = .005) and social networks (β = 0.189, p = .037) as significant predictors of depressive symptoms in gender diverse youth. Moderation analyses conducted with the entire sample showed that gender moderates the relationship between depressive symptoms and smartphone use (B = - 0.008, p = .014), with the effect being the most negative for gender diverse individuals.

CONCLUSION

The findings underscore the complex relationship between media use and depressive symptoms among gender diverse youth, emphasizing the moderating role of gender. These results underline the need for gender-sensitive approaches in media literacy and mental health interventions. Stakeholders should be aware of risks and benefits of different media types to foster healthy media engagement.

Prevalence, severity and risk factors for mental disorders among sexual and gender minority young people: a systematic review of systematic reviews and meta-analyses

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.

The pride framework: a sociocultural-developmental approach for understanding LGBTQ+ adolescents' body image and disordered eating

This theoretical review paper offers a sociocultural-developmental framework for understanding LGBTQ+ adolescents' body image concerns and disordered eating risk. The Pride Framework integrates well-established sociocultural theories and extant empirical research, drawing from objectification theory, the tripartite influence model, minority stress theory, and intersectionality theory. The Pride Framework situates sociocultural appearance pressures within the adolescent developmental context, wherein biological, cognitive, and social transitions exacerbate the likelihood of body image disturbances and eating pathology. Various processes are then posited to link these sociocultural-developmental pressures to body image concerns and disordered eating. Crucially, this framework underscores that LGBTQ+ status itself does not pose a risk for body dissatisfaction and eating disorders. Instead, it is the experience of residing in a society that stigmatizes LGBTQ+ identities that increases youth's vulnerabilities. LGBTQ+ health researchers and practitioners are encouraged to engage in collaborative efforts with the aim of fostering acceptance for LGBTQ+ youth. This, in turn, could support normative adolescent identity exploration processes within sociocultural settings that are both affirming and inclusive, potentially mitigating adverse health consequences associated with body image disturbances.

Breaking challenges: queer perspectives on solutions to establish inclusive sexual-reproductive healthcare in Gauteng Province, South Africa

Introduction

In South Africa's diverse population, queer voices emerge as change agents, proposing new and critical solutions to reform sexual and reproductive healthcare services in the pursuit of inclusivity and equality. Our research aimed to explore and describe queer individuals' perceptions and solutions for promoting sexual-reproductive healthcare services and needs (SRHSN) in Gauteng Province, South Africa.

Methodology

An explorative-descriptive study was performed for this research. A total of 22 queer individuals was recruited using respondent-driven sampling (RDS) within a queer-inclusive non-governmental organization (NGO) clinic in Gauteng Province, South Africa. Semi-structured interviews and an interview guide were utilized to collect data using English. Thematic content analysis was applied using NVivo 14.

Results

Four main themes and related sub-themes were revealed from the study including the creation of healthcare equity for queer individuals, empowering and supporting healthcare providers (HCPs) to enhance skills, knowledge, and expertise, raising awareness on queer-related issues, and different stakeholders' involvement.

Conclusion

As we navigate South Africa's complex landscape of SRHSN for queer individuals, the crucial opinions and solutions offered by queer people not only challenge the status quo but also reveal an approach to a better, more equitable, empathetic, and accommodating healthcare system for everyone. Future studies should ensure the inclusiveness of queer individuals with the interest of improving their health not just for research outputs.

Passively sensing smartphone use in teens with rates of use by sex and across operating systems

Youth screen media activity is a growing concern, though few studies include objective usage data. Through the longitudinal, U.S.-based Adolescent Brain Cognitive Development (ABCD) Study, youth (mage = 14; n = 1415) self-reported their typical smartphone use and passively recorded three weeks of smartphone use via the ABCD-specific Effortless Assessment Research System (EARS) application. Here we describe and validate passively-sensed smartphone keyboard and app use measures, provide code to harmonize measures across operating systems, and describe trends in adolescent smartphone use. Keyboard and app-use measures were reliable and positively correlated with one another (r = 0.33) and with self-reported use (rs = 0.21-0.35). Participants recorded a mean of 5 h of daily smartphone use, which is two more hours than they self-reported. Further, females logged more smartphone use than males. Smartphone use was recorded at all hours, peaking on average from 8 to 10 PM and lowest from 3 to 5 AM. Social media and texting apps comprised nearly half of all use. Data are openly available to approved investigators ( https://nda.nih.gov/abcd/ ). Information herein can inform use of the ABCD dataset to longitudinally study health and neurodevelopmental correlates of adolescent smartphone use.

Social media use and its impact on adults' mental health and well-being: A scoping review

BACKGROUND

Social media use has grown in importance and prevalence, with its estimated number of users at 4.9 billion worldwide. Social media use research has revealed positive and negative impacts on users' mental health and well-being. However, such impacts among adults have not been examined in any reviews.

METHODS

A scoping review was conducted based on the framework by Arksey and O'Malley and reported based on the PRISMA-ScR guidelines. Eight databases were searched from 2005 to December 2021. Articles were included after being reviewed by three independent teams, with discrepancies resolved through consensus with the senior author. Publication-related information (i.e., authors, year of publication, aims, study population, methodology, interventions, comparisons, outcome measures and key findings) were extracted from each study. Thematic analysis was conducted to answer the research questions.

RESULTS

Among the 114 eligible articles, young adults (69.6%) represented the main age group. Most studies (78.6%) focused on the negative impacts of social media use on mental health and well-being, with nearly a third (32.1%) assessing such impacts on depression. Notably, this scoping review found that more than three-quarters (78.6%) of the included studies revealed that excessive and passive social media use would increases depression, anxiety, mood and loneliness. Nevertheless, a third (33.0%) also reported positive impacts, where positive and purposeful use of social media contributes to improvements in mental health and well-being, such as increased perceived social support and enjoyment.

LINKING EVIDENCE TO ACTION

This review has provided an overview of the existing knowledge on how social media use affects adults and identified areas of research that merit investigation in future studies. More attention should be given to maximizing the positive impacts of social media use on mental health and well-being among adults.

Social media use and mental health indicators among US adolescents: A population-based study

Social media use among young people has raised concerns about its potential impact on mental health. However, research is limited regarding whether certain subgroups may be differently affected. This study uses data from the 2022 National Youth Tobacco Survey, a nationally representative sample of middle and high school students aged approximately 11-18 years (n = 23,366). Mental health conditions were assessed using the Patient Health Questionnaire-4, and social media use was categorized by frequency levels. We employed multinomial logistic regression and a finite mixture Poisson model to explore the relationship between social media use, sexual identity, and mental health status. The study found a consistent association between social media use and mental health conditions, particularly among frequent users. The finite mixture model revealed two latent groups based on mental health status: a 'better' group with minimal or no poor mental health indicators and a 'worse' group with more indicators. For both groups, social media use was associated with mental health conditions, with a stronger association among frequent users. Notably, sexual minorities, especially bisexual students, were more likely to report poor mental health indicators. This study suggests that frequent social media use may adversely affect young people's mental health and that different youth subgroups may respond differently to social media use and mental health conditions.

Screen use in transgender and gender-questioning adolescents: Findings from the Adolescent Brain Cognitive Development (ABCD) Study

OBJECTIVE

To assess the association between transgender or gender-questioning identity and screen use (recreational screen time and problematic screen use) in a demographically diverse national sample of early adolescents in the U.S.

METHODS

We analyzed cross-sectional data from Year 3 of the Adolescent Brain Cognitive DevelopmentSM Study (ABCD Study®, N = 9859, 2019-2021, mostly 12-13-years-old). Multiple linear regression analyses estimated the associations between transgender or questioning gender identity and screen time, as well as problematic use of video games, social media, and mobile phones, adjusting for confounders.

RESULTS

In a sample of 9859 adolescents (48.8% female, 47.6% racial/ethnic minority, 1.0% transgender, 1.1% gender-questioning), transgender adolescents reported 4.51 (95% CI 1.17-7.85) more hours of total daily recreational screen time including more time on television/movies, video games, texting, social media, and the internet, compared to cisgender adolescents. Gender-questioning adolescents reported 3.41 (95% CI 1.16-5.67) more hours of total daily recreational screen time compared to cisgender adolescents. Transgender identification and questioning one's gender identity was associated with higher problematic social media, video game, and mobile phone use, compared to cisgender identification.

CONCLUSIONS

Transgender and gender-questioning adolescents spend a disproportionate amount of time engaging in screen-based activities and have more problematic use across social media, video game, and mobile phone platforms.

Mobilizing Meaning: Religion and Spirituality Among Future Generations

Religion and spirituality have long been known to impact both physical and mental health. Considering religion and spirituality as possible additions to social determinants of health, this article examines the current state of religion and spirituality in the United States and also discusses the ways in which they can contribute to the mental health of children and adolescents. Further, this article also discusses new approaches within religion and spirituality to address the changing needs of future generations.

Sexual Self-Identification Offsets and Self-Stigma Moderates: Expanding the Rejection-Identification Model to Examine Stigma's Effects on Well-Being Among Gay and Bisexual Men

Gender and sexual minorities still face stigma-related stress from all areas of society. The rejection-identification model (RIM) proposes that some stigmatized individuals may respond to the negative effects of stigma on well-being by enhancing their self-identification. However, this does not apply to all gender and sexual minorities. Grounded in minority stress theory and the RIM, this study examined how stigma-related stressors (i.e. perceived stigma and self-stigma) and their associated mechanisms impact sexual self-identification and subjective well-being. A total of 366 Chinese gay and bisexual men were included in the study. The results showed that sexual self-identification, as a protective factor, mediated the association between perceived stigma and subjective well-being. Furthermore, the indirect effect of the mediation model was moderated by self-stigma, such that the indirect effect of perceived stigma on subjective well-being through sexual self-identification was the highest among Chinese gay and bisexual men with low self-stigma. Given that research into the mental health and well-being of Chinese gay and bisexual men is still in its infancy, our findings are important and may help in developing and improving socially and psychologically sensitive counseling services or intervention strategies for these populations.

The queers are all right: a content analysis of LGBTQIA + mental health on TikTok

The formation of online communities instils a sense of connectedness which can ameliorate the mental health concerns that result from minority stressors for lesbian, gay, queer, intersex, asexual, and other diverse genders/sexualities (LGBTQIA+). The aim of this study was to explore how LGBTQIA + people communicate social and mental health concerns on TikTok. It was anticipated that factors affecting mental health, such as minority stressors and community connectedness, would be addressed by the videos collected. Engagement statistics, demographics and content analysis were used to describe the 50 most-viewed videos across the top five related hashtags: #genderidentity, #lgbtqawareness, #sexualidentity, #lgbtmentalhealth, and #transmentalhealth. The content analysis indicates that TikTok is used as a way for members of the LGBTQIA + community to connect with each other and enhance feelings of community connectedness, which research shows may buffer the effects of minority stressors. Engagement with social media can be especially beneficial for those who may not be able to connect in the real-world. Further interactions, such as analysis of the comment section, should be investigated to develop a fuller understanding of how LGBTQIA + TikTok users respond to these contents.

Gender Affirmation Surgery-related Hashtag Utilization on Instagram: Implications for Education and Patient Care

Background

Gender-affirmation surgery (GAS) allows for transgender and nonconforming patients to achieve a more congruent physical appearance and alleviate dysphoria. Social media, such as Instagram, has adopted an increasingly important role in plastic and reconstructive surgery, and understanding trends and usage related to GAS can have significant implications for patient education and outreach. As such, this cross-sectional study aims to address the following questions related to GAS-related content available on Instagram: (1) Who is posting this content? (2) What specific hashtags are they using? and (3) What are the implications behind these posts?

Methods

This study analyzed 22 GAS-related hashtags on Instagram. Content analysis was then used to evaluate the "top" 15 posts (n = 330) associated with each hashtag.

Results

A total of 425,607 posts were associated with the 22 hashtags queried. #topsurgery had the highest number of associated posts (n = 279,480), followed by #ftmtopsurgery (n = 41,769) and #vaginoplasty (n = 39,737). Of the "top" 330 posts, 299 were not duplicates. Plastic surgeons eligible for membership in the American Society of Plastic Surgeons accounted for only 1.7% of "top" posts (n = 5); noneligible physicians accounted for 6.0% of posts (n = 18). Patients accounted for the majority of the "top" posts sampled (n = 236; 79.9%).

Conclusions

When used appropriately, social media can be a powerful tool for spreading awareness on procedures and educating patients. Although there is a paucity of plastic surgeons posting GAS-related content on Instagram, patients are playing an important role in disseminating information.

Active Social Media Use and Health Indicators Among Sexual and Gender Minority Adults

Purpose: Sexual and gender minority (SGM) individuals may receive social support through active use of social media (i.e., posting and interacting). This study examined associations between active social media use, social support, and health indicators in a large sample of SGM adults in the United States. Methods: Data were derived from the 2017 wave of The PRIDE Study, a national cohort study of SGM health. SGM-identified adults reporting social media use (N = 5995) completed measures of active social media use, social support, depressive symptoms, cigarette smoking, hazardous drinking, sleep, and physical activity. Regression models examined main and interactive effects of active social media use and social support on health indicators. Results: The sample reported a moderate level of active social media use (mean [M] = 3.2 [1.0], scale = 1-5) and relatively high social support (M = 16.7 [3.3], scale = 4-20); 31.8% reported moderate-to-severe depressive symptoms. Participants with greater active social media use were more likely to experience depressive symptoms (adjusted odds ratio [AOR] = 1.18, 95% confidence interval [CI] = 1.10-1.26), cigarette smoking (AOR = 1.11, 95% CI = 1.01-1.22), insufficient sleep (AOR = 1.13, 95% CI = 1.06-1.21), and physical inactivity (AOR = 1.09, 95% CI = 1.02-1.15) than those with less active social media use. Active social media use did not significantly interact with social support to predict any health indicators (p values >0.159). Conclusions: Among SGM adults, active social media use was associated with several negative health indicators. Active social media use may increase health risks, or SGM adults with poor health may actively use social media to maintain social connections. Moderate active social media use may be compatible with health.

How social is social media for transgender and gender-diverse youth? Association of online social experiences with internalizing mental health problems

Adolescents spend a critical amount of their free time on the Internet and social media. Transgender and gender-diverse (TGD) adolescents, who report elevated rates of mental health issues, especially internalizing problems, have both positive and negative online social experiences (e.g., support and cyberbullying). This can have both beneficial and/or harmful effects on their mental health. Given the lack of research, the present study examined TGD adolescents' online (social) experiences and the association of positive and negative online social experiences with internalizing problems. The sample consisted of n = 165 TGD adolescents (11-18 years) diagnosed with gender dysphoria who attended a Gender Identity Service for children and adolescents (Hamburg GIS) in Germany between January 2020 and December 2022 during the COVID-19 pandemic. Positive (use of online support networks) and negative online social experiences (cyberbullying or other adverse online interactions) were assessed using study-specific items and internalizing problems using the Youth Self-Report. Frequencies of various online (social) experiences were analyzed, and a multiple linear regression analysis was performed to test their association with internalizing problems. In total, 42% of participants reported positive online social experiences (use of online support networks) and 51% of participants reported negative online social experiences (cyberbullying or other adverse online interactions). There was no significant association between negative online social experiences and internalizing problems but between positive online social experiences and more internalizing problems (adjusted R2 = .01). TGD adolescents may seek online support, especially when struggling with mental health problems. Therefore, it is crucial to support youth navigating these online spaces more safely and positively and to empower them to buffer against potentially harmful experiences. Furthermore, strengthening offline relations with peers and family members is pivotal, given their importance for TGD adolescents' mental health.

Sexual Minorities and Loneliness: Exploring Sexuality through Social Media and Gender-Sexuality Alliance (GSA) Supports

We examined online and offline social supports for sexual minority adolescents, underscoring the understudied developmental period of early adolescence and the mental outcome of loneliness. Stemming from a larger study in the northeast U.S., 967 youth participants were 26% sexual minority, 53% female, 45% male, and 2% other/nonbinary (mean age = 13.1, SD = 1.52). LGBTQ+ youth reported significantly higher levels of loneliness compared to their heterosexual counterparts. To understand potential sources of social support while exploring their sexual identities, we compared the experiences of LGBTQ+ youth at both ends of the loneliness spectrum. Gaining knowledge about their sexual orientation from LGBTQ+ organization websites, participating in gender-sexuality alliances, and using TikTok or Instagram were associated with lower levels of loneliness. Providing social support to online friends was associated with lower loneliness; however, receiving online support was not associated with lower loneliness. Furthermore, proactive social media engagement such as posting uplifting content, joining online communities, or raising awareness about social issues were associated with lower levels of loneliness. The results provide guidance on specific youth behaviors and online communities beyond a focus on screen time while highlighting the continued need for social support to ameliorate loneliness, such as gender-sexuality alliance networks.

Attitudes Toward School-Based Surveillance of Adolescents' Social Media Activity: Convergent Parallel Mixed Methods Survey

BACKGROUND

US schools increasingly implement commercially available technology for social media monitoring (SMM) of students, purportedly to address youth mental health and school safety. However, little is known about how SMM is perceived by stakeholders, including the students who are the focus of these efforts.

OBJECTIVE

We aimed to assess attitudes toward SMM in schools among 4 stakeholder groups and examine reasons for holding supportive, neutral, or unsupportive views toward the technology. We also sought to explore whether any differences in attitudes were associated with binary sex, race, ethnicity, sexual orientation, or gender identity.

METHODS

In October 2019, we conducted a convergent parallel mixed methods web-based survey of young adults (aged 18-22 y; n=206), parents (n=205), teachers (n=77), and school administrators (n=41) via Qualtrics web-based panels. We included Likert-type survey items to assess perceived benefits, risks, and overall support of SMM in schools and test for differences based on stakeholder group or demographic characteristics. We also included open-ended questions, and the responses to these items were analyzed using thematic content analysis of reasons given for holding supportive, neutral, or unsupportive views.

RESULTS

The tests of group differences showed that young adults perceived lower benefit (P<.001) as well as higher risk (P<.001) and expressed lower overall support (P<.001) of the use of SMM in schools than all other stakeholder groups. Individuals identifying as nonheterosexual also perceived lower benefit (P=.002) and higher risk (P=.02) and expressed lower overall support (P=.02) than their heterosexual counterparts; respondents who identified as people of racial and ethnic minorities also perceived higher risk (P=.04) than their White counterparts. Qualitative thematic content analysis revealed greater nuance in concerns about SMM. Specifically, the primary reasons given for not supporting SMM across all stakeholder groups were (1) skepticism about its utility, (2) perceived privacy violations, and (3) fears of inappropriate or discriminatory use of the data. Within the young adult group in particular, concerns were also raised about (4) unintended and adverse consequences, including the erosion of trust between students and school institutions and administrators, and the chronic adverse effects of constant or prolonged surveillance. Thematic analysis also showed that individuals in every stakeholder group who indicated overall support of SMM were likely to cite the potential for enhanced school safety as the reason. Young adults' overall stances toward SMM were the most polarized, either strongly for or strongly against SMM, and responses from teachers indicated similar polarization but more often favored support of SMM in schools.

CONCLUSIONS

This study found differing perspectives among stakeholder groups regarding SMM in schools. More work is needed to assess the ways in which this type of surveillance is being implemented and the range and complexity of possible effects, particularly on students.

Consideration of Developmental Stage and the Debate on the Effects of Screens Use-Not All Things Are Created Equal

This Viewpoint discusses the role of childhood developmental stage in research evaluating the effects of screen use among youth and its application to practice, policy, and the public.

Social Support-Seeking Strategies on Social Media at the Intersection of Lesbian, Gay, Bisexual, Transgender, and Queer Identity, Race, and Ethnicity: Insights for Intervention From a Qualitative Study

BACKGROUND

Lesbian, gay, bisexual, transgender, and queer (LGBTQ+) individuals experience a disproportionately higher prevalence of mental health challenges when compared to their heterosexual and cisgender counterparts. Moreover, they exhibit increased engagement with social media platforms relative to their peers. Understanding the intersectional dynamics of their identities is crucial in elucidating effective and safe approaches to garnering social support through social media channels. This exploration holds significance for informing future research endeavors and shaping targeted interventions to address the unique mental health needs of LGBTQ+ individuals.

OBJECTIVE

The purpose of this study was to explore the strategies used by Black, Hispanic, and non-Hispanic White LGBTQ+ young adults to acquire social support from social media. The study aimed to examine how these strategies may differ by race and ethnicity.

METHODS

We conducted semistructured interviews with LGBTQ+ young adults aged between 18 and 30 years recruited in the United States from social media. Of 52 participants, 12 (23%) were Black, 12 (23%) were Hispanic, and 28 (54%) were non-Hispanic White. Thematic analysis was used to analyze the collected data.

RESULTS

The analysis uncovered both divergent and convergent strategies among participants of different races and ethnicities. Black and Hispanic young adults exhibited a preference for connecting with individuals who shared similar identities, seeking safety and tailored advice. Conversely, non-Hispanic White participants demonstrated minimal preference for identity-based advice. Seeking support from anonymous sources emerged as a strategy to avoid unwanted disclosure among Hispanic participants. Furthermore, all participants emphasized the importance of content filtering with family members to cultivate positive and supportive social media experiences.

CONCLUSIONS

This study sheds light on the strategies used by LGBTQ+ individuals of different racial and ethnic backgrounds to seek social support from social media platforms. The findings underscore the importance of considering race and ethnicity when examining social support-seeking behaviors on social media in LGBTQ+ populations. The identified strategies provide valuable insights for the development of interventions that aim to leverage social support from social media to benefit the mental health of Black, Hispanic, and non-Hispanic White LGBTQ+ young adults.

Social Media Use for Cancer Support Among Young Adults with Cancer

Purpose: Social media can facilitate peer support among young adults with cancer; however, information is needed about what social media are used, by whom, and how to inform resource and intervention recommendations. Methods: In December 2021, we conducted an online survey with 396 young adults with cancer, ages 18-39, with any diagnosis ages 15-39. Participants reported their social media use to connect with other young adults with cancer, including frequency of use, type of support, and affect (positive to negative) when using to connect with cancer peers. Results: Participants were on average 31 years old (SD = 5.2), with an average age of 27 at diagnosis (63.4% male, 62.1% non-Hispanic White). Almost all (97.5%) reported using social media to connect with other young adults with cancer. Many (48.0%) used three or more social media platforms for cancer support, including Facebook (44.4%), YouTube (43.6%), Instagram (43.4%), Snapchat (36.9%), and Twitter (36.9%). Daily use for cancer support was common (32.9%-60.9%) among those who used social media, particularly among those who were younger; are not transgender; live in urban areas; or had brain, gynecologic, or testicular cancers. Across social media platforms, young adults with cancer reported seeking and sharing emotional support (88.9%), informational support (84.1%), and making connections (81.3%). Conclusion: Young adults with cancer use social media to connect with cancer peers for support. Commonly used existing social media (e.g., Facebook, YouTube, Instagram) should be prioritized in interventions to reach young adults who desire more age-appropriate resources to improve their psychosocial health.

Social media use and experiences among transgender and gender diverse adolescents

Objectives: For transgender and gender diverse (TGD) adolescents, the internet and social media have several risks and benefits. The present study aims at assessing how and for which purposes TGD adolescents use the internet and social media and how often they experience support compared to cyberbullying online. Methods: The sample comprised 114 TGD adolescents diagnosed with gender dysphoria who attended a Gender Identity Service for children and adolescents (Hamburg GIS). Internet and social media use and experiences were assessed using modified items from a German representative study and self-constructed items relating to TGD-specific online experiences. Frequencies of internet/social media use and various online experiences were analyzed and compared to data from the German general population. Results: Compared to peers from the general population, TGD adolescents reported similar offline and online activities and spent similarly long time online (internet: M = 4.16 h, social media: M = 2.84 h). All TGD adolescents sought TGD-specific information online. TGD adolescents used the internet to experiment with their gender identity (60%), and for the purpose of their coming out (31%) and their social transition (88%). About half of the sample each reported either online support (45%) and/or cyberbullying (48%). Conclusions: While TGD adolescents used the internet and social media for similar purposes as peers from the general population, they also used the internet and social media to gain TGD-specific information and for gender identity expression and exploration. They reported both positive and negative experiences online, calling for future studies investigating how online experiences affect TGD adolescents' mental health and gender identity development.

Associations Among Web-Based Civic Engagement and Discrimination, Web-Based Social Support, and Mental Health and Substance Use Risk Among LGBT Youth: Cross-Sectional Survey Study

BACKGROUND

Social media use is ubiquitous among lesbian, gay, bisexual, and transgender or nonbinary (LGBT) adolescents. The time spent on LGBT sites and involvement in social justice-oriented web-based civic activities can increase exposure to heterosexist and transphobic posts, resulting in increases in depression, anxiety, and substance use. Collaborative social justice civic engagement may also increase LGBT adolescents' social support on the web, which may buffer the mental health and substance use risks associated with web-based discrimination.

OBJECTIVE

Drawing on the minority stress and stress-buffering hypotheses, this study aimed to test time spent on LGBT sites, involvement in web-based social justice activities, the mediating effect of web-based discrimination, and the moderating effect of web-based social support on mental health and substance use.

METHODS

An anonymous web-based survey conducted from October 20 to November 18, 2022, analyzed data from 571 respondents (mean age 16.4, SD 1.1 years): 125 cisgender lesbian girls, 186 cisgender gay boys, 111 cisgender bisexual adolescents, and 149 transgender or nonbinary adolescents. Measures included demographics, web-based LGBT identity disclosure, hours per week spent on LGBT social media sites, engagement in web-based social justice activities (Online Civic Engagement Behavior Construct), exposure to web-based discrimination (Online Victimization Scale), web-based social support (adapted from scales examining web-based interactions), depressive and anxiety symptoms, and substance use (the Patient Health Questionnaire modified for Adolescents; Generalized Anxiety Disorder 7-item; and Car, Relax, Alone, Forget, Friends, Trouble Screening Test).

RESULTS

The time spent on LGBT social media sites was unrelated to web-based discrimination after civic engagement was accounted for (90% CI -0.007 to 0.004). Web-based social justice civic engagement was positively associated with social support (β=.4, 90% CI 0.2-0.4), exposure to discrimination (β=.6, 90% CI 0.5-0.7), and higher substance use risk (β=.2, 90% CI 0.2-0.6). Consistent with minority stress theory, exposure to web-based discrimination fully mediated the positive association between LGBT justice civic engagement and depressive (β=.3, 90% CI 0.2-0.4) and anxiety symptoms (β=.3, 90% CI 0.2-0.4). Web-based social support did not moderate the association between exposure to discrimination with depressive (90% CI -0.07 to 0.1) and anxiety symptoms (90% CI -0.06 to 0.1) and substance use (90% CI -0.04 to 0.01).

CONCLUSIONS

This study highlights the importance of examining LGBT youth's specific web-based activities and the need for future research to focus on the intersectional experiences of LGBT adolescents from racial and ethnic minoritized groups through culturally sensitive questions. This study also calls for social media platforms to implement policies that mitigate the effects of algorithms that expose youth to heterosexist and transphobic messaging, such as adopting machine learning algorithms that can efficiently recognize and remove harmful content.

Sexual stigmas among lesbian, gay, and bisexual individuals with problematic internet use and depression

Introduction

Sexual stigma causes psychological distress among lesbian, gay, and bisexual (LGB) individuals. LGB individuals are more likely to exhibit both problematic Internet use (PIU) and significant depression than are heterosexual individuals. Whether the severities of sexual stigma varied among LGB individuals with various statuses of comorbid PIU and depression warrants study. The present study aimed to investigate the differences in the experiences of familial sexual stigma (FSS), internalized sexual stigma (ISS), and sexual orientation microaggressions (SOMs) among LGB individuals with various statuses of comorbid PIU and depression.

Methods

In total, 1,000 self-identified LGB young adult individuals participated in the study. The level of PIU was assessed using the Chen Internet Addiction Scale, depression was assessed using the Center for Epidemiological Studies-Depression Scale, the experience of FSS was assessed using the Homosexuality-Related Stigma Scale, the experience of ISS was assessed using the Measure of Internalized Sexual Stigma for Lesbians and Gay Men, and the experience of sexual orientation microaggression was assessed using the Sexual Orientation Microaggression Inventory. The differences in the levels of FSS, ISS, and SOMs among the four groups [i.e., the groups with both PIU and depression (comorbid group), only depression, only PIU, and neither PIU nor depression (neither group)] were investigated using multivariate analysis of covariance.

Results

The results indicated that LGB individuals with comorbid PIU and depression reported higher levels of ISS and SOMs than did those with depression only and PIU only, respectively. Moreover, LGB individuals with PIU or significant depression had higher levels of FSS and SOMs than did those with neither PIU nor depression.

Discussion

The results of this study supported that the experiences of FSS, ISS, and SOMs were significantly associated with various levels of PIU and depression in LGB individuals.