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1.
J Rural Health ; 35(2): 270-281, 2019 03.
Artigo em Inglês | MEDLINE | ID: mdl-29940070

RESUMO

PURPOSE: Understanding the root causes of the substantial disparities in risk and protective factors among transgender and gender diverse (TGD) adolescents is essential to the development and expansion of resources and supports for this vulnerable population. This study examines differences in emotional distress, bullying victimization, and protective factors among TGD high school students in city, suburban, town, and rural locations. METHODS: Data come from a statewide school-based survey conducted in Minnesota in 2016 (n = 2,168 TGD youth). Analysis of covariance models were used to predict the prevalence of multiple indicators of emotional distress, bullying victimization, and protective factors across the 4 location categories, with multiple adjustments. FINDINGS: Significant linear trends were observed for 2 emotional distress outcomes and 2 bullying victimization outcomes, with urban TGD students having the lowest rates and rural having the highest prevalences. Additional significant differences in emotional distress were noted, with unexpectedly high rates of depressive symptoms and suicidal ideation among suburban students. CONCLUSIONS: Helping TGD adolescents in all types of locations identify resources and supportive professionals is critical to supporting this population.


Assuntos
Vítimas de Crime/psicologia , Fatores de Proteção , Angústia Psicológica , Características de Residência/estatística & dados numéricos , Pessoas Transgênero/psicologia , Adolescente , Análise de Variância , Vítimas de Crime/estatística & dados numéricos , Feminino , Mapeamento Geográfico , Humanos , Masculino , Pessoas Transgênero/estatística & dados numéricos
2.
Arch Suicide Res ; 23(2): 203-221, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-29461934

RESUMO

This study sought to identify factors distinguishing transgender/gender non-conforming (GNC) adolescents across three groups: no self-harm, non-suicidal self-injury (NSSI) only, and NSSI and suicide attempt (NSSI + SA). Data were from the 2016 Minnesota Student Survey. The final analytic sample included 1,635 transgender/GNC students in grades 9 and 11. Logistic regression analyses determined factors that best distinguished transgender/GNC students who reported self-harm (NSSI only or NSSI + SA) from those who reported no self-harm, and transgender/GNC adolescents who reported NSSI + SA from those who reported NSSI only. Final models were developed over 3 stages of analysis that tested associations of variables within risk factor, protective factor, and health-risk behavior domains to self-harm. Over half (51.6%) of transgender/GNC adolescents reported past-year self-harm behavior. Factors that consistently distinguished transgender/GNC youth who reported self-harm from those who reported no self-harm included reports of a mental health problem, depression, running away from home, and substance use (alcohol or marijuana use). Factors that distinguished the NSSI + SA group from the NSSI only group were reports of a mental health problem, physical or sexual abuse, relationship violence, bullying victimization, less parent connectedness, lower grades, lower levels of perceived school safety, and running away from home. Clinicians and school personnel need to be prepared to address risk factors and enhance protective factors that may reduce the likelihood this population of vulnerable youth will engage in NSSI and/or attempt suicide.

3.
LGBT Health ; 5(5): 312-319, 2018 07.
Artigo em Inglês | MEDLINE | ID: mdl-29920146

RESUMO

PURPOSE: As measures of birth-assigned sex, gender identity, and perceived gender presentation are increasingly included in large-scale research studies, data analysis approaches incorporating such measures are needed. Large samples capable of demonstrating variation within the transgender and gender diverse (TGD) community can inform intervention efforts to improve health equity. A population-based sample of TGD youth was used to examine associations between perceived gender presentation, bullying victimization, and emotional distress using two data analysis approaches. METHODS: This secondary data analysis of the Minnesota Student Survey included 2168 9th and 11th graders who identified as "transgender, genderqueer, genderfluid, or unsure about their gender identity." Youth reported their biological sex, how others perceived their gender presentation, experiences of four forms of bullying victimization, and four measures of emotional distress. Logistic regression and multifactor analysis of variance (ANOVA) were used to compare and contrast two analysis approaches. RESULTS: Logistic regressions indicated that TGD youth perceived as more gender incongruent had higher odds of bullying victimization and emotional distress relative to those perceived as very congruent with their biological sex. Multifactor ANOVAs demonstrated more variable patterns and allowed for comparisons of each perceived presentation group with all other groups, reflecting nuances that exist within TGD youth. CONCLUSION: Researchers should adopt data analysis strategies that allow for comparisons of all perceived gender presentation categories rather than assigning a reference group. Those working with TGD youth should be particularly attuned to youth perceived as gender incongruent as they may be more likely to experience bullying victimization and emotional distress.


Assuntos
Bullying/estatística & dados numéricos , Vítimas de Crime/estatística & dados numéricos , Disforia de Gênero/psicologia , Estresse Psicológico/epidemiologia , Pessoas Transgênero/psicologia , Adolescente , Interpretação Estatística de Dados , Feminino , Humanos , Masculino , Minnesota/epidemiologia , Estudantes/psicologia , Estudantes/estatística & dados numéricos , Inquéritos e Questionários , Pessoas Transgênero/estatística & dados numéricos
4.
Pediatrics ; 141(3)2018 03.
Artigo em Inglês | MEDLINE | ID: mdl-29437861

RESUMO

BACKGROUND: Transgender and gender nonconforming (TGNC) adolescents have difficulty accessing and receiving health care compared with cisgender youth, yet research is limited by a reliance on small and nonrepresentative samples. This study's purpose was to examine mental and physical health characteristics and care utilization between youth who are TGNC and cisgender and across perceived gender expressions within the TGNC sample. METHODS: Data came from the 2016 Minnesota Student Survey, which consisted of 80 929 students in ninth and 11th grade (n = 2168 TGNC, 2.7%). Students self-reported gender identity, perceived gender expression, 4 health status measures, and 3 care utilization measures. Chi-squares and multiple analysis of covariance tests (controlling for demographic covariates) were used to compare groups. RESULTS: We found that students who are TGNC reported significantly poorer health, lower rates of preventive health checkups, and more nurse office visits than cisgender youth. For example, 62.1% of youth who are TGNC reported their general health as poor, fair, or good versus very good or excellent, compared with 33.1% of cisgender youth (χ2 = 763.7, P < .001). Among the TGNC sample, those whose gender presentation was perceived as very congruent with their birth-assigned sex were less likely to report poorer health and long-term mental health problems compared with those with other gender presentations. CONCLUSIONS: Health care utilization differs between TGNC versus cisgender youth and across gender presentations within TGNC youth. With our results, we suggest that health care providers should screen for health risks and identify barriers to care for TGNC youth while promoting and bolstering wellness within this community.


Assuntos
Identidade de Gênero , Indicadores Básicos de Saúde , Saúde Mental , Aceitação pelo Paciente de Cuidados de Saúde/estatística & dados numéricos , Pessoas Transgênero/psicologia , Adolescente , Feminino , Pesquisas sobre Serviços de Saúde , Necessidades e Demandas de Serviços de Saúde , Disparidades em Assistência à Saúde , Humanos , Masculino , Minnesota
5.
J Adolesc Health ; 61(4): 521-526, 2017 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-28736148

RESUMO

PURPOSE: Research suggests that transgender and gender nonconforming (TGNC) youth may be at greatly increased risk of high-risk health behaviors compared with cisgender youth, but existing studies are limited by convenience samples and small numbers. This study uses a large school-based sample of adolescents to describe the prevalence of TGNC identity, associations with health risk behaviors and protective factors, and differences across birth-assigned sex. METHODS: This study analyzes existing surveillance data provided by 9th and 11th grade students in Minnesota in 2016 (N = 81,885). Students who were transgender, genderqueer, genderfluid, or unsure about their gender identity (TGNC) were compared with those who were not, using χ2 and t-tests. Outcome measures included four domains of high-risk behaviors and experiences and four protective factors. RESULTS: The prevalence of TGNC identity was 2.7% (n = 2,168) and varied significantly across gender, race/ethnicity, and economic indicators. Involvement in all types of risk behaviors and experiences was significantly higher, and reports of four protective factors were significantly lower among TGNC than cisgender youth. For example, almost two-thirds (61.3%) of TGNC youth reported suicidal ideation, which is over three times higher than cisgender youth (20.0%, χ2 = 1959.9, p < .001). Among TGNC youth, emotional distress and bullying experience were significantly more common among birth-assigned females than males. CONCLUSIONS: This research presents the first large-scale, population-based evidence of substantial health disparities for TGNC adolescents in the United States, highlighting numerous multilevel points of intervention through established protective factors. Health care providers are advised to act as allies by creating a safe space for young people, bolstering protective factors, and supporting their healthy development.


Assuntos
Desenvolvimento do Adolescente , Identidade de Gênero , Assunção de Riscos , Estresse Psicológico/epidemiologia , Pessoas Transgênero/psicologia , Pessoas Transgênero/estatística & dados numéricos , Adolescente , Bullying/estatística & dados numéricos , Feminino , Disparidades nos Níveis de Saúde , Humanos , Masculino , Vigilância da População , Fatores de Proteção , Fatores de Risco , Comportamento Sexual/psicologia , Ideação Suicida , Inquéritos e Questionários , Estados Unidos/epidemiologia
6.
Health Psychol ; 36(10): 927-936, 2017 10.
Artigo em Inglês | MEDLINE | ID: mdl-28368143

RESUMO

OBJECTIVE: Studies indicate that transgender individuals may be at risk of developing eating disorder symptoms (EDS). Elevated risk may be attributed to body dissatisfaction and/or societal reactions to nonconforming gender expression, such as nonaffirmation of a person's gender identity (e.g., using incorrect pronouns). Limited research suggests that gender-confirming medical interventions (GCMIs) may prevent or reduce EDS among transgender people. METHOD: Participants included 154 transfeminine spectrum (TFS) and 288 transmasculine spectrum (TMS) individuals who completed the Trans Health Survey. Serial multiple mediation analyses controlling for age, education, and income were used to examine whether body satisfaction and nonaffirmation mediate any found relationships between various GCMIs (genital surgery, chest surgery, hormone use, hysterectomy, and hair removal) and EDS. RESULTS: For TFS individuals, the nonaffirmation to body satisfaction path mediated relationships between all GCMIs and EDS, although body satisfaction alone accounted for more of the indirect effects than this path for chest surgery. For TMS individuals, relationships between all GCMIs and EDS were mediated by the nonaffirmation to body satisfaction path. CONCLUSION: Findings support the hypothesis that GCMIs reduce experiences of nonaffirmation, which increases body satisfaction and thus decreases EDS. Among TFS participants, the relationship between chest surgery and lower levels of EDS was mediated most strongly by body satisfaction alone, suggesting that satisfaction with one's body may result in lower EDS even if affirmation from the external world is unchanged. Implications of these findings for intervention, policy, and legal efforts are discussed, and future research recommendations are provided. (PsycINFO Database Record


Assuntos
Transtornos da Alimentação e da Ingestão de Alimentos/etiologia , Pessoas Transgênero/psicologia , Adolescente , Adulto , Idoso , Humanos , Masculino , Pessoa de Meia-Idade , Adulto Jovem
7.
Child Neuropsychol ; 22(5): 587-99, 2016.
Artigo em Inglês | MEDLINE | ID: mdl-25952145

RESUMO

The Test of Visuospatial Construction (TVSC), a measure of visuoconstruction that does not rely on upper extremity motor response or written production, was administered to extremely low birth weight (ELBW), late preterm (LPT), and term participants at preschool (n = 355) and kindergarten (n = 265) ages. TVSC showed statistically significant weak-to-moderate positive correlations (age 3: r = .118-.303; age 6: r = .138-.348) with Developmental VMI, Differential Ability Scales-II Copying, Matrices, and Pattern Construction subtests, Baron-Hopkins Board Test, and the Purdue Pegboard. One-way ANOVA indicated ELBW performed worse than Term (p = .044) on visuospatial construction at age 3 with a small-to-medium effect size (d = -0.43). No other statistically significant differences were found at age 3 on the TVSC (ELBW/LPT: p = .608, d = -0.17; LPT/Term: p = .116, d = -0.31). At age 6, ELBW participants performed worse than LPT participants (p = .027) and Term participants (p = .012); LPT participants did not differ from Term participants. Small effect sizes at age 3 (ELBW < LPT, d = -0.17; ELBW < Term, d = -0.43) were notably larger at age 6 (ELBW < LPT, d = -0.42; ELBW < Term, d = -0.53). Important practical differences showing LPT participants performed below Term participants (d = -0.31) at age 3 were no longer evident at age 6 (d = -0.097). These findings provide preliminary evidence of TVSC validity supporting its use to detect neuropsychological impairment and to recommend appropriate interventions in young preterm children.


Assuntos
Deficiências do Desenvolvimento/fisiopatologia , Recém-Nascido de Peso Extremamente Baixo ao Nascer/fisiologia , Recém-Nascido Prematuro/fisiologia , Testes Neuropsicológicos/normas , Percepção Visual/fisiologia , Análise de Variância , Criança , Pré-Escolar , Feminino , Humanos , Recém-Nascido de Peso Extremamente Baixo ao Nascer/psicologia , Recém-Nascido , Recém-Nascido Prematuro/psicologia , Masculino , Desempenho Psicomotor/fisiologia , Reprodutibilidade dos Testes , Instituições Acadêmicas
9.
Child Neuropsychol ; 20(6): 737-51, 2014.
Artigo em Inglês | MEDLINE | ID: mdl-24295445

RESUMO

Executive function is a heterogeneous construct applied to cognitive capacities that together enable individuals to effectively engage in activities toward a purposive goal. Children born at extremely low birth weight (ELBW) are at risk of executive dysfunction on performance-based measures. In natural contexts, executive function may be described using such parental and teacher questionnaires as the Behavior Rating Inventory of Executive Function (BRIEF). This study examined the factor structure of the BRIEF-parent form in 124 ELBW children and of the BRIEF-teacher form in 90 ELBW children. Although our data showed that the fit of a two-factor structure was adequate for the parent report, a three-factor model provided advantages over the two-factor model across all fit indices and best characterized the data. For teacher report, these data supported a three-factor but not a two-factor model. Using the three-factor model for both groups of informants, we compared parent and teacher reports (n = 90 pairs) between the three identified latent variables. Parents reported significantly more difficulty with Emotional Regulation (p < .05), and teachers reported significantly more difficulty with Behavioral Regulation (p < .05). No significant differences were found between parent and teacher reports for Metacognition.


Assuntos
Função Executiva , Docentes , Recém-Nascido de Peso Extremamente Baixo ao Nascer , Recém-Nascido Prematuro , Testes Neuropsicológicos , Pais , Inquéritos e Questionários , Criança , Comportamento Infantil , Pré-Escolar , Emoções , Feminino , Humanos , Recém-Nascido , Masculino , Modelos Estatísticos , Estudos Retrospectivos
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