Ayelet Shapira-Daniels, Dana S King, Sari L Reisner, Lauren B Beach, Oseiwe Benjamin Eromosele, Sandhiya Ravichandran, Robert H Helm, Emelia J Benjamin, Carl G Streed
Purpose: Sex differences in cardiac arrhythmias are well established. This study aimed to explore the prevalence of arrhythmias in transgender and nonbinary (TGNB) adults. Methods: This cross-sectional study utilized electronic medical records from a center specializing in TGNB care. Adults aged ≥18 years with ≥2 medical visits between January 1, 2010, and December 31, 2021, were categorized into self-reported gender groups: TGNB (transgender men, transgender women, nonbinary [NB]-assigned male at birth, NB-assigned female at birth), cisgender men, and cisgender women. The primary outcome was any arrhythmia using age- and race-adjusted regression models comparing transgender patients with cisgender men and cisgender women. Prevalence of arrhythmias was explored in transgender people with a gender-affirming hormone therapy (GAHT) prescription. Results: The sample included 49,862 adults, with 7121 (14%) TGNB persons. Median age was 28 years. Prevalence of arrhythmias was low (0.7-1.4% NB persons, 1.4-1.5% transgender persons). After adjustment, transgender women and transgender men had similar odds of any arrhythmia compared with cisgender men (transgender women: adjusted odds ratio [aOR] 0.89, 95% confidence interval [CI] 0.63-1.24, p = 0.52; transgender men: aOR 1.17, 95% CI 0.82-1.62, p = 0.37), but higher odds of any arrhythmia compared with cisgender women (transgender women: aOR 1.65, 95% CI 1.13-2.34, p = 0.01; transgender men: aOR 2.15, 95% CI 1.48-3.04, p < 0.001). Prevalence of arrhythmias appeared similar among transgender adults regardless of GAHT use (transgender men: 1.5% vs 1.9%, transgender women: 1.2% vs 2.1%). Conclusion: Further research examining arrhythmias in TGNB patients and across gender minority subgroups is warranted, including longitudinal studies evaluating the potential impact of GAHT.
目的:心律失常的性别差异已得到公认。本研究旨在探讨变性和非二元性(TGNB)成年人心律失常的患病率。研究方法这项横断面研究利用了一家专门从事变性和非二元性(TGNB)护理中心的电子病历。在 2010 年 1 月 1 日至 2021 年 12 月 31 日期间,年龄≥18 岁且就诊次数≥2 次的成年人被分为自报性别组:TGNB(变性男性、变性女性、出生时被指定为男性的非二元 [NB] 性别者、出生时被指定为女性的非二元 [NB] 性别者)、顺性别男性和顺性别女性。主要结果是任何心律失常,使用年龄和种族调整回归模型将变性患者与顺性别男性和顺性别女性进行比较。研究还探讨了变性人在接受性别确认激素疗法(GAHT)处方后心律失常的发生率。研究结果样本包括 49,862 名成年人,其中 7121 人(14%)为变性人。中位年龄为 28 岁。心律失常的发病率较低(0.7-1.4% 的 NB 人,1.4-1.5% 的变性人)。经调整后,变性女性和变性男性与同性男性相比,发生任何心律失常的几率相似(变性女性:调整后的几率比 [aOR] 0.89,95% 置信区间 [CI] 0.63-1.24,P = 0.52;变性男性:aOR 1.17,95% CI 0.82-1.62,p = 0.37),但与顺性别女性相比,出现任何心律失常的几率更高(变性女性:aOR 1.65,95% CI 1.13-2.34,p = 0.01;变性男性:aOR 2.15,95% CI 1.48-3.04,p < 0.001)。无论是否使用 GAHT,变性成人的心律失常患病率似乎相似(变性男性:1.5% vs 1.9%;变性女性:1.2% vs 2.1%)。结论有必要进一步研究 TGNB 患者的心律失常情况以及不同性别少数群体的心律失常情况,包括评估 GAHT 潜在影响的纵向研究。
{"title":"Prevalence of Cardiac Arrhythmias in Transgender and Nonbinary Adult Community Health Center Patients.","authors":"Ayelet Shapira-Daniels, Dana S King, Sari L Reisner, Lauren B Beach, Oseiwe Benjamin Eromosele, Sandhiya Ravichandran, Robert H Helm, Emelia J Benjamin, Carl G Streed","doi":"10.1089/lgbt.2024.0151","DOIUrl":"https://doi.org/10.1089/lgbt.2024.0151","url":null,"abstract":"<p><p><b><i>Purpose:</i></b> Sex differences in cardiac arrhythmias are well established. This study aimed to explore the prevalence of arrhythmias in transgender and nonbinary (TGNB) adults. <b><i>Methods:</i></b> This cross-sectional study utilized electronic medical records from a center specializing in TGNB care. Adults aged <i>≥</i>18 years with <i>≥</i>2 medical visits between January 1, 2010, and December 31, 2021, were categorized into self-reported gender groups: TGNB (transgender men, transgender women, nonbinary [NB]-assigned male at birth, NB-assigned female at birth), cisgender men, and cisgender women. The primary outcome was any arrhythmia using age- and race-adjusted regression models comparing transgender patients with cisgender men and cisgender women. Prevalence of arrhythmias was explored in transgender people with a gender-affirming hormone therapy (GAHT) prescription. <b><i>Results:</i></b> The sample included 49,862 adults, with 7121 (14%) TGNB persons. Median age was 28 years. Prevalence of arrhythmias was low (0.7-1.4% NB persons, 1.4-1.5% transgender persons). After adjustment, transgender women and transgender men had similar odds of any arrhythmia compared with cisgender men (transgender women: adjusted odds ratio [aOR] 0.89, 95% confidence interval [CI] 0.63-1.24, <i>p</i> = 0.52; transgender men: aOR 1.17, 95% CI 0.82-1.62, <i>p</i> = 0.37), but higher odds of any arrhythmia compared with cisgender women (transgender women: aOR 1.65, 95% CI 1.13-2.34, <i>p</i> = 0.01; transgender men: aOR 2.15, 95% CI 1.48-3.04, <i>p</i> < 0.001). Prevalence of arrhythmias appeared similar among transgender adults regardless of GAHT use (transgender men: 1.5% vs 1.9%, transgender women: 1.2% vs 2.1%). <b><i>Conclusion:</i></b> Further research examining arrhythmias in TGNB patients and across gender minority subgroups is warranted, including longitudinal studies evaluating the potential impact of GAHT.</p>","PeriodicalId":18062,"journal":{"name":"LGBT health","volume":" ","pages":""},"PeriodicalIF":3.9,"publicationDate":"2024-11-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142605011","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Alena Kuhlemeier, Daniel G Shattuck, Cathleen E Willging, Mary M Ramos
Purpose: Lesbian, gay, bisexual, and questioning (LGBQ) high schoolers experience high prevalence of poor behavioral health, but little is known about LGBQ middle schoolers. We sought to quantify behavioral health disparities of LGBQ middle school students. Methods: Using 2021 New Mexico Middle School Youth Risk and Resiliency Survey data (N = 12,400), we estimated the size of the LGBQ middle school population and calculated adjusted risk ratios to investigate behavioral health disparities between LGBQ and heterosexual youth. Results: A quarter of the sample identified as LGBQ. These youth reported significantly more suicidal behaviors and poorer mental health than heterosexual youth. LGBQ youth were more likely to use most substances compared with heterosexual youth. Conclusion: LGBQ middle school students demonstrated high prevalence of poor behavioral health. These findings show that disparities begin earlier than previously assumed and underscore that sociocultural landscapes for sexually diverse youth remain challenging.
{"title":"Comparing Behavioral Health of Lesbian, Gay, Bisexual, Questioning, and Heterosexual Middle School Students.","authors":"Alena Kuhlemeier, Daniel G Shattuck, Cathleen E Willging, Mary M Ramos","doi":"10.1089/lgbt.2023.0477","DOIUrl":"https://doi.org/10.1089/lgbt.2023.0477","url":null,"abstract":"<p><p><b><i>Purpose:</i></b> Lesbian, gay, bisexual, and questioning (LGBQ) high schoolers experience high prevalence of poor behavioral health, but little is known about LGBQ middle schoolers. We sought to quantify behavioral health disparities of LGBQ middle school students. <b><i>Methods:</i></b> Using 2021 New Mexico Middle School Youth Risk and Resiliency Survey data (<i>N</i> = 12,400), we estimated the size of the LGBQ middle school population and calculated adjusted risk ratios to investigate behavioral health disparities between LGBQ and heterosexual youth. <b><i>Results:</i></b> A quarter of the sample identified as LGBQ. These youth reported significantly more suicidal behaviors and poorer mental health than heterosexual youth. LGBQ youth were more likely to use most substances compared with heterosexual youth. <b><i>Conclusion:</i></b> LGBQ middle school students demonstrated high prevalence of poor behavioral health. These findings show that disparities begin earlier than previously assumed and underscore that sociocultural landscapes for sexually diverse youth remain challenging.</p>","PeriodicalId":18062,"journal":{"name":"LGBT health","volume":" ","pages":""},"PeriodicalIF":3.9,"publicationDate":"2024-11-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142582797","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Charlie Giraud, Michael E Newcomb, Sarah W Whitton
Purpose: Sexual and gender minority (SGM) individuals often face minority stressors that negatively affect their mental health, making it important to identify protective factors against the adverse psychological effects of minority stress. We investigated the potential protective effect of trait resilience in SGM individuals assigned female at birth (SGM-AFAB), who are understudied despite being at particularly high risk for mental health problems. Methods: As part of an ongoing longitudinal cohort study, 452 SGM-AFAB young people (age 16-31 years) completed measures of resilience, minority stressors (victimization, microaggressions, internalized heterosexism, and cisgenderism), and mental health (depression, anxiety, suicidal ideation) in 2017-2018. Moderating effects of resilience on associations between the minority stressors and mental health outcomes were tested using regression analyses. Results: Resilience attenuated the positive associations of microaggressions with both depression and anxiety and of internalized cisgenderism with depression (in transgender and gender-diverse participants), suggesting protective effects. Resilience did not moderate any other associations. Conclusion: These findings suggest that resilience serves as a protective factor against depressive and anxiety symptoms following experiences of microaggressions and against depressive symptoms following internalized cisgenderism among diverse SGM-AFAB individuals. These results underscore the importance of identifying factors that bolster resilience and developing intervention strategies aimed at promoting resilience within SGM-AFAB individuals, especially following experiences of microaggressions and internalized cisgenderism.
{"title":"An Evaluation of Resilience as a Protective Factor for Mental Health Among Sexual and Gender Minority Young People.","authors":"Charlie Giraud, Michael E Newcomb, Sarah W Whitton","doi":"10.1089/lgbt.2024.0135","DOIUrl":"https://doi.org/10.1089/lgbt.2024.0135","url":null,"abstract":"<p><p><b><i>Purpose:</i></b> Sexual and gender minority (SGM) individuals often face minority stressors that negatively affect their mental health, making it important to identify protective factors against the adverse psychological effects of minority stress. We investigated the potential protective effect of trait resilience in SGM individuals assigned female at birth (SGM-AFAB), who are understudied despite being at particularly high risk for mental health problems. <b><i>Methods:</i></b> As part of an ongoing longitudinal cohort study, 452 SGM-AFAB young people (age 16-31 years) completed measures of resilience, minority stressors (victimization, microaggressions, internalized heterosexism, and cisgenderism), and mental health (depression, anxiety, suicidal ideation) in 2017-2018. Moderating effects of resilience on associations between the minority stressors and mental health outcomes were tested using regression analyses. <b><i>Results:</i></b> Resilience attenuated the positive associations of microaggressions with both depression and anxiety and of internalized cisgenderism with depression (in transgender and gender-diverse participants), suggesting protective effects. Resilience did not moderate any other associations. <b><i>Conclusion:</i></b> These findings suggest that resilience serves as a protective factor against depressive and anxiety symptoms following experiences of microaggressions and against depressive symptoms following internalized cisgenderism among diverse SGM-AFAB individuals. These results underscore the importance of identifying factors that bolster resilience and developing intervention strategies aimed at promoting resilience within SGM-AFAB individuals, especially following experiences of microaggressions and internalized cisgenderism.</p>","PeriodicalId":18062,"journal":{"name":"LGBT health","volume":" ","pages":""},"PeriodicalIF":3.9,"publicationDate":"2024-10-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142503154","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Purpose: Sexual minority adolescents (SMAs) have disproportionate experiences of mental health symptoms during adolescence, and minority stress contributes to mental health inequities among SMAs. Gender nonconformity (GNC) could place SMAs at higher risk for minority stress and subsequent mental health symptoms. The current study was designed to examine associations between GNC, minority stress, and psychological distress among SMAs. Method: SMAs ages 12-17 years (n = 455; mean age = 15.52 years) in the United States completed a cross-sectional online survey from February to July 2022, including measures of GNC, peer victimization, family rejection, negative expectations, negative disclosure experiences, internalized homonegativity, and psychological distress. We conducted path analysis to examine associations between GNC, minority stressors, and psychological distress, including indirect effects of GNC on psychological distress via minority stress. Results: In multivariable path analysis adjusted for demographic characteristics, GNC was associated with higher levels of peer victimization and negative expectations and lower internalized homonegativity among SMAs. Higher levels of peer victimization and negative expectations were associated with higher psychological distress. GNC was indirectly related to higher levels of psychological distress via higher peer victimization. Conclusions: The current study is the first to document associations between GNC and multiple minority stress experiences among SMAs, and GNC was indirectly related to psychological distress among SMAs via peer victimization. Although all SMAs would benefit from interventions designed to reduce peer victimization and increase their capacity to cope with minority stress, such interventions may be particularly beneficial for SMAs who are gender nonconforming.
目的:性取向少数群体青少年(SMAs)在青春期出现心理健康症状的比例过高,少数群体压力导致了性取向少数群体青少年心理健康的不平等。性别不一致(GNC)可能会使性取向少数群体青少年面临更高的压力风险,进而出现心理健康症状。本研究旨在探讨 GNC、少数群体压力和 SMA 心理困扰之间的关联。研究方法:美国 12-17 岁的 SMA(n = 455;平均年龄 = 15.52 岁)于 2022 年 2 月至 7 月期间完成了一项横断面在线调查,调查内容包括 GNC、同伴伤害、家庭排斥、负面期望、负面披露经历、内化的同性恋倾向和心理困扰。我们进行了路径分析,研究 GNC、少数群体压力源和心理困扰之间的关联,包括 GNC 通过少数群体压力对心理困扰的间接影响。结果:在对人口统计学特征进行调整的多变量路径分析中,GNC 与 SMAs 中较高水平的同伴伤害和负面期望以及较低的内化同质性有关。较高程度的同伴伤害和消极期望与较高程度的心理压力有关。GNC 通过较高的同伴受害程度与较高的心理困扰间接相关。结论:目前的研究首次记录了 SMA 中 GNC 与多重少数群体压力体验之间的关联,并且 GNC 通过同伴受害与 SMA 的心理困扰间接相关。尽管所有 SMA 都能从旨在减少同伴伤害和提高他们应对少数群体压力能力的干预措施中受益,但此类干预措施可能对性别不符的 SMA 尤其有益。
{"title":"Gender Nonconformity, Minority Stress, and Psychological Distress Among Sexual Minority Adolescents.","authors":"Brian C Thoma, Candice L Biernesser, Emma Win","doi":"10.1089/lgbt.2024.0059","DOIUrl":"https://doi.org/10.1089/lgbt.2024.0059","url":null,"abstract":"<p><p><b><i>Purpose:</i></b> Sexual minority adolescents (SMAs) have disproportionate experiences of mental health symptoms during adolescence, and minority stress contributes to mental health inequities among SMAs. Gender nonconformity (GNC) could place SMAs at higher risk for minority stress and subsequent mental health symptoms. The current study was designed to examine associations between GNC, minority stress, and psychological distress among SMAs. <b><i>Method:</i></b> SMAs ages 12-17 years (<i>n</i> = 455; mean age = 15.52 years) in the United States completed a cross-sectional online survey from February to July 2022, including measures of GNC, peer victimization, family rejection, negative expectations, negative disclosure experiences, internalized homonegativity, and psychological distress. We conducted path analysis to examine associations between GNC, minority stressors, and psychological distress, including indirect effects of GNC on psychological distress via minority stress. <b><i>Results:</i></b> In multivariable path analysis adjusted for demographic characteristics, GNC was associated with higher levels of peer victimization and negative expectations and lower internalized homonegativity among SMAs. Higher levels of peer victimization and negative expectations were associated with higher psychological distress. GNC was indirectly related to higher levels of psychological distress via higher peer victimization. <b><i>Conclusions:</i></b> The current study is the first to document associations between GNC and multiple minority stress experiences among SMAs, and GNC was indirectly related to psychological distress among SMAs via peer victimization. Although all SMAs would benefit from interventions designed to reduce peer victimization and increase their capacity to cope with minority stress, such interventions may be particularly beneficial for SMAs who are gender nonconforming.</p>","PeriodicalId":18062,"journal":{"name":"LGBT health","volume":" ","pages":""},"PeriodicalIF":3.9,"publicationDate":"2024-10-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142503155","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Faraan O Rahim, Perisa Ashar, Robert Garofalo, Frank Mugisha, Chris Beyrer
In the past year, new laws criminalizing same-sex conduct and the promotion of lesbian, gay, bisexual, transgender, and queer (LGBTQ) rights have emerged as barriers to addressing the HIV epidemic in sub-Saharan Africa (SSA). An augmented approach to addressing HIV within the region's disproportionately affected LGBTQ populations, particularly transgender women and gay, bisexual, and other men who have sex with men (MSM), is imperative for achieving the international goal of ending the HIV epidemic by 2030. In this article, we present recommendations to bolster the continuum of HIV care for MSM and transgender women in SSA.
{"title":"Navigating Stigma Against At-Risk Sexual and Gender Minority Populations to End the HIV Epidemic in Sub-Saharan Africa.","authors":"Faraan O Rahim, Perisa Ashar, Robert Garofalo, Frank Mugisha, Chris Beyrer","doi":"10.1089/lgbt.2024.0110","DOIUrl":"https://doi.org/10.1089/lgbt.2024.0110","url":null,"abstract":"<p><p>In the past year, new laws criminalizing same-sex conduct and the promotion of lesbian, gay, bisexual, transgender, and queer (LGBTQ) rights have emerged as barriers to addressing the HIV epidemic in sub-Saharan Africa (SSA). An augmented approach to addressing HIV within the region's disproportionately affected LGBTQ populations, particularly transgender women and gay, bisexual, and other men who have sex with men (MSM), is imperative for achieving the international goal of ending the HIV epidemic by 2030. In this article, we present recommendations to bolster the continuum of HIV care for MSM and transgender women in SSA.</p>","PeriodicalId":18062,"journal":{"name":"LGBT health","volume":" ","pages":""},"PeriodicalIF":3.9,"publicationDate":"2024-10-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142469028","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Alison R Walsh, Devon E Spiars, Charisse Loder, Emily Dove-Medows, Claire Kalpakjian, Andrea Hess, Kelsey Postler, Michelle L Munro-Kramer, Susan Ernst
Purpose: Inappropriate, disrespectful, or coercive health care (IDCH) is associated with patient age and sexual orientation and gender identity (SOGI) and can impact healthcare engagement and outcomes. Emerging adulthood is a critical period for establishing trust in health care, yet little is known about university students' IDCH experiences. This study assessed the IDCH prevalence and identified IDCH-SOGI associations in a university student sample. Methods: Using data from the cross-sectional IDC Survey (2021), we quantified the lifetime prevalence of 18 IDCH items in a sample of 3403 university students. Chi-squared and Kruskal-Wallis tests were used to assess bivariate associations between IDCH items and SOGI. We modeled associations between demographic characteristics and two types of provider-sexual misconduct using logistic regression. Results: Statistically significant associations between SOGI and 17 of the analyzed IDCH items were identified. Self-reported IDCH experiences were more prevalent among minoritized SOGI students than heterosexual cisgender students, including receiving inappropriate/harmful treatment and dismissive or biased provider communication. Gender minority and sexual minority cisgender male and female students had significantly higher odds of ever being touched inappropriately during an exam, compared with heterosexual cisgender males (adjusted odds ratios [95% confidence interval]: 3.07 [1.59-5.93], 2.34 [1.24-4.41], and 1.85 [1.16-2.90], respectively). SOGI was not significantly associated with experiencing a provider's sexual advances. Conclusion: University students with historically minoritized SOGIs may be particularly vulnerable to IDCH experiences; research is needed to understand differential experiences within minoritized sexual and gender subpopulations. Patient and provider education about healthcare norms and trauma-centered care could potentially reduce IDCH and its harms.
{"title":"Sexual and Gender Identity-Associated Disparities in University Students' Experiences with Inappropriate, Disrespectful, and Coercive Health Care.","authors":"Alison R Walsh, Devon E Spiars, Charisse Loder, Emily Dove-Medows, Claire Kalpakjian, Andrea Hess, Kelsey Postler, Michelle L Munro-Kramer, Susan Ernst","doi":"10.1089/lgbt.2023.0373","DOIUrl":"https://doi.org/10.1089/lgbt.2023.0373","url":null,"abstract":"<p><p><b><i>Purpose:</i></b> Inappropriate, disrespectful, or coercive health care (IDCH) is associated with patient age and sexual orientation and gender identity (SOGI) and can impact healthcare engagement and outcomes. Emerging adulthood is a critical period for establishing trust in health care, yet little is known about university students' IDCH experiences. This study assessed the IDCH prevalence and identified IDCH-SOGI associations in a university student sample. <b><i>Methods:</i></b> Using data from the cross-sectional IDC Survey (2021), we quantified the lifetime prevalence of 18 IDCH items in a sample of 3403 university students. Chi-squared and Kruskal-Wallis tests were used to assess bivariate associations between IDCH items and SOGI. We modeled associations between demographic characteristics and two types of provider-sexual misconduct using logistic regression. <b><i>Results:</i></b> Statistically significant associations between SOGI and 17 of the analyzed IDCH items were identified. Self-reported IDCH experiences were more prevalent among minoritized SOGI students than heterosexual cisgender students, including receiving inappropriate/harmful treatment and dismissive or biased provider communication. Gender minority and sexual minority cisgender male and female students had significantly higher odds of ever being touched inappropriately during an exam, compared with heterosexual cisgender males (adjusted odds ratios [95% confidence interval]: 3.07 [1.59-5.93], 2.34 [1.24-4.41], and 1.85 [1.16-2.90], respectively). SOGI was not significantly associated with experiencing a provider's sexual advances. <b><i>Conclusion:</i></b> University students with historically minoritized SOGIs may be particularly vulnerable to IDCH experiences; research is needed to understand differential experiences within minoritized sexual and gender subpopulations. Patient and provider education about healthcare norms and trauma-centered care could potentially reduce IDCH and its harms.</p>","PeriodicalId":18062,"journal":{"name":"LGBT health","volume":" ","pages":""},"PeriodicalIF":3.9,"publicationDate":"2024-10-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142469029","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Allen B Mallory, Jared K Martin, Margaret M Fitzpatrick, Tansel Yilmazer, Laura Chavez, Natasha Slesnick
Purpose: The purpose of this study was to examine differences in mental health outcomes of two groups within youth experiencing homelessness (YEH) and who have a substance use disorder (SUD): sexual minority (SM) and heterosexual females. Methods: This study used baseline data from four randomized clinical trials of substance use interventions for YEH with a SUD to examine differences in depression and suicidality between SM and heterosexual female youth. Participants were between 12 and 24 years of age. Meta-analytic methods were used to aggregate data across studies to estimate differences in mental health. Results: Results indicated that female SM-YEH had higher depression symptoms (Hedge's g [g]=0.20; 95% confidence interval [CI] 0.01-0.39), higher risk of a history of suicide behavior (risk ratio = 1.63; 95% CI: 1.17-2.27), and a greater number of suicide behaviors (g = 0.31; 95% CI: 0.09-0.54) compared to their heterosexual peers. These effect sizes were not moderated by age. Conclusion: Female SM-YEH had elevated levels of depression and suicidality compared to their heterosexual peers. The findings of this study align with research on mental health disparities between SM and heterosexual youth generally, which underscores the unique struggles and risks associated with identifying as a female SM-YEH with a SUD.
目的:本研究旨在探讨无家可归青年(YEH)中患有药物使用障碍(SUD)的两个群体:性少数群体(SM)和异性恋女性在心理健康结果方面的差异。研究方法本研究使用了四项针对患有药物滥用障碍的无家可归青年的药物滥用干预随机临床试验的基线数据,以研究性少数群体和异性恋女性青年在抑郁和自杀方面的差异。参与者年龄在 12-24 岁之间。研究采用了元分析方法来汇总各项研究的数据,以估计心理健康方面的差异。结果显示结果显示,与异性恋同龄人相比,女性 SM-YEH 有更高的抑郁症状(海杰氏 g [g]=0.20; 95% 置信区间 [CI] 0.01-0.39)、更高的自杀行为史风险(风险比 = 1.63; 95% CI: 1.17-2.27)和更多的自杀行为(g = 0.31; 95% CI: 0.09-0.54)。这些效应大小不受年龄的影响。结论与异性恋同龄人相比,女性 SM-YEH 的抑郁和自杀水平较高。本研究的结果与有关 SM 青少年与异性恋青少年之间心理健康差异的研究结果一致,强调了女性 SM-YEH 在被认定为患有 SUD 后所面临的独特困境和风险。
{"title":"Differences in Mental Health Between Female Sexual Minority and Heterosexual Youth with a Substance Use Disorder Who Are Experiencing Homelessness.","authors":"Allen B Mallory, Jared K Martin, Margaret M Fitzpatrick, Tansel Yilmazer, Laura Chavez, Natasha Slesnick","doi":"10.1089/lgbt.2023.0230","DOIUrl":"https://doi.org/10.1089/lgbt.2023.0230","url":null,"abstract":"<p><p><b><i>Purpose:</i></b> The purpose of this study was to examine differences in mental health outcomes of two groups within youth experiencing homelessness (YEH) and who have a substance use disorder (SUD): sexual minority (SM) and heterosexual females. <b><i>Methods:</i></b> This study used baseline data from four randomized clinical trials of substance use interventions for YEH with a SUD to examine differences in depression and suicidality between SM and heterosexual female youth. Participants were between 12 and 24 years of age. Meta-analytic methods were used to aggregate data across studies to estimate differences in mental health. <b><i>Results:</i></b> Results indicated that female SM-YEH had higher depression symptoms (Hedge's <i>g</i> [<i>g</i>]<i>=</i>0.20; 95% confidence interval [CI] 0.01-0.39), higher risk of a history of suicide behavior (risk ratio <i>=</i> 1.63; 95% CI: 1.17-2.27), and a greater number of suicide behaviors (<i>g =</i> 0.31; 95% CI: 0.09-0.54) compared to their heterosexual peers. These effect sizes were not moderated by age. <b><i>Conclusion:</i></b> Female SM-YEH had elevated levels of depression and suicidality compared to their heterosexual peers. The findings of this study align with research on mental health disparities between SM and heterosexual youth generally, which underscores the unique struggles and risks associated with identifying as a female SM-YEH with a SUD.</p>","PeriodicalId":18062,"journal":{"name":"LGBT health","volume":" ","pages":""},"PeriodicalIF":3.9,"publicationDate":"2024-10-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142372236","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Phillip W Schnarrs, Armin A Dorri, Stephen T Russell, Timothy J Grigsby, Ruby Charak, Hayden Dawes, Amy L Stone, R Andrew Yockey, Joshua G Rosenberger
Purpose: The purpose of this study was to assess the relationship between adverse childhood experiences (ACEs) exposure, perceived discrimination, and anxiety and depressive symptoms in sexual and gender minoritized (SGM) adults in the United States. Methods: Respondents (n = 4445) from a national Qualtrics research panel completed a web-based survey. Guided by the stress proliferation (mediation model) and stress sensitization (moderation model) models, we examined the relationships between ACEs and perceived discrimination and the severity of anxiety and depressive symptoms in adulthood. Results: Cumulative ACEs exposure was positively associated with everyday discrimination scale (EDS) scores. ACEs and EDS scores had a significant direct association with anxiety and depressive symptoms. We found support for EDS as a mediator for anxiety (β = 0.12, p < 0.001) and depressive symptoms (β = 0.14, p < 0.001) and for ACEs as a moderator of the relationship between EDS and anxiety (β = -0.04, p = 0.004) and depressive (β = -0.05, p = 0.001) symptoms. Conclusions: These findings suggest that both stress proliferation and stress sensitization likely contribute to disparities in anxiety and depressive symptoms in SGM adults. This finding supports the integration of social safety and minority stress perspectives regarding health disparities in SGM populations. Exposure to early life adversity likely alters neurodevelopment, which in turn increases awareness of the lack of social safety in adulthood, reduces capacity to cope with minority stress exposure, and ultimately contributes to increased anxiety and depressive symptoms. Prevention efforts should focus on building positive and compensatory childhood experiences.
{"title":"Adverse Childhood Experiences, Perceived Discrimination, and Mental Health in Sexual and Gender Minoritized Adults: Comparing Stress Accumulation and Stress Sensitization Models.","authors":"Phillip W Schnarrs, Armin A Dorri, Stephen T Russell, Timothy J Grigsby, Ruby Charak, Hayden Dawes, Amy L Stone, R Andrew Yockey, Joshua G Rosenberger","doi":"10.1089/lgbt.2023.0296","DOIUrl":"https://doi.org/10.1089/lgbt.2023.0296","url":null,"abstract":"<p><p><b><i>Purpose:</i></b> The purpose of this study was to assess the relationship between adverse childhood experiences (ACEs) exposure, perceived discrimination, and anxiety and depressive symptoms in sexual and gender minoritized (SGM) adults in the United States. <b><i>Methods:</i></b> Respondents (<i>n</i> = 4445) from a national Qualtrics research panel completed a web-based survey. Guided by the stress proliferation (mediation model) and stress sensitization (moderation model) models, we examined the relationships between ACEs and perceived discrimination and the severity of anxiety and depressive symptoms in adulthood. <b><i>Results:</i></b> Cumulative ACEs exposure was positively associated with everyday discrimination scale (EDS) scores. ACEs and EDS scores had a significant direct association with anxiety and depressive symptoms. We found support for EDS as a mediator for anxiety (<i>β</i> = 0.12, <i>p</i> < 0.001) and depressive symptoms (<i>β</i> = 0.14, <i>p</i> < 0.001) and for ACEs as a moderator of the relationship between EDS and anxiety (<i>β</i> = -0.04, <i>p</i> = 0.004) and depressive (<i>β</i> = -0.05, <i>p</i> = 0.001) symptoms. <b><i>Conclusions:</i></b> These findings suggest that both stress proliferation and stress sensitization likely contribute to disparities in anxiety and depressive symptoms in SGM adults. This finding supports the integration of social safety and minority stress perspectives regarding health disparities in SGM populations. Exposure to early life adversity likely alters neurodevelopment, which in turn increases awareness of the lack of social safety in adulthood, reduces capacity to cope with minority stress exposure, and ultimately contributes to increased anxiety and depressive symptoms. Prevention efforts should focus on building positive and compensatory childhood experiences.</p>","PeriodicalId":18062,"journal":{"name":"LGBT health","volume":" ","pages":""},"PeriodicalIF":3.9,"publicationDate":"2024-10-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142372235","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-10-01Epub Date: 2023-11-10DOI: 10.1089/lgbt.2023.0025
Sarah I Leonard, Yashika Sharma, Tonda L Hughes, Kasey B Jackman, Jean-Marie Bruzzese
Purpose: Weight stigma is associated with poor mental and emotional health and may be especially harmful to sexual and gender minority (SGM) individuals due to co-occurring minority stress. The literature on this topic has not been synthesized. We conducted a scoping review of the literature on weight stigma and mental and emotional health among SGM individuals to synthesize findings, highlight gaps, and identify clinical and research implications. Methods: Following Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews, we searched PubMed, CINAHL, PsycINFO, and Scopus in April 2022. Included studies examined the relationship between weight stigma and mental and emotional health among SGM people of any age. We did not restrict study design or publication date. Results: Of 513 records identified, 23 met inclusion criteria. Most focused on sexual minority individuals; one focused specifically on gender minority individuals. Weight stigma was associated with poorer mental and emotional health in nearly all studies. The most common outcomes examined were self-esteem, maladaptive eating, and depressive symptoms. Five studies, all using the same dataset, focused on adolescents; none focused on older adults. Conclusions: Weight stigma is associated with poorer mental and emotional health among SGM individuals and, through its intersections with minority stress, might impact SGM individuals differently than their cisgender and heterosexual counterparts. There are important gaps regarding weight stigma's effect on SGM adolescents and gender minority individuals and its relationship with a broader range of mental and emotional health outcomes.
{"title":"Weight Stigma and Mental and Emotional Health Among Sexual and Gender Minority Individuals: A Scoping Review.","authors":"Sarah I Leonard, Yashika Sharma, Tonda L Hughes, Kasey B Jackman, Jean-Marie Bruzzese","doi":"10.1089/lgbt.2023.0025","DOIUrl":"10.1089/lgbt.2023.0025","url":null,"abstract":"<p><p><b><i>Purpose:</i></b> Weight stigma is associated with poor mental and emotional health and may be especially harmful to sexual and gender minority (SGM) individuals due to co-occurring minority stress. The literature on this topic has not been synthesized. We conducted a scoping review of the literature on weight stigma and mental and emotional health among SGM individuals to synthesize findings, highlight gaps, and identify clinical and research implications. <b><i>Methods:</i></b> Following Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews, we searched PubMed, CINAHL, PsycINFO, and Scopus in April 2022. Included studies examined the relationship between weight stigma and mental and emotional health among SGM people of any age. We did not restrict study design or publication date. <b><i>Results:</i></b> Of 513 records identified, 23 met inclusion criteria. Most focused on sexual minority individuals; one focused specifically on gender minority individuals. Weight stigma was associated with poorer mental and emotional health in nearly all studies. The most common outcomes examined were self-esteem, maladaptive eating, and depressive symptoms. Five studies, all using the same dataset, focused on adolescents; none focused on older adults. <b><i>Conclusions:</i></b> Weight stigma is associated with poorer mental and emotional health among SGM individuals and, through its intersections with minority stress, might impact SGM individuals differently than their cisgender and heterosexual counterparts. There are important gaps regarding weight stigma's effect on SGM adolescents and gender minority individuals and its relationship with a broader range of mental and emotional health outcomes.</p>","PeriodicalId":18062,"journal":{"name":"LGBT health","volume":" ","pages":"496-513"},"PeriodicalIF":3.9,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"72209765","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-10-01DOI: 10.1089/lgbt.2024.68296.rfs2023
Samantha E Lawrence
{"title":"Rosalind Franklin Society Proudly Announces the 2023 Award Recipient for <i>LGBT Health</i>.","authors":"Samantha E Lawrence","doi":"10.1089/lgbt.2024.68296.rfs2023","DOIUrl":"https://doi.org/10.1089/lgbt.2024.68296.rfs2023","url":null,"abstract":"","PeriodicalId":18062,"journal":{"name":"LGBT health","volume":"11 7","pages":"495"},"PeriodicalIF":3.9,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142406583","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}