The Power of Recognition: A Qualitative Study of Social Connectedness and Wellbeing through LGBT Sporting, Creative and Social Groups in Ireland

Social power may be associated with health through positive emotion

Increased social power-defined as one's influence on another's behavior-guides activation of one's behavioral activation system which, in turn, elicits greater positive emotion. Positive emotion has also been linked to greater health. The current research assessed whether power and positive emotion are related to health. In Study 1, participants (N = 403; Mage = 48.33 years) wrote a narrative about a time in which they felt powerful or powerless. Greater self-reported feelings of power, concurrent with more frequent use of positive emotional words within the narrative, was associated with fewer references to health within the narrative. In Study 2, participants (N = 401; Mage = 33.05 years) primed with the concept of power (vs. powerlessness) reported greater health competency through enhanced positive emotion. Findings provided preliminary data supporting the continued study of power to better understand the link between positive emotion and health. Future research should elucidate the long-term relationships between these variables to examine whether increased power can produce downstream positive effects on health and health behavior.

'My parkrun friends.' A qualitative study of social experiences of men at parkrun in Ireland

Social support is a well-established determinant of mental wellbeing. Community initiatives, which combine a purposeful activity with social connection, may be appropriate to promote the mental wellbeing of middle-aged men in Ireland-a group at risk of poor mental wellbeing due to social isolation. parkrun offers free, weekly, 5km run or walk events in 22 countries. This study aims to explore the social experience of parkrun participation for middle-aged men in Ireland and considers how social connections made at parkrun relate to mental wellbeing. Online semi-structured interviews were conducted in 2022/23 with 39 men aged 45-64 years, who run, walk or volunteer at parkrun in Ireland, recruited purposively in rural and urban communities. Men with a range of parkrun experience gave interviews lasting a mean of 32 minutes. Interviews were recorded and transcribed verbatim. Reflexive thematic analysis resulted in three themes and ten subthemes. The men described parkrun as offering a welcoming and supportive environment (Theme 1). Men at parkrun could choose the level of social connections, building strong or weak social ties to provide social support and improve mental wellbeing (Theme 2). Social engagement with parkrun evolved following repeated participation (Theme 3). The results suggest that parkrun is a suitable community initiative for middle-aged men at risk of poor mental wellbeing due to social isolation. Social connections were developed after repeated participation in parkrun and these connections improved subjective mental wellbeing. The findings from this study could be used to design new initiatives for mental health promotion.

Societal discrimination and mental health among transgender athletes: a systematic review and Meta-analysis

BACKGROUND

Discrimination and inequality have been identified as significant problems faced by transgender individuals in sports participation. However, uncertainties remain regarding the effectiveness of interventions aimed at promoting equality.

OBJECTIVES

This systematic review and meta-analysis aimed to examine the experiences of transgender athletes in sports, focusing on mental health issues and factors contributing to inequality among transgender and other sexual minorities.

METHODS

The study followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines and searched 10 electronic databases, including PubMed, Google Scholar, and Web of Science, to identify eligible studies published between 2005 and 2022. The search yielded 1430 articles, of which only 12 studies met the inclusion criteria for this review.

RESULTS

The meta-analysis of the 12 studies included in this review revealed that transgender athletes faced social discrimination and inequality in sports participation, resulting in mental health problems and higher rates of suicide. From a cohort of 21,565 participants in the studies, 7152 (33%) were subjected to discrimination in sports participation and healthcare, with a rate of 0.61 (95% confidence interval [CI]: 0.35, 0.81). However, transgender athletes who felt welcomed and embraced by their respective teams accounted for 0.39 (95% CI: 0.19, 0.65). These results indicated significant differences between how transgender athletes are treated in healthcare settings and when participating in sports.

CONCLUSION

The study findings underscore the need for policies, cultural research, and interventions to address discrimination and inequality faced by transgender athletes in sports participation. Promoting equality and safeguarding the rights of transgender athletes can mitigate the risk of mental health problems and increase physical activity among sexual minorities.

Characterizing Social Connectedness and Associated Mental Health Symptoms among Sexual Minority Men Enrolled in a Substance Use Recovery Support Program

BACKGROUND

Sexual minority men (SMM; gay, bisexual, and other men who have sex with men) report higher rates of substance use compared to other populations. Social connectedness is a critical component for promoting and maintaining recovery from substance use disorders. However, the degree of social connectedness among SMM who report substance use is largely unknown.

OBJECTIVES

We examined substance use, social connectedness (past 30-d participation in formal recovery support, past 30-d interaction with supportive family/friends, relationship satisfaction, and types of support) and mental health among SMM at the time of their enrollment in a behavioral substance use program from September 2019 to October 2021.

RESULTS

Of the107 SMM, 80% of the sample reported past 30-d illicit substance use, with methamphetamine representing the most commonly reported drug used (53%). Participants used a variety of social connections for support, including self-help groups (44% voluntary; 5% religious-affiliated; 20% other) and family/friends (81%). Importantly, 15% reported they had no one to turn to when having trouble and 36% were either dissatisfied or very dissatisfied with their relationships. Participants who endorsed significant depressive (58%) and anxiety (70%) symptoms were more likely to endorse relationship dissatisfaction than participants who did not endorse symptoms (p < 0.01).

CONCLUSIONS

One-third of SMM enrolled in a substance use recovery program expressed relationship dissatisfaction, particularly those struggling with depression or anxiety. Future research and programming should examine ways of leveraging existing social connectedness or forging new social supports to enhance mental health and substance use recovery for SMM using substances.

Gender- and Sexuality-Minoritised Adolescents in DBT: A Reflexive Thematic Analysis of Minority-Specific Treatment Targets and Experience

Gender- and sexuality-minoritised (GSM) adolescents are at increased risk of self-harm and suicidal behaviours compared to their cisgender and heterosexual peers. This increased risk is thought to be explained in part by exposure to stigma and societal oppression. Dialectical Behaviour Therapy (DBT) is an evidence-based intervention for self-harm and suicidal behaviour that may have advantages for supporting GSM young people in distress. No study has yet sought to understand what GSM-associated difficulties may be important to consider in DBT for adolescents, or the experiences of GSM young people in a standard DBT programme. Therefore, this study aimed to understand the experiences of GSM young people in DBT and what difficulties and dilemmas associated with their gender and sexuality diversity were thought by them to be important to target in DBT. Qualitative interviews were conducted with 14 GSM young people in a comprehensive DBT programme and were analysed using Reflexive Thematic Analysis. The analysis was supported by two further GSM young people who had finished DBT. The findings were split into three overarching themes (Identity, Impact of Others, and Space for Sexual and Gender Identity in DBT), each with themes within. The identity-based theme included "identity confusion and acceptance"; the relationship-based themes included "cis-Heterosexism" and "community connectedness"; and the space within DBT themes included "negotiating focus and targeting in DBT" and "creating safety in DBT". Findings are discussed in relation to implications and recommendations for therapists working with GSM young people within and outside of DBT.

Supporting LGBTIQA+ communities in small rural settings: a case study of health promotion in a community health service

People from LGBTIQA+ communities living in rural areas experience significant disparities across a range of health and wellbeing indicators, high levels of stigma and discrimination, and difficulty accessing inclusive health and support services. This article discusses a targeted health promotion intervention designed to build supportive health and social programs to address these problems. We describe the initial needs assessment undertaken to inform the intervention, the role and activities of the health promotion officer funded through the program, and present evaluation data on program outcomes. The article demonstrates that modest funding for health promotion can make a positive contribution to connecting and supporting individuals in a small regional community, leading to better health and wellbeing outcomes.

Prevalence and Determinants of Depressive and Anxiety Symptoms among Transgender People: Results of a Survey

OBJECTIVES

The aim was to investigate the prevalence of probable depression and probable anxiety and to investigate the determinants of depressive symptoms and anxiety symptoms among transgender people.

METHODS

In this "Transgender Survey" (n = 104) we included transgender people who had joined self-help groups to obtain and share information about the gender-affirming surgeries performed at the Division of Plastic, Reconstructive and Aesthetic Surgery at the University Medical Center Hamburg-Eppendorf. Data collection took place between April and October 2022. To measure probable depression, the patient health questionnaire-9 was used. The generalized anxiety disorder-7 was used to quantify probable anxiety.

RESULTS

The prevalence of probable depression was 33.3% and it was 29.6% for probable anxiety. Multiple linear regressions showed that both more depressive symptoms and anxiety symptoms were significantly associated with younger age (β = -0.16, p < 0.01; β = -0.14, p < 0.01), being unemployed (e.g., full-time employed compared to unemployment: β = -3.05, p < 0.05; β = -2.69, p < 0.05), worse self-rated health (β = -3.31, p < 0.001; β = -1.88, p < 0.05), and having at least one chronic disease (β = 3.71, p < 0.01; β = 2.61, p < 0.05).

CONCLUSIONS

Remarkably high prevalence rates were identified among transgender people. Furthermore, risk factors of poor mental health (e.g., unemployment or younger age) were identified-which can help to address transgender people at risk for poor mental health.

Treatment interruptions and community connectedness among gbMSM living with HIV in Metro Vancouver, Canada

HIV treatment interruptions are a major public health concern that demonstrate a lack of engagement in care and is detrimental to the health of people living with HIV. Community connectedness have demonstrated a protective effect for psychosocial health but are not well understood for HIV treatment outcomes. We explored associations between community connectedness and treatment interruptions among gay, bisexual and other men who have sex with men (gbMSM) living with HIV in Vancouver, British Columbia. We analyzed survey data from the Momentum Health Study and identified treatment interruptions through data linkages with the provincial HIV Drug Treatment Program as episodes lasting more than 60 days beyond an expected antiretroviral therapy refill date from February 2012 to July 2019. We built a mixed-effects logistic regression model, adjusting for confounders. Of 213 gbMSM living with HIV, 54 experienced treatment interruption (25.4%) over a median five-year follow-up. Multivariable results found the number gbMSM who spoken to in the past month (aOR = 0.995; 95% CI = 0.991, 1.000 (per 100-unit increase)) and attending a gay community meeting more than once per month (aOR = 0.32; 95% CI = 0.11, 0.89) were associated with lower odds of treatment interruptions. These results highlight the importance of social connections in facilitating effective HIV care.

Drug use and perceived social support in a sexual minority

AIM

To evaluate the perception of social support in a sexual minority and to associate it with the risk of drug addiction.

METHOD

Cross-sectional study, with 254 self-declared gay, bisexual, lesbian, or transsexual participants in the city of Fortaleza, between October and December 2019. Data analyzed by descriptive statistics and likelihood ratio tests.

RESULTS

Most were satisfied with social support between low and medium (74.4%). The most commonly used drugs were alcohol (91.5%), tobacco (67.4%) and marijuana (66.9%). Assessing the risk of addiction, 28.7% scored it as low, 46.9% as moderate, and 9.8% as high risk. There was significance between satisfaction of social support and years of study.

CONCLUSION

We found a level of satisfaction between low and medium, and it was possible to report the most consumed drugs. There was no association between social support and drug use, although the weaknesses and strengths of social support have been highlighted.

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

Background

Lesbian, gay, bisexual, transgender, and queer (LGBTQ) individuals are at higher risk of poor mental health and well-being. Social media platforms can provide LGBTQ youths with a space that counters heteronormative environments and potentially supports mental health and well-being. Mental health includes an individual’s state of psychological and emotional well-being and not merely the absence of mental disorders.

Objective

We sought to identify how LGBTQ youths and adolescents use social media for connection with other LGBTQ peers and groups, identity development, and social support and how these affect mental health and well-being.

Methods

PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) procedures were used to guide this review. Searches were conducted in ACM Digital Library, CINAHL, Ovid Embase, Ovid MEDLINE, and Web of Science in March 2021. This review focused on LGBTQ youths aged 10 to 24 years. Included peer-reviewed studies must comprise social media; explore peer connection, identity development, or social support; and be published from 2012 onward. In total, 2 researchers extracted data and performed quality assessments independently using the Newcastle-Ottawa Scale for quantitative articles and the Critical Appraisal Skills Programme for qualitative articles. Qualitative synthesis was performed on articles that satisfied the eligibility criteria.

Results

A total of 26 studies (n=15, 58% qualitative; n=8, 31% quantitative; n=3, 12% mixed methods) met the inclusion criteria. Of the 8 quantitative studies, 6 (75%) were cross-sectional, and 2 (25%) were cohort studies. All studies ranged from moderate to high quality. Social media was a popular tool used by LGBTQ youths to connect with LGBTQ communities. In qualitative data, we found that LGBTQ youths negotiated and explored identity and obtained support from peers on social media. Instagram, Tumblr, and Twitter were commonly used to access LGBTQ content owing to ease of anonymity. Identity management was the most studied social media affordance, important to LGBTQ youths for strategic disclosure. Key strategies for managing identities included being anonymous, censoring locations or content, restricting audiences, and using multiple accounts. Quantitative studies (3/8, 38%) showed that social media was associated with reduced mental health concerns and increased well-being among LGBTQ youths. Mental health concerns arising from social media use were attributed to discrimination, victimization, and policies that did not accommodate changed identities.

Conclusions

We found that social media may support the mental health and well-being of LGBTQ youths through peer connection, identity management, and social support, but findings were limited by weaknesses in the evidence. More robust and longitudinal studies are needed to determine the relationship between social media use and LGBTQ mental health, particularly among adolescents. The findings may inform interventions to promote social media health literacy and the mental health and well-being of this vulnerable group.

Trial Registration

PROSPERO CRD42020222535; https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=222535

Social Connectedness Matters: Depression and Anxiety in Transgender Youth During the COVID-19 Pandemic

BACKGROUND

Gender-affirming and supportive relations for transgender youth are considered protective in terms of mental health.

AIM

To describe how transgender youth perceived changes in their gender expression, in the course of the gender-affirming path, and the effect of social connectedness and social support on depression and anxiety during the pandemic.

METHODS

In this cross-sectional study, transgender youth completed an online survey developed to evaluate the perceived changes in gender expression and affirmation path that occurred during COVID-19 and the age-stratified lockdown. Furthermore, we aimed to investigate the effect of social connectedness and social support on depression and anxiety in this population during the pandemic. The participants completed the following scales: Social Connectedness Scale Revised (SCS-R), Multidimensional Scale of Perceived Social Support (MSPSS), Beck Depression Inventory (BDI), State-Trait Anxiety Inventory (STAI). The effect of lockdown on life conditions, gender expression, social and medical gender-affirming path, social connectedness, social support, depression, and anxiety levels were examined. Linear regression analyses were performed to evaluate the relationships between BDI and STAI scores and other variables.

OUTCOMES

The relationship between the levels of perceived social connectedness, and social support, the pandemic-related changes in living conditions and depression and anxiety scores were calculated.

RESULTS

A total of 49 transgender youth with a mean age of 20.53 ± 1.86 years were enrolled. Participants reporting discomfort at the place they live and who had difficulties concerning gender expression and affirmation had higher depression and anxiety scores and perceived lower social support from their family. Social connectedness score was a significant negative predictor of depression severity, whereas social connectedness and social support were both significant negative predictors of anxiety severity.

CLINICAL IMPLICATIONS

Our results show increased adversity for transgender youth when connectedness with supportive people is diminished. During the COVID-19 pandemic, social connectedness and social support perceived by transgender youth are associated with better mental health.

STRENGTHS AND LIMITATIONS

This is one of the first studies to evaluate the changes that occurred during the COVID-19 pandemic in transgender youth with relation to social support and connectedness, during an age-stratified lockdown. The main limitations were the small study size, skewed gender ratio and that the study sample came from a single gender clinic.

CONCLUSION

As social connectedness and social support are significant predictors of depression and anxiety severity, special attention is needed to increase contact and support for transgender youth during the pandemic. Tüzün Z, Başar K, Akgül S. Social Connectedness Matters: Depression and Anxiety in Transgender Youth During the COVID-19 Pandemic. J Sex Med 2022;19:650-660.

Social Connectedness Matters: Depression and Anxiety in Transgender Youth During the COVID-19 Pandemic

BACKGROUND

Gender-affirming and supportive relations for transgender youth are considered protective in terms of mental health.

AIM

To describe how transgender youth perceived changes in their gender expression, in the course of the gender-affirming path, and the effect of social connectedness and social support on depression and anxiety during the pandemic.

METHODS

In this cross-sectional study, transgender youth completed an online survey developed to evaluate the perceived changes in gender expression and affirmation path that occurred during COVID-19 and the age-stratified lockdown. Furthermore, we aimed to investigate the effect of social connectedness and social support on depression and anxiety in this population during the pandemic. The participants completed the following scales: Social Connectedness Scale Revised (SCS-R), Multidimensional Scale of Perceived Social Support (MSPSS), Beck Depression Inventory (BDI), State-Trait Anxiety Inventory (STAI). The effect of lockdown on life conditions, gender expression, social and medical gender-affirming path, social connectedness, social support, depression, and anxiety levels were examined. Linear regression analyses were performed to evaluate the relationships between BDI and STAI scores and other variables.

OUTCOMES

The relationship between the levels of perceived social connectedness, and social support, the pandemic-related changes in living conditions and depression and anxiety scores were calculated.

RESULTS

A total of 49 transgender youth with a mean age of 20.53 ± 1.86 years were enrolled. Participants reporting discomfort at the place they live and who had difficulties concerning gender expression and affirmation had higher depression and anxiety scores and perceived lower social support from their family. Social connectedness score was a significant negative predictor of depression severity, whereas social connectedness and social support were both significant negative predictors of anxiety severity.

CLINICAL IMPLICATIONS

Our results show increased adversity for transgender youth when connectedness with supportive people is diminished. During the COVID-19 pandemic, social connectedness and social support perceived by transgender youth are associated with better mental health.

STRENGTHS AND LIMITATIONS

This is one of the first studies to evaluate the changes that occurred during the COVID-19 pandemic in transgender youth with relation to social support and connectedness, during an age-stratified lockdown. The main limitations were the small study size, skewed gender ratio and that the study sample came from a single gender clinic.

CONCLUSION

As social connectedness and social support are significant predictors of depression and anxiety severity, special attention is needed to increase contact and support for transgender youth during the pandemic. Tüzün Z, Başar K, Akgül S. Social Connectedness Matters: Depression and Anxiety in Transgender Youth During the COVID-19 Pandemic. J Sex Med 2022;19:650-660.

Consumo de drogas e suporte social percebido por minoria sexual

RESUMO Objetivo Avaliar a percepção de suporte social em minoria sexual e associá-la com o risco de dependência de drogas. Método Estudo transversal, com 254 participantes autodeclarados gays, bissexuais, lésbicas ou transexuais na cidade de Fortaleza, entre outubro e dezembro de 2019. Dados analisados por estatística descritiva e teste de razão de verossimilhança. Resultados A maioria apresentou satisfação com suporte social entre baixa e média (74,4%). Acerca do uso de drogas, as mais utilizadas foram álcool (91,5%), tabaco (67,4%) e maconha (66,9%). Quanto ao risco de dependência, 28,7% pontuaram como baixo, 46,9% como moderado e 9,8% como alto. Houve significância entre satisfação do suporte social e anos de estudo. Conclusão Encontrou-se nível de satisfação entre baixo e médio e foi possível reportar as drogas mais consumidas. Não foi encontrada associação entre o suporte social e o consumo de drogas, embora as fragilidades e potencialidades do suporte social tenham sido evidenciadas.

Protective Factors for LGBTI+ Youth Wellbeing: A Scoping Review Underpinned by Recognition Theory

Considerable research has been undertaken regarding the mental health inequalities experienced by lesbian, gay, bisexual, transgender and intersex (LGBTI+) youth as a consequence of societal and individual prejudice, stigma and discrimination. Far less research has focussed on protective factors that promote wellbeing for this population. A scoping review was conducted using a six-stage methodological framework, and is reported in accordance with the PRISMA-ScR statement. This explored the extent, range and nature of the peer-reviewed, published, academic literature on what is known about the protective factors that promote LGBTI+ youth wellbeing. Six databases were systematically searched applying Population–Concept–Context key inclusion criteria, complemented by contact with authors to identify additional sources, reference checks and hand searches. Ninety-six individual research records were identified and analysed, drawing from Honneth’s Recognition Theory. Interpersonal relations with parents (n = 40), peers (n = 32) and providers (n = 22) were associated with indicators of enhanced wellbeing, as were LGBTI+ community relations (n = 32). Importantly, online (n = 10), faith (n = 10) and cultural (n = 5) communities were potentially protective. Content and thematic analysis highlighted the importance of Gay–Straight Alliances (GSAs) (n = 23) offering powerful protective opportunities through intersecting interpersonal, community and legal forms of recognition. GSAs enhance allyship by peers and providers (n = 21), facilitate access to LGBTI+ community networks (n = 11) and co-exist alongside inclusive policies (n = 12), curricular (n = 5) and extracurricular activities (n = 1). This scoping review underscores the need to move beyond the predominant focus on risk factors for LGBTI+ youth, which subsequently inform protectionist approaches. It concludes with an appeal to develop mechanisms to apply recognitive justice to policy, practice and, importantly, future research directions. This emphasises the salience of enhanced understandings of inclusion, which is rights-based, universally available and of potential benefit to all.

A healthier way to meet people: the experiences of LGBT people exercising with a peer group

BACKGROUND

Lesbian, gay, bisexual and trans (LGBT) individuals have been shown to have poorer health when compared to those who identified as heterosexual. Additionally, they encounter barriers that deter participation in sports.

AIM

To understand the experiences of LGBT individuals who participate in physical activity with peers.

METHOD

An exploratory-descriptive qualitative (EDQ) study with data collected via face-to-face interviews from 12 participants. Data were thematically analysed to identify findings.

FINDINGS

exercising with peers represents a healthier way to meet people. Participants experienced improved physical, mental and social health.

CONCLUSION

Engaging with a peer group for physical activity can have a transformational effect on members of the LGBT community, impacting on all aspects of their wellbeing. Nurses, and other health professionals, should be aware of the multifaceted benefits that exercising with a peer group can have, using their regular interactions with this patient group to recommend peer-supported exercise.

The health of lesbian, gay, bisexual, transgender and intersex people

Sex, gender and sexual orientation are diverse, as are the ways of living associated with them. The extent to which people can live a free and self-determined life according to their own body, gender, sexuality and way of life influences their social resources, opportunities for participation and discrimination and has an influence on their life situation and health. A narrative review of lesbian, gay, bisexual, transgender and intersex (LGBTI) health was conducted including international and German reviews, meta-analyses and population-based studies. The focus of this article is the legal, social and medical recognition as well as health status of LGBTI people in Germany. While the legal framework in Germany for homosexual and bisexual people has gradually improved, many civil society stakeholders have pointed to major deficits in the medical and legal recognition of transgender and intersex people. In addition, scientific findings frequently have not yet found its way into medical practice to an adequate extent. Available data on LGBTI health indicate a need for action in the areas of mental health and health care provision. However, due to a lack of comprehensive data, conclusions cannot be drawn on the general health situation and health resources of LGBTI people. For the concrete planning and implementation of measures as well as the differentiated portrayal of the situation in Germany, the databases must be expanded, not least via population-representative surveys.