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1.
Fam Process ; 63(2): 1025-1045, 2024 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-38171537

RESUMO

While recent research has begun to address the effects of family support on transgender and/or nonbinary youth (TNY), almost no studies have directly examined how cisgender siblings in families with TNY navigate their sibling's gender disclosure and affirmation within both their families and their larger communities. We conducted an exploratory secondary analysis of in-person, semi-structured interviews with 15 adolescent and young adult siblings (age 13-24 years) of TNY from the northeastern United States from the baseline wave of the community-based, longitudinal, mixed methods Trans Teen and Family Narratives Project. Interview transcripts were analyzed using immersion/crystallization and template organizing approaches. Analyses yielded three main themes: gender-related beliefs and knowledge, peri- and post-disclosure family dynamics, and assessing responses to their sibling. Subthemes included anticipation of their sibling's TN identity, expectations post-disclosure, participants' level of involvement in gender-related family processes, perceptions of changes in family relationships, concern for their sibling (including a high degree of attunement to gender-affirming name and pronoun usage), and concern for themselves. Findings from this study suggest the need to engage directly with siblings of TNY to further elucidate their intrapersonal, intra-familial, and extra-familial experiences related to having a TN sibling and determine their unique support needs. Implications for families, clinicians, and communities are discussed.


Assuntos
Irmãos , Pessoas Transgênero , Humanos , Adolescente , Feminino , Masculino , Pessoas Transgênero/psicologia , Adulto Jovem , Irmãos/psicologia , Pesquisa Qualitativa , Relações entre Irmãos , Relações Familiares/psicologia , Identidade de Gênero , Estudos Longitudinais , Entrevistas como Assunto , Adulto
2.
J Pediatr ; 257: 113355, 2023 06.
Artigo em Inglês | MEDLINE | ID: mdl-36822509

RESUMO

OBJECTIVES: To examine fluidity in sexual orientation identity and behavior among cisgender youth. STUDY DESIGN: Data were analyzed from 5 survey waves of the longitudinal US Growing Up with Media Study (2010-2019). Participants were 989 cisgender youth, aged 13-20 years at baseline, who completed online surveys assessing sexual orientation identity and behavior (gender of sexual partners). Amount of change (mobility) and patterns of change across waves were assessed for identity and behavior. RESULTS: Consistently heterosexual was the most common sexual orientation identity (89%-97% for boys, 80%-90% for girls), followed by gay (3%) for boys, and bisexual (8%) for girls. Sexual minority identities increased (3%-11% for boys, 10%-20% for girls) over time, same-gender sexual behavior also increased. Girls had more identity mobility than boys; no gender difference was found for behavior mobility. Movement from heterosexual to a sexual minority identity occurred for 9% of girls and 6% of boys; movement from different-gender sexual behavior to same-gender sexual behavior occurred for 2% of girls and boys. CONCLUSIONS: Findings highlight the need to assess multiple dimensions and patterns of change of youth sexual orientation in research and clinical care. Recognizing and creating space for conversations about changes in sexual identity and behavior over time will help providers accurately and effectively address the health needs of all patients.


Assuntos
Comportamento Sexual , Minorias Sexuais e de Gênero , Humanos , Masculino , Adolescente , Feminino , Heterossexualidade , Parceiros Sexuais , Identidade de Gênero
3.
Teach Learn Med ; 35(4): 442-456, 2023.
Artigo em Inglês | MEDLINE | ID: mdl-35766109

RESUMO

ProblemLGBTQIA+ (lesbian, gay, bisexual, transgender, queer, intersex, asexual, and all sexual and gender minorities) people have unique health care needs related to their sexual orientation, gender identity and expression, and sex development. However, medical education has historically excluded LGBTQIA + health-related content in formal curricula. It is common for medical students to interact with diverse patient populations through clinical rotations; however, access to and knowledge about LGBTQIA + patients is inconsistently prioritized in medical schools. This is especially true for LGBTQIA + patients with intersecting historically marginalized identities, such as people of color and people with disabilities. Learning from and listening to medically underserved community members can help both medical students and educators better understand the unique health needs of these communities, and address implicit biases to improve health care and outcomes for their patients. Intervention: To address the lack of LGBTQIA + health-related content in medical education and improve access to and knowledge about LGBTQIA + patients, LGBTQIA + community members' perspectives and lived experiences were integrated into undergraduate medical education via four primary methods: Community Advisory Groups, community panel events, standardized patients, and community member interviews. Context: LGBTQIA + community members' perspectives and lived experiences were integrated into medical education at Harvard Medical School (HMS) as part of the HMS Sexual and Gender Minority Health Equity Initiative. Impact: LGBTQIA + community members' perspectives and lived experiences were successfully integrated into multiple aspects of medical education at HMS. During this process, we navigated challenges in the following areas that can inform similar efforts at other institutions: representation of diverse identities and experiences, meeting and scheduling logistics, structural barriers in institutional processes, and implementation of community member recommendations. Lessons Learned: Based on our experiences, we offer recommendations for integrating LGBTQIA + community members' perspectives into medical education. Engaging community members and integrating their perspectives into medical education will better enable medical educators at all institutions to teach students about the health care needs of LGBTQIA + communities, and better prepare medical students to provide affirming and effective care to their future patients, particularly those who are LGBTQIA+.

4.
J Clin Psychol ; 78(11): 2180-2196, 2022 11.
Artigo em Inglês | MEDLINE | ID: mdl-35881947

RESUMO

BACKGROUND: Sexual minority women (SMW) are at increased risk of elevated body mass index (BMI) compared to heterosexual women, increasing their vulnerability to chronic diseases. Nonmonosexual SMW appear to be at additional risk for elevated BMI, likely due to unique sexual minority stressors. METHODS: A total of 437 SMW and heterosexual women completed a cross-sectional, online survey including self-report measures of sexual orientation dimensions, weight, psychological distress, and eating behaviors. We investigated relations among these variables to better understand disparities in self-reported BMI based on sexual orientation and sexual orientation discordance (SOD). RESULTS: SMW self-reported more psychological distress, more binge eating, and higher BMIs than their heterosexual peers, with nonmonosexual groups of SMW often reporting the highest values. SOD was positively associated with psychological distress. CONCLUSIONS: SMW-particularly nonmonosexual SMW-are at increased risk for psychological distress, binge eating, and elevated BMI relative to heterosexual peers. Future research should further elucidate mechanisms for these disparities.


Assuntos
Saúde Mental , Minorias Sexuais e de Gênero , Índice de Massa Corporal , Estudos Transversais , Feminino , Heterossexualidade/psicologia , Humanos , Masculino , Comportamento Sexual
5.
J Trauma Dissociation ; 23(1): 124-139, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-34727837

RESUMO

Among sexual minorities, bisexual individuals experience higher rates of victimization and symptoms of PTSD than their lesbian and gay peers as well as heterosexual individuals. Despite these disparities, little work has examined factors contributing to PTSD symptoms among bisexual adults. The current study examined the associations between bisexual-specific minority stress and PTSD symptoms in a sample of adults with bisexual orientation and tested social support as a potential mediator of this association. Participants were 488 adults (378 cisgender women, 49 cisgender men, 61 transgender individuals), ages 18 to 66 years, with bisexual orientation based on identity and/or attraction to multiple genders. Greater anti-bisexual prejudice was associated with greater PTSD symptoms (ß = 0.16) and lower social support (ß = -.16), while accounting for sociodemographics and sexual identity-based victimization. Social support was associated with lower PTSD symptoms (ß = -.25), while accounting for sociodemographics, sexual identity-based victimization, and anti-bisexual prejudice. Mediation analyses indicated that anti-bisexual prejudice was indirectly associated with greater PTSD symptoms through lower social support. Addressing bisexual-specific minority stress and its role in diminishing social support for bisexual individuals represents a critical component of trauma-informed research and intervention development in the bisexual community.


Assuntos
Minorias Sexuais e de Gênero , Transtornos de Estresse Pós-Traumáticos , Adolescente , Adulto , Idoso , Bissexualidade , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Preconceito , Apoio Social , Adulto Jovem
6.
Arch Sex Behav ; 50(7): 3023-3033, 2021 10.
Artigo em Inglês | MEDLINE | ID: mdl-34586546

RESUMO

Gender minority (GM) youth are more likely to engage in sexual behaviors that increase risk of exposure to sexually transmitted infections, including HIV. However, family functioning may be protective against sexual risk taking. We characterized longitudinal associations between family functioning (family communication and family satisfaction) and sexual risk behaviors across two years in a community sample of 30 GM adolescents, ages 13-17 years. Participants were purposively recruited from community-based venues, through social media, and peer referrals throughout the New England area and completed surveys every 6 months, with measures of family functioning, sexual risk behaviors, risk factors (depressive and anxious symptoms, perceived stress related to parents), and protective factors (social support, gender-related pride, and community connectedness). Results indicated that higher levels of family communication, improved family satisfaction, and increased social support were protective for sexual risk taking, in general, and specifically for condom use for anal/vaginal sex. In contrast, increased depressive symptoms were associated with lower likelihood of anal/vaginal condom use. Associations between family functioning and sexual risk taking were not attenuated by adding risk and protective factors to the model; thus, these factors did not explain the observed associations between family functioning and sexual risk taking. These findings suggest improved family functioning, greater social support, and lower depressive symptoms are associated with reduced sexual risk taking among gender minority youth, thus making these factors an important target for future prevention efforts.


Assuntos
Minorias Sexuais e de Gênero , Infecções Sexualmente Transmissíveis , Adolescente , Feminino , Humanos , Fatores de Proteção , Assunção de Riscos , Comportamento Sexual
7.
Arch Sex Behav ; 48(1): 159-174, 2019 01.
Artigo em Inglês | MEDLINE | ID: mdl-30105618

RESUMO

Bisexual individuals experience unique discrimination related to their sexual orientation, which may increase their risk of adverse health outcomes. The study goal was to investigate how bisexual and other non-monosexual individuals experience discrimination, understand how they perceive discrimination to affect their health, and examine the ways in which they cope with discrimination by analyzing responses to open-ended survey questions. The sample included 442 bisexual and other non-monosexual adults, ages 18-68 years (M = 28.97, SD = 10.30), who either reported a bisexual identity or reported attractions to more than one gender. Gender identities included women (n = 347), men (n = 42), and transgender/non-binary individuals (n = 53); 29% of participants were currently located outside of the U.S. Participants completed an online survey, including three open-ended questions regarding their experiences with discrimination, how discrimination affects their health, and methods used to cope with discrimination. Themes related to perceived discrimination included: double discrimination of bisexuals and other non-monosexual individuals by heterosexuals, lesbian and gay individuals; bisexual invalidation and erasure; and sexual victimization. Themes related to the perceived effects of discrimination on health included: impact on mental health; impact on physical health; and effect of discrimination in healthcare. Themes related to coping with discrimination included: social support; resilience; and identity-specific media consumption. Findings demonstrate that bisexual and other non-monosexual individuals' experiences of discrimination can be additive, based on other marginalized facets of identity, including race/ethnicity, gender, and socioeconomic status. Our findings have implications for advancing bisexual health research from an intersectionality framework.


Assuntos
Adaptação Psicológica/fisiologia , Bissexualidade/psicologia , Discriminação Psicológica/fisiologia , Saúde/normas , Heterossexualidade/psicologia , Adolescente , Adulto , Idoso , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Adulto Jovem
8.
Arch Sex Behav ; 46(5): 1425-1439, 2017 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-27542082

RESUMO

This study examined associations between changes in self-reported attractions and mental health in a community-based sample of self-identified transgender adults. Participants were purposively recruited in 2013 using bimodal sampling methods and completed a one-time survey. Multivariable logistic regression models estimated adjusted risk ratios and 95 % confidence intervals to examine associations between changes in attractions and mental health outcomes (lifetime self-harm, suicide attempts, depression diagnosis; past-week clinically significant depressive distress assessed via CES-D 10) among the entire sample (N = 452; 285 female-to-male spectrum, 167 male-to-female spectrum) and after gender transition among those who had socially transitioned (n = 205; 156 female-to-male spectrum, 49 male-to-female spectrum). Models were adjusted for known population social determinants (age, race/ethnicity, gender identity, socioeconomic status, sexual orientation identity), transgender-specific determinants (age of transgender realization, social transition, medical transition, visual gender nonconformity, non-binary gender identification), and survey mode (online vs. in-person sampling). Lifetime changes in attractions were significantly associated with increased probability of all mental health outcomes; individuals reporting any change in attractions were more likely than individuals not reporting changes to indicate lifetime self-harm, suicide attempts, depression diagnosis, and current depressive distress (all ps < .05). Changes in attractions post-social transition were not significantly associated with mental health outcomes. Many, but not all, population and transgender-specific social determinants were significantly associated with mental health in the full sample and among those who had socially transitioned. Clinical implications of findings about changes in attractions and mental health are discussed for transgender individuals.


Assuntos
Saúde Mental , Comportamento Sexual/psicologia , Pessoas Transgênero/psicologia , Transexualidade/psicologia , Adulto , Idoso , Depressão/epidemiologia , Feminino , Identidade de Gênero , Humanos , Modelos Logísticos , Masculino , Pessoa de Meia-Idade , Razão de Chances , Autorrelato
9.
Arch Sex Behav ; 46(5): 1441-1452, 2017 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-28271349

RESUMO

Sexual minorities (mostly heterosexual, bisexual, lesbian/gay) are more likely than heterosexuals to have adverse mental health, which may be related to minority stress. We used longitudinal data from 1461 sexual minority women and men, aged 22-30 years, from Wave 2010 of the Growing Up Today Study, to examine associations between sexual minority stressors and mental health. We hypothesized that sexual minority stressors (earlier timing of sexual orientation developmental milestones categorized into early adolescence, middle adolescence, late adolescence/young adulthood; greater sexual orientation mobility; more bullying victimization) would be positively associated with mental health outcomes (depressive and anxious symptoms). Linear regression models stratified by gender and sexual orientation were fit via generalized estimating equations and controlled for age and race/ethnicity. Models were fit for each stressor predicting each mental health outcome. Reaching sexual minority milestones in early versus middle adolescence was associated with greater depressive and anxious symptoms among lesbians and gay men. Reaching sexual minority milestones in late adolescence/young adulthood versus middle adolescence was associated with greater depressive symptoms among lesbians, but fewer depressive and anxious symptoms among gay men. Greater sexual orientation mobility was associated with greater depressive symptoms among mostly heterosexual women. More bullying victimization was associated with greater depressive symptoms among bisexual women and with greater anxious symptoms among mostly heterosexual women. Sexual minority stressors are associated with adverse mental health among some sexual minority young adults. More research is needed to understand what may be protecting some subgroups from the mental health effects of sexual minority stressors.


Assuntos
Ansiedade/epidemiologia , Depressão/epidemiologia , Saúde Mental , Comportamento Sexual/psicologia , Desenvolvimento Sexual , Adolescente , Adulto , Fatores Etários , Ansiedade/psicologia , Vítimas de Crime , Depressão/psicologia , Feminino , Identidade de Gênero , Heterossexualidade/psicologia , Humanos , Estudos Longitudinais , Masculino , Pessoa de Meia-Idade , Grupos Minoritários/psicologia , Minorias Sexuais e de Gênero , Adulto Jovem
10.
Prev Sci ; 18(6): 716-725, 2017 08.
Artigo em Inglês | MEDLINE | ID: mdl-28593529

RESUMO

Bisexual individuals are at higher risk for poor mental health outcomes compared to heterosexual as well as lesbian and gay individuals and experience minority stressors, such as discrimination, from both heterosexual and sexual minority communities. However, there is little research examining the negative effects of bisexual-specific minority stressors on bisexual individuals' mental health as well as psychological factors that might help explain minority stressors' deleterious effects. This research examined the effects of distal minority stressors (i.e., anti-bisexual experiences from both heterosexual as well as lesbian and gay people) and proximal stressors (i.e., internalized heterosexism and sexual orientation concealment) on psychological distress and suicidality among bisexual adults (N = 503). Building on the relational framing of the minority stress model, we also tested one relational factor (i.e., loneliness) as a mediator of the associations between distal and proximal minority stressors and poor mental health (i.e., psychological distress and suicidality). Structural equation modeling analyses were used to test the mediating effects of loneliness on the associations between minority stressors and psychological distress and suicidality. Although distal and proximal minority stressors were not associated with each other, loneliness mediated the effects of distal and proximal minority stressors on psychological distress and suicidality. The results of this study underscore the importance of targeting bisexual-specific minority stressors as well as loneliness in preventive interventions to improve the mental health of bisexual individuals.


Assuntos
Bissexualidade , Solidão , Grupos Minoritários , Estresse Psicológico , Ideação Suicida , Adolescente , Adulto , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Modelos Psicológicos , Adulto Jovem
11.
J Couns Psychol ; 64(1): 26-40, 2017 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-28068129

RESUMO

Future perspectives of transgender youth and their caregivers may be shaped by knowledge of discrimination and adverse mental health among transgender adults. Qualitative data from the Trans Youth Family Study were analyzed to examine how transgender and gender nonconforming (TGN) youth and their caregivers imagine the youth's future. A community-based sample of 16 families (16 TGN youth, ages 7-18 years, and 29 caregivers) was recruited from 2 regions in the United States. Participants completed in-person qualitative interviews and surveys. Interview transcripts were analyzed using grounded theory methodology for coding procedures. Analyses yielded 104 higher order themes across 45 interviews, with 8 prominent themes: comparing experiences with others, gender affirming hormones, gender affirming surgery, gender norms, questioning whether the youth is really transgender, expectations for romantic relationships, uncertainty about the future, and worries about physical and emotional safety. A conceptual model of future perspectives in TGN youth and caregivers is presented and clinical implications are discussed. (PsycINFO Database Record


Assuntos
Aspirações Psicológicas , Cuidadores/psicologia , Imaginação , Pessoas Transgênero/psicologia , Adolescente , Adulto , Ansiedade/psicologia , Criança , Feminino , Identidade de Gênero , Humanos , Entrevista Psicológica , Masculino , Pessoa de Meia-Idade , Qualidade de Vida/psicologia , Identificação Social , Apoio Social , Adulto Jovem
12.
J Bisex ; 17(1): 125-139, 2017.
Artigo em Inglês | MEDLINE | ID: mdl-29249909

RESUMO

Theorists and researchers have noted an overlap between bisexually-identified and queer-identified individuals. Whereas early definitions of bisexuality may have been predominantly binary (i.e., attracted to women and men), in recent years there has been a move toward a more "queer" understanding of bisexuality (e.g., attraction to more than one gender beyond female and male). The purpose of this study was to examine similarities and differences between bisexually-identified and queer-identified adult women, ages 18-66 years, on sociodemographic characteristic, two dimensions of sexual orientation (sexual behaviors and attractions), fluidity in attractions and sexual orientation identity, and identity centrality and affirmation in an online sample (N = 489), which was mostly from the United States (73.5%). Our results indicated that bisexual and queer women were similar in terms of sociodemographic characteristics, with the exception of education; queer women were more educated than bisexual women. Queer women were also more likely than bisexual women to report variability in their sexual behaviors and attractions and more fluidity in their sexual orientation identity. Additionally, queer women reported higher levels of identity centrality and affirmation than bisexual women. Considerations for sexual minority women's health research are discussed.

13.
Ann Behav Med ; 49(6): 839-52, 2015 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-26156678

RESUMO

BACKGROUND: Sexual minorities are more likely than heterosexuals to engage in unhealthy eating behaviors. PURPOSE: The purpose of this study is to examine sexual minority stressors and internalizing symptoms as predictors of unhealthy eating behaviors among sexual minority youths. METHODS: We used longitudinal data from 1461 sexual minority youths in the Growing Up Today Study, across ages 14-28 years. We hypothesized that sexual minority stressors would predict unhealthy eating behaviors, in part due to internalizing symptoms. Linear regression models fit via generalized estimating equations were stratified by gender and sexual orientation. RESULTS: Significant positive and inverse associations between stressors and eating behaviors were detected among females and males, with more significant associations among females. Associations were attenuated by up to 71 % for females and 12 % for males when internalizing symptoms were added to the models. CONCLUSIONS: Sexual minority stressors predicted unhealthy eating behaviors overall and more so for some sexual orientation and gender groups; associations were partially explained by internalizing symptoms. The conceptual model appears to best describe the experiences of bisexual females. Findings have clinical implications for adolescent health.


Assuntos
Adaptação Psicológica , Ansiedade/psicologia , Bissexualidade/psicologia , Depressão/psicologia , Comportamento Alimentar/psicologia , Homossexualidade Feminina/psicologia , Homossexualidade Masculina/psicologia , Estresse Psicológico/psicologia , Adolescente , Adulto , Criança , Feminino , Humanos , Masculino , Grupos Minoritários/psicologia , Saúde das Minorias , Adulto Jovem
14.
Curr Opin Pediatr ; 27(4): 421-6, 2015 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-26087416

RESUMO

PURPOSE OF REVIEW: Transgender individuals display incongruence between their assigned birth sex and their current gender identity, and may identify as male, female, or being elsewhere on the gender spectrum. Gender nonconformity describes an individual whose gender identity, role, or expression is not typical for individuals in a given assigned sex category. This update highlights recent literature pertaining to the psychosocial and medical care of transgender and gender nonconforming (TGN) adolescents with applications for the general practitioner. RECENT FINDINGS: The psychological risks and outcomes of TGN adolescents are being more widely recognized. Moreover, there is increasing evidence that social and medical gender transition reduces gender dysphoria, defined as distress that accompanies the incongruence between one's birth sex and identified gender. Unfortunately, lack of education about TGN adolescents in medical training persists. SUMMARY: Recent literature highlights increased health risks in TGN adolescents and improved outcomes following gender dysphoria treatment. It is important for clinicians to become familiar with the range of treatment options and referral resources available to TGN adolescents in order to provide optimal and welcoming care to all adolescents.


Assuntos
Serviços de Saúde do Adolescente/organização & administração , Depressão/diagnóstico , Serviços de Saúde para Pessoas Transgênero/organização & administração , Papel do Médico , Transtornos Relacionados ao Uso de Substâncias/diagnóstico , Pessoas Transgênero/psicologia , Transexualidade/psicologia , Adolescente , Comportamento do Adolescente , Aconselhamento Diretivo , Feminino , Identidade de Gênero , Hormônios Esteroides Gonadais/uso terapêutico , Humanos , Comunicação Interdisciplinar , Masculino , Guias de Prática Clínica como Assunto , Cirurgia de Readequação Sexual , Comportamento Sexual/psicologia , Transtornos Relacionados ao Uso de Substâncias/psicologia , Transexualidade/diagnóstico , Transexualidade/terapia
15.
Arch Sex Behav ; 44(5): 1459-70, 2015 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-25378265

RESUMO

Little research has examined whether experiencing sexual fluidity--changes over time in attractions and sexual orientation identity--is related to specific cognitions. This study explored attitudes and beliefs among sexually fluid and non-sexually fluid individuals and developed two new measures of sexuality beliefs based on Diamond's sexual fluidity research and Dweck's psychological theory of intelligence beliefs. Participants were 188 female and male young adults in the United States with a same-gender orientation, ages 18-26 years. Participants completed an online questionnaire which assessed sexual fluidity in attractions and sexual orientation identity, attitudes toward bisexuality, sexuality beliefs, and demographics. Sexual fluidity in attractions was reported by 63 % of females and 50 % of males, with 48 % of those females and 34 % of those males reporting fluidity in sexual orientation identity. No significant gender differences in frequency of sexual fluidity were observed. Sexually fluid females had more positive attitudes toward bisexuality than non-sexually fluid females; however, no significant difference was observed for males. Females were more likely than males to endorse sexual fluidity beliefs and to believe that sexuality is changeable; and sexually fluid persons were more likely than non-sexually fluid persons to hold those two beliefs. Among males, non-sexually fluid individuals were more likely than sexually fluid individuals to believe that sexuality is something an individual is born with. Females were more likely than males to endorse the belief that sexuality is influenced by the environment. Findings from this research link sexual fluidity with specific cognitions.


Assuntos
Atitude , Identidade de Gênero , Autoimagem , Sexualidade/psicologia , Identificação Social , Adulto , Bissexualidade/psicologia , Feminino , Humanos , Relações Interpessoais , Masculino , Comportamento Sexual/psicologia , Inquéritos e Questionários , Estados Unidos , Adulto Jovem
16.
17.
J Adolesc Health ; 74(6): 1095-1105, 2024 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-38310507

RESUMO

PURPOSE: Transgender young adults (TYA) are burdened by adverse mental health outcomes. Guided by intersectionality and minority stress frameworks, we compared prevalence of psychological distress and suicidality among TYA of different social identities to inform future interventions. METHODS: In this secondary data analysis of 12,738 TYA, ages 18-25 years, from the 2015 United States Transgender Survey, we developed multivariable regression models examining associations between social identities and psychological distress and suicidality, adjusting for relevant covariates. Self-reported identities were used as proxies for minority stress resulting from structural oppressions related to gender binarism, transmisogyny, heterosexism, and racism. RESULTS: Overall, 53% met criteria for serious psychological distress, and 66% reported suicidal ideation. Statistically higher odds of serious psychological distress and suicidal ideation and plan were found for TYA assigned male compared to assigned female at birth (adjusted odds ratios [aORs] = 1.14-1.50). Nonbinary TYA assigned male at birth also had lower odds of all outcomes compared to all other TYA (aORs = 0.6-0.7). Compared to White TYA, Latiné/x TYA were more likely to experience serious psychological distress (aOR = 1.19, 95% confidence interval: 1.02, 1.39) and multiracial TYA were more likely to report suicide plan(s) and attempt(s) (aORs = 1.25-1.30). Finally, compared to heterosexual TYA, bisexual/pansexual TYA were more likely to report suicide plan(s) (aOR = 1.28, 95% confidence intervals: 1.04, 1.52), and all sexual minority TYA were more likely to report serious psychological distress and suicidal ideation (aORs = 1.31-2.00). DISCUSSION: Results highlight complex associations between intersectional minority stress and mental health outcomes among TYA. Associations between identities and mental health morbidity highlight an urgent need for targeted mental health interventions.


Assuntos
Angústia Psicológica , Ideação Suicida , Pessoas Transgênero , Humanos , Masculino , Feminino , Estados Unidos/epidemiologia , Pessoas Transgênero/psicologia , Pessoas Transgênero/estatística & dados numéricos , Adulto Jovem , Adolescente , Adulto , Prevalência , Estresse Psicológico/epidemiologia , Estresse Psicológico/psicologia , Inquéritos e Questionários
18.
Psychol Methods ; 2024 Apr 04.
Artigo em Inglês | MEDLINE | ID: mdl-38573664

RESUMO

Some researchers and clinicians may feel hesitant to assess sexual orientation and gender-related characteristics in youth surveys because they are unsure if youth will respond to these questions or are concerned the questions will cause discomfort or offense. This can result in missed opportunities to identify LGBTQ+ youth and address health inequities among this population. The aim of this study was to examine the prevalence and sociodemographic patterns of missingness among survey questions assessing current sexual orientation, gender identity and expression (SOGIE), and past change in sexual orientation (sexual fluidity) among a diverse sample of U.S. youth. Participants (N = 4,245, ages 14-25 years; 95% cisgender, 70% straight/heterosexual, 53% youth of color), recruited from an online survey panel, completed the Wave 1 survey of the longitudinal Sexual Orientation Fluidity in Youth (SO*FLY) Study in 2021. Current SOGIE, past sexual fluidity, and sociodemographic characteristics were assessed for missingness. Overall, 95.7% of participants had no missing questions, 3.8% were missing one question, and 0.5% were missing ≥ 2 questions. Past sexual fluidity and assigned sex were most commonly missing. Sociodemographic differences between participants who skipped the SOGIE questions and the rest of the sample were minimal. Missingness for the examined items was low and similar across sociodemographic characteristics, suggesting that almost all youth are willing to respond to survey questions about SOGIE. SOGIE and sexual fluidity items should be included in surveys and clinical assessments of youth to inform clinical care, policy-making, interventions, and resource development to improve the health of all youth. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

19.
Pediatrics ; 153(5)2024 May 01.
Artigo em Inglês | MEDLINE | ID: mdl-38651252

RESUMO

Equity, diversity, and inclusion (EDI) research is increasing, and there is a need for a more standardized approach for methodological and ethical review of this research. A supplemental review process for EDI-related human subject research protocols was developed and implemented at a pediatric academic medical center (AMC). The goal was to ensure that current EDI research principles are consistently used and that the research aligns with the AMC's declaration on EDI. The EDI Research Review Committee, established in January 2022, reviewed EDI protocols and provided recommendations and requirements for addressing EDI-related components of research studies. To evaluate this review process, the number and type of research protocols were reviewed, and the types of recommendations given to research teams were examined. In total, 78 research protocols were referred for EDI review during the 20-month implementation period from departments and divisions across the AMC. Of these, 67 were given requirements or recommendations to improve the EDI-related aspects of the project, and 11 had already considered a health equity framework and implemented EDI principles. Requirements or recommendations made applied to 1 or more stages of the research process, including design, execution, analysis, and dissemination. An EDI review of human subject research protocols can provide an opportunity to constructively examine and provide feedback on EDI research to ensure that a standardized approach is used based on current literature and practice.


Assuntos
Equidade em Saúde , Pediatria , Humanos , Diversidade Cultural , Criança , Centros Médicos Acadêmicos/organização & administração , Pesquisa Biomédica , Projetos de Pesquisa , Inclusão Social , Diversidade, Equidade, Inclusão
20.
J Clin Transl Sci ; 8(1): e44, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38476241

RESUMO

While mentors can learn general strategies for effective mentoring, existing mentorship curricula do not comprehensively address how to support marginalized mentees, including LGBTQIA+ mentees. After identifying best mentoring practices and existing evidence-based curricula, we adapted these to create the Harvard Sexual and Gender Minority Health Mentoring Program. The primary goal was to address the needs of underrepresented health professionals in two overlapping groups: (1) LGBTQIA+ mentees and (2) any mentees focused on LGBTQIA+ health. An inaugural cohort (N = 12) of early-, mid-, and late-career faculty piloted this curriculum in spring 2022 during six 90-minute sessions. We evaluated the program using confidential surveys after each session and at the program's conclusion as well as with focus groups. Faculty were highly satisfied with the program and reported skill gains and behavioral changes. Our findings suggest this novel curriculum can effectively prepare mentors to support mentees with identities different from their own; the whole curriculum, or parts, could be integrated into other trainings to enhance inclusive mentoring. Our adaptations are also a model for how mentorship curricula can be tailored to a particular focus (i.e., LGBTQIA+ health). Ideally, such mentor trainings can help create more inclusive environments throughout academic medicine.

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