Going the Extra Mile: How High School Staff Use Informal Strategies to Support, Protect, and Care for LGBTQ+ Students.

BACKGROUND: High school staff can play a key role in supporting students with LGBTQ+ identities through informal strategies; however, more research is needed to understand how staff are employing these strategies. METHODS: We conducted semi-structured interviews, collecting information on informal strategies used to support students identifying as LGBTQ+ from a diverse sample of 23 school staff from high schools across the United States. RESULTS: Staff employed informal support strategies across social ecological levels: within the school community, staff interacted with parents/guardians of students and advocated for more inclusive policies. Within the classroom, staff created inclusive physical environments, implemented inclusive curricula, and employed bullying prevention strategies. Interpersonally, staff listened to and affirmed students and collaborated to employ support strategies. Intrapersonal qualities, including having a personal connection to the LGBTQ+ community and demonstrating open-mindedness, facilitated staff efforts to support students. CONCLUSIONS: Supporting staff in the implementation of the strategies we identified could foster more inclusive school environments, advancing equity for students identifying as LGBTQ+.

Healthcare Experiences of Gender Diverse Youth Across Clinical Settings.

We explored gender diverse youth's experiences seeking and receiving gender-affirming care in various health system locations. Results provide evidence for system-, clinic-, and provider-level improvements to promote the development of affirming environments and to improve health outcomes for gender diverse youth.

Harmful masculinities among younger men in three countries: Psychometric study of the Man Box Scale.

In response to growing evidence of associations between harmful masculinities and adverse health outcomes, researchers developed the Man Box Scale to provide a standardized measure to assess these inequitable gender attitudes. In 2019, we evaluated the psychometric properties of the 17-item Man Box Scale and derived a 5-item short form. Using previously collected data (in 2016) from men aged 18-30 years across the United States (n = 1328), the United Kingdom (n = 1225), and Mexico (n = 1120), we conducted exploratory (EFA) and confirmatory factor analyses (CFA), assessed convergent validity by examining associations of the standardized mean Man Box Scale score with violence perpetration, depression, and suicidal ideation, and assessed internal consistency reliability of the full scale. We used item response theory (IRT) to derive a 5-item short form, and conducted CFA and additional assessments for reliability and convergent validity. We identified a single underlying factor with 15 items across all three countries. CFA resulted in good model fit. We demonstrated significant associations of standardized mean Man Box Scale score with violence perpetration (OR range = 1.57-5.49), depression (OR range = 1.19-1.73), and suicidal ideation (OR range = 1.56-2.59). IRT resulted in a 5-item short form with good fit through CFA and convergent validity, and good internal consistency. The Man Box Scale assesses harmful masculinities and demonstrates strong validity and reliability across three diverse countries. This scale, either short or long forms, can be used in future prevention research, clinical assessment and decision-making, and intervention evaluations.

Raising sexual minority youths' health levels by incorporating resiliencies into health promotion efforts.

Myriad health inequities that sexual minority youths (SMYs) experience have been documented over the past several decades. Evidence demonstrates that these are not a result of intrinsic characteristics; rather, they result from high levels of adversity that SMYs experience. Despite the pervasive marginalization that SMYs face, there is also evidence of great resilience within this population. It seems likely that if a culture of marginalization produces health inequities in SMYs, a culture of acceptance and integration can work to produce resiliencies. We have described how promoting forms of acceptance and integration could work to promote resilient SMYs despite an overarching culture of marginalization. Building on SMYs' resiliencies may potentiate the effectiveness of health promotion interventions to reduce health disparities within this population.