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Fish JN, Russell ST. The paradox of progress for sexual and gender diverse youth. Curr Opin Psychol 2022; 48:101498. [PMID: 36401907 DOI: 10.1016/j.copsyc.2022.101498] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2022] [Revised: 09/27/2022] [Accepted: 10/18/2022] [Indexed: 01/28/2023]
Abstract
In this essay, we explore diversity in sexual and gender identities, with a focus on implications of the current politicized moment for lesbian, gay, bisexual, transgender, queer, or questioning youth. As youth come out at younger ages, their personal identity development collides with the adolescence period characterized by peer influence, stigma, and possible victimization. We consider the changing and diverse experiences of coming out in adolescence for sexual and gender diverse youth. The current social and political moment offers possibilities for new identities, yet anti-LGBTQ + legislative and policy actions have crucial implications for health and wellbeing for youth.
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Affiliation(s)
- Jessica N Fish
- Department of Family Science, University of Maryland, 4200 Valley Drive, Suite 2242, College Park, MD 20742, USA
| | - Stephen T Russell
- Department of Human Development and Family Sciences, The University of Texas at Austin, 108 E Dean Keeton St, Austin, TX 78712, USA.
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Marchi M, Arcolin E, Fiore G, Travascio A, Uberti D, Amaddeo F, Converti M, Fiorillo A, Mirandola M, Pinna F, Ventriglio A, Galeazzi GM. Self-harm and suicidality among LGBTIQ people: a systematic review and meta-analysis. Int Rev Psychiatry 2022; 34:240-256. [PMID: 36151841 DOI: 10.1080/09540261.2022.2053070] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
Research evidence has consistently documented a higher risk of suicidality in the Lesbian, Gay, Bisexual, Transgender, Intersex, and Queer (LGBTIQ) population. This systematic review and meta-analysis aimed to report a detailed description of research data regarding the risk of Attempted Suicide (SA), Suicide Ideation (SI), and Non-Suicidal Self-Injury (NSSI) behaviours for LGBTIQ people and their subgroups. Medline, Scopus, PsycINFO, and EMBASE were searched for studies reporting a comparative estimation of SA, SI, and NSSI rates among LGBTIQ population and the general population (i.e. heterosexual/cisgender), without restrictions on participants' age and setting for the enrolment. Pooled analyses were based on odds ratios (ORs, with 95% CIs), estimated through inverse variance models with random effects. Fifty studies were selected for the quantitative synthesis and included fifty samples involving 3.735.601 controls and 87.252 LGBTIQ people. LGBTIQ people reported an increased risk of SA (OR:4.36[95%CI:3.32;5.71]), SI (OR:3.76[95%CI:3.02;4.69]), and NSSI (OR:4.24[95%CI:3.23;5.55]). Among LGBTIQ subgroups, the Bisexual group has shown the highest risk of suicidality (SA, OR:6.71; SI, OR:5.04; NSSI, OR: 5.03), followed by the Lesbian-Gay for attempted suicide (SA, OR:6.03), and the Transgender-Intersex-Queer for suicide ideation and non-suicidal self-injury (SI and NSSI, OR:3.42). The quality of the evidence ranged from low to moderate. Our findings have shown that LGBTIQ people report a higher risk of suicidality compared with their cisgender/heterosexual peers. This evidence may contribute to the public awareness on LGBTQI mental health needs and suggest supportive strategies as well as preventive interventions (e.g. supportive programs, counselling, and destigmatizing efforts) as parts of a tailored health-care planning aimed to reduce psychiatric morbidity and mortality in this at-risk population.
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Affiliation(s)
- Mattia Marchi
- Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Modena, Italy.,Department of Mental Health and Drug Abuse, Azienda USL-IRCCS di Reggio Emilia, Reggio Emilia, Italy
| | - Elisa Arcolin
- Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Modena, Italy
| | - Gianluca Fiore
- Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Modena, Italy
| | - Antonio Travascio
- Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Modena, Italy
| | - Daniele Uberti
- Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Modena, Italy
| | - Francesco Amaddeo
- Department of Neurosciences, Biomedicine and Movement Sciences, University of Verona, Verona, Italy
| | | | - Andrea Fiorillo
- Department of Psychiatry, University of Campania "Luigi Vanvitelli", Naples, Italy
| | - Massimo Mirandola
- Department of Diagnostics and Public Health, Infectious Diseases Section, University of Verona, Verona, Italy.,School of Health Sciences, University of Brighton, Brighton, UK
| | - Federica Pinna
- Department of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy
| | - Antonio Ventriglio
- Department of Clinical and Experimental Medicine, University of Foggia, Foggia, Italy
| | - Gian Maria Galeazzi
- Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Modena, Italy.,Department of Mental Health and Drug Abuse, Azienda USL-IRCCS di Reggio Emilia, Reggio Emilia, Italy
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de Graaf NM, Steensma TD, Carmichael P, VanderLaan DP, Aitken M, Cohen-Kettenis PT, de Vries ALC, Kreukels BPC, Wasserman L, Wood H, Zucker KJ. Suicidality in clinic-referred transgender adolescents. Eur Child Adolesc Psychiatry 2022; 31:67-83. [PMID: 33165650 DOI: 10.1007/s00787-020-01663-9] [Citation(s) in RCA: 24] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/09/2020] [Accepted: 10/11/2020] [Indexed: 12/20/2022]
Abstract
Gender and sexually diverse adolescents have been reported to be at an elevated risk for suicidal thoughts and behaviors. For transgender adolescents, there has been variation in source of ascertainment and how suicidality was measured, including the time-frame (e.g., past 6 months, lifetime). In studies of clinic-referred samples of transgender adolescents, none utilized any type of comparison or control group. The present study examined suicidality in transgender adolescents (M age, 15.99 years) seen at specialty clinics in Toronto, Canada, Amsterdam, the Netherlands, and London, UK (total N = 2771). Suicidality was measured using two items from the Child Behavior Checklist (CBCL) and the Youth Self-Report (YSR). The CBCL/YSR referred and non-referred standardization samples from both the U.S. and the Netherlands were used for comparative purposes. Multiple linear regression analyses showed that there was significant between-clinic variation in suicidality on both the CBCL and the YSR; in addition, suicidality was consistently higher among birth-assigned females and strongly associated with degree of general behavioral and emotional problems. Compared to the U.S. and Dutch CBCL/YSR standardization samples, the relative risk of suicidality was somewhat higher than referred adolescents but substantially higher than non-referred adolescents. The results were discussed in relation to both gender identity specific and more general risk factors for suicidality.
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Affiliation(s)
- Nastasja M de Graaf
- Gender Identity Development Service, The Tavistock and Portman NHS Trust, London, England
- Department of Medical Psychology, Center of Expertise on Gender Dysphoria, VU University Medical Center, Amsterdam, the Netherlands
| | - Thomas D Steensma
- Department of Medical Psychology, Center of Expertise on Gender Dysphoria, VU University Medical Center, Amsterdam, the Netherlands
| | - Polly Carmichael
- Gender Identity Development Service, The Tavistock and Portman NHS Trust, London, England
| | - Doug P VanderLaan
- Department of Psychology, University of Toronto Mississauga, Mississauga, ON, Canada
- Child and Youth Psychiatry, Centre for Addiction and Mental Health, Toronto, ON, Canada
| | - Madison Aitken
- Child and Youth Psychiatry, Centre for Addiction and Mental Health, Toronto, ON, Canada
| | - Peggy T Cohen-Kettenis
- Department of Medical Psychology, Center of Expertise on Gender Dysphoria, VU University Medical Center, Amsterdam, the Netherlands
| | - Annelou L C de Vries
- Department of Medical Psychology, Center of Expertise on Gender Dysphoria, VU University Medical Center, Amsterdam, the Netherlands
| | - Baudewijntje P C Kreukels
- Department of Medical Psychology, Center of Expertise on Gender Dysphoria, VU University Medical Center, Amsterdam, the Netherlands
| | - Lori Wasserman
- Reproductive Life Stages Program, Women's College Hospital, Toronto, ON, Canada
| | - Hayley Wood
- Psychological Services, Toronto Board of Education, Toronto, ON, Canada
| | - Kenneth J Zucker
- Department of Psychiatry, University of Toronto, 250 College St., Toronto, ON, M5T 1R8, Canada.
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Gattamorta KA, Salerno JP, Castro AJ. Intersectionality and Health Behaviors Among US High School Students: Examining Race/Ethnicity, Sexual Identity, and Sex. J Sch Health 2019; 89:800-808. [PMID: 31353476 DOI: 10.1111/josh.12817] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/02/2017] [Revised: 08/23/2018] [Accepted: 10/16/2018] [Indexed: 06/10/2023]
Abstract
BACKGROUND Little research exists examining the impact of multiple minority identities, particularly sexual orientation, race/ethnicity, and sex on health-risk behaviors like mental health, substance use, violence, and sexual risk among high school students in the United States. In this study, we use a nationally representative dataset to examine differences between non-Hispanic white heterosexuals (HSs) and non-Hispanic white sexual minority, black HS, black sexual minority, Hispanic HS, and Hispanic sexual minority students. METHODS Data from the 2015 wave of the Youth Risk Behavioral Surveillance System were used in this study. Chi-square and hierarchical logistic regression models examined differences between the groups on outcomes including: (1) mental health and suicide, (2) alcohol, tobacco, and illicit substances, (3) sexual risk and protective factors, and (4) school and physical and/or sexual violence. RESULTS Whereas sexual minority youth (SMY) generally demonstrate poorer health outcomes compared to HSs, SMY who are also racial/ethnic minorities often have even poorer health outcomes, particularly relating to substance use, sexual risk behaviors, physical/sexual violence, and suicide. CONCLUSIONS The need for culturally tailored education and school-based interventions that consider intersections between race/ethnicity, sexual identity, and biological sex are warranted to address health disparities related to mental health and suicide, substance use, sexual risk, and violence.
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Affiliation(s)
- Karina A Gattamorta
- University of Miami School of Nursing and Health Studies, 5030 Brunson Drive, Coral Gables, FL 33146
| | - John P Salerno
- University of Maryland School of Public Health, College Park, MD
| | - Amanda J Castro
- University of Miami School of Nursing and Health Studies, Coral Gables, FL
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