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Joy P, Thomas A, Aston M. Compassionate Discourses: A Qualitative Study Exploring How Compassion Can Transform Healthcare for 2SLGBTQ+ People. QUALITATIVE HEALTH RESEARCH 2022; 32:1514-1526. [PMID: 35739090 PMCID: PMC9411689 DOI: 10.1177/10497323221110701] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
Compassion can be seen as a necessary, but often lacking, concept and practice in healthcare. Due to the cis-heteronormative nature of societies, people who identify as Two-Spirit, lesbian, gay, bisexual, transgender, queer (2SLGBTQ+) often experience health disparities and disparities in accessing compassionate healthcare. We aimed to explore the meanings of compassion in healthcare for Canadian 2SLGBTQ+ people. Using a poststructuralist framework, 20 self-identifying 2SLGBTQ+ participants were interviewed. Data was analyzed through discourse analysis. Three main discursive considerations are discussed, including (1) meanings and expectations of compassion in healthcare, (2) compassionate healthcare is not guaranteed, and (3) prescription for care: self-compassion for healing and health. The results provide insights into how compassionate healthcare is framed for 2SLGBTQ+ participants and how compassion is often lacking for them due to discourses of cis-heteronormativity and healthism.
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Affiliation(s)
- Phillip Joy
- Department of Applied Human Nutrition, Mount Saint Vincent University, Halifax, NS, Canada
| | - Andrew Thomas
- Department of Applied Human Nutrition, Mount Saint Vincent University, Halifax, NS, Canada
| | - Megan Aston
- School of Nursing, Dalhousie University, Halifax, NS, Canada
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2
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Eidson-Ton WS. Health Care of the Adolescent. Fam Med 2022. [DOI: 10.1007/978-3-030-54441-6_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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3
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Health Care of the Adolescent. Fam Med 2021. [DOI: 10.1007/978-1-4939-0779-3_22-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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4
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Abstract
To optimally address sex and sexuality, normalize gender and sexual diversities, and attend to adolescents' needs, clinicians will best serve their patients and their families by becoming comfortable initiating confidential, developmentally appropriate discussions with all adolescent patients. The goal is to create a safe, affirming, nonjudgmental space wherein adolescents may learn about sexual matters, discuss concerns, ask questions, and find support to assist them to achieve healthy, positive development. This article provides useful, practical suggestions to begin these conversations, offers specific examples and tips to encourage dialogue, and discusses ways to be a resource to adolescent patients.
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Affiliation(s)
- Betsy Pfeffer
- Division of Child & Adolescent Health, Columbia University Medical Center, Columbia University College of Physicians and Surgeons, 622 West 168th Street, VC4-417, New York, NY 10032, USA.
| | - Taylor Rose Ellsworth
- Division of Education, Research and Training, Physicians for Reproductive Health, 55 West 39th Street, Suite 1001, New York, NY 10018, USA
| | - Melanie A Gold
- Department of Pediatrics, Center for Community and Health Education, Columbia University Medical Center, New York, NY 10032, USA; Department of Population and Family Health, Center for Community and Health Education, Columbia University Medical Center, 60 Haven Avenue, Level B-3, Room 308, New York, NY 10032, USA
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5
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Eidson-Ton WS. Health Care of the Adolescent. Fam Med 2017. [DOI: 10.1007/978-3-319-04414-9_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Coleman TA, Bauer GR, Pugh D, Aykroyd G, Powell L, Newman R. Sexual Orientation Disclosure in Primary Care Settings by Gay, Bisexual, and Other Men Who Have Sex with Men in a Canadian City. LGBT Health 2016; 4:42-54. [PMID: 27996376 DOI: 10.1089/lgbt.2016.0004] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022] Open
Abstract
PURPOSE Sexual orientation affects individuals' health histories and is fundamental to providers' understanding of patients as a whole. Gay, bisexual, and other men who have sex with men (GB-MSM) are vulnerable to certain health conditions, including HIV. The aim of this exploratory analysis was to examine factors associated with sexual orientation disclosure and communication with providers about GB-MSM health issues and to discuss implications. METHODS We conducted a cross-sectional internet survey of GB-MSM (n = 202) in London-Middlesex, Ontario, Canada; analyses were limited to those with a regular primary care provider (n = 173). Blockwise regression models explored demographic, psychosocial, and healthcare-related factors associated with sexual orientation disclosure and physician-patient communication about GB-MSM-related health. RESULTS Just over seventy-one percent (71.1%) of participants reported that their primary care provider (PCP) knew their sexual orientation, and 44.5% had talked to them about GB-MSM health. Overt negative comments or being refused care based on sexual orientation occurred infrequently, although 26.6% reported their provider had assumed they were heterosexual. Being married to or living common-law with another man, more frequent experiences of homosexual prejudice, and higher quality assessment of provider's communication skills were associated with the PCP knowing respondents' sexual orientation. Greater internalized homonegativity was associated with not talking to a PCP about GB-MSM-related health issues. More frequent experiences of homosexual prejudice, higher assessment of provider communication, and having prior negative experiences with a PCP were significantly associated with talking to a PCP about GB-MSM health. CONCLUSION The majority of our sample disclosed their sexual orientation; however, not all patients voluntarily disclose. Medical training and education in Canada, where specific rights protections exist for sexual orientation minority populations, should emphasize awareness of essential patient health information. Training should include information about GB-MSM health and building a foundation on how to speak with GB-MSM patients nonjudgmentally.
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Affiliation(s)
- Todd A Coleman
- 1 Department of Psychology, Ryerson University , Toronto, Canada .,2 Department of Epidemiology and Biostatistics, University of Western Ontario , London, Canada
| | - Greta R Bauer
- 2 Department of Epidemiology and Biostatistics, University of Western Ontario , London, Canada
| | - Daniel Pugh
- 3 Gay Men's Sexual Health Alliance , Toronto, Canada
| | - Gloria Aykroyd
- 4 St. Joseph's Infectious Diseases Care Program , London, Canada
| | | | - Rob Newman
- 6 Regional HIV/AIDS Connection , London, Canada
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7
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Risque suicidaire et stress chez les jeunes homosexuels. PSYCHOLOGIE FRANCAISE 2015. [DOI: 10.1016/j.psfr.2015.01.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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Abstract
This article provides an overview of the medical and mental health needs of the lesbian, gay, bisexual, and transgender (LGBT) youth population. Information is reviewed regarding both primary medical care and the special health risks that these youth face. Providers are introduced to the concept that societal and internalized homophobia lead directly to certain health disparities, including substance use, school and family rejection, depression, and increased sexually transmitted infection acquisition. This article familiarizes the primary care practitioner with the health care needs of the LGBT population and the research behind the various recommendations for caring for these youth.
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Affiliation(s)
- John Steever
- Department of Pediatrics, Mount Sinai Adolescent Health Center, Icahn School of Medicine at Mount Sinai, Second Floor, 312-320 East 94th Street, New York, NY 10128, USA.
| | - Jenny Francis
- Department of Pediatrics, Mount Sinai Adolescent Health Center, Icahn School of Medicine at Mount Sinai, Second Floor, 312-320 East 94th Street, New York, NY 10128, USA
| | - Lonna P Gordon
- Department of Pediatrics, Mount Sinai Adolescent Health Center, Icahn School of Medicine at Mount Sinai, Second Floor, 312-320 East 94th Street, New York, NY 10128, USA
| | - Janet Lee
- Department of Pediatrics, Mount Sinai Adolescent Health Center, Icahn School of Medicine at Mount Sinai, Second Floor, 312-320 East 94th Street, New York, NY 10128, USA
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Lucassen MF, Clark TC, Denny SJ, Fleming TM, Rossen FV, Sheridan J, Bullen P, Robinson EM. What has changed from 2001 to 2012 for sexual minority youth in New Zealand? J Paediatr Child Health 2015; 51:410-8. [PMID: 25209060 DOI: 10.1111/jpc.12727] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 07/28/2014] [Indexed: 12/01/2022]
Abstract
AIM To provide an overview of the health and well-being of sexual minority high school students in New Zealand, investigate differences between sexual minority youth (SMY) and exclusively opposite-sex-attracted youth (EOSAY), and examine changes across survey waves. METHODS Nationally representative cross-sectional surveys were completed in 2001 (n = 9011), 2007 (n = 8002) and 2012 (n = 8167). Logistic regressions were used to examine the associations between selected outcomes and sexual attraction across survey waves. RESULTS SMY accounted for 6% of participants in all three waves, with a greater proportion being 'out' in 2012 (P < 0.0001). SMY were more likely to work as volunteers (OR = 1.37) than EOSAY, and the majority of SMY reported good general health, liking school and having caring friends. With the exceptions of binge drinking and being driven dangerously by someone, SMY reported comparatively diminished health and well-being relative to EOSAY. Increasing proportions of SMY had depressive symptoms from 2001 (OR = 2.38) to 2012 (OR = 3.73) compared with EOSAY. There were some differences between the sexes; female SMY were less likely to report positive family relationships (OR = 0.59) and liking school (OR = 0.55), and they were more likely to have been hit (2012 OR = 1.95) than female EOSAY. Male SMY reported especially high rates of suicide attempts (2012 OR = 5.64) compared with male EOSAY. CONCLUSIONS Health services, schools, communities and families must be more responsive to the needs of SMY to ensure that disparities are addressed.
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Affiliation(s)
- Mathijs Fg Lucassen
- Department of Psychological Medicine, University of Auckland, Auckland, New Zealand
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10
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Health Care of the Adolescent. Fam Med 2015. [DOI: 10.1007/978-1-4939-0779-3_22-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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11
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Florez-Salamanca L, Rubio J. Sexual prejudice among medical students. MEDICAL EDUCATION 2013; 47:758-759. [PMID: 23837421 DOI: 10.1111/medu.12208] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
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12
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Wolitski RJ, Fenton KA. Sexual health, HIV, and sexually transmitted infections among gay, bisexual, and other men who have sex with men in the United States. AIDS Behav 2011; 15 Suppl 1:S9-17. [PMID: 21331797 DOI: 10.1007/s10461-011-9901-6] [Citation(s) in RCA: 96] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
The sexual health of gay, bisexual, and other men who have sex with men (MSM) in the United States is not getting better despite considerable social, political and human rights advances. Instead of improving, HIV and sexually transmitted infections (STIs) remain disproportionately high among MSM and have been increasing for almost two decades. The disproportionate and worsening burden of HIV and other STIs among MSM requires an urgent re-assessment of what we have been doing as a nation to reduce these infections, how we have been doing it, and the scale of our efforts. A sexual health approach has the potential to improve our understanding of MSM's sexual behavior and relationships, reduce HIV and STI incidence, and improve the health and well-being of MSM.
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Affiliation(s)
- Richard J Wolitski
- Division of HIV/AIDS Prevention, National Center for HIV, Viral Hepatitis, STD, and TB Prevention, Centers for Disease Control and Prevention, 1600 Clifton RD NE (E-35), Atlanta, GA 30333, USA.
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Corliss HL, Cochran SD, Mays VM, Greenland S, Seeman TE. Age of minority sexual orientation development and risk of childhood maltreatment and suicide attempts in women. THE AMERICAN JOURNAL OF ORTHOPSYCHIATRY 2009; 79:511-21. [PMID: 20099942 DOI: 10.1037/a0017163] [Citation(s) in RCA: 34] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Women with minority sexual orientations (e.g., lesbian, bisexual) are more likely than heterosexual women to report histories of childhood maltreatment and attempted suicide; however, the importance of the timing of minority sexual orientation development in contributing to this increased risk is uncertain. This study investigated relationships between self-reported ages of achieving minority sexual orientation development milestones (first awareness of same-gender attractions, disclosure of a minority sexual orientation to another person, and same-gender sexual contact), and childhood maltreatment and suicide attempt experiences in a sample of 2,001 women recruited from multiple-community sources. Younger age of minority sexual orientation development milestones was positively linked to self-reported recall of childhood maltreatment experiences, and to a childhood suicide attempt. After adjusting for differences in maltreatment, the odds of suicide attempt attributable to younger age of sexual orientation development milestones was reduced by 50 to 65%, suggesting that maltreatment may account for about half of the elevated risk for childhood suicide attempts among women with early minority sexual orientation development. Implications for services, interventions, and further research to address maltreatment disparities for sexual minorities are discussed.
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Affiliation(s)
- Heather L Corliss
- Department of Epidemiology, University of California, Los Angeles School of Public Health, Los Angeles, CA, USA
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Cox N, Berghe WV, Dewaele A, Vinke J. General and Minority Stress in an LGB Population in Flanders. ACTA ACUST UNITED AC 2009; 4:181-94. [DOI: 10.1080/15574090802657168] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Affiliation(s)
- Nele Cox
- a Ghent University, Department of Sociology , Belgium
| | | | - Alexis Dewaele
- b Policy Research Centre on Equal Opportunities , Belgium
| | - John Vinke
- a Ghent University, Department of Sociology , Belgium
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Duberstein Lindberg L, Sonfield A, Gemmill A. Reassessing Adolescent Male Sexual and Reproductive Health in the United States: Research and Recommendations. Am J Mens Health 2007; 2:40-56. [DOI: 10.1177/1557988307309460] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023] Open
Abstract
Adolescent males are practicing safer sexual behaviors and experiencing healthier outcomes than their predecessors. In recent years, adolescent males have tended to start having sex later in life, have fewer sexual partners, use condoms and other contraceptive methods more often, and father fewer children. Yet sexual activity during adolescence remains the norm, and thus adolescent sexual and reproductive health (SRH) remains an important concern. Moreover, large disparities remain in risk and outcomes according to race/ethnicity, sexual orientation, social connectivity, and where men live. Policy and program advances have been limited. Adolescent males are less likely than they were a decade ago to be receiving broad-based SRH information in school, and their access to clinical services has increased only marginally. Most new funding has been provided for ineffective abstinence-only education programs. Prerequisites for continued progress include research to fill in gaps in our knowledge, arriving at societal consensus around key controversies, and new tactics and allies in the political arena.
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Kipke MD, Kubicek K, Weiss G, Wong C, Lopez D, Iverson E, Ford W. The health and health behaviors of young men who have sex with men. J Adolesc Health 2007; 40:342-50. [PMID: 17367727 PMCID: PMC2955360 DOI: 10.1016/j.jadohealth.2006.10.019] [Citation(s) in RCA: 56] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/07/2006] [Revised: 10/20/2006] [Accepted: 10/27/2006] [Indexed: 11/22/2022]
Abstract
PURPOSE To describe the range of health and mental health problems for which young men who have sex with men (YMSM) may be at risk. METHODS An audio-computer-assisted survey was administered to a large, ethnically diverse sample of 526 YMSM (aged 18-24 years) recruited from bars, clubs, and other social venues using a venue-based probability sampling method. RESULTS Subjects reported a range of health and mental health problems, and involvement in health-compromising behaviors, such as overweight/obesity, depression, and suicidal thoughts/attempts, and many were found to have high rates of sexually transmitted infections. Moreover, many reported not having insurance coverage and/or limited access to care. CONCLUSIONS Many of the health concerns and risks reported by these young men are preventable and can be addressed by any number of sectors, including health care and social service providers, religious organizations, schools, and employers.
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Affiliation(s)
- Michele D Kipke
- Community, Health Outcomes, and Intervention Research Program Saban Research Institute, Childrens Hospital Los Angeles, Los Angeles, California 90027, USA.
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Eyre SL, Arnold E, Peterson E, Strong T. Romantic relationships and their social context among gay/bisexual male youth in the Castro District of San Francisco. JOURNAL OF HOMOSEXUALITY 2007; 53:1-29. [PMID: 18689189 DOI: 10.1080/00918360802101039] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/26/2023]
Abstract
This article examines the culture of romantic relationships among gay/bisexual male youth in the Castro District of San Francisco. The article seeks to specify the cultural ideology that informs these relationships, drawing upon ethnographic observation, autobiographical accounts, and informant cultural exegesis. The article also seeks to link thinking and experience inside romantic relationships (e.g., bonding, jealousy) to patterns of social behavior associated with romantic relationships (e.g., relationship sequestering, cheating), showing how both are informed by shared assumptions which make these emotions and gestures intelligible to the group. Beliefs about love, compatibility, and monogamy are explored. Reciprocity, including its degradation into negative forms, is examined with focus on the units of value that are exchanged in romantic relationships, in particular sentimental gifts. Gestures of commitment that mark commencement of a romantic relationship as well as extension of the dynamics of a relationship after "breakup" (as in "revenge sex" and "rebound relationships") are examined. Cultural systems that challenge adherence to a romantic ideology, such as a prestige economy associated with sex linked to an ethos of sexual exploration/recreation, are weighed against the pull of romance. "Drama," a hallmark of gay youth, is viewed in the context of romantic culture.
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Affiliation(s)
- Stephen L Eyre
- Department of Pediatrics, University of California, San Francisco, USA
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Eisenberg ME, Resnick MD. Suicidality among gay, lesbian and bisexual youth: the role of protective factors. J Adolesc Health 2006; 39:662-8. [PMID: 17046502 DOI: 10.1016/j.jadohealth.2006.04.024] [Citation(s) in RCA: 227] [Impact Index Per Article: 12.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/06/2006] [Revised: 04/19/2006] [Accepted: 04/24/2006] [Indexed: 11/23/2022]
Abstract
PURPOSE Many reports have indicated that gay, lesbian and bisexual (GLB) youth are particularly vulnerable to poor outcomes, including suicide. Certain protective factors are likely to reduce this risk. The present study examines four protective factors (family connectedness, teacher caring, other adult caring, and school safety) and their association with suicidal ideation and attempts among adolescents with same-gender experience. METHODS Data come from the 2004 Minnesota Student Survey of 9th and 12th grade students; 21,927 sexually active youth were grouped according to the gender of their sex partner(s) into GLB and non-GLB groups. Four protective factors and suicidal ideation and attempts were compared across groups. Logistic regression was used to examine the influence of protective factors on suicide, and predicted probabilities of suicidal ideation and attempts were estimated using general linear modeling. RESULTS There were 2,255 respondents who reported same-gender experience. Over half of GLB students had thought about suicide and 37.4% reported a suicide attempt. GLB youth reported significantly lower levels of each protective factor than their non-GLB peers. Family connectedness, adult caring, and school safety were significantly protective against suicidal ideation and attempts. Risk associated with a GLB sexual orientation is largely mediated through protective factors. CONCLUSIONS Sexual orientation alone accounts for only a small portion of variability in suicidal ideation and attempts. If protective factors were enhanced among GLB youth, suicide in this population is expected to be considerably lower. Protective factors examined here are amenable to change and should be targeted in interventions.
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Affiliation(s)
- Marla E Eisenberg
- Healthy Youth Development Prevention Research Center, Division of General Pediatrics and Adolescent Health, Department of Pediatrics, University of Minnesota, Minneapolis, Minnesota, USA.
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Abstract
Adolescence is the period of life in which issues of sexuality come to the fore. This article describes the concept of sexuality, teens' expression of sexuality, and various consequences of sexual behaviors. Issues of sexual preference and identity are described,and a brief discussion of sex education is presented. Primary care clinicians should use this article as a basis for further exploration of these important issues for their adolescent patients.
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Affiliation(s)
- Robert T Brown
- Clinical Pediatrics/Obstetrics-Gynecology, The Ohio State University College of Medicine and Public Health, Columbus, USA.
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Santelli J, Ott MA, Lyon M, Rogers J, Summers D, Schleifer R. Abstinence and abstinence-only education: a review of U.S. policies and programs. J Adolesc Health 2006; 38:72-81. [PMID: 16387256 DOI: 10.1016/j.jadohealth.2005.10.006] [Citation(s) in RCA: 335] [Impact Index Per Article: 18.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/31/2005] [Revised: 10/09/2005] [Accepted: 10/14/2005] [Indexed: 11/23/2022]
Abstract
Abstinence from sexual intercourse is an important behavioral strategy for preventing human immunodeficiency virus (HIV), other sexually transmitted infections (STIs), and pregnancy among adolescents. Many adolescents, including most younger adolescents, have not initiated sexual intercourse and many sexually experienced adolescents and young adults are abstinent for varying periods of time. There is broad support for abstinence as a necessary and appropriate part of sexuality education. Controversy arises when abstinence is provided to adolescents as a sole choice and where health information on other choices is restricted or misrepresented. Although abstinence is theoretically fully effective, in actual practice abstinence often fails to protect against pregnancy and STIs. Few Americans remain abstinent until marriage; many do not or cannot marry, and most initiate sexual intercourse and other sexual behaviors as adolescents. Although abstinence is a healthy behavioral option for teens, abstinence as a sole option for adolescents is scientifically and ethically problematic. A recent emphasis on abstinence-only programs and policies appears to be undermining more comprehensive sexuality education and other government-sponsored programs. We believe that abstinence-only education programs, as defined by federal funding requirements, are morally problematic, by withholding information and promoting questionable and inaccurate opinions. Abstinence-only programs threaten fundamental human rights to health, information, and life.
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Affiliation(s)
- John Santelli
- Heilbrunn Department of Population & Family Health, Mailman School of Public Health, Columbia University, New York, New York 10032, USA.
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Santelli J, Ott MA, Lyon M, Rogers J, Summers D. Abstinence-only education policies and programs: a position paper of the Society for Adolescent Medicine. J Adolesc Health 2006; 38:83-7. [PMID: 16387257 DOI: 10.1016/j.jadohealth.2005.06.002] [Citation(s) in RCA: 115] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/07/2005] [Indexed: 11/16/2022]
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Benson PAS, Hergenroeder AC. Bacterial sexually transmitted infections in gay, lesbian, and bisexual adolescents: medical and public health perspectives. ACTA ACUST UNITED AC 2005; 16:181-91. [PMID: 16044392 DOI: 10.1053/j.spid.2005.04.007] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
Gay, lesbian, and bisexual adolescents, like all adolescents who engage in high-risk sexual behaviors, are at elevated risk for acquiring sexually transmitted infections (STIs). Personal sexual risk factors and issues related to access to care complicate the lives of youth who engage in same-gender sexual activity and who may or may not self-identify as gay, lesbian, or bisexual. Whereas epidemiologic rates of gonorrhea, chlamydia, and syphilis generally have trended downward in adolescents as a whole during the past 15 years, rates for these common reportable bacterial STIs have increased overall during recent years among men who have sex with men. This article focuses on bacterial STIs in youth with same-gender sexual activity. An understanding of trends among gay, lesbian, and bisexual youth remains incomplete, given the absence of consistent and uniform mechanisms for collecting data on sexual behaviors in adolescents and difficulties in associating these behaviors with reportable STIs. Special attention should be given to the screening, diagnosis, and treatment of bacterial STIs in those who engage in same-sex behavior, as new recommendations from the Centers for Disease Control and Prevention have been made available. It is critical that healthcare providers who work with adolescents be aware of the assortment of specific healthcare needs of gay, lesbian, and bisexual youth and address them appropriately in the clinical setting. Medical providers may be one of few true advocates for this often-marginalized adolescent population and have the power to have a positive influence on health promotion and education efforts.
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Affiliation(s)
- Paul A S Benson
- Adolescent Medicine and Sports Medicine Section, Department of Pediatrics, Baylor College of Medicine, Texas Children's Hospital, Houston, Texas 77030-2399, USA.
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Abstract
This policy statement defines culturally effective health care and describes its importance for pediatrics and the health of children. The statement also defines cultural effectiveness, cultural sensitivity, and cultural competence and describes the importance of these concepts for training in medical school, residency, and continuing medical education. The statement is based on the conviction that culturally effective health care is vital and a critical social value and that the knowledge and skills necessary for providing culturally effective health care can be taught and acquired through focused curricula throughout the spectrum of lifelong learning, from premedical education and medical school through residency and continuing medical education. The American Academy of Pediatrics also believes that these educational efforts must be supported through health policy and advocacy activities that promote the delivery of culturally effective pediatric care.
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Eccles TA, Sayegh MA, Fortenberry JD, Zimet GD. More normal than not: a qualitative assessment of the developmental experiences of gay male youth. J Adolesc Health 2004; 35:425.e11-8. [PMID: 15488440 DOI: 10.1016/j.jadohealth.2004.02.015] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 02/20/2004] [Indexed: 10/26/2022]
Abstract
PURPOSE To examine gay youth experiences within the context of normal adolescent development. METHODS Thematic analyses of interviews with 13 self-identified gay male youth, aged 16-22 years, each reporting minimal sexual identity distress, were completed. Interviews focused on: (a) descriptions of developmental changes perceived to occur for all adolescents, (b) descriptions of the participants' developmental experience, and (c) participants' direct comparisons of their perceptions of gay and nongay developmental experience. Data were analyzed by two investigators who, after initial review of the interview transcripts, developed a unified coding template to permit systematic analysis of the transcripts for recurrent themes. RESULTS (a) Few (2 of 13) participants reported overall developmental experience markedly different from nongay peers. (b) Peer interaction was seen as the domain most different from that of nongay peers. (c) Open gay self-identification altered, generally positively, all peer interaction. (d) Increased peer interaction enhanced maturity in other domains. (e) Family dynamics were not substantively altered by open gay self-identification. (f) Middle and high school were identified as relatively hostile environments in which to openly identify as gay, affecting the timing and the extent of self-disclosure. (g) Developmental progress showed asynchrony across developmental domains. CONCLUSION General developmental dysfunction is not inevitable for gay adolescents, nor is identifiable personal or family pathology directly related to sexual identity.
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Affiliation(s)
- Thomas A Eccles
- Section of Adolescent Medicine, Department of Pediatrics, Indiana University School of Medicine, Indianapolis, Indiana 70112, USA.
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Abstract
Development of sexual identity in middle childhood and early adolescence is a natural process. However, it is more stressful for homosexual adolescents. Society continues to stigmatize and marginalize homosexuality. To avoid rejection and hostility, homosexual adolescents are pressured to hide their sexual identities. This fact compounds the anticipated normal developmental concerns of adolescence, and can create unique problems for the homosexual adolescents. Homosexuality can place them at risk for social stigmatization, isolation, depression, suicide, abuse, and rejection by their families and friends. During this exceptionally stressful time, both adolescent students and their families need anticipatory guidance and support. In providing anticipatory guidance, this article discusses critical roles played by professionals who work with adolescents in community or school settings. Included are insights into development of this normal variant of sexual attraction and orientation, risks that homosexual adolescent students may face as well as their disclosure concerns, and possible reactions families may have following disclosure. Supporting homosexual adolescents and their families is emphasized with regard to sensitively providing information, disclosure decisions, coping with stigmatization, and resiliency factors.
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Affiliation(s)
- Therese W Harrison
- High School-Based Health Center, 573 Manhattan Ave., Thornwood, NY 10594, USA.
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Conard LAE, Blythe MJ. Sexual function, sexual abuse and sexually transmitted diseases in adolescence. Best Pract Res Clin Obstet Gynaecol 2003; 17:103-16. [PMID: 12758229 DOI: 10.1053/ybeog.2003.0351] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
As adolescents progress through puberty, many biological changes occur and, for young women, this includes the onset of menses and the capability for reproduction. During this time, sexual identity is developed and expressions of sexuality become more frequent. Adolescent women engage in a variety of sexual behaviours, both non-coital and coital. As teens begin dating relationships, they are at risk for dating violence and sexual abuse. Some may even be raped after sedation with a 'date rape' drug. As adolescents attempt to develop intimate sexual relationships, they may be at high risk for health consequences associated with sexual activity, such as pregnancy and sexually transmitted diseases (STDs). Providers, such as physicians, nurse practitioners, physician assistants and nurses, must know current STD diagnosis and treatment recommendations to decrease morbidity caused by these infections. By knowing how to interview, understanding legal issues and anticipating concerns pertinent to teens, providers have the opportunity to decrease barriers to health care for adolescents.
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Affiliation(s)
- Lee Ann E Conard
- Department of Pediatrics, West Virginia University School of Medicine, P.O. Box 9214, Morgantown, WV 26506-9214, USA
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