International Journal of Environmental Research and Public Health

Research

15 pages, 1106 KiB

Open AccessArticle

Understanding Intersectionality and Resiliency among Transgender Adolescents: Exploring Pathways among Peer Victimization, School Belonging, and Drug Use

by Tyler Hatchel and Robert Marx

Int. J. Environ. Res. Public Health 2018, 15(6), 1289; https://doi.org/10.3390/ijerph15061289 - 19 Jun 2018

Cited by 75 | Viewed by 9577

Abstract

Transgender youth experience elevated levels of victimization and may therefore report greater drug use than their cisgender peers, yet little is known about protective factors like school belonging that may mediate this relationship. Further, scant research has explored the experiences of youth at [...] Read more.

Transgender youth experience elevated levels of victimization and may therefore report greater drug use than their cisgender peers, yet little is known about protective factors like school belonging that may mediate this relationship. Further, scant research has explored the experiences of youth at the intersection of transgender identity and youth of color status or low socioeconomic status, especially with respect to these multiple minority statuses’ associations with peer victimization, drug use, and school belonging. Using data from the California Healthy Kids Survey, the current study employs structural equation modeling to explore the relationships among school belonging, peer victimization, and drug use for transgender youth. Findings indicate that school belonging does mediate the pathway between peer victimization and drug use for transgender youth and that although youth of color experience greater victimization, they do not engage in greater drug use than their white transgender peers. Based on these results, those concerned with the healthy futures of transgender youth should advocate for more open and affirming school climates that engender a sense of belonging and treat transgender youth with dignity and fairness. Full article

(This article belongs to the Special Issue Breakthroughs in LGBT Health Research)

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15 pages, 567 KiB

Open AccessArticle

Legal Immigration Status is Associated with Depressive Symptoms among Latina Transgender Women in Washington, DC

by Thespina Yamanis, Mannat Malik, Ana María Del Río-González, Andrea L. Wirtz, Erin Cooney, Maren Lujan, Ruby Corado and Tonia Poteat

Int. J. Environ. Res. Public Health 2018, 15(6), 1246; https://doi.org/10.3390/ijerph15061246 - 12 Jun 2018

Cited by 46 | Viewed by 6750

Abstract

Latina transgender women (LTW) are disproportionately vulnerable to depression, although the role of immigration/documentation status (legal authority to live/work in the U.S.) in depression has not been explored. LTW in Washington, DC were recruited into a cross-sectional study via convenience sampling. Most were [...] Read more.

Latina transgender women (LTW) are disproportionately vulnerable to depression, although the role of immigration/documentation status (legal authority to live/work in the U.S.) in depression has not been explored. LTW in Washington, DC were recruited into a cross-sectional study via convenience sampling. Most were Spanish-speaking Central American immigrants. Participants completed rapid HIV tests, and a Spanish-language survey assessing recent depressive symptoms (PHQ-2), sociodemographics, and factors from the minority stress framework: structural stressors (documentation status, stable housing), social stressors (discrimination, fear of deportation, violence) and coping resources (social support, resilience). Among immigrant LTW (n = 38), 24 were undocumented. Among the undocumented, the average PHQ-2 score was 2.7, and among the documented, the average PHQ-2 score was 1.4 (p < 0.05). Undocumented LTW were significantly more likely to experience employment discrimination, recent unstable housing, and fear of deportation. Bivariate and multiple linear regressions were performed to assess the relationship between documentation status and other correlates of past two week depressive symptoms. In multivariate analysis, PHQ-2 scores were inversely associated with being documented (p < 0.01), having an income above the federal poverty level, higher friends’ social support, and increased resiliency. Documentation status is an important correlate of depressive symptoms among LTW that should be considered within the context of health interventions. Full article

(This article belongs to the Special Issue Breakthroughs in LGBT Health Research)

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11 pages, 718 KiB

Open AccessArticle

The Association between State Policy Environments and Self-Rated Health Disparities for Sexual Minorities in the United States

by Gilbert Gonzales and Jesse M. Ehrenfeld

Int. J. Environ. Res. Public Health 2018, 15(6), 1136; https://doi.org/10.3390/ijerph15061136 - 1 Jun 2018

Cited by 38 | Viewed by 6395

Abstract

A large body of research has documented disparities in health and access to care for lesbian, gay, and bisexual (LGB) people in the United States. Less research has examined how the level of legal protection afforded to LGB people (the state policy environment) [...] Read more.

A large body of research has documented disparities in health and access to care for lesbian, gay, and bisexual (LGB) people in the United States. Less research has examined how the level of legal protection afforded to LGB people (the state policy environment) affects health disparities for sexual minorities. This study used data on 14,687 sexual minority adults and 490,071 heterosexual adults from the 2014–2016 Behavioral Risk Factor Surveillance System to document differences in health. Unadjusted state-specific prevalence estimates and multivariable logistic regression models were used to compare poor/fair self-rated health by gender, sexual minority status, and state policy environments (comprehensive versus limited protections for LGB people). We found disparities in self-rated health between sexual minority adults and heterosexual adults in most states. On average, sexual minority men in states with limited protections and sexual minority women in states with either comprehensive or limited protections were more likely to report poor/fair self-rated health compared to their heterosexual counterparts. This study adds new findings on the association between state policy environments and self-rated health for sexual minorities and suggests differences in this relationship by gender. The associations and impacts of state-specific policies affecting LGB populations may vary by gender, as well as other intersectional identities. Full article

(This article belongs to the Special Issue Breakthroughs in LGBT Health Research)

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19 pages, 1575 KiB

Open AccessArticle

“Everybody Puts Their Whole Life on Facebook”: Identity Management and the Online Social Networks of LGBTQ Youth

by Elizabeth McConnell, Bálint Néray, Bernie Hogan, Aaron Korpak, Antonia Clifford and Michelle Birkett

Int. J. Environ. Res. Public Health 2018, 15(6), 1078; https://doi.org/10.3390/ijerph15061078 - 26 May 2018

Cited by 41 | Viewed by 12669

Abstract

Lesbian, gay, bisexual, transgender, and queer (LGBTQ) youth and young adults almost inevitably “come out”, or self-disclose their identity to others. Some LGBTQ youth are more uniformly “out”, while others may disclose to some groups but not others. This selective disclosure is complicated [...] Read more.

Lesbian, gay, bisexual, transgender, and queer (LGBTQ) youth and young adults almost inevitably “come out”, or self-disclose their identity to others. Some LGBTQ youth are more uniformly “out”, while others may disclose to some groups but not others. This selective disclosure is complicated on real name social media sites, which tend to encourage a unified presentation of self across social contexts. We explore these complications with a cohort of LBGTQ youth on Facebook (N = 199, M_age = 24.13). Herein we ask: How do LBGTQ youth manage the disclosure of their sexual orientation and/or gender identity to different people in their lives? Further, are there identifiable differences in the online social network structure for LGBTQ youth who manage outness in different ways? Finally, how do LGBTQ young people describe their experiences on Facebook? We answer these questions using a mixed methods approach, combining statistical cluster analysis, network visualization, and qualitative data. Our findings illustrate patterns in network structure by outness cluster type, highlighting both the work involved in managing one’s online identity as well as the costs to (semi-) closeted individuals including a considerably lower overall network connectivity. In particular, outness to family characterized LGBTQ young people’s experiences on Facebook. Full article

(This article belongs to the Special Issue Breakthroughs in LGBT Health Research)

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11 pages, 315 KiB

Open AccessArticle

Mental Health Status and Associated Contributing Factors among Gay Men in China

by Xiaojun Liu, Dongdong Jiang, Xiangfan Chen, Anran Tan, Yitan Hou, Meikun He, Yuanan Lu and Zongfu Mao

Int. J. Environ. Res. Public Health 2018, 15(6), 1065; https://doi.org/10.3390/ijerph15061065 - 24 May 2018

Cited by 19 | Viewed by 5042

Abstract

Chinese gay men are preferentially vulnerable to mental health problems because of deep-rooted, traditional social influence that overemphasizes heterosexual marriage, fertility, and filial piety. A cross-sectional survey was conducted from November to December 2017 using the Chinese version of the Symptom Checklist-90-R (SCL-90-R) [...] Read more.

Chinese gay men are preferentially vulnerable to mental health problems because of deep-rooted, traditional social influence that overemphasizes heterosexual marriage, fertility, and filial piety. A cross-sectional survey was conducted from November to December 2017 using the Chinese version of the Symptom Checklist-90-R (SCL-90-R) to assess the status of, and factors associated with the mental health of Chinese gay men. Unadjusted associations between demographic factors and the total score of SCL-90-R were examined using t/F tests or person correlation analysis. The main factors that were most predictive of the aggregate score of SCL-90-R were identified by multiple linear regressions. A total of 367 gay men participated in this survey with an average score of SCL-90-R of 180.78 ± 79.58. The scores of seven dimensions (OCS, INTS, DEPR, ANX, HOS, PHOA, PARI) for Chinese gay men were found to be significantly higher than the national norm (all p < 0.001). Age (B = −1.088, SE = 0.478, p = 0.023), educational level (B = −14.053, SE = 5.270, p = 0.008), and degree of coming out publicly (B = −23.750, SE = 4.690, p < 0.001) were protective factors for participants’ mental health status. A gay man who is the only child in his family was more likely to obtain a higher total score of SCL-90-R in China (B = 59.321, SE = 7.798, p < 0.001). Our study reveals the worrying mental health status of Chinese gay men. Shifts in familial, governmental, and societal normas are suggested to improve the current social acceptance towards sexual minority men, as well as to reduce detrimental health effects. Full article

(This article belongs to the Special Issue Breakthroughs in LGBT Health Research)

10 pages, 496 KiB

Open AccessArticle

Condom and Substance Use at Last Sex: Differences between MSMO and MSWO High School Youth

by Gregory Phillips, Mariah M. Kalmin, Blair Turner, Dylan Felt, Rachel Marro, Paul Salamanca and Lauren B. Beach

Int. J. Environ. Res. Public Health 2018, 15(5), 995; https://doi.org/10.3390/ijerph15050995 - 15 May 2018

Cited by 8 | Viewed by 4471

Abstract

HIV disproportionately impacts youth, particularly young men who have sex with men (YMSM), a population that includes subgroups of young men who have sex with men only (YMSMO) and young men who have sex with men and women (YMSMW). In 2015, among male [...] Read more.

HIV disproportionately impacts youth, particularly young men who have sex with men (YMSM), a population that includes subgroups of young men who have sex with men only (YMSMO) and young men who have sex with men and women (YMSMW). In 2015, among male youth, 92% of new HIV diagnoses were among YMSM. The reasons why YMSM are disproportionately at risk for HIV acquisition, however, remain incompletely explored. We performed event-level analyses to compare how the frequency of condom use, drug and/or alcohol use at last sex differed among YMSMO and YMSWO (young men who have sex with women only) over a ten-year period from 2005–2015 within the Youth Risk Behavior Survey (YRBS). YMSMO were less likely to use condoms at last sex compared to YMSWO. However, no substance use differences at last sexual encounter were detected. From 2005–2015, reported condom use at last sex significantly declined for both YMSMO and YMSWO, though the decline for YMSMO was more notable. While there were no significant differences in alcohol and substance use at last sex over the same ten-year period for YMSMO, YMSWO experienced a slight but significant decrease in reported alcohol and substance use. These event-level analyses provide evidence that YMSMO, similar to adult MSMO, may engage in riskier sexual behaviors compared to YMSWO, findings which may partially explain the increased burden of HIV in this population. Future work should investigate how different patterns of event-level HIV risk behaviors vary over time among YMSMO, YMSWO, and YMSMW, and are tied to HIV incidence among these groups. Full article

(This article belongs to the Special Issue Breakthroughs in LGBT Health Research)

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16 pages, 348 KiB

Open AccessArticle

Turning the Co-Production Corner: Methodological Reflections from an Action Research Project to Promote LGBT Inclusion in Care Homes for Older People

by Paul Willis, Kathryn Almack, Trish Hafford-Letchfield, Paul Simpson, Barbara Billings and Naresh Mall

Int. J. Environ. Res. Public Health 2018, 15(4), 695; https://doi.org/10.3390/ijerph15040695 - 7 Apr 2018

Cited by 31 | Viewed by 8561

Abstract

Background: Older lesbian, gay, bisexual and trans (LGBT) residents are often invisible in long-term care settings. This article presents findings from a community-based action research project, which attempted to address this invisibility through co-produced research with LGBT community members. Particular Question: [...] Read more.

Background: Older lesbian, gay, bisexual and trans (LGBT) residents are often invisible in long-term care settings. This article presents findings from a community-based action research project, which attempted to address this invisibility through co-produced research with LGBT community members. Particular Question: What conditions enable co-produced research to emerge in long-term residential care settings for older people? Aims of Project: To analyse outcomes and challenges of action-oriented, co-produced research in the given context. In particular, we explore how co-production as a collaborative approach to action-orientated research can emerge during the research/fieldwork process; and reflect critically on the ethics and effectiveness of this approach in advancing inclusion in context. Methods: The project was implemented across six residential care homes in England. Reflections are based on qualitative evaluation data gathered pre- and post-project, which includes 37 interviews with care home staff, managers and community advisors (two of whom are co-authors). Results and Conclusions: We discuss how the co-production turn emerged during research and evaluate how the politics of this approach helped advance inclusion—itself crucial to well-being. We argue for the value of co-produced research in instigating organizational change in older people’s care environments and of non-didactic storytelling in LGBT awareness-raising amongst staff. Full article

(This article belongs to the Special Issue Breakthroughs in LGBT Health Research)

19 pages, 2114 KiB

Open AccessArticle

Internalized Transphobia, Resilience, and Mental Health: Applying the Psychological Mediation Framework to Italian Transgender Individuals

by Cristiano Scandurra, Vincenzo Bochicchio, Anna Lisa Amodeo, Concetta Esposito, Paolo Valerio, Nelson Mauro Maldonato, Dario Bacchini and Roberto Vitelli

Int. J. Environ. Res. Public Health 2018, 15(3), 508; https://doi.org/10.3390/ijerph15030508 - 13 Mar 2018

Cited by 85 | Viewed by 11567

Abstract

Transgender and gender nonconforming (TGNC) people are a highly-stigmatized population. For this reason, they might internalize society’s normative gender attitudes and develop negative mental health outcomes. As an extension of the minority stress model, the psychological mediation framework sheds light on psychological processes [...] Read more.

Transgender and gender nonconforming (TGNC) people are a highly-stigmatized population. For this reason, they might internalize society’s normative gender attitudes and develop negative mental health outcomes. As an extension of the minority stress model, the psychological mediation framework sheds light on psychological processes through which anti-transgender discrimination might affect mental health. Within this framework, the current study aimed at assessing in 149 TGNC Italian individuals the role of internalized transphobia as a mediator between anti-transgender discrimination and mental health, considering resilience as the individual-level coping mechanism buffering this relationship. The results suggest that both indicators of internalized transphobia (i.e., shame and alienation) mediate the relationship between anti-transgender discrimination and depression, while only alienation mediates the relationship between anti-transgender discrimination and anxiety. Furthermore, the results suggest that the indirect relation between anti-transgender discrimination and anxiety through alienation is conditional on low and moderate levels of resilience. Findings have important implications for clinical practice and psycho-social interventions to reduce stigma and stress caused by interpersonal and individual stigma. Full article

(This article belongs to the Special Issue Breakthroughs in LGBT Health Research)

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