Physical Violence and Psychological Distress Among Asian and Pacific Islander Sexual Minority Men in the United States Before and During the COVID-19 Pandemic.

Purpose: This study examined differences in self-reported physical violence and psychological distress among Asian American and Pacific Islander (AAPI) sexual minority men (SMM) before and during the 2019 novel coronavirus (COVID-19) pandemic (2019 vs. 2020). Methods: We used data from 1127 AAPI SMM who completed the 2019 (August 2019-December 2019) and 2020 (August 2020-January 2021) cycles of the American Men's Internet Survey (AMIS). We assessed differences in experiencing physical violence and serious psychological distress by year of survey completion. We used Poisson regression with robust variance estimation to examine whether physical violence was associated with serious psychological distress before and during COVID-19. Multivariate analyses adjusted for sociodemographic characteristics and the interaction between year and violence. Results: A greater percentage of AAPI SMM had serious psychological distress in 2020 during the pandemic relative to 2019 before the pandemic (56.6% vs. 35.64%, p < 0.001). AAPI SMM who experienced physical violence in the last 6 months were more likely to experience serious psychological distress than those who never experienced physical violence. The association between violence and psychological distress among AAPI SMM was not significantly different before and during the COVID-19 pandemic. Conclusions: Violence against AAPI SMM in the United States is widespread. Although we did not find significant differences in exposure to physical violence among AAPI SMM before and during the COVID-19 pandemic, the increase in serious psychological distress during the pandemic among AAPI SMM may indicate heightened need of mental health services.

To Go or Not to Go: Factors That Influence Health Care Use Among Trans Adults in a Non-Representative U.S. Sample.

Trans people tend to utilize health care at rates lower than cisgender people, which commonly results in short-term and long-term unfavorable health outcomes. Theoretically informed by Andersen's behavioral model of health services use and Lerner and Robles' adapted behavioral model of health services use for transgender people, the current study examined how individual characteristics of trans people along with the external environment and health care service environment they must navigate impact their health care utilization. Binary logistic regression was used to analyze data from the 2015 United States Trans Survey (N = 27,715), the largest trans sample to date. Perception of health care provider (HCP) knowledge, health insurance status, and health care costs each produced the strongest effect on visiting a doctor or HCP in the past year. The results showed that having a provider that had some level of knowledge about trans people was potentially most critical to increase utilization. Discussion points include increasing trans-focused curriculum in health professional schools, utilizing trans standardized patients in health professional schools, and holding insurance companies accountable to provide trans affirming care.

Transgender and Gender Diverse (TGD) Asian Americans in the United States: Experiences of Violence, Discrimination, and Family Support.

Transgender and gender diverse (TGD) Asian Americans in the U.S. have multiple stigmatized identities, yet their experiences of violence and discrimination are not well understood. We utilized the 2015 United States Trans Survey, the largest survey to date with U.S. TGD people, to study the experiences of TGD Asian Americans. Our study included 699 TGD Asian Americans who experienced violence and discrimination in the form of unequal treatment, verbal harassment, and physical attack. We assessed how experiences differed by sociodemographic characteristics, including birthplace, income, age, education, disability, gender identity, and region. We also explored how family support was associated with experiences of violence in the sample. Bivariate analyses and multivariable regressions were used to understand how sociodemographic variables and family support are linked to experiences of violence and discrimination. Results indicated that income, age, disability, gender identity, and family support are significantly associated with violence and discrimination. As TGD Asian Americans currently experience high levels of violence and discrimination due to transphobia and a rapidly rising anti-Asian bias stemming from the COVID-19 pandemic, efforts to better understand factors that may increase vulnerability and identify how family support can mitigate those experiences are imperative.

Educating "Helping" Professional Students to "Help" Trans People Navigate Their Health Care Needs: A Review of Recent Literature.

In the 2015 United States Trans Survey, trans people overwhelmingly indicated that training health-care providers about trans health is an urgent policy priority within the US. This literature review examines the types of educational training interventions health professional schools have developed from 2015-2020 focused on trans health. This review revealed that the fields of medicine and interprofessional education have created the majority of interventions, which tend to increase students' knowledge, comfort, and confidence working with trans patients. Schools of counseling, social work, and public health are not adequately developing curriculum and interventions that prepare students in health professional schools to work with trans people. Recommendations include schools of medicine developing more faculty expertise in trans medicine, professional organizations requiring trans content on licensure exams, state licensure boards requiring continuing education in trans health, and health professional schools increasing the use of trans standardized patients and trans panels.

Perceived Barriers and Facilitators to Health Care Utilization in the United States for Transgender People: A Review of Recent Literature.

Transgender people face numerous barriers when utilizing health care in the United States. The current study sought to highlight transgender consumer perspectives in order to present theoretically informed, concrete recommendations for increasing transgender health care utilization. The search yielded several prominent themes associated with barriers to health care for transgender people: 1) provider lack of knowledge concerning transgender identity issues and transgender health issues, 2) transgender patients' previous negative experiences with the health care system or anticipation of these experiences, 3) transgender patients' inability to pay for health care services, and 4) health care provider refusal to provide health care services to transgender people. We present a modified version of Adapted Behavioral Model of health care utilization for transgender people focused on transgender individuals as a guiding theoretical framework that informs our recommendations for increasing transgender health care utilization.

Welfare, Liberty, and Security for All? U.S. Sex Education Policy and the 1996 Title V Section 510 of the Social Security Act.

When adolescents delay (meaning they wait until after middle school) engaging in sexual intercourse, they use condoms at higher rates and have fewer sexual partners than those who have sex earlier, thus resulting in a lower risk for unintended pregnancies and sexually transmitted infections. The 1996 Section 510 of Title V of the Social Security Act (often referred to as A-H) is a policy that promotes abstinence-only-until-marriage education (AOE) within public schools. Using Stone's (2012) policy analysis framework, this article explores how A-H limits welfare, liberty, and security among adolescents due to the poor empirical outcomes of AOE policy. We recommend incorporating theory-informed comprehensive sex education in addition to theory-informed abstinence education that utilizes Fishbein and Ajzen's (2010) reasoned action model within schools in order to begin to address adolescent welfare, liberty, and security.