Transgender Adults From Minoritized Ethnoracial Groups in the U.S. Report Greater Subjective Cognitive Decline.

OBJECTIVES: Investigate subjective cognitive decline (SCD) among 4 study groups consisting of cisgender and transgender adults who are from minoritized ethnoracial groups (i.e., minoritized ethnoracial transgender, minoritized ethnoracial cisgender) and White cisgender and transgender adults aged 45+ (i.e., White transgender, White cisgender) to determine the odds of SCD by group and to test for group differences. METHODS: Data from the 2015-2020 Behavioral Risk Factor Surveillance System were used in a modified case-control approach to perform an intercategorical intersectional study. Each transgender participant was matched to 2 cisgender men and 2 cisgender women, on state, ethnoracial identity, and age. Multivariable logistic regressions modeled SCD odds by group and post hoc contrasts estimated pairwise odds ratios comparing the SCD odds for each combination of groups. RESULTS: SCD prevalence was highest among minoritized ethnoracial transgender (21.6%), followed by White transgender (15.0%), minoritized ethnoracial cisgender (12.0%), and White cisgender (9.0%). After accounting for age, education, and survey year, the odds of SCD were higher in minoritized ethnoracial transgender when compared to White cisgender (adjusted odds ratio [aOR] = 2.51, 95% confidence interval [CI]: 1.59-3.96) and minoritized ethnoracial cisgender (aOR = 1.89, 95% CI: 1.16-3.09). The odds of SCD were higher in White transgender compared to White cisgender (aOR = 1.66, 95% CI: 1.20-2.30). DISCUSSION: When considering the intersection of transgender and ethnoracial identities, we found that transgender adults from minoritized ethnoracial groups reported higher odds of SCD when compared to cisgender adults from minoritized ethnoracial groups. Additional studies are needed to understand the relationship between racialized and gendered inequities in cognitive impairment and how specific mechanisms of systemic transphobia and racism may contribute to this inequity.

How We Get Free: Graduate Training as an Opportunity for Equitable Participation and Liberation.

In this conceptual article, we assert that psychology should be transformed to adopt the explicit goal of working toward the liberation of people oppressed by society rather than striving for mere equality. To achieve such a transformation, it is necessary to reenvision graduate training in psychology. Graduate training in psychology is an important vehicle by which psychologists can become prepared to use research and practice to eradicate inequities in society. Therefore, we propose six pillars for liberation-focused graduate training in psychology: critical unlearning/unknowing, cooperative modes of production, prioritizing indigenous knowledge, embedded interdependence, systems-level action, and prioritizing members of oppressed groups. Although this conceptualization may engender resistance, we argue that there are many potential pathways by which graduate training may use liberation psychology to work equitably with oppressed groups to seek justice.

Too Manly and Too Straight? Perceived Sexual Orientation of Black and White Men and Women.

Using data from an online survey assessing perceptions of 12 target1 photos of Black and White males2 and females, the current study examined a moderated mediation model of sexual orientation perceptions (N = 310). Results indicated that perceived masculinity/femininity was not a mediator in the association between target gender and perceived sexual orientation. Black male targets were perceived to be more heterosexual than White male targets, Black female targets were perceived as less heterosexual than White female targets, and Black targets were perceived as more masculine than White targets. These findings may indicate rigid gender- and sexuality-related expectations for Black men. Black women who are perceived as gay may be more at risk of related interpersonal harm than White women. Black sexual minority individuals may face challenges in navigating identity concealment or disclosure. Future research should explore the potential antecedents and consequences of perceptions of Black individuals' sexual orientation.

Not Just Time on Social Media: Experiences of Online Racial/Ethnic Discrimination and Worse Sleep Quality for Black, Latinx, Asian, and Multi-racial Young Adults.

Sleep quality in young adulthood sets the stage for long-term health. Racial/ethnic sleep disparities between White college-attending young adults and college-attending young adults of color exist. The stress of experiencing racial/ethnic discrimination makes it difficult for college-attending young adults of color to get good quality sleep. Yet it remains unclear if experiencing online racial/ethnic discrimination also has consequences for sleep quality, and if this association may vary by frequency of social media use. To investigate the role of racial/ethnic discrimination on sleep quality, we conducted an online survey of 154 college-attending young adults (Mage = 19.51) who identified as Black (42.2%), Latinx (16.9%), Asian (20.8%), or Bi-/multi-racial (20.1%) from a predominantly White university. Results indicated that more exposure to racial/ethnic discrimination was associated with worse sleep quality for young adults of color. Results suggest that online racial/ethnic discrimination has a similar negative impact on sleep quality regardless of the frequency of social media use. Increased attention to negative race-related experiences online as one potential risk factor for poor long-term health for young adults of color is needed, regardless of how many hours they spend on social media. Structural interventions, screening for stress due to exposure to online racial/ethnic discrimination, and facilitating opportunities to prepare for this exposure may be an important priority for sleep health and reduction of racial/ethnic health disparities.

Syndemic relationship of depressive symptoms, substance use, and suicidality in transgender youth: a cross-sectional study using the U.S. youth risk behavior surveillance system.

PURPOSE: Syndemics are co-occurring epidemics that cluster within populations due to shared socio-structural factors and are often in populations with intersecting forms of vulnerability. Suicide, depression, and substance use all disproportionately affect transgender and gender diverse (TGD) youth. In this study, we test a syndemic model of the relationship between these three mental health conditions in the context of economic deprivation and interpersonal discrimination. METHODS: We used data on substance use, depressive symptoms, suicidality, and social-structural factors from 2680 TGD youth captured in the 2017 and 2019 survey waves of the Youth Risk Behavior Surveillance System. We used a latent class analysis (LCA) to identify groups with distinct patterns of self-reported substance use and depressive symptoms, and regression models to characterize the relationship between substance-use, depressive symptoms, class membership, social-structural factors, and suicidality. RESULTS: A three-class LCA solution identified a subset of student respondents in a "high use" latent class characterized by high self-reported substance use frequency and depressive symptoms compared with other classes. Online bullying (aOR: 1.58; 95% CI: 1.28-1.95) and housing insecurity (aOR: 8.78; 95% CI: 4.35-17.71) were associated with increased odds of "high use" class membership relative to the "no use" class membership. "High use" class membership was associated with increased odds of suicidal ideation (aOR: 2.26; 95% CI: 1.75-2.94), plans (aOR: 2.59; 95% CI: 2.01-3.36), and attempts (aOR: 6.85; 95% CI: 3.17-15.68). CONCLUSION: The co-occurrence of substance use and depressive symptoms is associated with socio-structural factors and may drive risk for suicidality among TGD youth. Meaningful suicide prevention efforts that address disproportionate risk in this population must be attentive to and mitigate the shared determinants of mood symptoms and substance use behavior.

Affect reactivity and lifetime racial discrimination among Black college students: The role of coping.

Black individuals face psychological distress resulting from lifetime experiences of racial discrimination, and these experiences may be especially harmful to Black college students as they forge their social identities. One way to examine psychological distress induced by racial discrimination is by assessing affect reactivity, or the degree to which aspects of individuals' mood changes in response to a stressor. This quantitative investigation examines the association between lifetime racial discrimination frequency and stress responses to acute racial discrimination via two aspects of affect reactivity, valence and arousal, and if coping strategies moderate this association. A sample of 239 Black college students (Mage = 19.59, SDage = 2.15, 68.6% female) completed an online questionnaire that included measures of racial discrimination, coping, and demographics. They then attended a laboratory visit during which their affective responses to a stress task were collected. Regression analyses indicated an interaction between lifetime racial discrimination and social support coping on arousal reactivity in response to acute racial discrimination. For individuals who reported low levels of social support coping, more frequent lifetime racial discrimination was associated with a decrease in arousal. For individuals who reported high levels of social support coping, more frequent lifetime racial discrimination was associated with an increase in arousal. Implications for the mental health of Black college students exposed to racial discrimination and avenues for further investigation are discussed. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

Anti-racism activism among Black adolescents and emerging adults: Understanding the roles of racism and anticipatory racism-related stress.

This study examines associations between individual racism, anticipatory racism-related stress, and anti-racism activism among Black adolescents (n = 443; Mage  = 15.6; 57.4% female) and emerging adults (n = 447; Mage  = 23.8; 77.6% female). The authors tested competing hypotheses about associations between individual racism and anti-racism activism on anticipatory racism-related stress. Findings indicated anticipatory racism-related stress may be both a catalyst and consequence of engagement in anti-racism activism for Black adolescents and emerging adults. Results for each age group varied by type of stress (physiological; psychological) and activism (low-risk; high-risk). Supporting youth engagement in anti-racism activism without increasing anticipatory racism-related stress is a key priority for meaningfully advancing scholarship on the development of anti-racism and pursuit of racial justice.

State- and Provider-Level Racism and Health Care in the U.S.

INTRODUCTION: This study examines the associations between state-level and provider sources of racism and healthcare access and quality for non-Hispanic Black and White individuals. METHODS: Data from 2 sources were integrated: (1) data from the Association of American Medical Colleges' Consumer Survey of Health Care Access (2014-2019), which included measures of self-reported healthcare access, healthcare quality, and provider racial discrimination and (2) administrative data compiled to index state-level racism. State-level racism composite scores were calculated from federal sources (U.S. Census, Department of Labor, Department of Justice). The data set comprised 21,030 adults (n=2,110 Black, n=18,920 White) who needed care within the past year. Participants were recruited from a national panel, and the survey employed age-insurance quotas. Logistic and linear regressions were conducted in 2020, adjusting for demographic, geographic, and health-related covariates. RESULTS: Among White individuals, more state-level racism was associated with 5% higher odds of being able to get care and 6% higher odds of sufficient time with provider. Among Black individuals, more state-level racism was associated with 8% lower odds of being able to get care. Provider racial discrimination was also associated with 80% lower odds of provider explaining care, 77% lower odds of provider answering questions, and 68% lower odds of sufficient time with provider. CONCLUSIONS: State-level racism may engender benefits to healthcare access and quality for White individuals and may decrease access for Black individuals. Disparities may be driven by both White advantage and Black disadvantage. State-level policies may be the actionable levers of healthcare inequities with implications for preventive medicine.

A mixed methods investigation of Black college-attending emerging adults' experiences with multilevel racism.

Experiences of racism contribute to the mental health burden of Black individuals in the United States, and during emerging adulthood, these impacts may be especially intensified. The majority of research on racism captures individual-level experiences and utilizes frequency-based measures. This mixed methods investigation examines convergence and divergence between a measure of recent experiences of racism and a measure of worst experiences of racism at multiple levels (individual, cultural, institutional). A sample of 186 Black college-attending emerging adults (Mage = 19.36; 62.7% female) reported their recent experiences using a quantitative measure and their worst experiences via a qualitative open-ended response, which were analyzed via convergent parallel design. The results indicated that a majority of reported worst experiences had an institutional-level component. Although the quantitative measure of recent experiences corresponded with reports of individual-level worst experiences, the institutional- and cultural-level worst experiences were rarely fully captured by the recent experiences measure. Implications for the mental health of Black college-attending emerging adults are discussed. (PsycInfo Database Record (c) 2020 APA, all rights reserved).