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Leonard SI, Liu J, Jackman KB, Bruzzese JM. Sexual and Gender Minority Sleep Health Disparities and Minority Stress in Early Adolescence. J Adolesc Health 2024:S1054-139X(24)00258-1. [PMID: 39001757 DOI: 10.1016/j.jadohealth.2024.05.022] [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: 11/02/2023] [Revised: 05/17/2024] [Accepted: 05/23/2024] [Indexed: 07/15/2024]
Abstract
PURPOSE Sleep is essential to adolescent development. Sexual and gender minority (SGM; e.g., lesbian, gay, bisexual, transgender) adults are at high risk for poor sleep, partially due to minority stress (e.g., discrimination). However, sleep has rarely been studied among SGM adolescents. In a national sample of early adolescents, we analyzed sexual minority (SM) and gender minority (GM) identity, gender incongruence, and gender nonconformity in association with sleep and tested minority and general stressors as mediators. METHODS We cross-sectionally analyzed data from 10,070 adolescents aged 10-14 in the Adolescent Brain Cognitive Development℠ Study. Using logistic regression models, we analyzed associations between identity (SM and GM), sexual identity discrimination, minority and general stressors (sexual identity discrimination, teasing, and conflict with parents) and sleep health (duration, latency, and disturbance). We used Baron and Kenny's method to test for mediation. RESULTS Participants reported sexual identity (4% SM, 4% questioning) and gender identity (0.4% GM, 0.6% questioning); 65% were White, 20% were Hispanic, and 52% were assigned male at birth. Compared to heterosexual, SM participants had higher odds of short sleep duration, long sleep latency, and sleep disturbance. GM participants and those reporting gender incongruence and nonconformity had higher odds of long sleep latency and sleep disturbance. Sexual identity discrimination and general social stressors partially mediated some associations. DISCUSSION SGM participants reported poorer sleep. Minority and general social stressors partially accounted for some disparities. Policies need to address SGM identity-based discrimination and challenge social norms that produce minority stress for SGM early adolescents.
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Affiliation(s)
- Sarah I Leonard
- Center for Sexual and Gender Minority Health Research, Columbia University School of Nursing, New York, New York; Office of Scholarship and Research Development, Columbia University School of Nursing, New York, New York.
| | - Jianfang Liu
- Office of Scholarship and Research Development, Columbia University School of Nursing, New York, New York
| | - Kasey B Jackman
- Center for Sexual and Gender Minority Health Research, Columbia University School of Nursing, New York, New York; Office of Scholarship and Research Development, Columbia University School of Nursing, New York, New York; NewYork-Presbyterian Hospital, New York, New York
| | - Jean-Marie Bruzzese
- Center for Sexual and Gender Minority Health Research, Columbia University School of Nursing, New York, New York; Office of Scholarship and Research Development, Columbia University School of Nursing, New York, New York
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Koh H, Farrant B, Fenaughty J, Ameratunga S, Peris-John R, Bavin L. Asian Rainbow Youth in New Zealand: Protective Factors. J Adolesc Health 2024:S1054-139X(24)00262-3. [PMID: 38980245 DOI: 10.1016/j.jadohealth.2024.05.026] [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: 10/26/2023] [Revised: 05/28/2024] [Accepted: 05/29/2024] [Indexed: 07/10/2024]
Abstract
PURPOSE To explore the impacts of double minority status (ethnic and sexual/gender minority) and protective factors associated with the emotional wellbeing and mental health of Asian Rainbow (sexual/gender minority) youth in New Zealand. METHODS The data were extracted from the Youth19 Rangatahi survey, which surveyed 7,374 students from 45 mainstream secondary schools. The comparison groups were Asian non-Rainbow youth and Pākehā (New Zealand European) Rainbow youth. A secondary analysis was performed examining the associations between postulated protective factors and the emotional wellbeing and mental health outcomes of Asian Rainbow youth. RESULTS Asian Rainbow youth had higher odds of depressive symptoms, anxiety, and suicidal thoughts and attempts and lower odds of good emotional wellbeing compared to Asian non-Rainbow youth. However, Asian Rainbow youth had lower odds of anxiety compared to Pākehā Rainbow youth. Among Asian Rainbow youth, family acceptance and feeling safe at school were associated with higher odds of good emotional wellbeing, and lower odds of depressive symptoms, anxiety, and suicidal thoughts. Several other protective factors were also associated with 1 or more (but not all) of the emotional wellbeing and mental health indicators. DISCUSSION This study suggests that family acceptance and feeling safe at school may serve as important buffers mitigating risks of adverse emotional wellbeing experienced by Asian Rainbow youth.
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Affiliation(s)
- How Koh
- Kidz First, Te Whatu Ora Counties Manukau, New Zealand
| | - Bridget Farrant
- Kidz First, Te Whatu Ora Counties Manukau, New Zealand; Department of Paediatrics, Faculty of Medical Health Sciences, University of Auckland, Auckland, New Zealand.
| | - John Fenaughty
- School of Counselling, Human Services and Social Work, Faculty of Education and Social Work, University of Auckland, Auckland, New Zealand
| | - Shanthi Ameratunga
- Section of Epidemiology and Biostatistics, School of Population Health, University of Auckland, Auckland, New Zealand; Te Whatu Ora - Service Improvement & Innovation, Population Health Gain Team, Counties Manukau, New Zealand
| | - Roshini Peris-John
- Section of Epidemiology and Biostatistics, School of Population Health, University of Auckland, Auckland, New Zealand
| | - Lynda Bavin
- Section of Epidemiology and Biostatistics, School of Population Health, University of Auckland, Auckland, New Zealand
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Kelly MD, Braswell AA, Thomley JE. Optimizing Sexual and Gender Minority Adolescent Health: Putting Evidence into Practice. J Pediatr Health Care 2024; 38:595-603. [PMID: 38551538 DOI: 10.1016/j.pedhc.2024.02.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/26/2023] [Revised: 02/15/2024] [Accepted: 02/18/2024] [Indexed: 07/05/2024]
Abstract
INTRODUCTION Sexual and gender minority (SGM) adolescents are at higher risk for adverse health outcomes compared to their cisgender and heterosexual peers. METHODS Guided by the EPQA standardized reporting system, we implemented an evidence-based practice (EBP) initiative centered on affirmative healthcare for adolescents in two pediatric primary care sites. This initiative revolved around: (1) provider training on healthcare needs of SGM adolescents, (2) the use of two new EHR charting tools for SGM needs, and (3) examination of the EBP initiative using quantitative and qualitative analyses. RESULTS Quick-texts tools were used 165 times in 3 months (20.4% compliance). Findings also show providers screened Hispanic patients at a proportionately lower rate (p = .043) as compared to other races and ethnicity. Providers perceived the EBP initiative as informative, feasible, without workflow disruption with suggestions for improvement. DISCUSSION This EBP initiative has implications for advanced nursing practice, organizational policy, and health equity.
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Hamley L, Kerekere E, Nopera T, Tan K, Byrne J, Veale J, Clark T. The glue that binds us: The positive relationships between whanaungatanga (belonging), the wellbeing, and identity pride for takatāpui who are trans and non-binary. Health Promot J Austr 2024. [PMID: 38866386 DOI: 10.1002/hpja.890] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2023] [Accepted: 05/29/2024] [Indexed: 06/14/2024] Open
Abstract
ISSUE ADDRESSED This article explores how belonging can enhance well-being for takatāpui (a traditional Māori term that embraces all Māori with diverse genders, sexualities and sex characteristics) who are trans and non-binary across a range of contexts. METHODS We drew data from the 2018 Counting Ourselves, a nationwide community-based survey of trans and non-binary people in Aotearoa (New Zealand) (N = 1178); of which 161 (13.7%) identified as Māori, the Indigenous people of Aotearoa. RESULTS Based on generalised regression models, feelings of belonging with friends, takatāpui communities, Māori communities, and work communities were correlated to higher feelings of life satisfaction, life worthwhileness, and identity pride for takatāpui who are trans and non-binary. In Te Ao Maōri (the Māori worldview), such concepts of belonging and relationships are collectively known as whanaungatanga. CONCLUSIONS Our findings affirm whanaungatanga as foundational to well-being among trans Māori people, enabling them to locate themselves within nurturing and supportive networks. SO WHAT?: Whanaungatanga is a key policy agenda, alongside other system-level change, that is needed to buffer takatāpui who are trans and non-binary from poverty, stigma, and racism they face. This will require changes to the current policy and practice context. We argue that whanaungatanga, while an important strategy of well-being for trans and non-binary people, must also occur alongside wider system transformations to address transphobia, racism, and cisheteronormativity.
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Affiliation(s)
- Logan Hamley
- School of Psychology, University of Waikato, Hamilton, New Zealand
| | | | - Tāwhanga Nopera
- Health Promotion - Student Health, University of Waikato, Hamilton, New Zealand
| | - Kyle Tan
- Faculty of Māori and Indigenous Studies, University of Waikato, Hamilton, New Zealand
| | - Jack Byrne
- Trans Health Research Lab, School of Psychology, University of Waikato, Hamilton, New Zealand
| | - Jaimie Veale
- Trans Health Research Lab, School of Psychology, University of Waikato, Hamilton, New Zealand
| | - Terryann Clark
- Faculty of Medical and Health Sciences, Nursing, University of Auckland, Auckland, New Zealand
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Wesche R, Kreager DA, Ramirez NG, Gupta S. Dating and friendships in adolescence: Variation across same-sex and other-sex romantic partners. JOURNAL OF RESEARCH ON ADOLESCENCE : THE OFFICIAL JOURNAL OF THE SOCIETY FOR RESEARCH ON ADOLESCENCE 2023; 33:1131-1142. [PMID: 37211755 DOI: 10.1111/jora.12865] [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] [Received: 10/10/2022] [Revised: 05/08/2023] [Accepted: 05/10/2023] [Indexed: 05/23/2023]
Abstract
This research examined associations between dating and number of friends for rural adolescents with same-sex and other-sex dating partners using longitudinal sociometric data (N = 2826; 55% female, 87% White, mean age = 14 at baseline). In multilevel models assessing within-person change, boys gained female friends when they were in same-sex romantic relationships, compared to when they were single. In contrast, girls in same-sex relationships lost female friends and gained male friends. Adolescents in other-sex romantic relationships gained same-sex friends compared to when they were single. Results advance understanding of adolescent social and sexual development, suggesting that sexual minority adolescents find allies when dating but may struggle to maintain same-sex friendships.
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Affiliation(s)
- Rose Wesche
- Virginia Polytechnic Institute and State University, Blacksburg, Virginia, USA
| | - Derek A Kreager
- The Pennsylvania State University, University Park, Pennsylvania, USA
| | - Nayan G Ramirez
- California State University Northridge, Northridge, California, USA
| | - Shivangi Gupta
- Virginia Polytechnic Institute and State University, Blacksburg, Virginia, USA
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Keski-Rahkonen A. Eating disorders in transgender and gender diverse people: characteristics, assessment, and management. Curr Opin Psychiatry 2023; 36:412-418. [PMID: 37781981 DOI: 10.1097/yco.0000000000000902] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/03/2023]
Abstract
PURPOSE OF REVIEW This review summarizes recent research on eating disorders among gender minorities, transgender and gender diverse people. The focus is on research published in 2022 and the first half of 2023. RECENT FINDINGS Up to 1.2% of young people and 0.3-0.5% of adults identify as transgender, and 2.7-8.4% of young people and 0.3-4.5% of adults report some degree of gender diversity. About 20-50% of transgender and gender diverse people report engaging in disordered eating and >30% screen positive for eating disorder symptoms, and 2-12% have received an eating disorder diagnosis from a health professional. Many transgender and gender diverse people describe eating disorder symptoms as a way of coping with gender dysphoria. They also report high levels of mental and behavioral symptoms, particularly mood and anxiety disorders, suicidal thoughts and behaviors, trauma-related symptoms and disorders, alcohol and substance use, and autism. Gender minorities frequently experience discrimination, victimization, and violence, primarily sexual and physical violence. The minority stress model attributes mental health symptoms to these factors. Promising interventions based on the minority stress model have recently become available, but more research is needed on how to support transgender and gender diverse people with eating disorders. To manage eating disorders in this population, gender-affirming care should be combined with specialist eating disorder treatment. SUMMARY Gender minorities are at high risk for eating disorders. Future studies should assess what is the most appropriate treatment for transgender and gender diverse people with eating disorders.
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Talbot J, Finlay F. Conversion therapy: change the law not the person. Arch Dis Child 2023; 108:595-596. [PMID: 35760455 DOI: 10.1136/archdischild-2022-324177] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/22/2022] [Accepted: 06/17/2022] [Indexed: 11/04/2022]
Affiliation(s)
| | - Fiona Finlay
- Community Paediatrics, HCRG Care Group, St Martins Hospital, Bath, UK
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Firkey MK, Tully LK, Schiros AM, Antshel KM, Woolf-King SE. Sexual Assault, Mental Health, and Alcohol Use in College Women: The Role of Resilience and Campus Belonging. JOURNAL OF INTERPERSONAL VIOLENCE 2023; 38:7990-8015. [PMID: 36757066 DOI: 10.1177/08862605231153884] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
Understanding the mental health outcomes of sexual assault among college women is a public health priority. Although research has identified risk factors for the development of mental health problems following an assault, few studies have utilized a strengths-based approach to identify personal and social resources that may mediate the sexual assault-mental health link. Prior studies allude to the role of resilience and perceived campus belonging in explaining the relationship between sexual assault and mental health. This study represents the first application of the stress process model using a large sample of college women to examine (a) the association between sexual assault and mental health (i.e., psychological distress, suicidality, self-harm) and alcohol use problems and (b) the role of resilience and perceived campus belonging as partial mediators of these associations. Data were collected as part of the Spring 2021 American College Health Association National College Health Assessment (ACHA-NCHA; n = 31,328, Mean age = 20.26, SD = 1.64, 58.8% White), a cross-sectional, online survey that samples college students from 143 self-selected United States colleges. To test our primary hypothesis, a structural regression model was conducted, which included a latent sexual assault predictor, manifest resilience and campus belonging mediators, a latent mental health outcome, and a manifest alcohol use problems outcome. Mental health and alcohol use problems were positively associated with sexual assault and negatively associated with resilience and campus belonging. Resilience partially mediated the association between sexual assault and mental health. Campus belonging partially mediated the association between sexual assault, mental health, and alcohol use problems. This model explained 23.2% of the variance in mental health and 5.9% of the variance in alcohol use. Resilience and campus belonging may represent modifiable factors that can be targeted in trauma-focused interventions in efforts to improve victimized college women's mental health.
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Dosanjh LH, Hinds JT, Cubbin C. The impacts of adverse childhood experiences on socioeconomic disadvantage by sexual and gender identity in the U.S. CHILD ABUSE & NEGLECT 2023; 141:106227. [PMID: 37163969 DOI: 10.1016/j.chiabu.2023.106227] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/28/2023] [Revised: 04/13/2023] [Accepted: 04/26/2023] [Indexed: 05/12/2023]
Abstract
BACKGROUND Adverse childhood experiences (ACEs) predict low education and low income, but this has scarcely been examined by sexual orientation and gender identity. OBJECTIVE We investigated prevalence and associations between ACEs, low income, and low education in sexual and gender diverse (SGD) and cisgender heterosexual (CGH) sub-groups. PARTICIPANTS AND SETTING Data came from 14 states in the 2019 Behavioral Risk Factor Surveillance System survey (n = 79,303). METHODS Chi-square, logistic regression, and moderation analyses were implemented to examine the prevalence and associations between ACEs, low income, and low education. Sample stratification was used to examine differences between SGD and CGH sub-groups. RESULTS SGD participants reported higher prevalence of ACEs, low income, and low education compared to CGH participants (p < 0.0001) with the highest proportions in transgender and queer/something else groups. ACEs were associated with low income (AOR 1.084, CI 1.067-1.102) and low education (AOR 1.056, CI 1.041-1.071) in the entire sample. Transgender and queer/something else groups had higher odds of low income (AOR 3.345, CI 1.975-5.665; AOR 1.702, CI 1.096-2.643) and low education (AOR 1.702, CI 1.096-2.643; AOR 3.552, CI 2.842-4.440) and gay/lesbian identity had reduced odds of low education (AOR 0.586, CI 0.457-0.751) compared to CGH males. The strength of associations between ACEs and low income and low education were weaker among SGD compared to CGH sub-groups. CONCLUSION These findings highlight the importance of including categories of sexual identity cross-classified by gender identity in population-based analyses in order to facilitate a comprehensive characterization of the life course outcomes of SGD populations.
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Affiliation(s)
- Laura H Dosanjh
- The Steve Hicks School of Social Work, The University of Texas at Austin, United States of America.
| | - Josephine T Hinds
- The Steve Hicks School of Social Work, The University of Texas at Austin, United States of America
| | - Catherine Cubbin
- The Steve Hicks School of Social Work, The University of Texas at Austin, United States of America
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Isano S, Yohannes T, Igihozo G, Ndatinya GI, Wong R. A qualitative study to explore the healthcare-seeking experiences of men who have sex with men (MSM) and transgender women (TGW) in Rwanda. BMC Health Serv Res 2023; 23:291. [PMID: 36978054 PMCID: PMC10045920 DOI: 10.1186/s12913-023-09286-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2022] [Accepted: 03/14/2023] [Indexed: 03/30/2023] Open
Abstract
BACKGROUND Globally, men who have sex with men (MSM) and transgender women (TGW) encounter many challenging experiences when accessing health services compared to the general population. Stigma, discrimination, and punitive laws against same-sex relationships in some sub-Saharan African countries have made MSM and TGW more prone to depression, suicidal ideation, anxiety disorders, substance abuse, non-communicable diseases, and HIV. None of the prior studies in Rwanda on MSM and TGW had explored their lived experience in accessing health services. Accordingly, this study aimed at exploring the healthcare-seeking experiences of MSM and TGW in Rwanda. METHODS This study utilized a qualitative research method employing a phenomenological design. Semi-structured in-depth interviews were conducted with 16 MSM and 12 TGW. Participants were recruited via purposive and snowball sampling approaches in five districts in Rwanda." RESULTS Data were analyzed using a thematic analysis approach. Three main themes emerged from the study: (1) The healthcare experiences of MSM and TGW were generally dissatisfactory, (2) MSM and TGW hesitated to seek care unless they were severely ill, (3) MSM and TGW's perspectives on how to improve their health-seeking behavior. CONCLUSION MSM and TGW in Rwanda continue to face negative experiences within the healthcare delivery settings. These experiences include mistreatment, refusal of care, stigma, and discrimination. Provision of services for MSM and TGW and On-the-job cultural competence training in the care of MSM and TGW patients is needed. Including the same training in the medical and health sciences curriculum is recommended. Furthermore, awareness and sensitization campaigns to improve the understanding of the existence of MSM and TGW and to foster acceptance of gender and sexual diversity in society are necessary.
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Affiliation(s)
- Sandra Isano
- Department of Community Health and Social Medicine, University of Global Health Equity, Kigali, Rwanda.
| | - Tsion Yohannes
- Center of Gender Equity, University of Global Health Equity, Kigali, Rwanda
| | - Gloria Igihozo
- Institute of Global Health, University of Global Health Equity, Kigali, Rwanda
| | - Grace Iliza Ndatinya
- Department of Community Health and Social Medicine, University of Global Health Equity, Kigali, Rwanda
| | - Rex Wong
- Institute of Global Health, University of Global Health Equity, Kigali, Rwanda
- School of Public Health, Yale University, Yale, USA
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Burish E, Wilcox MM, Pollard EM, Sims KN. Differentiating protective factors for transgender individuals who experience suicidality: The role of optimism as a mediator. Clin Psychol Psychother 2023. [PMID: 36662537 DOI: 10.1002/cpp.2833] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2022] [Revised: 01/14/2023] [Accepted: 01/17/2023] [Indexed: 01/21/2023]
Abstract
As a result of experiencing oppression-based stressors and trauma, suicide rates for lesbian, gay, bisexual and transgender (LGBTQ+) individuals are much higher than in the general population, and for trans and gender non-binary (TGNB) individuals specifically, rates of suicidality are even higher. To best understand how to engage in suicide prevention and intervention efforts for TGNB individuals, it is therefore crucial to understand factors that may mitigate suicidality for TGNB individuals. The purpose of this study was to examine the relationship between protective factors-body acceptance, optimism, social support and pride-and suicidality for TGNB adults. A total of 139 TGNB participants completed an online survey about suicidal behaviours, transgender-specific risk factors and transgender-specific protective factors. High rates of suicidality were observed in our sample. Initial results suggested that only optimism was inversely significantly related to suicidality. Given that optimism, which suggests a belief in a better future, has been found in previous studies to buffer the effects of deleterious stressors, optimism was also examined as a mediator between body acceptance (a key feature of gender dysphoria) and suicidality. Results suggested that optimism did mediate the relationship between body acceptance and suicidality. Optimism appears to be an important protective factor against suicidality for TGNB individuals and thus a potentially important target of intervention.
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Affiliation(s)
- Emily Burish
- School of Community Health Sciences, Counseling and Counseling Psychology, Oklahoma State University, Stillwater, Oklahoma, USA.,Department of Psychology, Louisiana Tech University, Ruston, Louisiana, USA
| | - Melanie M Wilcox
- Department of Psychological Sciences, Augusta University, Augusta, Georgia, USA
| | - Elinita M Pollard
- Department of Psychological Sciences, Augusta University, Augusta, Georgia, USA
| | - K' Nadja Sims
- Department of Psychological Sciences, Augusta University, Augusta, Georgia, USA
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Folayan MO, Oginni O, Ibigbami OI, Philip U, Mfam NN, Mbam C, Ganyam A, Salem AA, Osuji C, Bradley C, Lusher J, Sam-Agudu NA. Associations between mental health and HIV status among sexual minority and heterosexual adolescents in Nigeria. BMJ Glob Health 2022; 7:bmjgh-2022-010231. [PMID: 36564086 PMCID: PMC9791420 DOI: 10.1136/bmjgh-2022-010231] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2022] [Accepted: 12/03/2022] [Indexed: 12/25/2022] Open
Abstract
BACKGROUND We aimed to determine associations between the mental health status of adolescents by self-reported sexual identity; and to determine associations between the mental health status of sexual minority adolescents living with and without HIV. METHODS This cross-sectional study collected data from Nigerians aged 13-19 years old using an online survey. We collected information on dependent (sexual identity) and independent (presence of depressive symptoms, generalised anxiety disorder, suicidal attempt/ideation, HIV status) study variables. A multivariate regression model determined associations between the dependent and independent variables. A second multivariate regression model was developed to establish associations between HIV status among sexual minority individuals and the dependent variables. All models were adjusted for age, sex assigned at birth and education level. RESULTS Among 1247 respondents living in Nigeria, 497 (39.9%) identified as sexual minority individuals. Compared with their heterosexual peers, sexual minority adolescents had significantly higher odds of reporting depressive symptoms (adjusted OR (AOR): 5.54; 95% CI: 4.10 to 7.47; p<0.001), high general anxiety (AOR: 3.56; 95% CI: 2.64 to 4.79; p<0.001) and history of suicidal attempt/ideation (AOR: 2.95; 95% CI: 2.20 to 3.94; p<0.001). Sexual minority adolescents living with HIV had significantly higher odds of high general anxiety (AOR: 2.42; 95% CI: 1.21 to 4.84; p=0.013), while those with unknown HIV status had significantly higher odds of depressive symptoms (AOR: 3.82, 95% CI: 2.78 to 5.27; p<0.001), high general anxiety (AOR: 3.09; 95% CI: 2.29 to 4.17; p<0.001) and suicidal attempt/ideation (AOR: 1.65; 95% CI: 1.22 to 2.24; p=0.001). CONCLUSION Sexual minority adolescents reported poorer mental health status than heterosexual adolescents. Although there was no significant difference in the mental health status of sexual minority adolescents living and not living with HIV, sexual minority adolescents with unknown HIV status reported worse mental health than their HIV-negative peers. Sexual minority adolescents in Nigeria need comprehensive rights-based care that improves access to mental health services, and those with unknown HIV status may need both HIV and mental health screening and care.
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Affiliation(s)
| | - Olakunle Oginni
- Department of Mental Health, Obafemi Awolowo University, Ile-Ife, Nigeria
| | | | - Uma Philip
- Total Health Empowerment and Development Initiative (THEDI), Makurdi, Nigeria
| | - Nserd Ntonoba Mfam
- Department of Epidemiology and Community Medicine, Federal University of Lafia, Lafia, Nigeria
| | - Chinedu Mbam
- Total Health Empowerment and Development Initiative (THEDI), Makurdi, Nigeria
| | - Amos Ganyam
- Total Health Empowerment and Development Initiative (THEDI), Makurdi, Nigeria
| | - Agada A Salem
- Total Health Empowerment and Development Initiative (THEDI), Makurdi, Nigeria
| | - Christopher Osuji
- Total Health Empowerment and Development Initiative (THEDI), Makurdi, Nigeria
| | - Cory Bradley
- Department of Medicine, Washington University School of Medicine in St Louis, St Louis, Missouri, USA
| | | | - Nadia Adjoa Sam-Agudu
- International Research Center of Excellence, Institute of Human Virology Nigeria, Abuja, Nigeria,University of Maryland School of Medicine, Institute of Human Virology, Baltimore, Maryland, USA,Department of Paediatrics and Child Health, University of Cape Coast School of Medical Sciences, Cape Coast, Ghana
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Talbot J, Finlay F. Empowering healthcare professionals with health promotion information for transgender adolescents. Arch Dis Child Educ Pract Ed 2022; 108:158-162. [PMID: 36347600 DOI: 10.1136/archdischild-2022-324744] [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: 08/03/2022] [Accepted: 10/20/2022] [Indexed: 11/09/2022]
Abstract
While the majority of lesbian, gay, bisexual and transgender (LGBT) adolescents, much like their cis-gendered heterosexual peers, will be confident and healthy young individuals, there are well-known health disparities, particularly within the transgendered community, which may lead to inferior health outcomes. To improve these outcomes, we must empower professionals to feel confident in their interactions with transgender adolescents so they can recognise, discuss and address these disparities. For many healthcare professionals, this may be a novel experience, but following the announcement in 2022 that the Gender Identity Development Service (GIDS) will move towards a regional model, these discussions increasingly frequently be encountered in a general paediatric setting. In this article, we discuss some of the topics which may be relevant to transgender young people during a general paediatric consultation.
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Affiliation(s)
| | - Fiona Finlay
- Community Paediatrics, HCRG Care Group, St Martins Hospital, Bath, UK
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