Q Chat Space: Assessing the Feasibility and Acceptability of an Internet-Based Support Program for LGBTQ Youth.

There are few psychosocial support programs specifically designed to meet the unique developmental and health needs of LGBTQ youth. Even when available, many youth face significant barriers to accessing LGBTQ-specific services for fear of being "outed" to parents, peers, and community members. The current study assessed the utility, feasibility, and acceptability of a synchronous, adult-facilitated, chat-based Internet community support program for LGBTQ youth aged 13-19. Chat transcripts were analyzed to examine how LGBTQ youth used the chat-based platform to connect with peers and trusted adults. A separate user satisfaction survey was collected to assess the personal (e.g., sexual orientation, gender identity, age) and contextual (e.g., geography, family environment) characteristics of youth engaging in the platform, their preferred topics of discussion, and their satisfaction with the program focus and facilitators. Qualitative data analysis demonstrated the degree to which LGBTQ youth were comfortable disclosing difficult and challenging situations with family, friends, and in their community and in seeking support from peers and facilitators online. Youth also used the platform to explore facets of sexual and gender identity/expression and self-acceptance. Overall, users were very satisfied with the platform, and participants accurately reflect the program's desired populations for engagement (e.g., LGBTQ youth of color, LGBTQ youth in the South). Together, findings support the feasibility and acceptability of synchronous, adult-facilitated, chat-based Internet programs to connect and support LGBTQ youth, which encourage future research and innovation in service delivery.

Between cornfields and Kinfolk: Identity management among transgender youth in Midwestern families and communities.

Transgender and gender diverse (TGD) youth face high rates of discrimination and victimization in their communities and families that contribute to elevated rates of behavioral health concerns. While the individual links between community and family environments and well-being for this population are clear, how these environments work in unison remains unclear. Furthermore, the methods TGD youth use to manage their identities in these environments are not well understood. We address this gap by exploring the overlap between community climate and familial treatment of TGD identities and the methods TGD youth use to manage their identities in these environments. Semi-structured qualitative interviews were conducted with TGD youth (n = 19) in two Midwestern U.S. states. Thematic analysis was used to develop categories that represent the phenomena being investigated and to understand relationships between categories. Findings depict overlap about TGD people between three components of community climate and family members that shaped the treatment of TGD youth. Furthermore, community climate toward TGD people influenced identity management through the availability of proximal resources. Four methods of identity management emerged from the data: emotion work, educating, connections, and generativity. Findings are discussed in the context of current literature, and recommendations are made for future research and practice with TGD youth.

"It feels like home": Transgender youth in the Midwest and conceptualizations of community climate.

Community climate toward sexual and gender minority (SGM) youth is associated with higher rates of victimization and poorer health and wellbeing-related outcomes such as depression and suicidal ideation. However, this field of research has underemphasized the experiences of transgender youth, particularly within the Midwestern context which is marked by vast rurality and characterized as sociopolitically conservative. Using qualitative and community-based methods, this study identified factors that impact community climate from the perspective of transgender youth (n = 19) in the Midwest and situated them within the Ecological Systems Theory (EST). Thematic analysis of interviews revealed four themes: resources, visibility, policies, and ideologies. Themes often crossed levels within the EST, indicating the complexity and interrelated nature of climate across local, regional, and national contexts. Implications for theory, research, and practice are discussed.

The Perceived Health Implications of Policies and Rhetoric Targeting Transgender and Gender Diverse Youth: A Community-Based Qualitative Study.

Purpose: In early 2021, >50 bills targeting transgender and gender diverse (TGD) youth in the United States were proposed; these policies and the rhetoric surrounding them is associated with TGD health disparities. Methods: A community-based qualitative study utilized focus groups with a TGD youth research advisory board to explore their knowledge and perceived impacts of the current policy climate and rhetoric in one Midwestern state. Results: Themes revealed (1) mental health, (2) structural impacts, and (3) messages to policymakers. Conclusions: Discriminatory policies and rhetoric harm TGD youth; health professionals should denounce the harmful disinformation perpetuated by these policies.

"Sometimes You Get Married on Facebook": The Use of Social Media Among Nonmetropolitan Sexual and Gender Minority Youth.

Sexual and gender minority (SGM) youth experience risks due to their stigmatized SGM identities; however, supportive resources and people can mitigate these risks. In nonmetropolitan areas, SGM-affirming support may not be readily available. The internet and social media may be a way for SGM youth to access support and resources pertaining to their SGM identities, yet little research has been conducted in this area. This qualitative, exploratory study utilized in-depth interviews (N = 34) with nonmetropolitan SGM youth in one Midwestern state to better understand how they utilized the internet and social media related to their SGM identities. Grounded theory analysis revealed three categories of social media and internet usage among participants. Participants utilized the internet to establish a sense of community (access others, form relationships), express themselves (come out, vent), and access resources and information. These findings suggest important implications for practice and research.

Interdisciplinary, Inclusive, and Innovative: Promoting a Paradigmatic Shift in Cancer Research Among Transgender and Gender Diverse Adolescents and Young Adults.

Transgender and gender diverse (TGD) adolescents and young adults (AYA) face heightened risks of cancer due to cissexism and transphobia in healthcare, low cancer screening rates, limited knowledge and awareness of cancer risk and screenings, poor healthcare experiences, and exposure to sexually transmitted infections (STIs). Despite this, TGD AYA cancer risk is relatively unexamined in oncology research. To intervene early and mitigate risk, we require holistic understandings of cancer risk among TGD AYA. This research brief engages with an interdisciplinary knowledge base to identify gaps and limitations warranting critical attention by TGD AYA and cancer scholars. The current literature on TGD AYA risks for cancer are explored with specific attention to the social environment and its impact on cancer risk. The brief ends with a call to action for a paradigmatic shift to promote inclusive, innovative, and interdisciplinary cancer research with TGD AYA.

LGBTQ+ Inclusion and Support: An Analysis of Challenges and Opportunities Within 4-H.

LGBTQ+ youth experience health disparities compared with heterosexual and cisgender youth. Community-based, positive youth development organizations are an important resource to support and affirm LGBTQ+ youth. This study aimed to identify the opportunities and challenges in supporting LGBTQ+ youth within 4-H. The study took place in one state in the United States within a 4-H program and employed qualitative, community-based methods using SWOT (strengths, weaknesses, opportunities, threats) analyses and focus groups of 4-H staff, support staff, volunteers, and youth participants. The majority of participants were White and middle class with direct connections to the 4-H program. Thematic analyses were conducted by multiple analysts until consensus was reached. Challenges and opportunities emerged in 3 themes: (a) organizational climate; (b) policies and procedures; and (c) training, education, and resources. Two additional themes included opportunities only: (a) community engagement and (b) youth-specific resources. This study has important implications for the 4-H program, rural community practice, and research, including strategies to improve LGBTQ+ inclusivity through education, programs and policies, hiring, and community partnerships. Additionally, this study highlights the opportunity and unique positionality of the 4-H program to amplify youth voices in the creation of youth-specific resources.

Beyond a Shared Experience: Queer and Trans Youth Navigating COVID-19.

As queer scholars engaged in research and practice with queer and trans youth across the United States and internationally, we are deeply concerned about the impact of the COVID-19 pandemic on this vulnerable population. Physical distancing, social isolation, and school closures create challenges for adolescents as they navigate increasing independence from caregivers and more intimate relationships with peers. The challenges of the ongoing pandemic are exacerbated for queer and trans youth as they as they negotiate their sexuality and gender identit(ies) in addition to typical developmental activities. Simultaneously, social work practices that provide critical and lifesaving support for queer and trans youth have been hindered by the closures and other pandemic-related changes to schools and community programs. We present this reflexive essay to deconstruct the notion of a shared experience during this pandemic and elevate the voices of queer and trans youth during this unprecedented moment in time. Through engagement with a small, local group of queer and trans youth, we share the challenges they are facing--particularly the consequences of social isolation and lack of identity-affirming support caused by physical distancing measures. We end by sharing their ideas for social work practice and how they can best be supported during this time. We do this to emphasize variations in the shared experience of a global pandemic and ensure the experiences of queer and trans youth are documented during this moment in history.

"Thanks for hearing me out": Voices of social work students during COVID-19.

As social work educators and students, the COVID-19 pandemic impacted our teaching and learning in challenging ways. We embarked on a qualitative research study to better understand the ways in which the pandemic was affecting the social work students in our program. Three faculty mentors worked collaboratively with five social work students across BSW, MSW, and PhD programs to interview 66 BSW and MSW students about their experiences, challenges, and hopes during the early months of the pandemic. BSW and MSW students led the analysis and early dissemination for the project. This essay describes the unique experiences of social work students by using a research poem to capture the emotional and experiential aspects of the students we interviewed.

"I Have Nowhere to Go": A Multiple-Case Study of Transgender and Gender Diverse Youth, Their Families, and Healthcare Experiences.

Transgender and gender diverse (TGD) youth experience health disparities due to stigma and victimization. Gender-affirming healthcare mitigates these challenges; yet, we have limited understanding of TGD youth's healthcare experiences in the U.S. Midwest and South. Using a multiple case study design, we aimed to develop an in-depth and cross-contextual understanding of TGD youth healthcare experiences in one Midwestern state. Families with a TGD child under 18 were recruited with the goal of cross-case diversity by child age, gender, race, and/or region of the state; we obtained diversity in child age and region only. Four white families with TGD boys or non-binary youth (4-16) in rural, suburban, and small towns participated in interviews and observations for one year; public data were collected from each family's community. Thematic analysis was used within and across cases to develop both family-level understanding and identify themes across families. Findings include a summary of each family as it relates to their child's TGD healthcare experiences as well as the themes identified across cases: accessibility and affirming care. Although limited by a small sample with lack of gender and race diversity, this study contributes to our understanding of TGD youth healthcare in understudied regions.

The Impact of Community Size, Community Climate, and Victimization on the Physical and Mental Health of SGM Youth.

Sexual and gender minority (SGM) youth experience high rates of victimization leading to health disparities. Community size and community climate are associated with health outcomes among SGM youth; however, we lack studies that include them as covariates alongside victimization to understand their collective impact on health. This study utilized minority stress theory to understand how community context shapes experiences of victimization and health among SGM youth. SGM youth in one Midwestern U.S. state completed an online survey (n = 201) with measures of physical health, mental health, community context, and victimization. Data were analyzed via multiple regression using a path analysis framework. Results indicate that perceived climate was associated with mental, but not physical, health; Community size was unrelated to health outcomes. Victimization mediated the association between community climate and mental health.

"I'm Kinda Stuck at Home With Unsupportive Parents Right Now": LGBTQ Youths' Experiences With COVID-19 and the Importance of Online Support.

PURPOSE: LGBTQ youth are a population who experience unique stressors. This study investigated their experiences with the COVID-19 pandemic via Q Chat Space-a national online chat-based support program. METHODS: Transcript data from 31 synchronous, text-based chats collected during the onset of state-based "social distancing" ordinances in Spring 2020 were analyzed. RESULTS: While encountering COVID-19-related stressors likely to be experienced by youth generally, participants' experiences were concomitantly imbued with LGBTQ-specific intrapersonal, interpersonal, and structural challenges. Difficulties included maintaining mental health, being isolated with unsupportive families, and loss of in-person identity-based socialization and support. CONCLUSIONS: Findings highlight the importance of synchronous, text-based online platforms to enable LGBTQ youth to feel safe to seek support while at home. Given the potential for long-term physical distancing, concerted efforts are required to provide necessary resources and support for LGBTQ youth during the COVID-19 pandemic.

Differential Response family assessments: listening to what parents say about service helpfulness.

An increasing number of Child Protective Services (CPS) systems are implementing Differential Response (DR) approaches in which lower-risk families are served through a family assessment response that emphasizes a family centered approach and the provision of concrete and preventative services. Quantitative survey data collected from parents suggests that those who receive family assessments are more engaged, receive more concrete services, and have higher overall satisfaction than those who receive a traditional investigation; yet little is known about which services provided through a family assessment are most helpful to parents. This qualitative study sought input from 20 parents who received a DR family assessment response in order to provide an in-depth analysis of which aspects of their CPS experience they perceived as most helpful. Results suggest that a positive and emotionally supportive relationship with the caseworker was of utmost significance. Other caseworker-provided services were described as helpful, particularly those that helped parents establish or improve relationships with others, including advocacy with other service providers, mediation of family disagreements, and coaching on parenting or relationship skills. Material support, such as providing cash assistance for rent or furniture, was helpful when received but occurred less frequently and was sometimes a source of frustration when accompanied by lengthy waits for assistance. These findings have implications for CPS practice, including enhancing caseworkers' relationship-building and engagement skills through pre-service educational coursework and in-service trainings; allowing caseworkers adequate time to develop supportive relationships with parents; and reducing the institutional barriers that delay the provision of concrete support.

Factors associated with involvement in nonmetropolitan LGBTQ organizations: Proximity? Generativity? Minority stress? Social location?

Little is known about involvement in LGBTQ organizations. Factors associated with involvement in nonmetropolitan LGBTQ organizations were examined using logistic regression and survey data from 426 LGBTQ individuals residing in a nonmetropolitan region. Involvement was examined in five types of organizations (professional, social/recreational, religious, political, and community center/charity). The same model testing proximity, generativity, minority stress, and social location hypotheses was repeated for each organization type. Results demonstrate that the generativity hypothesis is most strongly supported. Indeed, emotional attachment to the LGBTQ community significantly increased the odds of involvement in every type of organization. However, the factors associated with involvement otherwise differed by organization type. Implications for organizational leaders are discussed.