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Jayne PE, Szucs LE, Lesesne CA, Grose RG, Johns MM. "I wouldn't have felt so alone": The sexual health education experiences of transgender and gender diverse youth living in the southeastern United States. PERSPECTIVES ON SEXUAL AND REPRODUCTIVE HEALTH 2024; 56:158-170. [PMID: 38623631 PMCID: PMC11304134 DOI: 10.1111/psrh.12258] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 04/17/2024]
Abstract
BACKGROUND Transgender and gender diverse youth experience multiple disproportionate adverse sexual health outcomes. Sexual health education teaches knowledge, attitudes, and skills for promoting sexual health, including reducing risk for sexually transmitted infection, HIV acquisition, and unintended pregnancy. Provision of sexual health education may be protective, but research remains scarce. METHODS We conducted a multi-stage thematic analysis of 33 in-depth interviews among transgender and gender diverse youth (ages 15-24) living in the southeastern United States on their sexual health education experiences. RESULTS Our study participants described school-based sexual health education as unhelpful due to a lack of relevant information, inadequately prepared teachers, and a perceived negative tone toward sexuality. They reported relying on online sources of sexual health information, finding relevant content and community despite some limitations. Participants desired content and pedagogy that expands beyond binary and white-centric presentations of sexuality and gender and sought resources that provide relevant, accurate, and judgment-free information while holding positive framing around sexuality and gender. CONCLUSION There is much work needed to improve the breadth, quality, and relevance of school-based sexual health education. Sexual health education can improve by strengthening critical media literacy skills of youth; raising staff cultural competency on gender, race, and sexual identity through training and supports; using culturally relevant and inclusive curricula; and partnering with community-based organizations. Transgender and gender diverse youth would benefit from sexual health education from multiple sources which is queer-friendly, affirms their existence, and provides information on gender, race, and sexuality in positive and expansive ways.
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Affiliation(s)
- Paula E. Jayne
- U.S. Centers for Disease Control and Prevention’s Division of Adolescent and School Health, Atlanta, Georgia, USA
| | - Leigh E. Szucs
- U.S. Centers for Disease Control and Prevention’s Division of Adolescent and School Health, Chamblee, Georgia, USA
| | | | - Rose Grace Grose
- Colorado School of Public Health, Community Health Education, University of Northern Colorado, Greeley, Colorado, USA
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Servais J, Vanhoutte B, Maddy H, Godin I. Ethical and methodological challenges conducting participative research with transgender and gender-diverse young people: a systematic review. INTERNATIONAL JOURNAL OF TRANSGENDER HEALTH 2024; 25:419-438. [PMID: 39055638 PMCID: PMC11268261 DOI: 10.1080/26895269.2024.2323524] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 07/27/2024]
Abstract
Introduction Research with transgender and gender-diverse (TGD) young people is essential to understand their experiences and to be able to propose, implement and adapt 'services' in the broadest sense to meet their needs. However, research outside clinical settings on current experiences and needs of youth under the age of 18 is limited which hinders the development of knowledge on TGD, as well as the development of research informed support practices. Acquiring parental consent for participatory research may present ethical and logistical difficulties, as it could jeopardize the safety, well-being, or confidentiality of adolescent participants. This creates a tension between the adolescent's right to autonomy, privacy, freedom, and all aspects related to the consent of the underage on the one hand, and the parents' right to protect their child on the other hand. This review aims to identify the methodological and ethical challenges associated with participatory research with transgender and gender-diverse young people. Methods We systematically searched bibliometric databases for studies published between 2006 and 2022 and included 4 main conceptual groups: transgender and gender non-conforming, adolescence, qualitative research (including participatory research) and consent. This review was registered in PROSPERO (CRD42022368360) in November 2022. Results Of the 3,794 articles initially identified, 291 met the inclusion criteria and 48 were examined. The selected studies were analyzed in the light of four main ethical tensions: involving parents or a trusted person in the consent gathering process, ensuring the protection and safety of young people while respecting confidentiality, and ensuring that spaces are created for transgender and gender-diverse young people to express themselves freely as part of an empowering research process. At the same time, several methodological challenges concerning public and stakeholder participation and recruitment, data collection and analysis as well as research integrity emerged from the selected studies. Conclusion & implications The existing literature of participatory research involving young transgender and gender-diverse individuals underscores the intricate and conflicting aspects, especially concerning power dynamics, empowerment, and the researcher's role. The relevance of these findings extends across various legal frameworks and is applicable to multiple contexts and countries.
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Affiliation(s)
- Julie Servais
- School of Public Health, Université Libre de Bruxelles, Brussels, Belgium
| | - Bram Vanhoutte
- School of Public Health, Université Libre de Bruxelles, Brussels, Belgium
| | - Herby Maddy
- Faculty of Medicine, Université Libre de Bruxelles, Brussels, Belgium
| | - Isabelle Godin
- School of Public Health, Université Libre de Bruxelles, Brussels, Belgium
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Weisblum M, Trussell E, Schwinn T, Pacheco AR, Nurkin P. Screening and Retaining Adolescents Recruited Through Social Media: Secondary Analysis from a Longitudinal Clinical Trial. JMIR Pediatr Parent 2024; 7:e47984. [PMID: 38416559 PMCID: PMC10938224 DOI: 10.2196/47984] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/06/2023] [Revised: 11/26/2023] [Accepted: 12/29/2023] [Indexed: 02/29/2024] Open
Abstract
BACKGROUND Social media has become a popular method to recruit participants, particularly for studies with hard-to-reach populations. These studies still face challenges in data quality and, for longitudinal studies, sample retention. However, in addition to aiding in recruitment, social media platforms can help researchers with participant verification and tracking procedures during the study. There is limited previous research describing how longitudinal studies can use social media to screen and retain participants. OBJECTIVE This paper describes strategies implemented to screen and retain a nationwide sample of sexual minority youth who were recruited through social media platforms for a longitudinal study testing a drug abuse prevention program. METHODS Our screening strategies for participants included collecting necessary demographic information (name, phone, email, and social media accounts), verifying this information using publicly available web-based records, and sending confirmation emails to ensure working email addresses and correct dates of birth. Retention strategies included communications designed to develop positive participant relationships, incentives for survey completion, regular updating of participant contact information, targeting hard-to-reach participants, and using social media as an alternative means of contacting participants. RESULTS During enrollment, although the only demographic data required were a phone number and an email address, 87.58% (1065/1216) of participants provided their Instagram as an alternative means of contact. This form of alternative communication remains the most preferred with 87.40% (1047/1198) of participants continuing to provide an Instagram username as of January 2023, about 3 years after recruitment began. In comparison, other alternative means of contact (eg, Facebook and alternative email) were provided by only 6.43% (77/1198) to 56.18% (673/1198) of participants. Direct messaging on Instagram was used to successfully confirm participant identity, remind participants to take annual follow-up surveys, and update lost participant contact information. Screening and retention strategies used in the study have helped achieve 96.30% (1171/1216) to 96.79% (1177/1216) sample retention across 3 waves of data collection. CONCLUSIONS Though social media can be a helpful tool to recruit participants, attrition and participant authenticity difficulties may be associated with this method. Screening and retention strategies can be implemented to improve retention. Internet searches are effective for screening youth to ensure they meet eligibility requirements. Additionally, social media-Instagram in this study-can help to track and locate participants who do not respond to traditional contact methods. TRIAL REGISTRATION ClinicalTrials.gov NCT03954535; https://clinicaltrials.gov/study/NCT03954535.
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Affiliation(s)
- Margaret Weisblum
- School of Social Work, Columbia University, New York, NY, United States
- Department of Psychology, Georgetown University, Washington, DC, United States
| | - Emma Trussell
- School of Social Work, Columbia University, New York, NY, United States
- School of Medicine, University of Queensland, Brisbane, Australia
- School of Medicine, Ochsner Health, New Orleans, LA, United States
| | - Traci Schwinn
- School of Social Work, Columbia University, New York, NY, United States
| | - Andrea R Pacheco
- School of Social Work, Columbia University, New York, NY, United States
- National Institute of Allergy and Infectious Diseases, International Center of Excellence in Research, Phnom Penh, Cambodia
| | - Paige Nurkin
- School of Social Work, Columbia University, New York, NY, United States
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Doll K, Craig S, Lee Y, Kourgiantakis T, Lee E, Dicesare D, Pearson A, Vo T. Protocol for a scoping review on technology use and sexual and gender minority youth and mental health. PLoS One 2024; 19:e0291539. [PMID: 38277342 PMCID: PMC10817184 DOI: 10.1371/journal.pone.0291539] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2023] [Accepted: 09/01/2023] [Indexed: 01/28/2024] Open
Abstract
INTRODUCTION Research indicates that sexual and gender minority youth [SGMY] may engage more with information communication technologies [ICTs] more than their non-SGMY counterparts Craig SL et al. 2020. While scholarship generally explores youth's use of ICTs, there are gaps in scholarship that connect SGMY, their ICT engagement and influences to mental health. This scoping review will synthesize the literature that connects these core concepts in order to better understand the influence ITCs have on the mental health of SGMY and to develop a more fulsome understanding of this emerging area of literature. METHODS AND ANALYSIS Following the scoping review framework of Arksey and O'Malley, the search will be conducted in the PsycINFO [Ovid interface, 1980-], MEDLINE [Ovid interface, 1948-], CINAHL [EBSCO interface, 1937-], Sociological Abstracts [ProQuest interface, 1952-], Social Services Abstracts [ProQuest interface, 1979-], and Scopus. Descriptive summaries and thematic analysis will summarize the articles that meet the inclusion criteria using an extraction table. ETHICS AND DISSEMINATION The review outlined in this paper provides an overview of information that exists on the technology use of SGMY, ICTs and the interconnection with mental health. Results will be disseminated through peer reviewed journals and national and international conferences. As information collected for this paper as is retrieved from publicly available sources, ethics approval is not required.
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Affiliation(s)
- Kaitrin Doll
- Factor-Inwentash Faculty of Social Work, University of Toronto, Toronto, ON, Canada
| | - Shelley Craig
- Factor-Inwentash Faculty of Social Work, University of Toronto, Toronto, ON, Canada
| | - Yoonhee Lee
- User Services, Robarts Library, University of Toronto, Toronto, ON, Canada
| | - Toula Kourgiantakis
- Factor-Inwentash Faculty of Social Work, University of Toronto, Toronto, ON, Canada
| | - Eunjung Lee
- Factor-Inwentash Faculty of Social Work, University of Toronto, Toronto, ON, Canada
| | - Dane Dicesare
- Department of Educational Studies Brock University, St. Catharines, ON, Canada
| | - Ali Pearson
- Factor-Inwentash Faculty of Social Work, University of Toronto, Toronto, ON, Canada
| | - Tin Vo
- Lyle S. Hallman Faculty of Social Work, Wilfrid Laurier University, Toronto, ON, Canada
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Mejova Y, Hommadova Lu A. Self-Disclosure of Loneliness by LGBTQ+ Twitter Users During COVID-19. JOURNAL OF HOMOSEXUALITY 2023:1-28. [PMID: 37796146 DOI: 10.1080/00918369.2023.2263801] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/06/2023]
Abstract
Mental health in LGBTQ+ community is often challenged by stigma, prejudice, and discrimination. The "social distancing" public health measures during COVID-19 epidemic have exacerbated the trend. During the pandemic, many took to social media as an outlet for sharing their feelings and in search of connection. Social media may help alleviate loneliness-an increasingly prevalent condition associated with both physical and mental health issues. In this study, we examine 147,736 Twitter posts mentioning loneliness by users who self-identify as part of the LGBTQ+ community, posted before and during the COVID-19 lockdowns. We find that, compared to the year before COVID-19, these users posted 67% more loneliness self-disclosures during the first year of COVID-19. Examining the emotional content of these tweets, we find frequent references to depression, dysphoria, and suicidal ideation. During COVID-19, the users mentioned more "pain" and "numbness" in association with the lack of social and physical contact. However, many found Twitter to be a safe space to express these feelings. The replies to these disclosures were rare: only about 29% received one. Using a large dataset of self-disclosures, we reveal quantitatively and qualitatively the disclosure around loneliness by LGBTQ+ users at an unprecedented time of social isolation.
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Affiliation(s)
- Yelena Mejova
- Data Science for Social Impact and Sustainability, ISI Foundation, Turin, Italy
| | - Anya Hommadova Lu
- Department of Communication Studies, Sam Houston State University, Huntsville, Texas, USA
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Craig SL, Brooks AS, Doll K, Eaton AD, McInroy LB, Hui J. Processes and Manifestations of Digital Resilience: Video and Textual Insights From Sexual and Gender Minority Youth. JOURNAL OF ADOLESCENT RESEARCH 2023. [DOI: 10.1177/07435584221144958] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/23/2023]
Abstract
Minority stressors harm sexual and gender minority youth (SGMY). This may be mitigated by promotive and protective factors and processes that manifest resilient coping. SGMY increasingly interact with information communication technologies (ICTs) to meet psychological needs, yet research often problematizes youths’ ICT use, inhibiting understanding about ICTs’ potential resilience-enhancing utilities. This study analyzes text and video responses of 609 SGMY aged 14 to 29 residing in Canada or the United States to an open-ended survey question about the benefits of using ICTs. Constructivist grounded theory integrating multimodal coding was used to analyze the data, producing a framework of digital resilience—digital processes and actions that generate positive growth—with four themes: Regulating Emotions and Curating Microsystems; Learning and Integrating; Advocating and Leading; and Cultivating Relationships and Communities of Care. Implications for clinical practice, survey innovation, and application of findings in fostering affirming digital microsystems for SGMY are discussed.
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Mezzalira S, Scandurra C, Mezza F, Miscioscia M, Innamorati M, Bochicchio V. Gender Felt Pressure, Affective Domains, and Mental Health Outcomes among Transgender and Gender Diverse (TGD) Children and Adolescents: A Systematic Review with Developmental and Clinical Implications. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 20:ijerph20010785. [PMID: 36613106 PMCID: PMC9819455 DOI: 10.3390/ijerph20010785] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/26/2022] [Revised: 12/28/2022] [Accepted: 12/28/2022] [Indexed: 05/04/2023]
Abstract
Although capable of mobilizing significant resilience factors to face stigma and discrimination, transgender and gender diverse (TGD) children and adolescents tend to suffer from more adverse mental health outcomes compared to their cisgender counterparts. The minority stressors that this population faces are mainly due to the gender-based pressure to conform to their assigned gender. This systematic review was aimed at assessing the potential mental health issues that affect the TGD population. The literature search was conducted in three databases; namely, Scopus, PubMed, and Web of Science, based on the PRISMA guidelines. The 33 articles included in the systematic review pointed out how TGD children and adolescents experience high levels of anxiety and depression, as well as other emotional and behavioral problems, such as eating disorders and substance use. Resilience factors have been also pointed out, which aid this population in facing these negative mental health outcomes. The literature review highlighted that, on the one hand, TGD individuals appear to exhibit high levels of resilience; nonetheless, health disparities exist for TGD individuals compared with the general population, which are mainly attributable to the societal gender pressure to conform to their assigned gender. Considerations for research and clinical practice are provided.
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Affiliation(s)
- Selene Mezzalira
- Department of Humanities, University of Calabria, 87036 Rende, Italy
| | - Cristiano Scandurra
- Department of Neuroscience, Reproductive Sciences, and Dentistry, University of Naples Federico II, 80131 Naples, Italy
| | - Fabrizio Mezza
- SInAPSi Center, University of Naples Federico II, 80133 Naples, Italy
| | - Marina Miscioscia
- Department of Developmental Psychology and Socialization, University of Padua, 35131 Padua, Italy
| | - Marco Innamorati
- Department of History, Cultural Heritage, Education, and Society, University of Rome Tor Vergata, 00133 Rome, Italy
| | - Vincenzo Bochicchio
- Department of Humanities, University of Calabria, 87036 Rende, Italy
- Correspondence:
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8
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Austin A, Craig SL, D'Souza S, McInroy LB. Suicidality Among Transgender Youth: Elucidating the Role of Interpersonal Risk Factors. JOURNAL OF INTERPERSONAL VIOLENCE 2022; 37:NP2696-NP2718. [PMID: 32345113 DOI: 10.1177/0886260520915554] [Citation(s) in RCA: 41] [Impact Index Per Article: 20.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
Data indicate that 82% of transgender individuals have considered killing themselves and 40% have attempted suicide, with suicidality highest among transgender youth. Using minority stress theory and the interpersonal theory of suicide, this study aims to better understand suicide risk among transgender youth. The present study examines the influence of intervenable risk factors: interpersonal and environmental microaggressions, internalized self-stigma, and adverse childhood experiences (ACEs), and protective factors: school belonging, family support, and peer support on both lifetime suicide attempts and past 6-month suicidality in a sample of transgender youth (n = 372). SPSS 22 was utilized to examine the impact of the independent variables on both suicidality and lifetime suicide attempt through two separate logistic regressions. Fifty six percent of youth reported a previous suicide attempt and 86% reported suicidality. Logistic regressions indicated that models for both lifetime suicide attempts and suicidality were significant. Interpersonal microaggressions, made a unique, statistically significant contribution to lifetime suicide attempts and emotional neglect by family approached significance. School belonging, emotional neglect by family, and internalized self-stigma made a unique, statistically significant contribution to past 6-month suicidality. Results have significant practice and policy implications. Findings offer guidance for practitioners working with parents and caregivers of trans youth, as well as, for the creation of practices which foster interpersonal belonging for transgender youth.
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9
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Wong WG, Curran P, Koetter P, Hoover T, Roden RC, Martin K. Are pediatric surgery clinics LGBTQ+ inclusive? J Pediatr Surg 2022; 57:104-110. [PMID: 34670677 DOI: 10.1016/j.jpedsurg.2021.09.020] [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: 08/31/2021] [Accepted: 09/08/2021] [Indexed: 10/20/2022]
Abstract
PURPOSE Creating inclusive LGBTQ+ environments is important in the provision of inclusive care. This cross sectional study assessed whether patient intake forms in pediatric surgery departments were LGBTQ+ inclusive (L-I). METHODS North American pediatric surgery departments affiliated with pediatric surgery fellowships or general surgery residencies were contacted to retrieve patient intake forms. Forms were assessed for LGBTQ+ inclusivity using a novel L-I scoring system consisting of 6 criteria: preferred name, pronouns, preferred language, gender identity, sex assigned at birth, and l-I guardianship. Institutions without intake forms were invited to comment on their use of l-I intake questions. RESULTS 59/125 programs responded to our query, 10 of which provided intake forms. Median l-I score was 2/6 points (range 1-4). l-I guardianship was the most common question asked. No intake form asked for pronouns. Of the 49 institutions without forms, 30.5% reported asking l-I questions during initial visits. Narratives from these institutions varied widely. Some institutions supported routine l-I questions while others stated l-I questions were unnecessary, irrelevant, and/or offensive. CONCLUSIONS Few North American pediatric surgery departments consistently ask l-I questions during the intake process. Comments questioning the appropriateness and necessity of l-I questions highlight the need for LGBTQ+ education. LEVEL OF EVIDENCE Level III. TYPE OF STUDY Cross sectional study.
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Affiliation(s)
- William G Wong
- Department of Pediatric Surgery, PennState Health Milton S. Hershey Medical Center, 500 University Drive, Hershey, PA, USA.
| | - Pierce Curran
- PennState College of Medicine, 500 University Drive, Hershey, PA, USA
| | - Paige Koetter
- PennState College of Medicine, 500 University Drive, Hershey, PA, USA
| | - Travis Hoover
- PennState College of Medicine, 500 University Drive, Hershey, PA, USA
| | - Rosemary Claire Roden
- Division of Adolescent Medicine, Department of Pediatrics, PennState Health Milton S. Hershey Medical Center, 12 Briarcrest Square, Hershey, PA 17033, USA
| | - Kathryn Martin
- Department of Pediatric Surgery, PennState Health Milton S. Hershey Medical Center, 500 University Drive, Hershey, PA, USA
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Sherman ADF, Balthazar M, Klepper M, Febres-Cordero S, Valmeekanathan A, Prakash D, Cimino AN, Wharton W, Allure K, Kelly U. Approach and avoidant coping among black transgender women who have experienced violence: A qualitative analysis. Psychol Serv 2022; 19:45-61. [PMID: 34460276 PMCID: PMC9891319 DOI: 10.1037/ser0000581] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
Black transgender women face nearly universal exposure to violence. Coping behaviors among cisgender women who have survived violence are well delineated; however, there are relatively few studies examining coping strategies for transgender women. The purpose of this qualitative study was to identify and characterize coping behaviors employed by Black transgender women (from Baltimore, MD and Washington, DC metropolitan areas) following an experience of violence. Secondary qualitative data analysis was conducted using framework analysis to explore narratives of 19 Black transgender women. Themes regarding avoidant and approach coping behaviors were developed within the context of existing literature. Approach coping behavior themes included: Help-Seeking, Seeking Guidance and Support, Self-Protecting Behavior, Positive Reappraisal, Self-Affirmation, Self-Care, Connection to a Higher Power, and Acceptance. Avoidant coping behavior themes included: Cognitive Avoidance, Substance, Alcohol, and Tobacco Use, Emotional Discharge, and Seeking Alternative Rewards. Participants employed similar coping behaviors as seen among cisgender women survivors of violence. However, several unique applications of approach coping mechanisms were identified including self-protecting behavior and self-affirming behavior. Culturally informed application of the identified coping behaviors can be taught and integrated into trauma-informed mental health interventions to promote strength and resilience among Black transgender women. (PsycInfo Database Record (c) 2022 APA, all rights reserved).
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Affiliation(s)
| | - Monique Balthazar
- The Nell Hodgson Woodruff School of Nursing, Emory University,Byrdine F. Lewis College of Nursing and Health Professions, Georgia State University
| | - Meredith Klepper
- The Johns Hopkins University School of Nursing, Johns Hopkins University
| | | | | | - Diane Prakash
- The Nell Hodgson Woodruff School of Nursing, Emory University
| | - Andrea N. Cimino
- Danger Assessment Training and Technical Assistance Center, Johns Hopkins School of Nursing
| | - Whitney Wharton
- The Nell Hodgson Woodruff School of Nursing, Emory University
| | - Kisha Allure
- Casa Ruby, Washington, District of Columbia, United States
| | - Ursula Kelly
- The Nell Hodgson Woodruff School of Nursing, Emory University,Atlanta VA Health Care System, Atlanta, Georgia, United States
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McInroy LB, Beaujolais B, Craig SL, Eaton AD. The Self-Identification, LGBTQ+ Identity Development, and Attraction and Behavior of Asexual Youth: Potential Implications for Sexual Health and Internet-Based Service Provision. ARCHIVES OF SEXUAL BEHAVIOR 2021; 50:3853-3863. [PMID: 34136992 DOI: 10.1007/s10508-021-02064-y] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/12/2019] [Revised: 05/27/2021] [Accepted: 05/29/2021] [Indexed: 05/28/2023]
Abstract
While often included in the spectrum of sexual minority identities, asexuality receives comparatively little attention. Awareness and understanding remains limited, and knowledge has been generated primarily from adult populations. This paper employs a sample of 711 self-identified asexual youth (aged 14-24, M = 17.43 years) who identified as members of the LGBTQ+ community to consider the implications of a number of different areas for service provision. Two-thirds (66.8%) of participants identified as gender minorities within the spectrum of transgender and non-binary identities. Findings include aspects of participants' LGBTQ+ developmental processes, including that only 14.3% had disclosed their LGBTQ+ status to everyone in their lives. However, just 2.4% had disclosed to no one. Their attraction and sexual activity were also explored, with 27.1% having never experienced any kind of romantic or sexual attraction and 20.6% having ever been sexually active. Findings regarding participants' accessing of LGBTQ+ health information and engagement in a range of offline and online LGBTQ+ community activities are also provided. Participants acquired more health information online than offline-including sexual health information. Recommendations for service provision, particularly implications for sexual health and Internet-based services, are discussed.
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Affiliation(s)
- Lauren B McInroy
- College of Social Work, The Ohio State University, Columbus, OH, 43210, USA.
| | | | - Shelley L Craig
- Factor-Inwentash Faculty of Social Work, University of Toronto, Toronto, ON, Canada
| | - Andrew D Eaton
- Faculty of Social Work - Saskatoon Campus, University of Regina, Saskatoon, SK, Canada
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12
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Craig SL, Eaton AD, Kirkland A, Egag E, Pascoe R, King K, Krishnan S. Towards an integrative self: a digital photo elicitation study of resilience among key marginalized populations of sexual and gender minority youth. Int J Qual Stud Health Well-being 2021; 16:1961572. [PMID: 34375157 PMCID: PMC8366624 DOI: 10.1080/17482631.2021.1961572] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
Abstract
Purpose: Sexual and gender minority youth (SGMY) experience unique challenges related to identity and disclosure, and cope in vibrant ways. Qualitative research has not yet fulsomely explored the risk, resilience, and identity intersections that impact vulnerable SGMY wellbeing. Methods: This digital photo-elicitation study (QueerView) recruited thirty SGMY (aged 14–29) from priority populations that had one or more of the following experiences: trans and gender diverse, homelessness, child welfare, and immigration. From submission of fifteen photos representing resilience and a semi-structured interview via web conferencing, constructivist grounded theory was utilized for multimodal analysis of photos, interview video, and interview transcript. Triangulation, an audit trail, and member checking were employed to support trustworthiness. Results: A visual model emerged showing how participants work towards an integrative self, with themes of reflecting and knowing, discrimination and intersectional challenges, connecting, performing, curating, coping, (re)defining and (re)creating, growing and being. Sub-themes of the impact of family dynamic and values, mental health and trauma, and the cathartic benefit from advocacy and leadership offered insight. Participant images were captured in a digital gallery. Conclusions: QueerView animates the complex lives of multiply marginalized SGMY and their intersectional strengths and challenges while demonstrating the utility of a digital multimodal approach.
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Affiliation(s)
- Shelley L Craig
- Factor-Inwentash Faculty of Social Work, University of Toronto, Toronto, ON, Canada
| | - Andrew D Eaton
- Faculty of Social Work, University of Regina - Saskatoon Campus, Regina, Canada
| | - Alexa Kirkland
- Factor-Inwentash Faculty of Social Work, University of Toronto, Toronto, ON, Canada
| | - Egag Egag
- Factor-Inwentash Faculty of Social Work, University of Toronto, Toronto, ON, Canada
| | - Rachael Pascoe
- Factor-Inwentash Faculty of Social Work, University of Toronto, Toronto, ON, Canada
| | - Kourteney King
- Ontario Institute for Studies in Education, University of Toronto, Toronto, ON, Canada
| | - Sreedevi Krishnan
- Factor-Inwentash Faculty of Social Work, University of Toronto, Toronto, ON, Canada
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13
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Craig SL, Iacono G, Pascoe R, Austin A. Adapting Clinical Skills to Telehealth: Applications of Affirmative Cognitive-Behavioral Therapy with LGBTQ+ Youth. CLINICAL SOCIAL WORK JOURNAL 2021; 49:471-483. [PMID: 33678921 PMCID: PMC7922718 DOI: 10.1007/s10615-021-00796-x] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 02/02/2021] [Indexed: 06/12/2023]
Abstract
Online social work services (e.g., telemental health; telebehavioral health; virtual care; telehealth) present significant opportunities for clinical social workers to provide effective care to marginalized populations, such as LGBTQ+ youth. The COVID-19 pandemic has led to an increased focus on telehealth, and while there are excellent resources to guide ethics, standards, and legal decisions (NASW, n.d.), there is less guidance in the literature to specifically inform the adaptation of offline clinical skills to telehealth, particularly for LGBTQ+ youth. To address this gap, we present examples from our experience offering AFFIRM, an affirmative cognitive behavioral therapy (CBT) group intervention now being delivered through telehealth. Specifically, this paper will: (a) describe the key considerations for the delivery of CBT via telehealth to youth; (b) detail specific clinical skills and strategies to enable successful online implementation; (c) describe the adaptation approach through a case study of cognitive restructuring with a transgender youth; (d) and offer specific guidance to support clinicians to adapt their clinical skills to the virtual environment.
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Affiliation(s)
- Shelley L. Craig
- Factor-Inwentash Faculty of Social Work, University of Toronto, 246 Bloor Street West, Toronto, ON M5S 1V4 Canada
| | - Gio Iacono
- School of Social Work, University of Connecticut, 38 Prospect Street, Hartford, CT 06103-2814 USA
| | - Rachael Pascoe
- Factor-Inwentash Faculty of Social Work, University of Toronto, 246 Bloor Street West, Toronto, ON M5S 1V4 Canada
| | - Ashley Austin
- Ellen Whiteside McDonnell School of Social Work, Barry University, 11300 NE 2nd Avenue, Miami Shores, FL 33161-6695 USA
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Craig SL, Eaton AD, Pascoe R, Egag E, McInroy LB, Fang L, Austin A, Dentato MP. QueerVIEW: Protocol for a Technology-Mediated Qualitative Photo Elicitation Study With Sexual and Gender Minority Youth in Ontario, Canada. JMIR Res Protoc 2020; 9:e20547. [PMID: 33151153 PMCID: PMC7677025 DOI: 10.2196/20547] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2020] [Revised: 10/08/2020] [Accepted: 10/20/2020] [Indexed: 01/02/2023] Open
Abstract
BACKGROUND The experiences of resilience and intersectionality in the lives of contemporary sexual and gender minority youth (SGMY) are important to explore. SGMY face unique experiences of discrimination in both online and offline environments, yet simultaneously build community and seek support in innovative ways. SGMY who identify as transgender, trans, or gender nonconforming and have experiences with child welfare, homelessness, or immigration have been particularly understudied. A qualitative exploration that leverages technology may derive new understanding of the negotiations of risk, resilience, and identity intersections that impact the well-being of vulnerable SGMY. OBJECTIVE The objectives of the QueerVIEW study were to (1) enhance understanding of SGMY identities, both online and offline, (2) identify experiences of intersectionality among culturally, regionally, and racially diverse SGMY in Ontario, Canada, (3) explore online and offline sources of resilience for SGMY, and (4) develop and apply a virtual photo elicitation methodological approach. METHODS This is the first study to pilot a completely virtual approach to a photo elicitation investigation with youth, including data collection, recruitment, interviewing, and analysis. Recruited through social media, SGMY completed a brief screening survey, submitted 10 to 15 digital photos, and then participated in an individual semistructured interview that focused on their photos and related life experiences. Online data collection methods were employed through encrypted online file transfer and secure online interviews. Data is being analyzed using a constructivist grounded theory approach, with six coders participating in structured online meetings that triangulated photo, video, and textual data. RESULTS Data collection with 30 participants has been completed and analyses are underway. SGMY expressed appreciation for the photo elicitation and online design of the study and many reported experiencing an emotional catharsis from participating in this process. It is anticipated that results will form a model of how participants work toward integrating their online and offline experiences and identities into developing a sense of themselves as resilient. CONCLUSIONS This protocol presents an innovative, technology-enabled qualitative study that completely digitized a popular arts-based methodology-photo elicitation-that has potential utility for contemporary research with marginalized populations. The research design and triangulated analyses can generate more nuanced conceptualizations of SGMY identities and resilience than more traditional approaches. Considerations for conducting online research may be useful for other qualitative research. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) DERR1-10.2196/20547.
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Affiliation(s)
- Shelley L Craig
- Factor-Inwentash Faculty of Social Work, University of Toronto, Toronto, ON, Canada
| | - Andrew D Eaton
- Factor-Inwentash Faculty of Social Work, University of Toronto, Toronto, ON, Canada
| | - Rachael Pascoe
- Factor-Inwentash Faculty of Social Work, University of Toronto, Toronto, ON, Canada
| | - Egag Egag
- Factor-Inwentash Faculty of Social Work, University of Toronto, Toronto, ON, Canada
| | - Lauren B McInroy
- College of Social Work, The Ohio State University, Columbus, OH, United States
| | - Lin Fang
- Factor-Inwentash Faculty of Social Work, University of Toronto, Toronto, ON, Canada
| | - Ashley Austin
- Ellen Whiteside McDonnell School of Social Work, Barry University, Miami Shores, FL, United States
| | - Michael P Dentato
- School of Social Work, Loyola University Chicago, Chicago, IL, United States
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15
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Craig SL, Austin A, Levenson J, Leung VWY, Eaton AD, D'Souza SA. Frequencies and patterns of adverse childhood events in LGBTQ+ youth. CHILD ABUSE & NEGLECT 2020; 107:104623. [PMID: 32682145 DOI: 10.1016/j.chiabu.2020.104623] [Citation(s) in RCA: 46] [Impact Index Per Article: 11.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/01/2020] [Revised: 06/14/2020] [Accepted: 07/03/2020] [Indexed: 05/16/2023]
Abstract
BACKGROUND Trauma, specifically adverse childhood experiences (ACEs), predicts significant health and mental health disparities, yet there is a paucity of research with LGBTQ + youth. OBJECTIVE This study explored ACE prevalence in a large sample of LGBTQ+ youth; examined ACE patterns within and across subgroups; and compared results with the general population. PARTICIPANTS AND SETTING Participant (n = 3,508) ages ranged between 14-18 (x̄ = 16.02) and represented a range of sexual orientations: pansexual (33.9 %), bisexual (26.6 %), and queer (16.2 %), and gender identities: female (39.9 %), non-conforming (38 %), male (14.9 %), and transgender (16.6 %). METHODS An online cross-sectional survey was conducted with LGBTQ+ youth ages 14-18 that self-identified as LGBTQ+ and resided in the US or Canada. Descriptive statistics generated the prevalence of ACEs, and ANOVAs and post-hoc tests were run for comparisons. RESULTS Participants reported multiple ACEs (M = 3.14, SD = 2.44) with emotional neglect (58 %), emotional abuse (56 %), and living with a family member with mental illness (51 %) as the most prevalent. Notably, 43 % of participants experienced 4+ ACEs, considered to be a high level of trauma exposure. Compared to national samples, LGBTQ + youth demonstrated unique patterns of ACEs and were higher in 9 of 10 categories. Significantly high (all p < .001) ACEs were found in pansexual (t = 7.67), transgender and gender non-conforming (t = 5.19), American-Indian (t = 6.42), Latinx (t = 2.83) and rural youth (F = 12.12) while those with highly educated parents (F = 83.30, p < .001), lived with a parent (t = 6.02), and in Canada (t = 6.14) reported fewer ACEs. CONCLUSION LGBTQ+ youth experience significant childhood trauma with potential impact on their mental health. This study identifies implications for trauma-informed practice and research.
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Affiliation(s)
- Shelley L Craig
- Factor-Inwentash Faculty of Social Work, University of Toronto, 246 Bloor St. W., Toronto, ON, M5S 1V4, Canada.
| | - Ashley Austin
- Ellen Whiteside McDonnell Faculty of Social Work, Barry University, 11300 NE 2nd Ave., Miami Shores, FL, 33161-6695, USA.
| | - Jill Levenson
- Ellen Whiteside McDonnell Faculty of Social Work, Barry University, 11300 NE 2nd Ave., Miami Shores, FL, 33161-6695, USA.
| | - Vivian W Y Leung
- Factor-Inwentash Faculty of Social Work, University of Toronto, 246 Bloor St. W., Toronto, ON, M5S 1V4, Canada.
| | - Andrew D Eaton
- Factor-Inwentash Faculty of Social Work, University of Toronto, 246 Bloor St. W., Toronto, ON, M5S 1V4, Canada.
| | - Sandra A D'Souza
- Factor-Inwentash Faculty of Social Work, University of Toronto, 246 Bloor St. W., Toronto, ON, M5S 1V4, Canada.
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McInroy LB, Beaujolais B, Leung VWY, Craig SL, Eaton AD, Austin A. Comparing asexual and non-asexual sexual minority adolescents and young adults: stressors, suicidality and mental and behavioural health risk outcomes. PSYCHOLOGY & SEXUALITY 2020. [DOI: 10.1080/19419899.2020.1806103] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Affiliation(s)
- Lauren B. McInroy
- College of Social Work, The Ohio State University, Columbus, OH, USA
| | | | - Vivian W. Y. Leung
- Factor-Inwentash Faculty of Social Work, University of Toronto, Toronto, Canada
| | - Shelley L. Craig
- Factor-Inwentash Faculty of Social Work, University of Toronto, Toronto, Canada
| | - Andrew D. Eaton
- Factor-Inwentash Faculty of Social Work, University of Toronto, Toronto, Canada
| | - Ashley Austin
- Ellen Whiteside McDonnell School of Social Work, Barry University, Miami, FL, USA
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Budenz A, Klassen A, Leader A, Fisher K, Yom-Tov E, Massey P. HPV vaccine, Twitter, and gay, bisexual and other men who have sex with men. Health Promot Int 2020; 35:290-300. [PMID: 31006017 DOI: 10.1093/heapro/daz030] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
This study aimed to quantify human papillomavirus (HPV) vaccine Twitter messaging addressing gay, bisexual and other men who have sex with men (GB+MSM) and describes messaging by vaccine sentiment (attitudes towards vaccine) and characteristics (topic of messaging). Between August 2014 and July 2015, we collected 193 379 HPV-related tweets and classified them by vaccine sentiment and characteristics. We analysed a subsample of tweets containing the terms 'gay', 'bisexual' and 'MSM' (N = 2306), and analysed distributions of sentiment and characteristics using chi-square. HPV-related tweets containing GB+MSM terms occupied 1% of our sample. The subsample had a largely positive vaccine sentiment. However, a proportion of 'gay' and 'bisexual' tweets did not mention the vaccine, and a proportion of 'gay' and 'MSM' tweets had a negative sentiment. Topics varied by GB+MSM term-HPV risk messaging was prevalent in 'bisexual' (25%) tweets, and HPV transmission through sex/promiscuity messaging was prevalent in 'gay' (18%) tweets. Prevention/protection messaging was prevalent only in 'MSM' tweets (49%). Although HPV vaccine sentiment was positive in GB+MSM messaging, we identified deficits in the volume of GB+MSM messaging, a lack of focus on vaccination, and a proportion of negative tweets. While HPV vaccine promotion has historically focused on heterosexual HPV transmission, there are opportunities to shape vaccine uptake in GB+MSM through public health agenda setting using social media messaging that increases knowledge and minimizes HPV vaccine stigma. Social media-based HPV vaccine promotion should also address the identities of those at risk to bolster vaccine uptake and reduce the risk of HPV-attributable cancers.
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Affiliation(s)
- Alexandra Budenz
- Drexel University Dornsife School of Public Health, 3215 Market St., Philadelphia, PA 19104, USA
| | - Ann Klassen
- Drexel University Dornsife School of Public Health, 3215 Market St., Philadelphia, PA 19104, USA
| | - Amy Leader
- Division of Population Science, Thomas Jefferson University, 834 Chestnut St., Ste. 314, Philadelphia, PA 19107, USA
| | - Kara Fisher
- Association of American Medical Colleges, 655 K St. NW, #100, Washington, DC 20001, USA
| | - Elad Yom-Tov
- Microsoft Research Israel, 13 Shenkar St., Gay-Yam Bldg. 5, Herzliya 4672513, Israel
| | - Philip Massey
- Drexel University Dornsife School of Public Health, 3215 Market St., Philadelphia, PA 19104, USA
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Austin A, Craig SL, Navega N, McInroy LB. It's my safe space: The life-saving role of the internet in the lives of transgender and gender diverse youth. INTERNATIONAL JOURNAL OF TRANSGENDER HEALTH 2020; 21:33-44. [PMID: 33015657 PMCID: PMC7430466 DOI: 10.1080/15532739.2019.1700202] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
Background: Public awareness of Transgender and Gender Diverse (TGD) identities has grown significantly; however, acceptance and support remain elusive for many TGD youth. Resultant experiences of marginalization and stigmatization contribute to elevated rates of psychological distress and suicidality among TGD youth. Emergent evidence suggests that the internet may offer TGD youth safety, support, and community previously unavailable. Aim: The primary aim of this qualitative inquiry is to engage in an in-depth exploration of the online experiences and processes which help protect against psychological distress and promote well-being among TGD youth. Methods: Data were culled from a mixed-methods, online study of sexual and gender minority youth from across the United States and Canada which followed Institutional Review Board approved protocols. Participants for this study represent a sample (n = 260) of TGD participants aged 14-22 (x̄ = 17.30). Data were analyzed using Charmaz' grounded theory strategies. Results: Data revealed that the internet offers TGD youth affirming spaces that, for the most part, do not exist in their offline lives. Online, TGD youth were able to engage meaningfully with others as their authentic selves, often for the first time. These experiences fostered well-being, healing, and growth through five processes: 1. Finding an escape from stigma and violence, 2. Experiencing belonging, 3. Building confidence, 4. Feeling hope, and 5. Giving back. Discussion: The unique and innovative ways in which participants use online spaces to foster resilience offer important insights to inform affirmative practices with TGD young people.
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Affiliation(s)
- Ashley Austin
- School of Social Work, Barry University, Miami Shores, Florida, USA
| | - Shelley L. Craig
- Factor Inwentash Faculty of Social Work, University of Toronto, Toronto, Ontario, Canada
| | - Nicole Navega
- School of Social Work, Barry University, Miami Shores, Florida, USA
| | - Lauren B. McInroy
- College of Social Work, The Ohio State University, Columbus, Ohio, USA
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Craig SL, Eaton AD, McInroy LB, D’Souza SA, Krishnan S, Wells GA, Twum-Siaw L, Leung VWY. Navigating negativity: a grounded theory and integrative mixed methods investigation of how sexual and gender minority youth cope with negative comments online. PSYCHOLOGY & SEXUALITY 2019. [DOI: 10.1080/19419899.2019.1665575] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Affiliation(s)
- Shelley L. Craig
- Factor-Inwentash Faculty of Social Work, University of Toronto, Toronto, Canada
| | - Andrew D. Eaton
- Factor-Inwentash Faculty of Social Work, University of Toronto, Toronto, Canada
| | - Lauren B. McInroy
- College of Social Work, The Ohio State University, Columbus, OH, USA
| | - Sandra A. D’Souza
- Factor-Inwentash Faculty of Social Work, University of Toronto, Toronto, Canada
| | - Sreedevi Krishnan
- Factor-Inwentash Faculty of Social Work, University of Toronto, Toronto, Canada
| | - Gordon A. Wells
- Factor-Inwentash Faculty of Social Work, University of Toronto, Toronto, Canada
| | - Lloyd Twum-Siaw
- Factor-Inwentash Faculty of Social Work, University of Toronto, Toronto, Canada
| | - Vivian W. Y. Leung
- Factor-Inwentash Faculty of Social Work, University of Toronto, Toronto, Canada
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20
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Schrager SM, Steiner RJ, Bouris AM, Macapagal K, Brown CH. Methodological Considerations for Advancing Research on the Health and Wellbeing of Sexual and Gender Minority Youth. LGBT Health 2019; 6:156-165. [PMID: 31145662 PMCID: PMC6551986 DOI: 10.1089/lgbt.2018.0141] [Citation(s) in RCA: 28] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Continued research with sexual and gender minority (SGM) youth is essential both to understand health disparities and to develop interventions targeting those disparities, but conducting rigorous, ethical research with these populations remains a substantial challenge. In addition to considerations for research with adolescents in general, such as utilizing developmentally appropriate measures and obtaining parental permission, factors unique to SGM youth must be addressed at every step of the research process. Defining the study population is complex, as is recruiting a sample once it is defined. Measurement is another challenge, given the paucity of measures developed for or validated with SGM samples. Key constructs, such as sexual orientation, gender identity, and family acceptance, are not amenable to randomization and involving minor participants' parents poses ethical concerns given the precarious home and safety situations that can arise from employing typical study procedures with youth who have a stigmatized identity. In this article, we examine some of these unique methodological challenges. Informed by theoretical and empirical literature, practical experience, and an ongoing dialogue with SGM youth themselves, we present a guide to best practices for ethical, productive research with SGM youth. By discussing existing approaches to studying SGM youth and suggesting innovative ways to approach the questions that remain, we hope to assist the research community in addressing methodological gaps to advance research on SGM youth in relation to families and schools.
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Affiliation(s)
- Sheree M Schrager
- 1 Department of Research and Sponsored Programs, California State University, Northridge, Northridge, California
- 2 Suzanne Dworak-Peck School of Social Work, University of Southern California, Los Angeles, California
| | - Riley J Steiner
- 3 Division of Adolescent and School Health, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Alida M Bouris
- 4 School of Social Service Administration, University of Chicago, Chicago, Illinois
- 5 Chicago Center for HIV Elimination, University of Chicago, Chicago, Illinois
| | - Kathryn Macapagal
- 6 Feinberg School of Medicine, Northwestern University, Chicago, Illinois
- 7 Institute for Sexual and Gender Minority Health and Wellbeing, Northwestern University, Chicago, Illinois
| | - C Hendricks Brown
- 6 Feinberg School of Medicine, Northwestern University, Chicago, Illinois
- 7 Institute for Sexual and Gender Minority Health and Wellbeing, Northwestern University, Chicago, Illinois
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21
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Lucassen M, Samra R, Iacovides I, Fleming T, Shepherd M, Stasiak K, Wallace L. How LGBT+ Young People Use the Internet in Relation to Their Mental Health and Envisage the Use of e-Therapy: Exploratory Study. JMIR Serious Games 2018; 6:e11249. [PMID: 30578194 PMCID: PMC6320432 DOI: 10.2196/11249] [Citation(s) in RCA: 32] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2018] [Revised: 09/25/2018] [Accepted: 11/01/2018] [Indexed: 12/03/2022] Open
Abstract
Background Lesbian, gay, bisexual, and transgender (LGBT) youth and other young people diverse in terms of their sexuality and gender (LGBT+) are at an elevated risk of mental health problems such as depression. Factors such as isolation and stigma mean that accessing mental health services can be particularly challenging for LGBT+ young people, and previous studies have highlighted that many prefer to access psychological support on the Web. Research from New Zealand has demonstrated promising effectiveness and acceptability for an LGBT+ focused, serious game–based, computerized cognitive behavioral therapy program, Rainbow Smart, Positive, Active, Realistic, X-factor thoughts (SPARX). However, there has been limited research conducted in the area of electronic therapy (e-therapy) for LGBT+ people. Objective This study aimed to explore how and why LGBT+ young people use the internet to support their mental health. This study also sought to explore LGBT+ young people’s and professionals’ views about e-therapies, drawing on the example of Rainbow SPARX. Methods A total of 3 focus groups and 5 semistructured interviews were conducted with 21 LGBT+ young people (aged 15-22 years) and 6 professionals (4 health and social care practitioners and 2 National Health Service commissioners) in England and Wales. A general inductive approach was used to analyze data. Results LGBT+ youth participants considered that the use of the internet was ubiquitous, and it was valuable for support and information. However, they also thought that internet use could be problematic, and they highlighted certain internet safety and personal security considerations. They drew on a range of gaming experiences and expectations to inform their feedback about Rainbow SPARX. Their responses focused on the need for this e-therapy program to be updated and refined. LGBT+ young people experienced challenges related to stigma and mistreatment, and they suggested that strategies addressing their common challenges should be included in e-therapy content. Professional study participants also emphasized the need to update and refine Rainbow SPARX. Moreover, professionals highlighted some of the issues associated with e-therapies needing to demonstrate effectiveness and challenges associated with health service commissioning processes. Conclusions LGBT+ young people use the internet to obtain support and access information, including information related to their mental health. They are interested in LGBT-specific e-therapies; however, these must be in a contemporary format, engaging, and adequately acknowledge the experiences of LGBT+ young people.
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Affiliation(s)
- Mathijs Lucassen
- School of Health, Wellbeing and Social Care, The Open University, Milton Keynes, United Kingdom
| | - Rajvinder Samra
- School of Health, Wellbeing and Social Care, The Open University, Milton Keynes, United Kingdom
| | | | - Theresa Fleming
- Faculty of Health, Victoria University of Wellington, Wellington, New Zealand
| | - Matthew Shepherd
- Faculty of Education and Social Work, University of Auckland, Auckland, New Zealand
| | - Karolina Stasiak
- Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand
| | - Louise Wallace
- School of Health, Wellbeing and Social Care, The Open University, Milton Keynes, United Kingdom
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22
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Burk J, Park M, Saewyc EM. A Media-Based School Intervention to Reduce Sexual Orientation Prejudice and Its Relationship to Discrimination, Bullying, and the Mental Health of Lesbian, Gay, and Bisexual Adolescents in Western Canada: A Population-Based Evaluation. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2018; 15:ijerph15112447. [PMID: 30400236 PMCID: PMC6265963 DOI: 10.3390/ijerph15112447] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 09/03/2018] [Revised: 10/30/2018] [Accepted: 10/30/2018] [Indexed: 01/21/2023]
Abstract
School interventions to address sexual orientation discrimination can be important tools for fostering inclusive school climate, and improving student wellbeing. In this study, we empirically evaluated a film-based intervention, Out in Schools, designed to reduce sexual orientation prejudice and foster inclusive school attitudes. Our evaluation mapped data about Out in Schools presentations onto student data from the random cluster-stratified, province-wide 2013 British Columbia Adolescent Health Survey (BCAHS) as well as potential confounding variables of Gay-Straight Alliance clubs (GSAs) and inclusive school policies. Outcome measures included past year sexual orientation discrimination, bullying, suicidal ideation, and school connectedness among lesbian, gay, and bisexual (LGB) and heterosexual (HET) students in grades 8 through 12 (ages 13 to 18; unweighted N = 21,075, weighted/scaled N = 184,821). Analyses used complex samples logistic regression, adjusted for sample design, conducted separately by gender and orientation. We found Out in Schools presentations were associated with reduced odds of LGB students experiencing discrimination, and both LGB and HET girl students being bullied or considering suicide, and increased levels of school connectedness, even after controlling for GSAs and policies. Out in Schools appears to have an additive contribution to reducing orientation prejudice and improving LGB and heterosexual student wellbeing within schools.
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Affiliation(s)
- Jillian Burk
- Stigma and Resilience Among Vulnerable Youth Centre, School of Nursing, University of British Columbia, Vancouver, BC V6T 2B5, Canada.
| | - Minjeong Park
- Stigma and Resilience Among Vulnerable Youth Centre, School of Nursing, University of British Columbia, Vancouver, BC V6T 2B5, Canada.
| | - Elizabeth M Saewyc
- Stigma and Resilience Among Vulnerable Youth Centre, School of Nursing, University of British Columbia, Vancouver, BC V6T 2B5, Canada.
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