Beyond Same-Sex Attraction: Gender-Variant-Based Victimization Is Associated with Suicidal Behavior and Substance Use for Other-Sex Attracted Adolescents

Sexualization of Children or Human Rights? Attitudes Toward Addressing Sexual-Orientation Diversity in School

Lesbian, gay, and bisexual (LGB) adolescents are more likely to experience mental health problems than their heterosexual peers because they are victimized more often or fear discrimination. Governmental plans to improve this situation by addressing sexual diversity in German schools have been accompanied by public resistance and misinformation, e.g., that they aim to sexualize children. The present study assessed how widespread negative attitudes toward such plans really are and how they can be explained. A random sample of 2,013 German residents was surveyed by phone. Only 10% opposed promoting acceptance of LGB in school. Approval of such plans was predominantly predicted by respondents' beliefs about sexual orientation and the plans' aim, and only marginally by societal values. Respondents who knew that the plans' aim was to promote acceptance of LGB and not to sexualize children and that children with same-sex parents are just as well off as those with heterosexual parents showed higher approval, whereas respondents who believed that homosexuality is affected by socialization showed higher opposition.

The relationship between childhood gender nonconformity, aversive childhood experiences, and mental health in heterosexual and non-heterosexual cisgender men: The buffering effect of sense of coherence

Childhood gender nonconformity (CGNC) seems to be associated with more mental health problems in adulthood. Previous research has suggested that this link might be mediated via the increased risk for aversive childhood experiences (ACEs) as a negative social reaction to CGNC. However, no study yet examined the role of resilience factors in this relationship. The present study aims to address this gap by examining the potential buffering effect of sense of coherence (SOC). In a German sample of 371 cisgender men, we used mediation models to investigate the relationship between CGNC, ACEs, and mental health problems in adulthood, that is, depressive symptoms, loneliness, and suicidal behavior. We then employed moderated mediation models to examine the buffering effect of SOC on the association ACEs and mental health problems. The results showed that higher levels of CGNC were associated with more severe adult mental health problems, with this link being partially mediated by higher levels of ACEs. For depressive symptoms and suicidal behavior in the last 12 months, we found evidence of a buffering effect of SOC. Higher levels of SOC were associated with a weaker association between ACEs and mental health problems. In contrast, this effect was absent for loneliness and lifetime suicidal behavior. Our study provides evidence that ACEs partly account for the relationship between CGNC and mental health in adulthood. Moreover, we found support for SOC having a buffering effect on this link. Future studies need to examine whether SOC might be an important target for resilience training in those experiencing CGNC. However, sustainable interventions may rather address the negative social reactions to CGNC.

Socially Assigned Gender Nonconformity and School Violence Experience Among Transgender and Cisgender Adolescents

Although literature documents the experiences of socially assigned gender nonconformity (SAGNC) by minority sexual orientation (i.e., lesbian, gay, and bisexual [LGB]), examination of the role of gender expression on school violence outcomes in the presence of sexual orientation and gender identity is not well understood. This study describes SAGNC among a representative sample of adolescents, accounting for sexual orientation and gender identity (e.g., transgender). A secondary data analysis was conducted using Youth Risk Behavior Survey data from Los Angeles Unified School District high schools in 2013 (N = 1,496). The prevalence of school violence by self-reported SAGNC and gender identity was obtained. Associations between SAGNC and school violence were examined using multivariate logistic regression adjusted for mischievous response bias. Two hundred ninety-one (19.5%) adolescents reported SAGNC. Having missed school due to a safety concern and being bullied in the past year were more common among socially assigned gender nonconforming adolescents than those who conformed to gender expression expectations. Socially assigned gender nonconforming adolescents, regardless of sexual orientation or gender identity, are at greater risk of missed school due to safety concerns, and bullying, as compared with those who conform to norms of gender expression. Future research should measure SAGNC, sexual orientation, gender identity, and expression with larger representative samples of school populations across contexts (urban and rural), and inclusive of structural factors (e.g., school climate) to guide the development of prevention efforts.

Love and Dating Patterns for Same- and Both-Gender Attracted Adolescents Across Europe

Sexual orientation is a multidimensional phenomenon, which includes identity, behavior, and attraction. The attraction component, however, is less studied than the other two. In this article, we present the development of a two-item measure to identify adolescents who prefer same- and both-gender partners for love and dating. The questions were administered to nationally representative samples of 15-year-old adolescents in eight European countries and regions participating in the Health Behaviour in School-aged Children (HBSC) cross-national study. The distribution of attraction, as operationalized by preference for the gender of love and dating partners, was similar across countries. These questions offer an alternative or supplementary approach to identify same- and both-gender attracted youth, without administering questions related to sexual identity.

The Impact of Gender Variance on Adolescents' Wellbeing: Does the School Context Matter?

Schools are often heteronormative environments, negatively influencing the wellbeing of LGB students. Less is known about the impact on gender-variant adolescents. Hence, this study investigates the wellbeing of gender-variant students-as evidenced by their gender (a)typicality and pressure for gender conformity- in different school cultures-as evidenced by the level of traditional gender role attitudes and homonegativity. We examine these context-dependent associations in a sample of 4987 Flemish students, who were questioned three times in 2012-2014. Multilevel regression analyses show that both gender-typical and atypical adolescents feel worse in heteronormative than inclusive schools. Furthermore, the social acceptance of boys seems to be more conditional on gender-conformity in heteronormative than inclusive schools. Overall, inclusive schools ensure higher wellbeing for all students (regardless of sex or gender variance), and student-teacher relationships seem central in explaining these school differences. Implications for school policy as well as research considering heteronormativity and gender-variance are discussed.

Measuring the Health of an Invisible Population: Lessons from the Colorado Transgender Health Survey

BACKGROUND

Transgender people, those whose gender identity does not match their sex assigned at birth, face barriers to receiving health care. These include discrimination, prohibitive cost, and difficulty finding transgender-inclusive providers. As transgender identities are not typically recognized in public health research, the ability to compare the health of the transgender population to the overall population is limited.

OBJECTIVE

The Colorado Transgender Health Survey sought to explore current disparities and their effects on the health of transgender people in Colorado.

DESIGN AND PARTICIPANTS

The Colorado Transgender Health Survey, based on the Behavioral Risk Factor Surveillance System (BRFSS), was developed by the Colorado Department of Public Health and Environment, transgender advocates, and transgender community members. Outreach was targeted to transgender-inclusive events and organizations.

MAIN MEASURES

Responses to the 2014 Colorado Transgender Health Survey were compared side by side to Colorado 2014 BRFSS data.

RESULTS

Results from 406 transgender or gender-nonconforming adults who live in Colorado were included in the analysis. Forty percent of respondents report delaying medical care due to cost, inadequate insurance, and/or fear of discrimination. Respondents report significant mental health concerns, with 43% reporting depression, 36% reporting suicidal thoughts, and 10% attempting suicide in the past year. Respondents with a transgender-inclusive provider were more likely to receive wellness exams (76 versus 48%), less likely to delay care due to discrimination (24 versus 42%), less depressed (38 versus 54%), and less likely to attempt suicide (7 versus 15%) than those without.

CONCLUSIONS

The transgender community in Colorado faces significant disparities, especially around mental health. However, a transgender-inclusive provider is associated with improved mental and physical health and health behaviors. Further population-level research and provider education on transgender health should to be incorporated into national efforts to eliminate health disparities.

Risk and Protective Factors for Substance Use among Sexual and Gender Minority Youth: A Scoping Review

Purpose of Review

Alcohol and drug use are common among youth. Rates are especially high among sexual and gender minority youth (SGMY; lesbian, gay, bisexual, transgender). We conducted a scoping review of research on risk and protective factors for substance use among SGMY published between 2013-2017.

Recent Findings

Ninety-seven studies met our inclusion criteria. Most focused on individual-level minority stress risk factors, particularly stigma. Fewer studies addressed protective factors such as social support or affirming policies, and few focused on gender minority youth (GMY). We identified important, yet understudied differences by race/ethnicity, sex assigned at birth, and sexual orientation.

Summary

Findings highlight growing interest in this topic as well as methodological/topical gaps in the literature. Research is needed to examine SGMY substance use in nationally representative samples; expand information about GMY; investigate racial/ethnic and sex/gender differences; improve measurement; and increase translation of findings to support prevention and treatment interventions for this at-risk population.

Overcoming Challenges in School-Wide Survey Administration

School-based surveys provide a useful method for gathering data from youth. Existing literature offers many examples of data collection through school-based surveys, and a small subset of literature describes methodological approaches or general recommendations for health promotion professionals seeking to conduct school-based data collection. Much less is available on real-life logistical challenges (e.g., minimizing disruption in the school day) and corresponding solutions. In this article, we fill that literature gap by offering practical considerations for the administration of school-based surveys. The protocol and practical considerations outlined in the article are based on a survey conducted with 11,681 students from seven large, urban public high schools in the southeast United States. We outline our protocol for implementing a school-based survey that was conducted with all students school-wide, and we describe six types of key challenges faced in conducting the survey: consent procedures, scheduling, locating students within the schools, teacher failure to administer the survey, improper administration of the survey, and minimizing disruption. For each challenge, we offer our key lessons learned and associated recommendations for successfully implementing school-based surveys, and we provide relevant tools for practitioners planning to conduct their own surveys in schools.

Gender Policing During Childhood and the Psychological Well-Being of Young Adult Sexual Minority Men in the United States

Hegemonic masculinities (i.e., sets of socially accepted masculine behaviors and beliefs within a given time and culture) may affect the well-being of sexual minority men, yet quantitative relationships between these masculinities and well-being remain largely unexplored. Using data from a national cross-sectional survey of young sexual minority men ( N = 1,484; ages 18-24 years), the current study examined the relationship between parental gender policing during childhood and adolescence and subsequent substance use and psychological distress. Over one third of the sample (37.8%) reported their parent(s) or the person(s) who raised them had policed their gender, including the use of disciplinary actions. Using multivariable regression, this study examined the relationship between parental gender policing and psychological well-being and substance use, after adjusting for age, race/ethnicity, educational attainment, and current student status. Gender policing during childhood and adolescence was associated with recent substance use behaviors and psychological distress in multivariable models. A linear association between substance use behaviors and psychological distress and the number of disciplinary actions experienced during childhood and adolescence was also observed. Parents' attempts to police their sons' gender expression were associated with markers of distress among young sexual minority men. The relationship between parental gender policing during childhood and adolescence and distress among young sexual minority men are discussed.